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Week 130 - Sudden Visual Disturbance > Ocular Pharmacology > Flashcards

Ocular Pharmacology Flashcards

1
Q

Benefits of applying treatments to the eye for ocular disorders?

A

Quick action at the site of the problem

Minimises systemic side effects

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2
Q

Negatives of applying treatments to the eye for ocular disorders?

A

More technically difficult than taking a tablet

Limitations of site of administration include risk of damage and limited volume

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3
Q

How long to wait between instilling drops if several?

A

5 minutes

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4
Q

Problems with eye drops

A

Administration
Poor compliance in a condition with no visible symptoms
Unpleassant side effects, e.g. stinging on admin, blurred vision
SE developing over time, e.g. sensitivity

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5
Q

Other methods of applying drugs to the eye

A

Intravitreal injection
Inserts
Spray, eye wash
Systemic treatment

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6
Q

Which autonomic nervous system makes the pupil dilate?

A

Sympathetic

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7
Q

What do sympathomimetics do?

A

Act on alpha-1 receptors
Cause mydriasis in 60-90 mins and lasts 5-7 hours

e.g. phenylephrine

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8
Q

Side effects of Phenylephrine?

A

Photophobia and blurred vision
Stinging on instillation
Acute glaucoma
Hypertension and arrythmias

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9
Q

What do antimuscarinics do?

A

Block action of ACh at muscarinic receptors
Cause mydriasis

note: parasympathetic NS also controls accomodation

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10
Q

Give examples of antimuscarinics used in ocular therapy?

A

Atropine
Cyclopentolate
Tropicamide

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11
Q

What is cycloplegia?

A

Loss of the ciliary muscle resulting in a loss of accomodation

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12
Q

What therapeutic effect does tropicamide have?

A

Mydriasis

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13
Q

When is cyclopentolate used?

A

To induce cycloplegia
For uveitis

  • Immobilised iris and relaxes ciliary muscle
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14
Q

Side effects of antimuscarinics?

A

Stinging on instillation
Raised intra-occular pressure
Photophobia and blurred vision
Dry mouth, flushing, confusion

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15
Q

How do you check if pupils are fully dilated?

A

Using a pen torch, pupils should not dilate any more?

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16
Q

What are the symptoms of acute angle closure glaucoma?

A

Red painful eye
Blurred vision
N&V
Headache

17
Q

What do parasympathomimeics do?

A

Mimic effect of ACh on muscarinic receptors
Open up drainage channels in trabecular meshwork
Reverse mydriasis in around 30 mins - lasts 6 hours

18
Q

Give an example of a parasympathomimetic?

A

Pilocarpine - used to treat glaucoma

19
Q

Side effects of pilocarpine?

A

Headache/browache
Burning/stinging on instillation
Myopia (short-sighted)
Risk of retinal detachment

20
Q

What are beta-blockers used for in ocular therapy?

A

Inhibit aqueous humour production

21
Q

Give an example of a beta blocker used for ocular therapy?

A

Timolol

22
Q

Name carbonic anyhydrase inhibitors

A

Acetazolamide (po / iv)

Dorzolamide

23
Q

Give examples of artificial tears and lubricants

A

Hypromellose - supplements aqueous layer

Carbomers (e.g. viscotears)- thixotrophic to prolong retention

Polyvinyl alcohol (e.g. liquifilm tears) - surfactant, good replacement for mucin layer

Ointments (e.g. lacrilube) - highly viscous so long lasting, causes blurred vision

24
Q

What agent would be used to show up areas of damage to conjunctiva or cornea?

A

Fluorescin

25
Q

What agents would be used to anaethetise the eye?

A

Proxymetacaine
Lidocaine

(avoid absorption byappling pressure to inner corner of eye)

26
Q

What agent is used to treat a superficial eye infection?

A

Chloramphenicol 0.5% eye drops

27
Q

Name other antibacterial preperations

A

Ciprofloxacin - pseudomonas infection and corneal ulcer

Fusidic acid - 2nd line to chlorampheniol for Staph infection

Gentamicin - pseudomonas infection

Levofloxacin - pseudomonas infection, corneal ulcer

Ofloxacin - pseudomonas infection, corneal ulcer

28
Q

Which drug’s toxicity can cause distrubance in colour vision?

A

Digoxin

29
Q

Which drug can cause halos and optic neurpathy?

A

Amiodarone

30
Q

How can anti-psychotics affect vision?

A

Blurred vision, corneal deposits

31
Q

How can rifampicin affect the eye?

A

Orange staining of tears

32
Q

How can TCAs affect the eye?

A

Anticholinergic effects (increased IOP, blurred vision, accomodation disturbance)

33
Q

SE of opioids?

A

Miosis

34
Q

Which drugs can cause cataracts and increased IOP

A

Long term use of steroids

35
Q

SE of antihistamines

A

Blurred vision, reduction in tears

36
Q

Which drug can cause optic neuritis causing loss of cisual acuity and macular degeneration?

A

Ethambutol

Week 130 - Sudden Visual Disturbance (4 decks)

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