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Intro to Pharmacology > Ophthalmic Pharmacology > Flashcards

Ophthalmic Pharmacology Flashcards

1
Q

The ocular globe is protected by the _____ and _____ tissue and _______ structures

A

bony, soft, adnexal

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2
Q

Adnexal tissues of the eye include

A

Eyelids
* Nictitating membrane
* Conjunctiva
* Lacrimal glands
* Nasolacrimal system

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3
Q

The adenexal tissues of the eye function to?

A

Mechanical protection
and immune surveillance

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4
Q

Label the image accordingly

A
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5
Q

The globe is composed of three tunics:

A
  1. External, fibrous tunic (cornea and sclera) → It
    provides rigidity
  2. Middle vascular tunic (iris + ciliary body + choroid)
    → which provide blood supply, maintain the IOP,
    and control light entry to the retina
  3. Neural tunic (sensory retina) → signal
    transmission important for the visual function
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6
Q

External, fibrous tunic is composed of ? And functions to ?

A

(cornea and sclera) → It provides rigidity

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7
Q

Middle vascular tunic is composed of? Functions to?

A

(iris + ciliary body + choroid)
which provide blood supply, maintain the IOP, and control light entry to the retina

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8
Q

Neural tunic is composed of? Functions to?

A

(sensory retina) → signal transmission important for the visual function

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9
Q

The crystalline lens ________ light rays on the _______
retina→ optimal ________ power

A

focuses, sensory, focusing

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10
Q

Aqueous humor (AH) produced by the ______ ____
occupies the space between the _____ and the ____
(________ chamber), and nourishes the avascular ______ and _____

A

ciliary, body, cornea, lens, anterior, cornea, lens

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11
Q

Vitreous humor (VH) occupies the space between the _____ and _______ _____. It maintains _________ integrity of the __________ portion of the globe

A

lens, sensory, retina, structural, posterior

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12
Q

The globe may also be subdivided in:

A

➢ Anterior segment (structures anterior to the
junction of the retina and ciliary body)
➢ Posterior segment (structures posterior to this
junction

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13
Q

Name the two blood-ocular barriers. What is their main function?

A

The Blood-aqueous barrier and the Blood-retinal barrier. These barriers also impede entrance of many drugs

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14
Q

The Blood-aqueous barrier and the Blood-retinal barrier function to?

A

Both limit the entrance of blood components into the eye (WBC, RBC, large proteins, and lipid) –> Transparency of the ocular media necessary for vision

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15
Q

Intraocular inflammation _______ effectiveness of these barriers, allowing some drugs to enter the eye.

A

decreases

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16
Q

Autonomic ocular innervation

A

→ parasympathetic (ACh)
→ sympathetic (NE)

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17
Q

Make cards for this

A
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18
Q

Label accordingly

A
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19
Q

Which parts of the eye are parasympathetically innervated?

A

Parasympathetic innervation of:
* Lacrimal glands
* Iris sphincter muscle
* Extraocular muscles (control the movements of the eyes

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20
Q

Which parts of the eye are sympathetically innervated?

A

Sympathetic innervation of:
* Adnexal and orbital smooth muscle
* Iris dilator muscle
* Ciliary body (where AH is produced)
* Iridocorneal angle (ICA) structures (where AH drains)

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21
Q

Corneal epithelium: ?

A

lipophilic

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22
Q

Corneal stroma: ?

A

hydrophilic

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23
Q

Corneal endothelium: ?

A

lipophilic

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24
Q

Corneal epithelium: lipophilic
Corneal stroma: hydrophilic
Corneal endothelium: lipophilic

These layers limit?

A

IO movement of all but biphasic drugs

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25
Q

Medications can be altered by the ocular environment
to improve penetration. Example?

A

Prostaglandin analogues, are converted by sterases within the cornea → improving migration through the corneal layers

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26
Q
A

Enzymes can effect the ?

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27
Q

The _____-___ barriers are the major impediments to penetration of systematically administered drugs

A

blood-ocular

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28
Q

Which drugs can effectively penetrate noninflammed barriers?

