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1. Pharmacology > Ophthalmic medications > Flashcards

Ophthalmic medications Flashcards

1
Q

Advantages of ointments

A

Long contact time
Not diluted via tear film
Softens ocular discharge and crust
Helps prevent symblepharon
Less expensive

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2
Q

Disadvantages of ointments

A

Interferes with corneal epithelial lining
Add to discharge
Contact dermatitis
Dosing not precise
Difficult to sterilize and apply

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3
Q

Advantages of suspension (drops)

A

Less disturbance of vision, incident for contact derm, and less toxic to interior of eye
Easier application

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4
Q

Disadvantages of suspension (drops)

A

Short contact time, dilutes with tears, more expensive, shaking required, greater potential for systemic absorption

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5
Q

Antimicrobials

A

Triple antibiotic
Chloramphenicol
Tetracyclines
Erythromycin
Gentamicin/ Tobramycin
Ofloxacin/ ciprofloxacin/ moxifloxacin
Cefazolin

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6
Q

MOA for most antimicrobials

A

Inhibits bacterial protein synthesis by binding to 30S ribosomal subunits

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7
Q

Which antimicrobials are Mycoplasma and Chlamydophils sensitive to?

A

Tetracyclines, Erythromycin, Ofloxacin/ ciprofloxacin/ moxifloxacin

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8
Q

Triple antibiotic

A

Neopoly and Polymyxin B = gram -
Bacitracin and Gramicidin=gram +

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9
Q

Chloramphenicol uses

A

Deep and infected/melting corneal ulcerations or intraocular infections
Penetrates intact cornea

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10
Q

_______________ is resistant to Chloramphenicol and tetracyclines

A

Pseudomona aeuginosa

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11
Q

Tetracyclines

A

Bacteriostatic

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12
Q

Erythromycin

A

Targets gram +
Penetrates cornea
Use: Conjunctivitis

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13
Q

Gentamicin/ tobramycin

A

Targets gram -
Bactericidal
Poor intraocular penetration
Use: Ciliary body ablations (CBA)

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14
Q

Ofloxacin/ ciprofloxacin/ moxifloxacin

A

MOA: Inhibits DNA gyrase and prevents viral DNA synthesis
Bactericidal
Use: complicated corneal ulcers

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15
Q

Cefazolin

A

MOA: Destroys cell wall of bacteria
Bactericidal
Mix with sterile saline artificial tears (topical) or use intra operatively (IV)

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16
Q

Gram _________ are resistant to cefazolin

A

Negative

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17
Q

Anti-fungal administration

A

Topical, systemic, intranasal, IV

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18
Q

Antifungal marked for ophthalmic prep

A

Natamycin- attacks filamentous fungi and yeast

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19
Q

Azoles (anti-fungal)

A

MOA: destroys cell wall by inhibiting cytochrome P450
drugs ending is azole- micaonazole, voriconazole, etc

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20
Q

Silver sulfadiazine

A

Broad spectrum anti-fungal + Antiviral

21
Q

Antivirals

A

Idoxuridine
Cidofovir
Trifluridine
Adenine Arabinoside

22
Q

Idoxuridine

A

MOA: competes with thrymidine for incorporation of viral DNA
Virostatic, admin. 4-8 x a day

23
Q

Cidofovir

A

MOA: inhibits viral replication by inhibiting viral DNA synthesis
Administer 2x a day, expensive

24
Q

Anti-inflammatories MOA

A

Glucocorticoids blocks both cyclooxygenase and lipopoxygenase pathways
NSAIDs block the cyclic endoperoxidases (PGs)
compounded for ophthalmic use

25
Q

Uses for anti-inflammatories

A

Preserve corneal transparency
Extra-ocular inflamm. diseases (keratitism conjunctivitis)
Uveitis
Reduced leukocyte accumulation

