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PHRM 844 > Eye part 1 > Flashcards

Eye part 1 Flashcards

1
Q

what are local drug delivery dosage forms

A

eye drops, ointments, gels

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2
Q

what are systemic drug delivery dosage forms

A

injections, oral medications

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3
Q

what is the eye’s built in defense mechanism to sudden increase in tear volume

A

rapid reflex blinking

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4
Q

drug residence time in conjunctiva

A

3-5 minutes

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5
Q

what is the tear volume capacity

A

7-9 microliter

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6
Q

eye drop administration steps

A
  1. wash hands with soap and water. remove contacts if applicable.
  2. while tilting your head back, pull down lower lid of eye with index finger to form pocket.
  3. hold dropper with other hand, as close to eye as possible without touching it.
  4. while looking up, squeeze dropper so that single drop falls in pocket of lower lid.
  5. remove index finger from lower eyelid. close eyes for 2-3 min and tip head down.
  6. place a finger on tear duct and apply gentle pressure.
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7
Q

eye ointment administration steps

A
  1. wash hands w soap and water. remove contacts if applicable.
  2. holding the tube between thumb and forefinger, place it as near to eyelid as possible without touching it.
  3. while tilting your head back, pull lower lid down with index finger to form pocket.
  4. squeeze ribbon of ointment into pocket made by lower eyelid.
  5. remove index finger from lower eyelid. blink eye gently; then close for 1-2 min.
  6. wipe any excess ointment or gel from eyelids and lashes. clean tip of tube with clean tissue.
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8
Q

how long should a pt wait after using eye drops before reinserting contacts

A

15 min

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9
Q

is it recommended for a pt to reinsert contacts after use w ointment

A

No

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10
Q

how long should a pt wait between drops if they require 2 drops of the same medication

A

5 min between drops

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11
Q

how long should a pt wait between drops if they require 2 drops of a different medication

A

wait 5-10 min between drops

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12
Q

how long should a pt wait if they require 2 ointments

A

wait 30 min between ointments

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13
Q

how long should a pt wait if they require 1 ointment and 1 drop

A
  • use drop 1st
  • wait 5-10 min between
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14
Q

bacterial conjunctivitis presentation

A
  • redness, discharge
  • eye is “stuck shut” in morning
  • purulent yellow, white, or green discharge from eye
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15
Q

non pharm bacterial conjunctivitis tx

A
  • avoid sharing items that touch eye
  • remove contact lenses - do not resume until eye is white and there is no discharge for 24h after antibiotics
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16
Q

pharm bacterial conjunctivitis tx

A
  • topical antibiotics
  • antibiotic tx required in contact wearers
  • ointment preferred over drops in children and in pts w/ risk of poor compliance
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17
Q

how long should pts use antibiotics for bacterial conjunctivitis

A

5-7 days

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18
Q

antibiotic agents for bacterial conjunctivitis

A
  • erythromycin 5mg/g ointment
  • moxifloxacin 0.5% solution
  • ofloxacin 0.3% solution
  • trimethoprim-polymyxin B 0.1%-10,000 units/mL
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19
Q

erythromycin 5mg/g ointment dosing

A

0.5 in strip 4 times daily

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20
Q

moxifloxacin 0.5% solution dosing

A

1 drop 2-3x daily

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21
Q

ofloxacin 0.3% solution dosing

A

1-2 drops 4x daily

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22
Q

trimethoprim-polymyxin B 0.1%-10,000 units/mL dosing

A

1-2 drops 4x daily

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23
Q

viral conjunctivitis presentation

A
  • watery eyes
  • burning, sandy, gritty feeling in eye
  • pus is morning crusting followed by watery discharge throughout the day
  • other eye often involved within 24-48 h
  • part of viral upper respiratory infection
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24
Q

non pharm viral conjunctivitis tx

A
  • avoid sharing items
  • remove contact lenses - do not resume wearing until eye is white and there is no discharge for 24h
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25
Q

symptomatic relief viral conjunctivitis tx

A
  • warm or cool compress
  • topical decongestant - limit duration of use to avoid rebound congestion
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26
Q

decongestants (OTC) for viral conjunctivitis

A
  • naphazoline 0.012-0.2% solution
  • tetrahydrozoline 0.05% solution
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27
Q

naphazoline 0.012-0.2% solution brand name

A

Clear eyes redness relief

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28
Q

naphazoline 0.012-0.2% solution dose

A

1-2 drops 4x daily

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29
Q

tetrahydrozoline 0.05% solution brand name

A

visine advanced relief

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30
Q

tetrahydrozoline 0.05% solution dose

A

1-2 drops 4x daily

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31
Q

allergic conjunctivitis presentation

A
  • redness, watery discharge, itching
  • may have morning crusting
  • both eyes often involved
  • often accompanied by other allergic Sx: nasal congestion, sneezing, wheezing
  • eye rubbing can worsen sx
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32
Q

non pharm allergic conjunctivitis tx

A
  • do not rub eyes: can worsen Sx
  • cool compresses
  • avoidance or reduction of contact w/ known allergen
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33
Q

pharm allergic conjunctivitis tx

A
  • antihistamines
  • mast cell stabilizers
  • multiple acting agents
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34
Q

antihistamines for allergic conjunctivitis

A
  • olopatadine 0.1-0.7% solution
  • azelastine 0.05% solution
  • epinastine 0.05% solution
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35
Q