A
  • Lipid soluble
  • Low molecular-weight
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29
Q

The hyaloideocapsular ligament located at the junction of the ________ lens capsule and ___________ _______.

A

posterior, anterior vitreous

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30
Q

The hyaloideocapsular ligament functions as a barrier to the movement of drugs between the _______ and the ______ segments of the eye. Disruption of this barrier (___ surgery or lens _______) increases:

A

anterior, posterior, IO, luxation
➢ Posterior movement of topically applied drugs
➢ Anterior movement of systemically administered drugs

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31
Q

List the drig factors influencing drug levels in ocular tissues

A
  1. Solubility
  2. pH
  3. Formulation
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32
Q

How does solubility influence drug levels in ocular tissues?

A

➢ Solubility
→ Biphasic drugs (topically administration)
→ Lipophilic drugs (systemically administration)

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33
Q

How does pH influence drug levels in ocular tissues?

A

➢ pH
→ Drugs formulated at physiological pH (7-7.4) avoid discomfort upon instilation (↑ drug availability)
→ Drugs formulated at nonphysiological pH need to be combined with buffers

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34
Q

How does drug formulation (solutions) influence drug levels in ocular tissues?

A

➢ Formulation

Solutions
Are generally easier to administer to small animals and may be administered to large animals
through subpalpebral lavage systems → by large dosing quantities, spillage over the lids may occur
* Volume of drops of commercially manufactured dropper bottles ranges from 25 μl to 70 μl
* Palpebral fissure of dogs and cats holds only approx. 30 μl

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35
Q

How does drug formulation (suspensions) influence drug levels in ocular tissues?

A

Suspensions
Are composed of larger particles suspended in an aqueous vehicle → minimally irritating

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36
Q

How does drug formulation (ointments) influence drug levels in ocular tissues?

A

Ointments
Contain drug within various viscous vehicles (petrolatum and lanolin). Advantages:
* Ability to administer lipid-soluble drugs
* Achieve a longer contact time with less drainage through the nasolacrimal system
Disadvantage: oily residue frequently remaining following administration

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37
Q

Medication to treat ocular disease are most commonly administered either _______ or _________/___________, with local ocular _______.

A

topically, orally/parenterally, injections

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38
Q

Which forms of injection are used only in specific circumstances?

A
  • Intracameral
  • Intravitreal
  • Suprachoroidal
  • Subconjuntival
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39
Q

Label the drug administration routes accordingly

A
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40
Q

Subconjuntival administration involves the injection into the space between the _________ and the _______.
Drugs will penetrate through the ________ and ______ or be absorbed by the __________ vasculature.

A

conjunctiva, sclera, sclera, cornea, conjunctival

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41
Q

Intracameral administration (_____ commonly used) involves the injection into the _______ chamber,
allowing the drug movement within the _________ environment → drainage from the eye with _____
→ This administration is associated with a ______ risk of ________ damage and ______ drug toxicity

A

less, anterior, intraocular, AH, high, iatrogenic, IO

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42
Q

Intravitreal administration involves the drug injection into the _________, which serves as a _____-term
reservoir

A

vitreous, long

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43
Q

Peribulbar or retrobulbar injection involves injection ________ the globe, and is reserved for placement of ________ around the globe to provide ______ and _______

A

behind, anesthesics, akinesia (no movement of eye), analgesia

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44
Q

The ocular/periocular injection should be used only with detailed knowledge of potential _____ ______ and _______ of the specific drug being injected

A

side effect, toxicities

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45
Q

Topical administration enables ____ levels of medication to be reached ______ (locations?)

