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Pharmacology > Ophthalmic > Flashcards

Ophthalmic Flashcards

1
Q

Fluorescein is used to

A

detect dendritic figures is herpes keratitis

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2
Q

diminished tear production or anatomical abnormalities in delivery of tears to the surface of the eye

A

keratoconjunctivitis sicca

aka xerophthalmia

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3
Q

MC cause of keratoconjunctivitis sicca

A

contact lens wear

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4
Q

complications of untreated keratoconjunctivitis sicca

A

cornea ulceration or ocular infx

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5
Q

What is recommended when prescribing artificial tears

A

use preservative free!

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6
Q

Topical cyclosporine 0.05% sol’n (Restasis) is used to tx

A

keratoconjunctivitis sicca

doesn’t get absorbed systemically so minimal s/e, which included stinging and redness

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7
Q

non-pharmacologic interventions for keratoconjunctivitis sicca

A

1) avoid anticholinergics
2) smoking cessation
3) warm compress
4) take breaks from reading/looking at electronic devices
5) oral omega-6 FA (EPO), esp. in females with contacts

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8
Q

Viral conjunctivitis is usually associated with _________, whereas bacterial conjunctivitis is usually associated with _________

A

1) URI (i.e. adenovirus)

2) Staphylococcus

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9
Q

Allergic conjunctivitis mild tx

A

cool compress + antihistamine/decongestant + lubricant

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10
Q

Allergic conjunctivitis moderate tx

A

cool compress + antihistamine/decongestant + lubricant + mast cell stabilizer

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11
Q

Allergic conjunctivitis severe tx

A

cool compress + antihistamine/decongestant + lubricant + mast cell stabilizer + steroid + NSAID

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12
Q

Ocular decongestants include

A

1) Tetrahydrozoline (Visine)

2) Naphazoline (Clear Eyes, Vasocon, Naphcon, Naphcon Forte (Rx))

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13
Q

Ocular decongestant MOA

A

constricts dilated arterioles of conjunctiva

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14
Q

Ocular decongestant/antihistamine combos

A

1) Antazoline/Naphazoline (Vasocon A)

2) Pheniramine/Naphazoline (Naphcon A, Opcon A)

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15
Q

Ocular Antihistamines include

A

1) Azelastine hydrocholride (Optivar)
2) Emedastine (Emadine)
3) Olopatadine (Patanol (Rx), Pataday (Rx))

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16
Q

Ocular Antihistamine MOA

A

blocks H1 receptor sites

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17
Q

Ocular Mast Cell Stabilizers include

A

1) Ketotifen (Zaditor, Alaway (also an antihistamine))
2) Cromolyn Sodium (Crolom, Opticrom)
3) Nedocromil Sodium (Alocril)

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18
Q

Which mast cell stabilizer is also an antihistamine?

A

Alaway

Ketotifen

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19
Q

Ocular NSAIDs include

A

1) Ketorolac (Acular and Acular LS)
2) Diclofenac Sodium (Voltaren)
3) Flurbiprofin (Ocufen)
4) Suprafen (Profenal)

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20
Q

Which microorganisms are associated with mucopurulent ocular d/c?

A

the bacteria S. aureus, S. epidermidis, and Strep. pneumoniae

21
Q

Which microorganisms are associated with purulent ocular d/c?

A

the bacteria N. gonorrhoeae

22
Q

Drug(s) of choice for tx bacterial conjunctivitis

A

1) 0.3% Tobramycin (Tobrex)

2) Polymyxin B/Trimethoprim (Polytrim)

23
Q

Drug(s) used to tx more severe bacterial conjunctivitis infx

A

1) 0.3% Ofloxacin (Ocuflox)

2) 0.3% Ciprofloxacin (Ciloxan)

24
Q

If you don’t see improvement in ________ days after starting to tx bacterial conjunctivitis

A

2-3 days

25
Q

What are the ocular aminoglycosides?

A

topical antibiotics

1) Gentamicin
2) Neomycin
3) Tobramycin

26
Q

What are the ocular fluoroquinolones?

