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OCULAR PHARM > Ocular Intro > Flashcards

Ocular Intro Flashcards

1
Q

If you are having a Anaphylactic reaction what should you do?

A

This will lead to obstruction in airways
Should care with EPINEPHRINE
1) IV Steroids
2) O2
3) Intubation - insert a tube to the airways
4) Airway management

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2
Q

What is FDA REQUIREMENT FOR Drugs?

A

90% have to be active
>18 mo shelf life
Antimicrobial preservation vs non preserved until dosing vials

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3
Q

What are the routes of Injection?

A

1) Sub-junctival
2) Intra-cameral
3) Intra-veitreal
4) Peri-bulbar
5) Retro-bulbar
6) Subtenon’s

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4
Q

In what case and what drugs would you use SUB-TENON’S for the injection?

A

If you have EDEMA, UVEITIS, and Post cataract Surgery

Use : Steroids

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5
Q

In what case and what drugs would you use SUBCONG for the injection?

A 
Lower dosage
High local concentration***
No compliance concerns
Useage: Severe corneal disease
ex. Treating bacterial ulcer or using 5 FU post trabeculoplasty
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6
Q

In what case and what drugs would you use Intracameral for the injection?

A

Visco elastic for glaucoma filtration and cataract surgery to protect corneal endothermic and anterior chamber collapse

1% Post OP LIDOCAINE for comfort at ciliary body iris

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7
Q

In what case and what drugs would you use INTRA-VITREAL for the injection?

A 
Endopthalmitis with subconj injection
Retinitis
ex. cytomegalovirus
Triamicnolone for diabetic macular edema
Antiangiogenic inserts for macular degeneration's
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8
Q

In what case and what drugs would you use PERIBULBAR for the injection?

A

Anesthesia and Akinesia

    • Slower than retrobular injection
    • Considered safer alternative from early days
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9
Q

In what case and what drugs would you use RETROBULBAR for the injection?

A

Into the muscle cone
- High penetration risk
Much lesson common today than early days

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10
Q

What chemical class does EDTA belong to?

A

Chelators (metals )

They bind to heavy metals

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11
Q

What are chemical toxins? and what are the types?

A

ALCOHOL
HEAVY MEALS
Bacteriostatic

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12
Q

Which ones are Bacteriostatic?

A

PROVIDONE (PVP)

  • – This is a water soluble synthetic
    • Non ionic polymer
    • Absorbs 40% its weight in water
    • Used in WWII as plasma expander for trauma
    • It complexes with iodine, mercury, nicotine, cynanide
    • *** it reduces their toxicity but preserves bactericidal action
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13
Q

Which ones are mercury based?

A

Thimersol

    • Used in CL solutions in early days
  • – Toxicity caused reactions
    • then they found dilution of this that can reduce the toxicity
    • Still used in VET products
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14
Q

What is often combines with EDTA?

A

Chlorobutanol

    • Less allergenic than benzalkonium chloride
    • When combined with alcohol it will be a potent preservative
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15
Q

What are PRESERVATIVE SURFACTANTS?

A

Biguanides

Quaternary Ammonium compounds

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16
Q

What drugs are includes under Biguanides?

A

PHAMB
PAPB
Chlohexidine
Alexidine

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17
Q

What are quaternary Ammonium compounds?

A

Benzalkonium Chloride (BAK)
Polyquaternium (Quats)
PQ-1 (polyquad)
PQ-10

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18
Q

What does the Ammonium compounds do to the cell membranes?

A

Cationic surfactants are ammonium containing molecules that disrupt cell membranes and destablize enzyme structure and function
— anionic solutions mixed with cationic surfactants will inactivate them

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19
Q

whats good about Cationic surfactants compared to anionic surfactants?

A

Cationic surfactants are less toxic to the ocular surface owning to ineractions with the negatively charge corneal cells

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20
Q

What is Poly-amino-propyl-buguanide forumated as?

A

1ppm DYMED Baush + Lomb

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21
Q

Whats the advantage of Chlorhexidine?

A

2 separated plus charges and less membrane intercalation compared to BAK

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22
Q

What is advantage Alexidine?

A

it is similar chlorhexidine and that has ehtylhexyl end grps making it more BACTERCIDAL

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23
Q

Whats so convterversioal about BAK?

A

it has 0.01% reduces TBUT by 50% through corneal epithelial toxicity, thts why using this product on artifical tears is controversial

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24
Q

What are drugs that included in OXIDANTS category?

A

Sodium perborate
= this is inactivated pH sensitive and questioned in use on dry eyes

Metabolized frm hydrogen peroxide to water and oxygen

Sodium Chlorite
== Light inactivated
= Convertes it to water and Sodium

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25
Q

What drugs are included in sodium Perborate?