A

high, locally, conjunctiva, cornea, and anterior chamber

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46
Q

Topical administration ___ systemic exposure thus ___ adverse drug reactions /interactions

A

↓ , ↓

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47
Q

Systemic (oral/parenteral) is indicated for the treatment of:

A
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48
Q

Posterior segment disease → presence of the _____ and ________ barriers

A

corneal, hyaloidecapsular

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49
Q

Glaucoma is a result of ________ pressure (IOP) is maintained by a balance between production and drainage of ____

A

Intraocular, AH

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50
Q

Production of AH by the _____ body occurs via _____ secretion → _______ ______ enzyme and _____-mediated mechanism
* Following production posterior to the ______, AH flows ______ through the ____ and drains
out of the eye via **_______ and _______ outflow at the _____________ angle (ICA)

A

ciliary, active, carbonic anhydrase, cAMP, pupil, anteriorly, pupil, conventional, unconventional, iridocorneal

**more important than unconventional

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51
Q

Conventional outflow through the trabecular meshwork into _____ vessels (majority of ___)

Unconventional (_________) outflow drains the ______ (____% in dogs, ___% in cats, ___-___% in horses)

A

scleral, HA, uveoscleral, remainder, 15, 3, 60-70

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52
Q

Glaucoma is characterized by ?

A

increased IOP

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53
Q

Glaucoma causes?

A
  • Retinal damage
  • Optic nerve damage
  • Vision loss
  • Variable degrees of discomfort
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54
Q

Glaucoma is always caused by ?

A

decreased drainage

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55
Q

What is the difference between primary and secondary glaucoma?

A
  • Inherent abnormality in the drainage angle itself → primary glaucoma
  • Obstruction of AH flow within or from the eye → secondary glaucoma
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56
Q

Medical treatment of glaucoma has the purpose to ?

A

decrease AH production or
to increase AH drainage

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57
Q
A

Topically administered ocular hypotensives available for use in veterinary ophthalmology

58
Q

Ttimolol and betaxolol are?

A

beta-blockers

59
Q

What is the function of beta-blockers in the eye?

A

β-blockers decrease AH production by an unknown mechanism → interaction with either
cAMP or Na+/K+-ATPase (or both)

60
Q

Beta-blockers are known to be absorbed?

A

systemically

61
Q

It is recommended to avoid using beta-blockers in ?

A

small dogs (i.e.,< 10 Kg) and cats, particularly in case of
cardiovascular disease

62
Q

List the Carbonic Anhydrase Inhibitors (CAIs):

A

Dorzolamide (2%), brinzolamide (1%), methozolamine (oral),
and acetozolamide (oral)

63
Q

Carbonic Anhydrase Inhibitors (CAIs) function to?

A

These agents decrease AH production by blockade of the carbonic anhydrase enzyme system
in the ciliary body epithelium

64
Q

Carbonic Anhydrase Inhibitors (CAIs) are able to decrease AH production via what mechanism?

A

The conversion of CO2 to HCO3- and the subsequent movement of H2O into the posterior
chamber is thus inhibited → decreased IOP

65
Q

What can be used to treat acute emergency glaucoma?

A

Carbonic Anhydrase Inhibitors (CAIs) can be used in the emergency treatment of acute glaucoma they can be used every 15-30 minutes

66
Q

Topical formulation of CAIs may cause?

A

local ocular discomfort upon administration

67
Q

Systemic side effects of CAIs include?

A

Systemic side effects generally do not develop with topical administration

68
Q

latanoprost, bimatoprost, and travoprost are?

A

Prostaglandin analogue

69
Q

latanoprost, bimatoprost, and travoprost function to?

A

These PG analogues decrease IOP by increasing uveoscleral (nonconventional) AH outflow
through activation of FP receptors

70
Q

Current PG analogues are ________ →administered form of the drug converted by corneal
esterases into the active form

A

prodrugs

71
Q

Clinically significant IOP reductions of 20-60% result from the administration of these agents in dogs

A
72
Q

Current PG analogues are ineffective in cats. Why?

A

ocular hypotensive effects in cats are mediated by EP receptors

73
Q

Prostaglandin analogues have have ___________ side effects (?) in horses

A

inflammatory, conjunctival hyperemia, miosis, flare

74
Q

List the side effects of prostaglandin analogues

A

Conjuntival hyperemia and moderate to marked miosis → these drugs are contraindicated in
most cases of secondary glaucoma

75
Q

Mannitol 20% (IV) and glycerol (oral) are ?

