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GOP SEM 2 > OAR > Flashcards

OAR Flashcards

1
Q

What does Amiodarone treat? What are the OAR’s?

A

Cardiac arrhythmeia (class III agent- works by prolonging repolarisation in heart)

Corneal micro deposists (verticillata) - penetrate into lysosomes and bind with lipids inside cells which produces drug induce lipdoses (accumualtion of lipids) keratopathy

oral admin- lipophillic

400-1000mg (longer than 6months) 90%

Tears film /Aq humor or BV at the limbus

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2
Q

What are the 3 stages of Amiodarone Keratopathy

A

S1- fine grey/brown coalescent deposits linear fashion inferior cornea
S2- additional horizontal lines
- Aborizing
S3- Verticallate whorl like

Do fade usually between 3-20months after stopping
Found in basal cell layer of corneal epithelium

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3
Q

What are other OAR’s with Amiodarone?

A 
Lens opacities 
Retinal $ ON deposits
Optic neuropathy- disc swelling, indistinct boarders, bilateral vision loss, starts unilateral. 12month after start of medication 
glare halos blur
SLIT LAMP!
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4
Q

What does Chlorpromazine treat?

A

Antipsychotic drug

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5
Q

What are the OAR’s for Chlorpromazine

A

Increase melanin production leading to pigment deposits on corneal Endo and DM

2000mg/day for 6months 12% corneal deposits
2500mg/day 90% lenticular deposits

some in posterior stroma, a sign that distributed via stroma

can cause stellate cats

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6
Q

What is Topirmate used for?

A

Antiepilectic

used for adults & children >2

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7
Q

What are the OAR’s for Topirmate?

A 
Acute Onset Angle Closure Glaucoma
-Ciliary body odema..pushes iris forward blocking the angle (secondary angle closure)...also swelling of CL
Acute Myopia
Peri-orbital oedema
Scleritis
Bleparospasm
Nystagmus
Diplopia
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8
Q

Who is more at risk for AACG in px taking Topirmate?

A

34 F
taking SSRI ^
first 2 weeks mean 7 days

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9
Q

What are the OAR’s for Tricyclic antidepressents (amitriptyline hydrochloride)?

A 
Anti-muscarinic (ocular motor)
pupil dilation and cyclo effect 
Photophobia - sun specs
Blurred vision esp at near 
Risk of Angle closure

REVERSABLE EFFECTS

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10
Q

What are the OAR’s for motion sickness drugs (Hysoscine, scopolmine)

A 
Anitmuscaranic effect (ocular motor)
anti ach blocks vestibular signals

REVERSABLE

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11
Q

What are the OAR’s of sympathomimmetic drugs?

A

Angle closure
Pupil dilation
BV constriction (OTC could reduce conjunctival hyperemia) could miss potential eye disease

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12
Q

What is a Nystagmus?

A

A involuntary osscaltion of one or both eyes about one or more axes

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13
Q

What drugs can be asscoiated with nystagmus?

A

Verticle nystagmus and ptosis of eye lids- barbiturates (sedative)

Strepromycin (antibiotic)- Vestibular nystagmus dur yo CN8 interaction

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14
Q

How do thyroid drugs effect the eyes?

A 
Synthetic hormones (levothyroxine, dextrothyroxine)
neuromuscular blocking effects lead to diplopia and also ptosis

Papillodema, conjunctival hyperemia and odema, visual hallucinations,dry eye, photophobia

if excess thyroid, symptoms like myasthenia gravis

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15
Q

How does Heroin/methadone detoxifcation affect the eyes ?

A

Detox

Diplopia, blurred vision
deviaitions ^ ESO
reduced VA, redcuded stereoactuuty,reduce convg, reduced contrast sensitivity

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16
Q

How do antimuscarnic drugs affect the tears ?

A

Inhibit gland secretion reducing tear volume

KCS probs for CL wearer

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17
Q

How do antihistmamines, beta blockers, and oral contraceptives affec the tears film

A

decrease- KCS CL probs

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18
Q

How do paraysmpathomimetics affect the tears film (such as pilocarpine and neostigmine)?