A

broad-spectrum topical antibiotics

1) Ciprofloxacin
2) Ofloxacin
3) Gatifloxacin
4) Moxifloxacin

27
Q

____________ are indicated for confirmed ocular gonococcal or chlamydial disease

A

IV antibiotics b/c these are systemic infx

28
Q

Erythromycin ointment is reserved primarily for ____________

A

prophylaxis of neonatal gonococcal and chlamydial infx

problems with Strep. pneumonia and H. influenzae resistance

29
Q

Drug(s) of choice for HSV keratitis?

A

Trifluridine (VIROPTIC) topical sol’n

*tx should not exceed 21 days

30
Q

Drug(s) used to tx CMV keratoconjunctivitis (aka CMV retinitis)

A

1) Ganciclovir (CYTOVENE)
2) Cidofovir (VISTIDE)
3) Foscarnet (FOSCAVIR)

*if retinal lesions are life-threatening use intravitreal injection of ganciclovir or foscarnet

31
Q

First line tx for primary open-angle glaucoma

A

1) Beta blockers to decrease aqueous production

2) Prostaglandin analogs to increase aqueous outflow

32
Q

Adjunctive agents for tx of primary open-angle glaucoma

A

1) Brimonidine (alpha-adrenergic agonist)
2) Topical carbonic anhydrase inhibitors (CAIs)

*Both of these agents decrease aqueous production

33
Q

Second line tx for primary open-angle glaucoma

A

1) Pilocarpine (parasympathomimetic)
2) Dipivefrin or epinephrine (sympathomimetic)
3) Apraclonidine (sympathomimetic)

*All of these agents decrease aqueous production

34
Q

What is the MC BB used in tx of primary open-angle glaucoma?

A

Timolol

nonspecific

35
Q

Which nonspecific BB is/are used to tx primary open-angle glaucoma?

A

1) Timolol (MC)
2) Levobunolol
3) Metipranolol

nonspecific are more effective b/c we have both alpha and beta receptors in eye

36
Q

Which specific BB is/are used to tx primary open-angle glaucoma?

A

1) Betaxolol (B1)
2) Carteolol (B1 and B2)

(less effective than nonspecific BB)

37
Q

Which ocular BB have lower risk of systemic s/e

A

1) Betaxolol

2) Carteolol

38
Q

With most topical ocular drugs we are not very concerned w/ s/e. However, with _________ we do see systemic s/e.

A

Beta blockers

can see CV effects (decr. HR, decr. BP, conduction defects) and pulmonary effects (bronchospasm)

39
Q

Topical timolol caution

A

can potentially worsen CHF

40
Q

What is the #1 prescribed prostaglandin analog for primary open-angle glaucoma?

A

Latanoprost (Xalatan)

41
Q

BB local s/e

A

stinging

42
Q

prostaglandin analog local s/e

A

iris pigmentation

ocular irritation

43
Q

Alpha-2 Adrenergic Agonist local s/e

A

allergic type reaction

44
Q

Alpha-2 Adrenergic Agonist systemic effects

A

dizziness, somnolence, dry mouth, decreased BP, decreased pulse

45
Q

Alpha-2 Adrenergic Agonist cautions

A

CV disease, renal compromise, cerebrovascular dz, diabetes

Pt. taking: antihypertensives, CAD drugs, MAO inhibitors, tricyclic antidepressants

46
Q

What are the topical carbonic anhydrase inhibitors (CAIS) commonly used to tx primary open-angle glaucoma

A

1) Dorzolamide (Trusopt)
2) Brinzolamide (Azopt)

*Acetazolamide (Diamox) can also be used, however it is a systemic formulation

47
Q

T/F: Topical carbonic anhydrase inhibitors (CAIS) are a first-line tx for primary open-angle glaucoma

A

FALSE

they are rarely used as an initial therapy

48
Q

Topical carbonic anhydrase inhibitors (CAIS) MOA

A

reduces IOP by decreasing bicarbonate production (by inhibiting carbonic anhydrase) resulting in 40-60% decrease in aqueous humor secretion

49
Q

Topical carbonic anhydrase inhibitors (CAIS) local s/e

A

ocular burning, stinging, discomfort, and allergic rxn, bitter taste

*generally well-tolerated

Pharmacology (14 decks)

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