Drugs - Ophthalmology Flashcards

1
Q

What does ‘g’ denote?

A

Drops

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2
Q

What does ‘oc’ denote?

A

Eye ointment

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3
Q

Give some ophthalmologic indications for chloramphenicol

A
  1. Severe cases of bacterial conjunctivitis
  2. Prophylaxis against 2ary infection in corneal abrasions, post foreign body removal, post-operative, chemical eye injury
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4
Q

Give an otologic indication for chlormaphenicol

A

Otitis externa

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5
Q

Why is systemic chloramphenicol rarely used?

A

Due to its severe toxicity

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6
Q

What is a potential serious side effect of systemic chloramphenicol?

A

Bone marrow suppression

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7
Q

Why is chloramphenicol contraindicated in the 3rd trimester of pregnancy, breastfeeding & children <2 years?

A

Due to risk of grey baby syndrome

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8
Q

Give an ophthalmologic indication for oc aciclovir

A

HSV corneal ulcers

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9
Q

Give an ophthalmologic indication for oral aciclovir

A

Ophthalmic shingles

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10
Q

What class of drug is pilocarpine?

A

Miotic

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11
Q

What is the function of miotics?

A

Produce contraction of the iris sphincter muscle and ciliary muscle → constrict pupils

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12
Q

What is the mechanism of miotics?

A

Produces contraction of the iris sphincter muscle and ciliary muscle by mainly stimulating muscarinic receptors.

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13
Q

Main indication of pilocarpine?

A

Acute angle closure glaucoma → to reduce intraocular pressure

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14
Q

What are mydriatic drugs/cytoplegic drugs?

A

Mydriatic → dilate pupils

Cytoplegic → paralyse ciliary muscles

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15
Q

Give some examples of mydriatic drugs

A
  • Atropine
  • Cyclopentolate
  • Tropicamide
  • Phenylephrine
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16
Q

What class of drugs are Atropine, Cyclopentolate, Tropicamide, Phenylephrine?

A

Antimuscarinics

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17
Q

Which 2 drugs are most commonly used as dilating agents in fundoscopy?

A
  • Phenylephrine
  • Tropicamide
18
Q

Give some indications for mydriatics/cytoplegics

A
  • Dilating agent in fundoscopy
  • Symptomatic pain relief e.g anterior uveitis, chemical eye injuries etc
19
Q

How does atropine or cyclopentolate provide symptomatic pain relief?

A

by paralysing the iris and helping to reduce ocular pain

20
Q

Mechanism of mydriatrics/cycloplegics?

A
  • Block the action of ACh on the iris sphincter muscles and ciliary body.
  • This dilates the pupil and reduces pain associated with ciliary spasm by stopping the action of the ciliary body
21
Q

What can the use of mydriatris be a risk factors for?

A

Acute angle closure glaucoma due to dilation of the pupil

22
Q

What is the most commonly used steroid in ophthalmology?

A

Prednisolone 1%

23
Q

Indications for prednisolone in ophthalmology?

A

Inflammatory conditions of the eye e.g. uveitis, severe cornea ulceration, post-op

24
Q

Give 2 examples of topical beta blocker eye drops

A
  1. Timolol 0.5%
  2. Betaxolol
25
Q

Indication for timolol?

A

Used to reduce intraocular pressures by reducing aqueous production e.g. chronic/primary open angle glaucoma

26
Q

How do topical beta blocker eye drops reduce intraocular pressure?

A

Reduce aqueous production

27
Q

Give 2 examples of prostaglandin analogues

A
  1. Latanoprost
  2. Bimatoprost
28
Q

What is the 1st line agent to reduce intraocular pressures in chronic/1ary open angle glaucoma?

A

Latanoprost

29
Q

Why are prostaglandin analogues generally preferred over topical beta blockers in ocular hypertension?

A

as they cause fewer systemic side effects

30
Q

Mechanism of prostaglandin analogues?

A

Analogues of prostaglandin reduce intraocular pressure by increasing outflow of aqueous humour via the uveoscleral pathway

31
Q

Side effects of prostaglandin analogues?

A
  • Locally in the eye – blurred vision, conjunctival reddening (hyperaemia), ocular irritation and pain
  • May cause a permanent change in eye colour by increasing the amount of melanin in stromal melanocytes of the iris (not harmful)
    • This affects about 1/3 patients and is most noticeable when treatment is restricted to one eye
32
Q

What is aphakia?

A

Absent lens

33
Q

What is pseudophakia?

A

Artificial lens

34
Q

What class of drug is Brimonidine eye drops?

A

Sympathomimetics

35
Q

Purpose of sympathomimetic drugs?

A

Topical sympathomimetics reduce intraocular pressure

36
Q

How do sympathomimetics reduce intraocular pressure?

A

By decreasing aqueous humour production by an effect on ciliary epithelium and increasing uveoscleral outflow of aqueous humour.

37
Q

Mechanism of sympathomimetics?

A

Stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system.

38
Q

What class of drug is acetazolamide?

A

Carbonic anhydrase inhibitor

39
Q

Main indication of acetazolamide?

A

Used to reduce intra-ocular pressures in open angle glaucoma/2ary glaucoma or peri-operative in angle-closure glaucoma

40
Q

How does acetazolamide reduce intraocular pressure?

A

By reducing the production of aqueous humour

41
Q

Give some examples of ocular lubricants

A
  • oc. lacrilube
  • g. celluvisc
  • g. Hypromellose
42
Q

Indications for ocular lubricants?

A

Used to increase ocular lubrication in conditions that may cause dry eyes or ocular surface irritation e.g. dry eyes, blocked nasolacrimal duct, blepharitis, thyroid eye disease, allergic conjunctivitis