olopatadine 0.1-0.7% solution brand name

A

Pataday

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36
Q

olopatadine 0.1-0.7% solution brand dosing

A

1 drop daily or BID

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37
Q

azelastine 0.05% solution brand name

38
Q

azelastine 0.05% solution dosing

A

1 drop BID

39
Q

epinastine 0.05% solution dosing

A

1 drop BID

40
Q

mast cell stabilizers for allergic conjunctivitis

A
  • cromolyn sodium 4% solution
  • lodoxamide 0.1% solution
  • nedocromil 2% solution
41
Q

cromolyn sodium 4% solution brand name

42
Q

cromolyn sodium 4% solution dosing

A

1-2 drops 4-6x daily

43
Q

lodoxamide 0.1% solution brand name

44
Q

lodoxamide 0.1% solution dosing

A

1-2 dros 4x daily

45
Q

nedocromil 2% solution brand name

46
Q

nedocromil 2% solution dosing

A

1-2 drops BID

47
Q

multi-acting agents for allergic conjunctivitis

A
  • ketotifen 0.025% solution
  • alcaftadine 0.025% solution
48
Q

ketotifen 0.025% solution brand names

A

Zaditor, Alaway

49
Q

ketotifen 0.025% solution dosing

A

1 drop BID

50
Q

alcaftadine 0.025% solution brand name

51
Q

alcaftadine 0.025% solution dosing

A

1 drop daily

52
Q

what is uveitis

A

intraocular inflammation

53
Q

anterior uveitis presentation

A
  • patterned (wagon wheel) redness associated w/ iritis
  • dilated pupil
  • complains of discomfort and sensitivity to light
54
Q

tx for anterior uveitis

A
  • topical glucocorticoids
  • mydriatic/cycloplegic
55
Q

how long is tx for uveitis

56
Q

what should a pharmacist do if a pt comes in w/ uveitis

A

referral to ophthalmologist or optometrist for tx

57
Q

what are risk factors for uveitis

A

primary open-angle glaucoma, ocular htn, elderly, children, connective tissue disease, T1DM w/ myopia

58
Q

what can be caused from ophthalmic steroid toxicity

A

secondary infections, secondary open angle glaucoma

59
Q

what is dry macular degeneration

A
  • common >50 yo
  • usually both eye affected
  • gradual loss in vision
  • 90% of macular degeneration cases
60
Q

what is wet macular degeneration

A
  • advanced macular degeneration
  • vision loss may be rapid
  • loss of central vision due to abnormal growth of new blood vessels
61
Q

what is the leading cause of blindness

A

macular degeneration

62
Q

what are the top risk factors for macular degeneration

A

smoking and age

63
Q

macular degeneration tx goals

A
  • slow progression
  • prevent severe visual impairment or blindness
64
Q

what is the difference between AREDS1 and AREDS2 for macular degeneration

A
  • AREDS1 has no B keratine
  • B keratine has higher risk of lung cancer for smokers
65
Q

vascular endothelial growth factor inhibitors (VEGFi) for macular degeneration

A
  • important for formation of new blood vessels and vascularization of tissues
66
Q

what is vascular endothelial growth factor inhibitors (VEGFi)

A

antineoplastic agents typically used to treat certain forms of cancer and prevent tumors from creating blood vessels

67
Q

vascular endothelial growth factor inhibitors (VEGFi) use in age-relate macular degeneration

A
  • shown to slow disease progression
  • may cause moderate gains in vision
68
Q

vascular endothelial growth factor inhibitors (VEGFi) SEs

A

increased BP, retinal detachment, increased IOP, eye infection, vitreous floaters

69
Q

how is vascular endothelial growth factor inhibitors (VEGFi) administered

A

injected directly into eye (intravitreal)

70
Q

VEGFi agents

A
  • Bevacizumab
  • Ranibizumab
  • Aflibercept
  • Pegaptanib
  • Verteoprofin
71
Q

Bevacizumab brand name

72
Q

bevacizumab dosing

A

1.25 mg every 4,6, or 8 weeks for 1 year

73
Q

ranibizumab brand name

74
Q

ranibizumab dosing

A

0.5 mg every 4 weeks

75
Q

aflibercept brand name

76
Q

aflibercept dosing

A

2 mg then 4 weeks for 12 weeks, then every 8 weeks maintenance

77
Q

pegaptanib brand name

78
Q

pegaptanib dosing

A

0.3 mg every 6 weeks

79
Q

verteporfin brand name

80
Q

verteporfin dosing

A

6 mg/m2 BSA; may repeat at 3 month intervals

81
Q

dry eyes causes

A
  • decreased tear production (Sjogren’s sydrome v non-Sjogren’s syndrome)
  • increased evaporative loss
82
Q

what is sjogren’s syndrome

A

autoimmune disease characterizied by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes

83
Q

risk factors for dry eyes

A

advanced age, female, contact lens wearers, low humidity environment, meds

84
Q

presentation of dry eyes

A

dryness, red eyes, general irritation, gritty sensation, blurred vision, light sensitivity

85
Q

aqueous tear supplementation for dry eyes

A
  • carboxymethylcellulose (Refresh, TheraTears)
  • hydroxypopylcellulose (Genteal)
  • polyethylene glycol, propylene glycol (Systane)
86
Q

lipid tear supplementation for dry eyes

A
  • DMPG, propylene glycol (Systane balance)
  • mineral oil (Retaine MGD)
87
Q

nonpharmacologic therapy for drug induced dry eyes

A
  • warm compress
  • increased fluid intake
  • use humidifier
88
Q

how to increase tear volume for drug induced dry eyes

A

artificial tears or other ocular lubricants

89
Q

how to decrease inflammation for drug induced dry eyes

A

Restasis or Xiidra eye drops

90
Q

what med changes is needed for drug induced dry eyes

A
  • d/c causative agent if possible
  • switch to preservative free eye drops

PHRM 844 (13 decks)

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