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Pharmacology > Eye/Skin Drugs, Antiinfectives, Antineoplastics > Flashcards

Eye/Skin Drugs, Antiinfectives, Antineoplastics Flashcards

1
Q

Narrow Angle Glaucoma (Primary Glaucoma)

A

Caused by poor drainage of fluid in the eye due to position of the iris, blocking the Canal of Schlemm.
May experience blurred vision.
Rare. May occur after trauma, e.g. pupil constricting too rapidly. Usual unilateral.
Drug treatment: Pupil constrictors to open the angle between the iris and the Canal of Schlemm.

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2
Q

Wide Angle Glaucoma (Primary Glaucoma)

A

Caused by poor drainage of fluid in the eye, possibly due to abnormal blood vessel permeability or deterioration of the tribicular meshwork leading to the Canal of Schlemm.
Common, requires permanent drug therapy.
Drug treatment: Pupil constriction and reduction of aqueous humor formation.

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3
Q

Secondary Glaucoma

A

Develops secondarily to other eye disease e.g. inflammation or cataract surgery (which may prevent proper drainage).
Drug treatment: corticosteroid or antiinfective

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4
Q

Congenital Glaucoma

A

Requires surgery to correct (remove tribicular meshwork or LASER treatment)

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5
Q

Miotics

Cholinergic Drugs

A

Indicated for: Narrow and wide angle glaucoma (especially narrow angle)
MOA: Contraction of the sphincters of the iris and vasodilation of vessels draining the eyes
Side effects: Ciliary muscle spasms, possible headache, salivation, sweating, diarrhea, increased asthma attacks, decreased blood pressure
Caution: Will affect night driving due to pupil constriction and blurred vision

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6
Q

Carbonic Anhydrase Inhibitors

Prostaglandin Analogs

A

Indicated for: Acute glaucoma attack
MOA: Inhibits production of enzyme required for aqueous humor production
Side effects: Cross-allergy w/sulfa drugs
tingling in extremities, tingling in lips, tingling in anus, long-term flaccid paralysis, and convulsions
Caution: Teratogenic in first trimester of pregnancy
Usually given in conjunction with other glaucoma meds

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7
Q

Adrenergic Drugs

Mydriatics

A

Indicated for: Wide angle primary glaucoma, glaucoma secondary to inflammation (given after cholinergic agent to counteract pupil dilatory effect), ocular exam, and congestion relief
MOA: Decrease formation of aqueous humor, dilate pupils, constrict conjunctival blood vessels
Side effects: Not serious
Caution: Narrow angle glaucoma, cardiovascular disease

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8
Q

Beta blockers

Timolol maleate

A

Indicated for: Wide angle glaucoma
MOA: Decrease production of aqueous humor, without changing pupil size
Cautions: Asthma, heart block, heart failure

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9
Q

Prostaglandin Analogs

A

Indicated for: Glaucoma (drug of choice, especially wide angle glaucoma)
MOA: Decrease IOP by 25-30%, stabilize IOP, and increase fluid outflow

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10
Q

Osmotic diuretics

Mannitol

A

Indicated for: Acute glaucoma attacks, postoperative use
MOA: Removes trapped fluid from the eye, decreasing pressure
Side effects: Headache, dryness, and fluid/electrolyte imbalance

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11
Q

Anticholinergics

Mydriatics

A

Indicated for: Pupil dilation to rest intraocular muscles and relieve pain/inflammation, for eye exam, and for pre/postoperative rest
MOA: Prevention of pupil constriction
Side effects: Photophobia, systemically causes dry mouth, tachycardia, and fever sue to reduced sweating
Cautions: Narrow angle primary glaucoma

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12
Q

Eye Antiinfectives

A

Indicated for: Eye infections/inflammation
MOA: Bacteriacidal/bacteriostatic, intivirals
Topical cautions: Possible local sensitivity (eye inflammation), interference with normal flora
Systemic cautions: Possible sensitivity to antiinfective, bacterial/viral resistance may develop

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13
Q

Eye Steroids

A

Indicated for: Allergic reactions in eye, severe eye injury, and non-pus producing inflammation
MOA: Reduction of scarring/impaired vision, reduction of inflammation to prevent proteins/blood cells from entering aqueous humor and increasing IOP
Cautions: Pus-producing inflammation, prolonged therapy may cause systemic side effects, secondary glaucoma, and cataracts

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14
Q

Local eye anesthetics

A

Indicated for: Eye pain

Caution: Eye may dry out due to decreased blink reflex

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15
Q

Emollient

A

Fatty or oily substance used to soften or soothe irritated skin or mucous membrane

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16
Q

Antiseptic

A

Substance used on living tissue to inhibit or kill microorganisms capable of producing infection

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17
Q

Keratolytic

A

Keratin dissolvers, used on warts and noninflammatory acne

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18
Q

Topical corticsteroids

A

Antiinflammatory agents used topically for itchy skin, may cause capillary dilation, skin atrophy, and decreased skin pigmentation. Allergies possible. Not to be used for skin infection, as they are immunosuppressive.