A

Hyperosmotic agents

76
Q

Administration of hyperosmotic agents causes the serum to become?

A

hyperosmotic to intraocular fluids → fluid movement from the AH and VH

77
Q

How is Mannitol administered?

A

Is administered IV (1g/Kg over 15-20 minutes), with coinciding water deprivation (for 4-6 h) postadministration → acute primary glaucoma only

78
Q

Glycerol (1-2 g/Kg orally) as a component of ________ -term management

A

long

79
Q

Side effects/contraindications
* Hyperosmotic agents are contraindicated in the presence of ?
* Systemic contraindications include: ?
* Glycerol may also induce _______ at higher doses

A

Side effects/contraindications
* Hyperosmotic agents are contraindicated in the presence of anterior uveitis
* Systemic contraindications include: cardiovascular disease, renal disease and diabetes
mellitus
* Glycerol may also induce vomiting at higher doses

80
Q

Use of hyperosmotic agents in veterinary ophthalmology is ?

A

limited

81
Q
A
82
Q

Parasympathomimetics: 1-2% pilocarpine is ____ acting and 0.125% - 0.25% demecarium bromide is _________ acting

A

direct, indirect

83
Q

Pilocarpine and demecarium bromidedrugs function to?

A

increase outflow by inducing miosis, thus widening the iridocorneal angle (ICA)
and incresing AH outflow

84
Q

Pilocarpine is generally indicated for administration ?

A

three to four times daily. It leads to 30-40%
IOP reduction in glaucomatous dogs

85
Q
  • The _______ pH of pilocarpine solutions causes irritation following topical administration
  • Due to the induction of ______, pilocarpine is contraindicated in patients with _____ and/or pupillary ____ glaucoma
A
  • The acidic pH of pilocarpine solutions causes irritation following topical administration
  • Due to the induction of miosis pilocarpine is contraindicated in patients with uveitis and/or
    pupillary block glaucoma
86
Q

The effect of parasympathomimetics on IOP is minimal compared to other classes of ocular
hypertensive agents

A
87
Q

Antiinflammatory therapy is important to minimize ________ effects of inflammation, and to preserve the ocular _____ and ______
➢ ______ antinflammatory therapy is indicated for treatment of ocular surface inflammation (2) and anterior segment inflammation (1)
➢ Systemic antinflammatories are indicated for treatment of ?

A

secondary, structure, function, Topical, conjunctivitis, keratitis, anterior uveitis, posterior uveitis

88
Q

Corticosteroids exert __________ effects through inhibition of the ________ acid cascade
* The location and severity of ocular inflammation determines the ___________ of administration
and drug ______
* Regardless of the ______ of inflammation, severely inflamed eyes may require dosing every __-___ hours and every __-__ h dosing for lesser degrees of inflammation

A

antiinflammatory, arachidonic, frequency, selection, location, 2-4 h, 8-12

89
Q

List the side effects of corticosteroids

  • Long-term topical administration may result in the formation of corneal _________
  • Systemic absorption may occur affecting coinciding ______ imbalances
  • Topical corticosteroids are contraindicated in the presence of corneal _______ → inhibit ________ of the wound → infections
A
  • Long-term topical administration may result in the formation of corneal deposits
  • Systemic absorption may occur affecting coinciding endocrine imbalances
  • Topical corticosteroids are contraindicated in the presence of corneal ulcer → inhibit
    reepithelialization of the wound → infections
90
Q
A
91
Q

Nonsteroidal antiinflammatory agents (NSAIDs) exert their effects by ________ the production of ___ through the ?
* Frequency of administration of topical NSAIDs depends upon the ____ of inflammation
* NSAIDs are considered ___ effective than topical corticosteroids in the treatment of ocular ____________ diseases
* _________ penetration of NSAIDs is variable. ______ agents are reported to have improved penetration