26
Q

Adverse effects of anti-inflammatories

A

↓ corneal epithelial healing time, keratocyte proliferation and collagen, neovascularization, capillary permeability, vasodilation
Activates collagenase (digests cornea)
Interferes with host defenses
Corneal opacities

27
Q

Steroids

A

Interferes with inflamm. mediators like arachidonic acid
Neopolydex (extraocular disease), dexamethasone SP, prednisolone aceate (corneal penetration)

28
Q

NSAIDs

A

Inhibits synthesis of enzymes (cyclco-oxygenase, endoperoxide isomerase, PGs)
Ketorolac, diclofenas, flurbiporfen

29
Q

Anti-glaucoma medications

A

Block aqueous humor pathway
Carbonic anhydrase inhibitors, beta blockers, latanoprost/ bematoprost/ travprost, demecarium bromide, pilocarpine

30
Q

Carbonic anhydrase inhibitors

A

Dorzolamide
Causes irritation and mild blepharitis
Combined with timolol

31
Q

Beta blockers

A

Timolol: nonselective, caution in animals with cardiac disease of asthma, prevents glaucoma
Betaxolol: Selective

32
Q

Latanoprost/ bematoprost/ travprost

A

MOA: PG analog and miotic
Emergency glaucoma, trans-corneal reduction procedure for lens luxations

33
Q

Effects of latanoprost/ bematoprost/ travprost

A

Causes miosis and prevents lens from entereing the anterior chamber (don’t use if already in chamber)

34
Q

Demecarium bromide

A

Parasympathomimetic
Inhibits AChE and pseudocholinesterase
Indirectly causes miosis due to constriction of iris sphincter muscles, aiding in outflow of humor

35
Q

Pilocarpine MOA

A

MOA: cholinergic muscanaric receptor agonist→ contracts ciliary body, ↑ outflow of humor and stimulates tear gland directly if nerve damage

36
Q

Pilocarpine use

A

Neurogenic keratoconjunctivitis sicca
Adverse: hypersalivation, urinating, V/D
Orally or topically

37
Q

Tear stimulators

A

Cyclosporine
Tacrolimus
Artificial tears and lubrications (I-drop vet gel, optixcare, AnHyPro, GenTeal)

38
Q

Cyclosporine and Tacrolimus MOA

A

Reduces inflamm. associated with tear production, suppresses T cell function
Calcineurin inhibitor
Immunosuppressive

39
Q

Cyclosporine and tacrolimus uses

A

KCS, pannus, immune mediated keratitis and excessive vasculature pigment

40
Q

Mydratics

A

Atropine
Tropicamide
Epinephrine and phenylephrine

41
Q

Atropine

A

ACh muscarinic receptor blocker, relaxes iris and ciliary body sphincter muscles
Therapeutic drops for pain
Wash hands after use

42
Q

Beware of using atropine in what animals?

A

Horses and cats

43
Q

Tropicamide

A

Same MOA as atropine
Dilates for OFA exams, ERGs, pre-op cataract surgery

44
Q

Epinephrine and phenylephrine

A

Sympathomimetic
Causes vasoconstriction of vasculature and reduces bleeding during procedures

45
Q

Anticollangenases

A

Serum (a2 macoglobulin)
EDTA (binds to Ca)
Amonion drops
Doxycycline
N-acetylcysteine

46
Q

Amonion drops

A

Promotes cell migration and epithelialization
Medical management for desmetocele
Lubrication and anti-inflamm properties

47
Q

Atracarium

A

Neuromuscular paralytic
Aids in cataract surgery so eye doesn’t move while extracting lens fibers

48
Q

NaCl ointment or suspension (Muro)

A

Hyperosmotic solution that draws fluid from the cornea (corneal edema)
Endothelial degeneration

49
Q

Tissue Plasminogen Activator (TPA)

A

Dissolves fibrin in aqueous humor
Reduces synechia, glaucoma, or cataract formation
Post-op to control inflammation

1. Pharmacology (29 decks)

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