Corticosteroids Flashcards
adrenal cortex synthesizes two classes of steroids:
- corticosteroids
- androgen
is the main glucocorticoid
Cortisol
the main mineralocorticoid
aldosterone
Topical steroids can delay the wound-healing by:
fibroblast infiltration
Ocular Indications for Corticosteroids:
given systemically OR sub-Tenon’s capsule injection in posterior uveitis.
Intravitreal injection - used to treat retinal conditions like ARMD, DR, and cystoid macular edema
Parenteral glucocorticoids followed by oral doses are used for optic neuritis.
Corticosteroids can alter _____
- carbohydrate, protein, and lipid metabolism
Glucocorticoids formulated for topical administration to the eye:
- dexamethasone
- prednisolone
- Fluorometholone
- loteprednol
- medrysone
- rimexolone
Ocular complications of Corticosteroid therapy:
- posterior subcapsular cataracts
- secondary ocular infections
- Secondary open-angle glaucoma
- Retardation of corneal epithelial healing
- Keratitis
- Corneal thinning or melting
- Scleral thinning
- Uveitis
- Mydriasis
- Ptosis
- Transient ocular discomfort
- Most commonly prescribed/clinically proven topical steroid
Prednisolone acetate 1%
As effective as prednisolone acetate 1%
Rimexolone
Uses of Prednisolone acetate:
For moderate to severe forms of ocular inflammation:
episcleritis,
scleritis,
iritis,
inflammatory keratitis,
chemical/thermal burns of the cornea
Penetrates less readily in aqueous
Less effective in uveal inflammations
Prednisolone sodium phosphate
corticosteroid Used in treating chronic inflammations requiring long term therapy
- Reduced tendency to cause secondary IOP increase
Fluoromethalone Alcohol
5 topical NSAIDs approved for ocular use:
- diclofenac (VOLTAREN)*
- flurbiprofen (OCUFEN)*
- ketorolac* (ACULAR)
- bromfenac (XIBROM)*
- nepafenac (NEVANAC)*
Ocular topical NSAID:
used to counter unwanted intraoperative miosis during cataract surgery
Flurbiprofen - OCUFEN