A

inhibiting, PG, constitutive cyclooxygenase-1 (COX-1) and the inducible cyclooxygenase-2 (COX-2), severity, less, inflammatory, Transcorneal, Newer

92
Q

List the side effects of NSAIDs

A
  • Safer to use in the presence of corneal ulceration than corticosteroids
  • Topical NSAIDs may inhibit reepithelialization of the cornea → associated with acute
    corneal melts
93
Q
A
94
Q

Ocular infections: antibacterial therapy
➢ Prophylactic
➢ Therapeutic

A
95
Q

Most of the ocular infections are caused by ?

A

pathogenic effects of normal ocular surface bacteria

96
Q

Normal ocular bacteria → predominantly gram- ______–> ?

A

positive, The appropriate antibiotic choice

97
Q

___________ _____ (gram-negative) → potent ocular pathogens

A

Pseudomonas aeruginosa

98
Q

General principles of antibacterial therapy:
* Prophylactic use for _______, _______ corneal ulcers
* Prophylactic use is indicated in association with ____ procedures in which ________ is involved
* Therapeutic use is indicated for _____, complicated _____ diseases
* Therapeutic use is indicated for ____________ __________
* Side effects, both ____ and ___, must be considered

A

superficial, uncomplicated, surgical, conjunctiva, infected, corneal, bacterial endophthalmitis, ocular, systemic

99
Q

Ability of a specific antibiotic (formulation) to reach desired site of infection (deep
cornea, anterior chamber)

A
100
Q

List the most common aminoglycosides used for antibacterial therapy

A

Aminoglycosides: tobramycin, gentamicin, and neomycin → topical solutions and oinments

101
Q

What is the spectrum of action of the aminoglycosides used for antibacterial therapy in ocular infections?

A

Spectrum:
gram-negative (principally), with gram-positive restricted to Staphylococcus aureu

102
Q

Aminoglycosides indications in antibacterial therapy

A

➢ Indication:
* Used as prophylaxis or therapy for ocular surface infection with variable intraocular
penetration
* Use is limited in patients with deep corneal infections. Gentamicin is used for chemical
ablation of the ciliary body (chronically glaucomatous eyes

103
Q

Side effects of aminoglycosides in antibacterial therapy for ocular infections

Low pH of gentamicin → is ______ irritating and may be ______. _____ and _______ reactions are more common with neomycin

A

Low pH of gentamicin → is locally irritating and may be painful. Allergic and hypersensitivity
reactions are more common to neomycin

104
Q

List the most common tetracyclines used for antibacterial therapy

A

oxytetracycline formulated with polymyxin B. Topical suspensions and oinments

105
Q

What is the spectrum of action of the tetracyclines used for antibacterial therapy in ocular infections?

A

➢ Spectrum:
* Good activity

106
Q

Tetracyclines indications in antibacterial therapy

  • It is useful for _______ or therapy for ocular _____ infections
  • Tetracyclines have shown increased _______ ______ wound healing
A
  • It is useful for prophylaxis or therapy for ocular surface infections
  • Tetracyclines have shown increased corneal epithelial wound healing
107
Q

Side effects of tetracyclines in antibacterial therapy for ocular infections.

A

➢ Side effects:
* Local ocular irritation may occur

108
Q

List the most common fluroquinolones used for antibacterial therapy

A

norfloxacin, ofloxacin, ciprofloxacin, levofloxacin, morifloxacin, gatifloxacin,
besifloxacin → topical solutions and oinments

109
Q

What is the spectrum of action of the fluroquinolones used for antibacterial therapy in ocular infections?

A

➢ Spectrum:
* gram-negative and gram-positive efficacy

110
Q

Fluroquinolones indications in antibacterial therapy

➢ Indication:
* Used as _______ or therapy for ocular _____ and _______ infections. Newer agents are indicated for _____ use only

A

➢ Indication:
* Used as prophylaxis or therapy for ocular surface and intraocular infections. Newer agents are indicated for therapeutic use only

111
Q

Side effects of fluroquinolones in antibacterial therapy for ocular infections.

