Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Eye Disease > Drug Toxicology - Priyesh > Flashcards

Drug Toxicology - Priyesh Flashcards

1
Q

What is a toxic effect?

A

When you get an unwanted effect of the drug when using its NORMAL concentration

*Normal is important because this will disregard overdose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an example of a Type A reaction - Beta Blockers in glaucoma

A

Bronchoconstriction - beta receptors in the lungs.

(DO not use on px with asthma or obstructive airways disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

There is two types of Adverse drug reaction… What is type A?

A
  1. Exaggeration of the normal pharmacological reaction of the drug. The higher the dosage the more likely this will happen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why can we predict Type A reactions?

A

We know how the drug mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a type B reaction?

A

This is idiopathic aka fuck knows why these happen. They are rare.
Uncommon and unrelated to the known action of these drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What Px variables are involved in an adverse side effect?

A
  1. Drug allergy history ; if they are allergic to one drug, there is a possibility they will be allergic to another drug
  2. Age
  3. Gender
  4. Renal/hepatic function (kidney / liver)
  5. GH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What Pharmacological variables are involved with an adverse side effect?

A
  1. Dosage
  2. Therapeutic Index ; min toxic / min effective
  3. Formulation ; impact on the gut
    route of delivery ; does it go through the liver or not?
  4. Duration
  5. Multiple drug intervention : like Hypertension drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is digoxin?

A

Originating from foxglove plant and found in the leaves. It is used to treat heart failure and cardiac arrythmias
- 11-25% will have an OAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Digoxin mode of action?

A

It works by inhibiting NA/K ATPase which is found in the heart and in cornea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side effects of Digoxin?

A
  1. Death.
    2.Slow pulse
    3.Cold sweats
    4.Fainting
    5.Sickness
    6.Confused vision (xanthopsia- they see yellow or green tinge to objects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the black triangles on drugs?

A

This is showing it is a new drug and needs to be monitored when the px has this as intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the the yellow card scheme 1964?

A
  1. The MHRA (Medicines and Healthcare Products Regulatory Agency) and commissions human medicines monitor this closely.
  2. It is a database of drugs with voluntary reporting’s of side effects of drugs. Px and clinician report
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does the yellow card cover?

A
  1. Adverse effects of P,POM and GS drugs
  2. Medical devices- Cl products
  3. Suspecting fake medicines
  4. E-cigs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Vigabatrin?

A

Drug for epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why was Vigabatrin problematic?

A

It took 10 years to realise the VF loss ; 33% had Peripheral VF loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is our role as optometrists detecting ADR?

A
  1. Most of them are revisable, early we detect the better.
  2. Be aware of what drugs can cause ADR, from other clinicians
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Types of ADR:

A
  1. Blepharoconjunctivitis
  2. Deposits and opacity in cornea and lens
    3.Refractive changes in the lens
    4.Uveitis, IOP change and cycloplegia
  3. Retinopathy
  4. CV disturbances
  5. Reduced VA
  6. Scotomas - field changes
  7. Optic nerve , optic neuritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When do we detect an ADR?

A
  1. Make connection via an unexpected clinical sign when taking a drug.
  2. Number of reports will help determine the risks of AR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the guidelines for recording drug reactions?

A
  1. In general population we only interested with life threatening reactions
  2. However, in children we want to record everything
20
Q

Where to find information on a drug (reminder)?

A

BNF, Optometry Formulary

21
Q

What is chloroquine?

A

It is used for anti-malaria and rheumatoid arthritis

22
Q

What adverse effect can chloroquine initiate?

A

Binds to melanin so it will express as the following:
1.Pigmentary retinopathy
2.Maculopathy - Bullseye pattern
3. VF affected - idiopathic

23
Q

What is hydrochloroquine?

A

More modern drug of chloroquine, malaria prophylaxis + rheumatoid arthritis

24
Q

What is the problem with Hydrochloroquine?