A

increase tear production

19
Q

What are general effects on the tears film?

A

inflamed glands or a reduction in nerve impluse so reflext tearing is reduced

20
Q

How does blood pressure reduction relate to iop?

A

10mmHg in systolic BP reduction = 1-2mmHg IOP reduction

21
Q

If a px is taking drugs to reduce blood pressure, what do we need to bare in mind?

A

BP lowering drugs:

may not need as much IOP lowering drugs
question medicine routine as effects are transient (1-4hrs) and pressure may rise after test

22
Q

How do oral beta blockers effect IOP? (anenolol)

A

LOWER by decreasing aqueous production

23
Q

How do vasodilators effect IOP (catopril)

A

LOWER by increasing aqueous outlflow

24
Q

How do Achestarase inhibitors effect iop? (rivastigmine)

A

Lower by increasing aqueous outflow

25
Q

How do systemic corticosteriods effect IOP?

A

Increase- increasse aq production and decreease outflow

are they a steriod responder?

topcial admin usually inc risk

26
Q

Who is at risk of steriod induced CSCR? and what is the method at which it occurs ?

A

Middle aged men & stress

Inhibition of collagen synthase which ^ perm od choroid capilaries OR dyfunction of RPE - ^ fluid VA reduced and hyperopic shift

27
Q

How often should IOP be measured in people taking corticosteriods ?

A

Before medcation starts

then at 1,3,6 months … then every 6month

28
Q

What is an effect of corticosteriods?

A

PSC- 30% prevelence in those taking drug

dose dependant

10mg per day= low risk
16mg per day for several yrs = 75%

Drug reacts with amino groups in the fibres of the lens causing clumps

29
Q

Why is PSC so trouoblesome ?

A

Cats close to nodal point of the eye

greater effect at near due to pupil constirction

30
Q

Why is a PSC in children so harmful?

A

Could lead to amblyopia

31
Q

Is a PSC reversabile ?

A

No unless its been short term (<2yrs) and a low dose

32
Q

What drugs can unduce a myopic shift? How?

A

Suplhonamides

Diuretics

carbonic anyhdrase inhibitors

Topiramate

Odema of ciliary body -> zonualr relaxation
Odema of CL
Spasm of AA

33
Q

What drugs are used for the management of Osteoporosis?

A

Bisphosphonates

Alendronate sodium, risedronate sodium

34
Q

How do Bisphonates affect the eye?

A

anterior uveitis

conjucntivitis
episcleritis
scleritis

35
Q

What is Chloroquine used to treat?

A

Anti-malarial drug and also treats rhemotoid arthiritis

36
Q

What is a OAR of Chloroquine?

A

Narrowing of retinal BV
Bulls eye ring of pigment in the perimacular region
Pigmented tissue binds to drug -> degen of RPE->amsler scotoma

Vision normal until toxicity occurs later

dose dependant >300mg

37
Q

What are the factors thaat ^ the risk of an OAR with the use of hdroxychloroquine?

A

Liver disease
60 or over
renal disease
Dose and retinal diseases

38
Q

What are tetracylcines ?

A

group of bacteriostatic antibiotics

hyperpigmentiation aroound the eyes, palpebral conjunctiva

transient myopia, changes in colour vision, dipliopia

drug can get into to CSF-> papilodema

39
Q

What is tamoxifen used for ?

A

Antiestrogen … used in treatment of breast cancer

40
Q

What are the OAR’s for Tamoxifen?

A 
bilateral maculopathy
-fine yellow/white opacties
-cystoid macula odema 
-parafoveal haem 
-rpe changes 
-va reduction 
1yr >100mg

Check for colour defect (tritan)

41
Q

What is vigabatrin used to treat ?

A

Epilepsy

42
Q

What are the OAR’s for vigabtanib?

A

Bilateral VF loss-

43
Q

What is Ethambutol used to treat?

A

TB
Optic neurpoathy- couple of months
VF defects- Central as pipillo macula bundle most effected
colour deciencies

GOP SEM 2 (1 decks)

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