  • The parenteral administration may cause retinal ____________ in cats → toxicity is _____- related. ____ cats are more susceptible
A

➢ Side effects:
* The parenteral administration may cause retinal degeneration in cats → toxicity is dose-
related. Aged cats are more susceptible

112
Q

List the most common Lincosamides and macrolides used for antibacterial therapy

A

: erythromycin oinment; clindamycin and azithromicin orally

113
Q

What is the spectrum of action of the Lincosamides and macrolides used for antibacterial therapy in ocular infections?

A

➢ Spectrum:
* Gram-positive efficacy (Chlamydophila felis, Mycoplasma ssp)

114
Q

Lincosamides and macrolides indications in antibacterial therapy

A

Used as prophylaxis or therapy for ocular surface infections

115
Q

Side effects of Lincosamides and macrolides in antibacterial therapy for ocular infections.

A

Local ocular irritation may occur (mild)

116
Q

Ocular infections: antifungal therapy
➢ The most frequent indication for antifungal agents is the treatment of fungal infections of the cornea (_________) in _____
➢ These infections are common in ____, ____ climates → ? (filamentous organisms)
➢ ____-ocular infection with _____ mycotic organisms occurs mostly in dogs

A

keratomycosis, horses, warm, humid, Aspergillus spp. and Fusarium spp., Intra, systemic

117
Q

List the most common Polyenes used for antifungal therapy

A

: natamycin, amphotericin B

118
Q

What is the spectrum of action of the polyenes used for antifungal therapy in ocular infections?

A

Both agents are considered broad spectrum

119
Q

Polyenes indications in antifungal therapy

A

➢ Indication:
* Polyenes have poor penetration following topical administration to a cornea with an intact
epithelium → used in confirmed ulcerative keratomycosi

120
Q

Side effects of polyenes in antifungal therapy for ocular infections.

A

➢ Side effects:
* Local ocular irritation is the primary side effect
* Systemic administration of amphotericin B may induce nephrotoxicity

121
Q

List the most common azoles used for antifungal therapy

A

voriconazole (formulation for IV injection); miconazole; itraconazole; ketoconazole;
fluconazole

122
Q

What is the spectrum of action of the azoles used for antifungal therapy in ocular infections?

A

Azoles are broad spectrum againts filamentous fungi

123
Q

Azoles indications in antifungal therapy

Administration of topical agents is indicated in cases of _________ and __________
keratomycosis

A

Administration of topical agents is indicated in cases of ulcerative and nonulcerative
keratomycosis

124
Q

Side effects of azoles in antifungal therapy for ocular infections.

A
  • Topical ocular irritation is generally minimal
  • Monitoring liver enzymes may be indicated in animals receiving oral azoles
  • Fluconazole has been implicated in prolonged recovery from anesthesia in horses
125
Q

The most commom indication for antiviral agents is the treatment of feline herpesvirus-1 (FHV-1) infections, which manifest as ______ _____ disease in cats.
Dogs and horses may experience ______ ocular surface disease → investigations into efficacy of antiviral agents towards canine and equine herpesvirus variants are ______ than those involving FHV-1

A

The most commom indication for antiviral agents is the treatment of feline herpesvirus-1 (FHV-1) infections, which manifest as ocular surface disease in cats.
Dogs and horses may experience herpectic ocular surface disease → investigations into efficacy of antiviral agents towards canine and equine herpesvirus variants are fewer than those involving
FHV-1

126
Q

List the most common pyrimidine analogs used for antiviral therapy

A

: trifluridine; idoxuridine

127
Q

Pyrimidines indications in antiviral therapy

A

As these agents exert their action on DNA synthesis, they are active when virus is actively
replicating. They are indicated by the presence of corneal and/or conjunctival ulceration

128
Q

Side effects of pyrimidines in antiviral therapy for ocular infections.