A

You do not get any pigmentary changes ; it does not bind to melanin like Chloroquine

However, using the OCT we can see there is still adverse reactions.

25
Q

Chloroquine and hydrochloroquine as still issued, so what are the rules for them?

NEED TO REVIEW ANSWER

A

Anyone with these drugs of 5 years they need a ophthalmic exam, they will take a OCT + fundus photos as baseline and then do a full VF 10-2 (lots of points in the central 10 degrees)
- Then repeat periodically during the 5 years.
Then repeat these rests periodically for how long this px is taking these drugs

26
Q

what is chlorpromazine?

A

This is a tranquilizer, used for schizophrenia.

27
Q

What are adverse effects of chlorpromazine?

A

It can deposit into the:
1.Cornea
2.Lens
3.Retina
4.Eyelids (pigmentary changes)

28
Q

How can chlorpromazine deposit?

A
  1. Lens ; originating from the AH
  2. Cornea ; originating from AH or surrounding blood vessels in the periphery
29
Q

What can cortiocosteroids cause?

A
  1. High IOP
  2. PSC - 4% chance
  3. Weaker cornea - this is the reason as SUPER infection can manifest
30
Q

List of corticosteroids

A

1.Prednisolone
2.Betamethasone
3.Dexamethasone
4.Hydrocortisone
5.Fluromethalone
5.Loteprednol

31
Q

What are the chances of a px getting PsC from corticosteroid usage?

A

Depends on the dosage and how long they have been using it ; normally usage over a year will increase the risk

32
Q

SIDE : Px has been using prednisolone for a long time and a high %. They get glare, photophobia and reduced VA. What do they have?

A

Posterior Subcapsular Cataract

33
Q

What is a steroid responder?

A

This is a px who get a higher IOP whilst they take corticosteroids - indefinitely

Some px are some are not - due to genetic variation

34
Q

Px has anterior uveitis, what corticosteroid do we administer and why?

A

Dexamethasone- this has the penetrating strength to get the job done

35
Q

Px has Surface inflammation what do we give?

A
  1. Loteprednol
  2. Fluromethalone

These are non - penetrating corticosteroids

36
Q

Px is a steroid responder, they have anterior uveitis. What are we going to do and how are we as a team going to help alleviate this?

A

REFER - emergency

Ophthalmologist knows from past records they are a Steroid Responder : they most likely will give them dexamethasone (penetrating) and during this endurance they will be in a HOS bed receiving IOP lowering drugs .

37
Q

What is tamoxifen?

A

This is a drug for Breast cancer. It is an anti-oestrogen drug - 20mg

38
Q

What can tamoxifen cause with the retina?

A
  1. Deposits in the retina, pigmentary changes and hemorrhages.
  2. Macular oedema and yellow refractile opacities
39
Q

What can tamoxifen cause moving more outside of the eye?

A
  1. Dry eye
  2. Keratopathy
40
Q

When giving out tamoxifen what should we do?

A
  1. Give a baseline screening : VAs and Fields.
  2. Then we do annual monitoring when given the drug out.
41
Q

Can the Contraceptive pill give any adverse reactions?

A

This has low prevalence of causing a reaction but the possible OAR are:

  1. Decreased CL tolerance due to change in tear film
  2. Potential risk of thrombosis in the retinal vascular abnormalities
42
Q

What is the therapeutic index?

A

Minimum toxic dose/ minimum effective dose

43
Q

Where can the black triangle drugs be obtained from?

A

The MHRA website

44
Q

What is amiodarone used for?

A

Treatment of cardiac arrhythmias

45
Q

What ocular issue is associated with taking amiodarone?

A

Bilateral corneal epithelial deposits- starts as horizontal line in the lower of cornea (reversible)

46
Q

How many grades are there grade bilateral corneal deposits from taking aminodarone?

A

3

47
Q

What OARs can occur with digoxin?

A

Colour vision effected

Eye Disease (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions