Intro To Opthalmic pt 1

Question 1

Where is the primary absorption site for eye medications?

Answer 1

Cornea

Question 2

Give 2 reasons why the cornea is unique

Answer 2

1. Avascular

2. Dual nature = lipophilic + hydrophilic

Question 3

The cornea has 5 layers but only the _________ and ________ contribute to absorption

Answer 3

Epithelium

Stroma

Question 4

The _______ of the cornea is lipophilic and the _______ is hydrophilic

Answer 4

Epithelium

Stroma

Question 5

The __________ accounts for less than 1/5 of drug absorption; because it is highly vascularized the drug can reach systemic circulation

Answer 5

Conjunctiva

Question 6

T/F: redness of the eye increases drug absorption into the eye due to increased vascular presence

Answer 6

False

- it decreases absorption in the eye but increases systemic absorption

Question 7

Miosis

Answer 7

Contraction
Iris
Sphincter
PNS
Cholinergic

Question 8

Mydraisis

Answer 8

Contraction
Radial muscle
Iris
SNS
Adrenergic

Question 9

What is the role of the ciliary body?

Answer 9

1. Aqueous humor production
2. Ocular source of drug metabolizing enzymes
3. No tight junctions = passage for systemic drugs

Question 10

If the ciliary body is inflamed, how will the patient present?

Answer 10

1. Ciliary body spasm = fluctuating vision, pain and photophobia
2. May induce cycloplegia to reduce pain (paralyze the ciliary body)
3. Prostaglandins may result in pupillary constriction

Question 11

_________ ___________ accounts for why darker eyes take longer to respond to lipophilic drugs

Answer 11

Pigment absorption

Question 12

__________ humor circulates with thermal differential

Answer 12

Aqueous

Question 13

What is a concern with administration of digitalis, quinine, methyl alcohol?

Answer 13

Renal toxicity

Question 14

What is the concern with administration of ethambutol, sulfonamide, vit A & digitalis?

Answer 14

Optic nerve toxicity

Question 15

_________ preservatives are ionically charged and disrupt cell membranes

Answer 15

Bacteriocidal

Question 16

________ preservatives are those that disrupt metabolic processes

Answer 16

Bacteriostatic

Question 17

Artificial tears that contain preservatives should be limited to use only ______ times per day

Answer 17

4 to 5

Question 18

pH ranging from _____ to _____ is tolerated in the eye for comfort

Answer 18

6.5 - 8.5

Question 19

Ophthalmic solutions are typically _____ in terms of tonicity

Answer 19

Hypotonic

Question 20

Polymers are added to eye drug formulations to _________

Answer 20

Increase viscosity to create a “shielding” effect to allow for more contact time on eye

Question 21

What type of solutions are used to draw water from the ocular surface?

Answer 21

Hypertonic solutions, like for corneal edema

Question 22

Why are antioxidants included in eye drop formulations?

Answer 22

Prevent deterioration upon exposure to oxygen to preserve efficacy

Question 23

DMSO is an example of which type of ingredient in eye drops? What is its role?

Answer 23

Absorption enhancer

• readily increases penetration and bioavailability by epithelial modification
• makes it “leaky”

Question 24

Which preservative is highly toxic to the cornea?

Answer 24

Benzalkonium chloride (BK)

Question 25

A ______ is defined as any agent other than active drug/preservative that is added to a formulation to achieve proper tonicity, buffering and viscosity

Answer 25

Vehicle

Question 26

_______/_________ are used to increase lipophilic nature of a compound and tend to penetrate the cornea better

Answer 26

Phosphates | Hydrochlorides

Question 27

_________/___________ increase hydrophilicity of a compound and tend to remain more surface-based

Answer 27

Alcohols | Acetates

Question 28

What is a concern with contact wearers and eye drop administration?

Answer 28

- may act as a reservoir for the drug and may result in a slow release or corneal irritation - sodium fluoresceine will stain soft contact lenses

Question 29

Which dosage form is difficult to avoid contaminating the tube tip and may be administered alternatively with a cotton swab?

Answer 29

Ointments

Question 30

T/F: Keeping your eye open helps reduces systemic absorption following administration fo the drug

Answer 30

False Close you eyes gently or use punctal occulsion

Question 31

T/F: Do not squeeze eye lids or rub the eye after administration

Answer 31

True | Just gently clsoe the eye

Question 32

How many minutes should you wait between drop administration?

Answer 32

5 to 10 mins

Question 33

______ should always be administered before ointments or suspensions

Answer 33

Drops

Question 34

Bradycardia, hypotension and impotency are all signs of systemic absorption of which eye drop medication?

Answer 34

Beta blockers

Question 35

Which eye drop may cause delirium, tachycardia and urinary retentions?

Answer 35

Atropine

Question 36

Which eye drop class causes ototoxicity?

Answer 36

Aminoglycosides

Question 37

T/F: most eye drop products are temperature dependent

Answer 37

False

Question 38

Refrigeration of eye drops primarily lets the patient know what?

Answer 38

When the drop hits the surface

Question 39

What are exceptions to refrigerating eye drops to feel it?

Answer 39

Prostaglandins | Antiviral

Question 40

Non-preserved eye drops are ______ dose and should be discarded after opening

Answer 40

Single

Question 41

Yellow or blue cap

Answer 41

Beta blocker

Question 42

Red cap

Answer 42

Mydriatic | Cycloplegic

Question 43

Green cap

Answer 43

Miotic

Question 44

Grey cap

Answer 44

NSAID

Question 45

Brown or tan cap

Answer 45

Anti-infective

Question 46

White cap

Answer 46

Carbonic anhydrase inhibitor

Question 47

Pink cap

Answer 47

Steroids

Question 48

Order mydriatics/cycloplegics from shortest DOA to longest

Answer 48

Tropicamide Homatropine Scoplamine Atropine