A

Topical ocular irritation

129
Q

List the most common purine analogs used for antiviral therapy

A

vidarabine; cidofovir; famciclovir; acyclovir; valocyclovir

130
Q

Purine analog indications in antiviral therapy

A

➢ Indication:
* They are used to treat FHV-1 and keratitis in horses due to equine herpesvirus-2

131
Q

Side effects of purine analogs in antiviral therapy for ocular infections.

A

➢ Side effects:
* Topical ocular irritation may occur
* Nasolacrimal punctal occlusion has been reported in people with cidofovir administration
* Acyclovir and valacyclovir should not be administered to cats (orally or topically) due to life-
threatening toxicities (kidney, bone marrow)

132
Q

Lacrimogenics are drugs that?

A

increase tear production

133
Q

Dogs with neurogenetics KCS keratoconjuntivitis sicca (KCS) are lacking ___________ input to
____________ ______.

A

neurological, lacrimal gland

134
Q

One agent that can be used for Dogs with neurogenetics KCS is Parasympathomimetic, a _______
Oral administration of the 2% ophthalmic solution → applied on the _____. Increases production of _______ gland.
Adverse effects
May be noted as dosing ______, resulting in signs of _________ overstimulation including
* Excessive ________
* _________
* ________
* __________

A

pilocarpine, food, lacrimal, increases, parasympathetic, salivation, Lacrimation, Urination, Defecation

135
Q

Mydriatics are drugs that ____ the pupil → indicated for diagnostic examination

A

dilate

136
Q

Cycloplegic are drugs that _____ ciliary body muscle)→ therapy of anterior ____

A

paralize, uveitis

137
Q

List the most common sympathomimetics used for ocular therapy (pupillary dilation).

A

epinephrine; phenylephrine

138
Q

Sympathomimetic indications in ocular therapy

A

➢ Indication:
* prior to intraocular surgery, and to diagnose Horner‘s syndrome
* Their efficacy as mydriatic agents is less than that of parasympatholitic agent

139
Q

Side effects of sympathomimetics in ocular therapy. Which side effect is the most common?

A

➢ Side effects:
* Ocular surface irritation may occur (most common)
* Systemic absorption may induce systemic hypertension
* Use should be limited in patients with preexisting cardiovascular disease b/c epi and phenyl affects cardiovascular rate and systemic pressure.

140
Q

Parasympatholytics : 0.5-1% tropicamide; 1% atropine
Mydriatics and cycloplegics
* They induce __________ blockade of ____ sphincter and _____ body muscles → _______ while producing ______
* Relative efficacy also depends upon iridal ________ → ______ serves as a reservoir for drug, _______ onset of action and _____ duration in _____ pigmented versus ____ pigmented
eyes.
➢ Side effects:
* ______
* Temporary reduction in aqueous ___ ____ production
* _______ may occur due to mydriasis

A

anticholinergic, iris, ciliary, mydriasis, cycloplegia, pigmentation, pigment, slowing, prolonging, heavily, poorly, Salivation, tear film, Photophobia

141
Q

Local anesthetics, such as (4)
- Topical local anesthetics are used to provide _____ and _____ anesthesia → routine diagnostic and therapeutic procedures: ___ collection, and ____ or _____ surgery
* Following administration of a single drop in dogs of proparacaine, anesthetic effect is noted
within ___ minute, reaching maximal effect within ___ minutes (total duration ___ minutes)
* ________ administration in horses has a dose-dependent effect.
➢ Side effects:
* ________ causes transient tear film instability → repeated dosing may result in epithelial keratitis.
* All local anesthetics inhibit ______ ______ formation and corneal ________.
* ________, _____ anesthetics are contraindicated as therapy for any ocular surface disease
(diagnostic setting).

A

0.5% proparacaine; 0.5%, 1% tetracaine; butacaine; dibucaine

corneal, conjunctival, cytology, corneal, intraocular, one, 15, 45, Tetracaine, Proparacaine, blood vessel, epithelialization, Topical local

Intro to Pharmacology (31 decks)

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