L6 Flashcards
what are the 5 cardinal signs of inflammation
pain
heat
redness
swelling
loss of function
what is prostaglandin and leukotrienes
they are chemical mediators incharge of causing
Increase permeability of vessels: EDEMA
Increase sensitivity to PAIN caused by prostaglandins
what are the 4 types of hypersensitivity reaction
1: immediate
2: cytotoxic
3: immune complex
4: delayed
what is type 1 hypersensitivity reaction
Antigen is reintroduced into an individual who has been exposed to the antigen previously.
First exposure results in formation of Immunogloblin E (IgE)
IgE binds to mast cells and makes cell rupture when Antigen is reintroduced
What is hypersensitivity
immune system overreacts
what is histamine
it is a mediator of hypersensitivity. it is release in large quantities from mast cell in type 1 reaction.
Synthesized and stored in almost all tissues: skin, lungs, nasal mucosa etc
Ocular: lids, conjunctiva, episclera, limbus
what are the effect of histamine
Vasodilation
Edema
Itching
pain
what are the types of anti-inflammation drugs
-Anti-histamine
-Mast cells Stabilizer
-Vasoconstrictors (decongestants)
-NSADIS
-Corticosteroids
what is anti-histamine
Blocks the actions of produced histamine
Used topically for relief of mild to moderate symptoms of allergic conjunctivitis or irritation (itching), pinguecula, pterygium
They bind to histamine receptors
Resulting in the prevention of physiologic actions of histamine
Compound of anti-histamine: pyrilamine, pheniramine, antazoline
what are some of the example of anti-histamine drug
Ketotifen
Optivar
Emedine
what is mast cell stabilizer
- Inhibits the degranulation of mast cells, therefore inhibits the release of histamine.
- Prophylactic treatment (preventive)
- Long term management of allergies: vernal and seasonal allergic conjunctivitis
- It has NO EFFECT on mediators that has already been released.
what are the example of mast cell stabilizer
Cromolyn sodium (Opticrom 2%)
what is vasoconstrictors
- Adrenergic agonists
- Usually combined with anti-histamines
- Compound of vasoconstrictors: phenylephrine, tetrahydrozoline, oxymetazoline
what are the example of vasoconstrictors
Visine
Opcon-A
what is NSAID
- Alternative to steroids
- Inhibit prostaglandin formation
- Conditions: Episcleritis, scleritis, uveitis, cystoid macular edema
example of NSAID
Paracetamol (oral)
Aspirin (oral)
Ocufen (ocular)
indocin (ocular)
acular (ocular)
what is corticosteroid
- Supress inflammation but underlying cause still remains
- Supress inflammatory responses often caused by:
Allergy
Infection
Trauma
what are the different type of steroid
- Short acting:
Hydrocortisone, prednisolone - Intermediate acting:
Traimcinolone, Fluprednisolone - Long acting:
Dexamethasone, betamethasone
indication for corticosteroid
- Topical
Allergic conjunctivitis
Uveitis
Scleritis
After intraocular surgeries: IOL implants - Systemic (disease behind the crystalline lens)
Posterior uveitis
Optic neuritis
what is ocular complication of steroid
- Lens opacities (Posterior subcapsular cataract)
- Elevated IOP
- Mask diseases
- Lower resistance to infections
- Retards corneal healing
what is anti-infective drug
Anti-infectives are medicines that work to prevent or treat infections, they include antibacterials, antivirals, antifungals and antiparasitic medications.
what are the ocular defence system
- Tears: Lysozyme, Immunoglobulin A, Lactoferrin, albumin, B-lysin
- Blinking: constant flow and movement of the tear film to wash away debris
- Conjunctiva: lymphoid tissue which has anti-microbial defence
- Cornea: Langerhans’ cells (antigen presenting cell) from the limbus, cytokines
what are bacterial eye infection
Yellowish discharge, usually severe.
Example: blepharitis, preseptal cellulitis
what are the anti-bacterial drugs
- Bacitracin
Ointment form
Bacteriocidal against most gram-positive bacteria
Treatment for: Blepharitis - Chloramphenicol
Broad spectrum
eye drops/solution or ointment
Treatment for: Conjunctivitis - Aminoglycosides: most active against gram negative bacteria
- For superficial ocular infections
Neomycin
Tobramycin
Gentamycin
what is fungal eye infection
Most aggressive, hard to resolve.
Example: fungal corneal ulcer
what are the anti-fungal drug
Nystatin
Amphotericin
Natamycin
what is viral eye infection
Watery discharge, very infectious.
Example: herpetic keratitis, Cytomegalovirus retinitis
what are the drug available for viral eye infection
Topical drugs
Trifluridine
Topical Acyclovir ointment (zovirax)
Intravenous route:
Ganciclovir
Foscarnet
Oral:
Acyclovir
Famcyclovir