A

Genteal (gen aqua)

Thera Tears

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26
Q

What drugs are included in Sodium chlorite?

A

Allergan Refresh (Purite)
Blink
Brimonidine (purite)

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27
Q

Why Brimondine with purite is better choice?

A

it is more pH neutral and absorbed better than higher preserved formulations

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28
Q

What are Preservative Free (PF) drugs?

A 
Artifical tears
Cyclosprine
Timolol
Zioptan
Ketoralac
Cosopt- PF
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29
Q

What are Self preserved drugs?

A

Moxifloxacin 0.5%

30
Q

Can you reuse PF?

A

YES as long as they are recapped, can be used over 12hr period

31
Q

What is the Yellow eye drop cap means?

A

Beta Blockers

32
Q

What is the Dark Blue eye drop cap means?

A

Beta blocker combos

33
Q

What is the RED eye drop cap means?

A

Mydriatics and Cycloplegics

34
Q

What is the DARK GREEN eye drop cap means?

A

Miotics

35
Q

What is the ORANGE eye drop cap means?

A

Carbonic anhydrase inhibitors

36
Q

What is the GRAY eye drop cap means?

A

Non steroidal anti-inflammatories

37
Q

What is the PINK eye drop cap means?

A

Steroids

38
Q

What is the TAN eye drop cap means?

A

Anti-infectives

39
Q

What is the TEAL eye drop cap means?

A

Prostaglandin analogs

40
Q

What is the PURPLE eye drop cap means?

A

Adrenergic agonists

41
Q

Define Affinity

A

The ability of the drug to bind to receptor

** greater affinity means you need less concentrations than with less affinity**

42
Q

Receptor

A

binding site with a biological effect; can be bound to a membrane or floating around

43
Q

Intrinsic activity

A

capacity to produce a biological effect

44
Q

Define o Agonis

A

Have INTRINSIC affinity and Affinity

45
Q

Define Antagonist

A

Have affinity but NOT INTRINSIC,
NO biological effect, no ED50 or EC50,
Efficacy = 0

46
Q

Allostery

A

a bound ligand influences specificity at another site

47
Q

Efficacy

A

affinity x intrinsic activity

Dose INDEPENDENT

48
Q

EC50

A

Effective concentration at 50% of subjects

once the drug in the body, how much concentration must be present in order to get the effect on the body

49
Q

ED50

A

Effective dosage at 50% subjects

How much drug is given into the body, only part of it will reach the blood and some of it will be eliminated

50
Q

IC50

A

inhibitory concentration at 50% of subjects

51
Q

Hypersensivitiy

A

Result of chronic antagonism

52
Q

Maximum dosage

A

Using minimum amount of dosage to get the maximal therapeutic effect so we will not run into any toxic effects

53
Q

o Partial agonist:

A

low intrinsic activity with potency and affinity within the therapeutic range
 It has lower capacity to produce the desirable biological effect

54
Q

o Pharmacodynamics:

A

the drugs action on the body, biochemical and physiological effects of drugs and their mechanisms of action

55
Q
  • Pharmokinetics
A

the body’s action on the drug (ADME)

  • Absorption
  • Distrubition
  • metabolism
  • Elimination
56
Q

o Pharmacotherapeutics:

A

drugs action on the target disease

57
Q

o Potency

A

response to a given dose; less dose to present the same effect means the drug is more potent;

 Potency and EC50 are inversely related in agonists
 Potency and IC50 are inversely related in antagonists

58
Q

Specificity

A

ability to act at a specific receptor; side effects occur when a drug does not have a high degree of specificity

59
Q

Selectivity

A

The ability to give desired effect vs adverse effects

60
Q

Therapeutic Index

A

LD50:ED50
Lethal dosage = on animals
Higher the therapeutic number the safest ***

ED50: TD50

61
Q

what is Tachyphylaxis

A

rapidly decreases the therapeutic response

62
Q

Teratogenesis

A

Congenital malformation

63
Q

Bioavailability

A

Amount of active drug that is reaching target tissue

64
Q

What is supplemental?

A

When you are taking additional vitamins since you are not making them
Ex. insulin

65
Q

What is supportive?

A

when you are helping to RELIEVE the symptoms but do not cure the problem
ex. Glucose

66
Q

What is PROPHYLACTIVE

A

You are preventing the sympptoms

Ex. low dosage of asprin

67
Q

What is Symptomatic

A

You are TREATING The symptomatics, but not the problem

ex. histamine allergy drops
ex. olopatadine

68
Q

Diagnostic

A

Dilating drops

ex. fluoresecine drops to figure out whats wrong

69
Q

Therapeutic

A

has effects deep within the cell, produces many changes and can be seriously toxic if not closely monitored

70
Q

What are the 4 superfamilies?

A

ION CHANNELS

Cacium release

OCULAR PHARM (4 decks)

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