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19
Q

Tretinion

Retinoic acid

A

Indicated for: Acne (especially blackheads)
May cause: Light sensitivity and possible acceleration of carcinogenic effects of UV light
May be used concurrently with benzoyl peroxide

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20
Q

Benzoyl peroxide

A

Indicated for: Acne (especially whiteheads)

May be used concurrently with tretinoin

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21
Q

Tetracycline

A

Spectrum: Broad. Many gram-positive and gram-negative bacteria.
Indicated for: Acne, chlamydia/STIs, animal-borne infections.
May cause: Gastric upset, vaginitis, skin infection, and fungal infection. Children’s teeth may be permanently discolored. May decrease effectiveness of contraceptives. Possible interaction with calcium and magnesium, should not be taken with milk.
Caution: Decreases effectiveness of contraceptives. Contraindicated in pregnancy. Superinfection possible.

22
Q

Erythromycins

A

Indicated for: Acne
May cause: Gastric upset, vaginitis, skin infection and fungal infection.
Caution: Possible effects upon pregnancy. Superinfection possible.

23
Q

Oral contraceptives

A

Indicated for: Acne

MOA: Estrogens suppress sebum production

24
Q

Oral 13

Cisretinoic acid

A

Indicated for: Acne, especially severe case
MOA: Inhibits sebum production
May cause: Cracked skin, alopecia, hypertriglyceridemia, hepatitis, acute pancreatitis, pseudotumor cerebri joint/musckuloskeletal pain and skeletal hyperostoses.
Caution: Contraindicated in pregnancy, highly teratogenic. Women must take monthly pregnancy tests to continue medication.

25
Q

Infection

A

Presence of an organism on or within tissue resulting in an immune response and/or destruction of the tissue

26
Q

Colonization

A

Presence of an organism on or within tissue which does not result in an immune response nor destruction of the tissue

27
Q

Antibiotic

A

A product of a living microorganism that can exert a deleterious effect on other microorganisms

28
Q

Antimicrobial

A

Any naturally occurring or synthetic substance which kills or inhibits growth of microorganisms

29
Q

Broad spectrum

A

Effective against more than one class of microorganisms and sometimes nonbacterial parasites. Best used topically

30
Q

Narrow spectrum

A

Effective against a limited number of microorganisms. More desirable systemically

31
Q

Disinfectant

A

An agent used on objects that kills microorganisms capable of producing infection. Doe not kill spores, viruses, or some very resistant bacteria

32
Q

Antiseptic

A

Agent used on living tissue that inhibits or kills microorganisms capable of producing infection. Not as strong as disinfectant

33
Q

Bactericide

A

Agent that kills bacteria independent of the immune system. Generally affect bacterial cell walls or membrane permeability. Penicillins, cephalosporins, polymyxin, and vancomycin

34
Q

Bacteriostatic

A

Substance that inhibits growth and replication of bacteria. Requires assistance from the body’s immune system. Generally function as antimetabolites or inhibitors of protein synthesis. Infection may be life-threatening if the hosts’s immune system is malfunctioning. Tetracyclines, sulfonamides, erythrmocycin, and lincomycin

35
Q

Superinfection

A

Development of an infection suprimposed on the one being treated, possibly due to overgrowth of a resistant strain or minimized competition from helpful bacteria

36
Q

Penicillin

A

Spectrum: Narrow. Chiefly gram-positive, but useful for many common infections.
MOA: Beta-lactam ring inhibits cell wall synthesis. Bactericidal.
Caution: Renal disease. High doses may lead to CNS stimulation and convulsions. Allergy possible.

37
Q

Penicillinase resistant drugs

A

Used if bacteria resistant to penicillin.
MOA: Not affected by penicillinase
Caution: IV forms include sodium and potassium, may cause electrolyte imbalance in patients with kidney failure.

