F: Ophthalmic Drugs Flashcards
What are the 6 reasons to use ophthalmic drugs
- Dilate/constrict pupil
- Dec. Aq. fluid/IOP
- Inc. Tear production
- Dec. inflammation
- Treat infection
- Topical anesthetics
T/F. topical preparations are generally prefered
T
When giving two separate drugs in the eye, you should wait ___ min. between drops
5min
What are the 2 concerns about topical ophthalmic meds.
- Adverse effects
2. Short duration at site
Parasympathetic NS drugs cause Constriction/Dilation of the pupil
Constriction
Sympathetic NS drugs cause Constriction/Dilation of the pupil
Dilation
Sympathetic innervation of the eye!
- relaxation of ciliary m
- Contraction of iris
- Production of Aq. fluid
Parasympathetic innervation of the eye
- Contraction of cilliary m.
2. Contraction of the iris sphincter m.
What is the Miotic ophthalmic drug we learned?
Pilocarpine
What is the MOA of Pilocarpine
Direct acting parasympathomimetic
When is Pilocarpine used
- Dx of parasympathetic lesions
- Tx of glaucoma
- Tx. KSC
What are the Mydriatics we learned about
- Atropine
2. Tropicamide
MOA of Atropine
Direct acting parasympatholytic
What does Atropine cause?
- mydriasis
2. Cycloplegia (blurred vision)
Indications for use of Atropine
- Mydriatic-cycloplegic (dec. pain with uveitis)
2. can break up synchiae in uveitis
T/F. you can use atropine safely in glaucoma patients
F. DO NOT USE IN GLAUCOMA
MOA of Tropicamide
Direct acting parasympatholytic
What does Tropicamide cause?
- Mydriasis and cycloplegia
Since Atropine and tropicamide cause the same thing, why would you pick which to use?
Tropicamide =Faster onset, but shorter duration
Which drug would you use for short term dilation for retinal exam?
Tropicamide
T/F. Both atropine and Tropicamide can be used to prevent adhesions after cataract sx
T
Cautions of Tropicamide use.
- Avoid in glaucoma
2. Alter schirmer’s tear test
T/F Tropicamide is more effective for pain control than atropine
F
Why would you want to dec. the amt. of aq. humor in the eye?
Dec. IOP in glaucoma
Drugs that reduce aqueous humor formation and/or improve aqueous outflow:
- Alpha-agonists
- Beta-antagonists (timolol)
- Carbonic anhydrase inhibitors (dorzolamide)
- Prostaglandin analogs (latanoprost)
What is the MOA of Timolol?
Ophthalmic nonselective beta-agonists
What is Timolol used for?
Management of glaucoma
How is Timolol used?
- used to prevent glaucoma in contralateral eye
- dec. aq. formation
- sometimes causes miosis
What is cosopt?
Timolol + dorzolamide
What is the MOA of Cosopt?
Carbonic anhydrase inhibitor
Topical carbonic anhydrase inhibitors
- Dorzolamide
Topical prostaglandin anolog
Latanoprost
MOA of Latanoprost
Inc. uveoscleral outflow by stimulating FP (prostaglandin) receptors
Agents that provide lubrication but do not perfectly replicate natural tears
Lacrimomimetic agents
Agents that stimulate the eye to produce more tears
Lacrimogenic agents
What are the topical immunomodulator lacrimal agents
- Cyclosporine
What is cyclosporine used to tx
KCS
How do you monitor cyclosporine use
Schirmer tear test
Why should owners be cautious when admin. cyclosporine
immunosuppressive
Anti-inflammatories for the eye
- Glucocorticoids
What are ophthalmic glucocorticoids use for?
manage inflammatory and immune mediated conditions
When are topical NSAIDs used
Manage inflam. associated with uveitis, keratiti, cataracts
What are the 2 Topical NSAIDs used on the eye?
- Flurbiprofen
2. Diclofenac
Which of the following is a Glucocorticoid?
a) Flurbiprofen
b) Flutiscasone
c) Fludroxortisone
d) Flunixin Meglumine
Fludrocortisone
Which of the following is a Mineralocorticoid?
a) Flurbiprofen
b) Flutiscasone
c) Fludroxortisone
d) Flunixin Meglumine
Fluticasone
Which of the following is an ophthalmic NSAID?
a) Flurbiprofen
b) Flutiscasone
c) Fludroxortisone
d) Flunixin Meglumine
Flubiprofen
Which of the following is a systemic NSAID?
a) Flurbiprofen
b) Flutiscasone
c) Fludroxortisone
d) Flunixin Meglumine
Flunixin Meglumine
What are 4 antimicrobial agents that can be applied to the eye?
- Aminoglycosides (gentamicin)
- Fluoroquinolones
- Chloramphenicol
- Oxytetracycline
When treating eye infections, why would you pick topical treatment over systemic?
avoid systemic toxicity
how do you choose which antimicrobial to use when treating an eye infection?
select based on suspected organism, gram stain, or culture
Topical Antiviral agent
Gancyclovir
Topical antifungal agent
Natamycin
What would you use to tx fungal keratitis and conjunctavitis
Natamycin
Topical anesthetic for the eye?
Proparacaine
What is the MOA of Proparacaine
Blocks Na+ channels to prevent axonal depolarization
When is proparacine commonly used
To dec. corneal sensation to allow dx evaluation