38
Q

Beta lactamase inhibitors

Clavulanic acid, Sulbatctam, Tazobactam

A

Used if bacteria have beta lactamase.

MOA: “Rejuvenate” penicillins by inhibiting beta lactamase

39
Q

Probenacid

A

Used for gout and to inhibit renal secretion of penicillins, cephalosporins, and some quinolones
MOA: Keep some drugs in the body longer by inhibiting renal secretion

40
Q

Cephalosporins

A

Spectrum: 5 generations with varying spectrums, generally narrow spectrum. Chiefly gram-positive in earlier generations, switches to gram-negative in later generations. 5th generation works against MRSA. Meningitis.
MOA: Beta lactam ring inhibits cell wall synthesis. Bactericidal.
Used prophylactically before, during, and after surgery
Caution: Must be used with sensitivity tests to indicate effectieness. Allergy possible.

41
Q

Carbapenems

A

Spectrum: Most gram-positive and gram-negative bacteria. May be used for mixed infections.
MOA: Beta lactam ring, resistant to beta lactamase
Given IV or IM. May be given with glycopeptides. May be given with cylastin to decrease kidney excretion and prolong effects
Caution: Renal disease, may cause CNS stimulation and convulsions

42
Q

Monobactams

A

Spectrum: Effective against more resistant gram-negative organisms (UTI, URI, intra-abdominal and gynecological infections).
MOA: Beta lactam ring, inhibits cell wall synthesis.
May cause: Elevated liver values, nausea, vomiting, rashes and phlebitis
Little to no cross-allergenicity to penicillins and cephalosporins

43
Q

Glycopeptides

Vancomycin, bacitracin

A

MOA: Inhibit cell wall synthesis by depolarizing the bacterial cell membrane. No beta lactam ring. Bactericidal.
Vancomycin does not absorb through the gut. Bacitran is strictly used topically.
May cause: Red Man Syndrome. Systemic toxicity if absorbed.

44
Q

Aminoglycosides

Streptomycin, Amikacin, Gentamicin, Neomycin, Tobramycin

A

Spectrum: Broad, especially aerobic gram-negative organisms. Resistance uncommon.
MOA: Protein synthesis inhibitor. Bactericidal.
Used parenterally, expect for GI parasites. Does not cross blood-brain barrier adequately.
May cause: Ototoxicity, renal damage, neuromuscular blockade at neuromuscular junction

45
Q

Streptomycin

A

An aminoglycoside. Bactericidal.
Used for tuberculosis
May cause: Hearing loss, renal disease, neuromuscular blocking and respiratory paralysis if low blood calcium. Avoid prune, plum, and cranberry juice

46
Q

Quinolones/Fluoroquinolones

“Floxacins”

A

Spectrum: Broad spectrum, most gram-negative and gram-positive bacteria. Works against pseudomonas.
MOA: Synthetic. Inhibit DNA synthesis. Bactericidal. Resistance less likely due to destruction of DNA.
May cause: Fewer adverse reactions, but can cause nausea, anaphylaxis, rashes, visual disturbances, phototoxicity, depressed bone marrow, acute interstitial nephritis, arthritis, and tendonitis. Activation of CP450.
Contraindicated for: Pregnancy

47
Q

Macrolides

Erythromycin, Azithromycin

A

Spectrum: Narrow, chiefly gram-positive but some gram-negative.
MOA: Inhibits protein synthesis. Bacteriostatic. Resistant strains develop easily.
May cause: Epigastric pain, jaundice, ototoxicity, Possible allergy. Some antiinflammatory effects.

48
Q

Lincosamides

Clindamycin, lincomycin

A

Used for: Patients with penicillin allergies.
MOA: Bacteriostatic.
Caution: Possible toxicity. Possible serious adverse effects, may wipe out natural flora.

49
Q

Chloramphenicol

A

Spectrum: Broad. Typhoid fever, systemic salmonella, meningeal infections (especially from influenza), and anaerobic infections.
MOA: Protein synthesis inhibitor. Bacteriostatic.
May cause: Blood abnormalities, toxic build up in infants (Grey Baby Syndrome).

50
Q

Sulfonamides

A

Spectrum: Broad. UTI., otitits media, and vaginal infections. Resistance common.
MOA: Inhibition of cell metabolism. Bacteriostatic.
Low cost and easily administered.
May cause: Kidney damage possible.

51
Q

Trimethoprim

Septra

A

Used for: UTI, URI, GI infections.

Caution: Folate deficiency.

Pharmacology (10 decks)

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