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Pharmacology Test 2 > Ophthalmics > Flashcards

Ophthalmics Flashcards

1
Q

uses of glucocorticoids

A 
inflammation caused by:
allergic conjunctivitis
superficial keratitis
iritis
post op
corneal injury
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2
Q

ADRs of glucocorticoids

A

glaucoma, loss of visual acuity, delayed wound healing, secondary infection, dry eyes, corneal ulcers, systemic side effects

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3
Q

Examples of glucocorticoids

A

*Dexamethasone (C)- soln, susp, oint
*Prednisolone (C) - soln, susp
Flurometholone (C)- soln, susp
Rimexolone (C)- susp
loteprednol

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4
Q

steroid + antibiotic combos

A

polymyxin B + neomycin+ dexamethasone (C)

used for inflammation due to infection

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5
Q

use for NSAIDs

A

inflammation post op

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6
Q

NSAIDs MOA

A

inhibit prostaglandin synthesis

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7
Q

NSIADs precautions

A

cross sensitivity with aspirin

bleeding if absorbed systemically

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8
Q

NSAIDs ADRs

A

burning, stinging, itching, allergic reactions, blurred vision, dryness

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9
Q

Examples of NSAIDs

A

Ketorolac (C) - for allergic conjunctivitis itching, post cataract surgery inflammation
Diclofenac (B)
Flurbiprophen (C)- inhibition of intraoperative miosis

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10
Q

uses for Antibiotics

A

superficial ocular infections such as conjunctivitis, keratitis, blepharitis, corneal ulcers

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11
Q

All ophthalmic antibiotics effective against

A

staph, strep, h. influenza

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12
Q

sulfonamides effective against

A

E. coli, Klebsiella, enterobacter

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13
Q

sulfonamides examples

A

Sulfacetamide (C)- soln, oint

4x per day - low compliance

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14
Q

macrolides

A

erythromycin (B)- used in eyes of newborns, oint

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15
Q

fluoroquinolones ADRs

A 
white crystalline precipitates
bitter taste
corneal staining
decreased vision
lid margin crusting
lid edema
tearing
photophobia
DO NOT USE IN CHILDREN UNDER 18
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16
Q

fluoroquinolones Examples

A

all end in oxacin, all (C) solns

norfloxacin, ciprofloxacin, gatifloxacin, ofloxacin, moxifloxacin

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17
Q

aminoglycosides ADRs

A

localized toxicity, localized hypersensitivity, lid edema, lid itching

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18
Q

aminoglycosides examples

A

gentamycin (C) - soln, oint

tobramycin (C)- soln, oint

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19
Q

advanced macrolides example

A

azithromycin (C) soln

broad spectrum, very compliant, long half life, expensive

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20
Q

combo products examples

A

polymyxin B + neomycin + bacitracin
polymyxin B + trimethoprim (good for kids)
polymyxin B + bacitracin

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21
Q

uses of mydriatics, cycloplegics

A

only in office pre-procedures to dilate pupils (anticholinergics)

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22
Q

mydriatics/ cycloplegics ADRs

A 
increase IOP
burning, stinging
conjunctivitis
allergic lid reactions
blurred vision
light sensitivity
dry mouth
tachycardia
headache
hallucinations
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23
Q

Examples of mydriatics/cycloplegics

A

tropicamide (C)- short duration

atropine (C) up to 24 hours, usually avoided

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24
Q

Lubricants examples

A

used for dry eyes

artificial tears, Celluvisc, Tearisol, Refresh, Adsorbanac, Muro 128, Duratears Naturale, Lacrilube, Hypotears,

25
Q

Antihistamines uses

A

prevention and relief of eye from symptoms of allergic conjunctivitis

26
Q

Antihistamine MOA

A

stabilize mast cells and/or block H1

27
Q

Histamine H1 blockers

A

*Levocabstine (C)

Emedastine (B)

28
Q

Mast Cell Stabilizers

A

*Cromolyn (B)
Lodoxamide
Nedcromil

29
Q

Combo H1 blockers/ Mast Cell Stabilizers

A

*Olopatadine
Azelastine
Epinastine
Ketotifen

30
Q

MOA for mixed receptor adrenergic agonists

A

α1 agonist: Contraction of radial dilator pupillae muscle → stretch trabecular meshwork → ↑ outflow of aqueous humor → Decreased IOP
α2 agonist: Bind to presynaptic α2 receptor → inhibits NE release → Decreased NE binding to beta receptors → Decreased secretion/production of aqueous humor from ciliary body → Decreased IOP

31
Q

Precautions in mixed receptor adrenergic agonists

A

HTN, CVD (α1 agonist activity will exacerbate these conditions)
DM, asthma (α2 agonist activity with subsequent beta-blocking activity will exacerbate these conditions)

32
Q

ADRs for mixed receptor adrenergic agonists

A

Local: stinging, burning, allergic reactions
Systemic: headache, tachycardia, HTN

33
Q

examples of mixed action adrenergic agonists

A

Dipivefrin (Propine)

34
Q

α2 agonist MOA

A

Bind to presynaptic α2 receptor → inhibits NE release → Decreased NE binding to beta receptors → Decreased secretion/production of aqueous humor from ciliary body → Decreased IOP

35
Q

α2 agonist precautions

A

DM, asthma, depression, orthostatic hypotension

36
Q

α2 agonist ADRs

A

Local: stinging, burning, redness, itching
Systemic: tachycardia, headache, CNS effects, dyspepsia, cough

37
Q

α2 agonist example

A

Brimonidine (Alphagan)

38
Q

beta blocker MOA

A

Block beta receptor in ciliary body → Decreased secretion/production of aqueous humor from ciliary body → Decreased IOP

39
Q

beta blocker precautions

A

Contraindicated in: asthma, COPD, sinus bradycardia

Precautions: CVD, DM, hyperthyroid, angle closure glaucoma

40
Q

beta blocker ADRs

A

Local: itching, burning, keratitis, visual distrubances
Systemic: CVS, CNS, pulmonary, DM, nausea,

41
Q

beta blocker examples

A 
“olol” ending - all (C)
Levobunolol (Betagan)
Carteolol (Ocupres)
Timolol (Timoptic)
Betaxolol (Betoptic)
42
Q

direct muscarinic agonist MOA

A

Contraction of circular constrictor pupillae muscle → stretch trabecular meshwork → ↑ outflow of aqueous humor → Decreased IOP

43
Q

direct muscarinic agonist precautions

A

Contraindicated in: acute iritis & uveitis
Precautions:
CVD, asthma, PUD, GI spasm, Parkinson’s Disease

44
Q

direct muscarinic agonist ADRs

A

Local: edema, clouding, burning, stinging, retinal detachment, visual disturbances
Systemic: SLUDGE

45
Q

direct muscarinic agonist examples

A

Pilocarpine (Pilocar) (C)

carbachol (C)

46
Q

carbonic anhydrase inhibitors MOAs

A

Inhibition of carbonic anhydrase II in the ciliary processes of the eye → decreased aqueous humor secretion → Decreased IOP

47
Q

carbonic anhydrase inhibitors precautions

A

Sulfonamide derivative – same potential ADRs as sulfonamide antibiotics

48
Q

carbonic anhydrase inhibitors ADRs

A

Local: burning, stinging, blurred vision
Systemic: Sulfonamide ADRs, headache, metallic taste

49
Q

carbonic anhydrase inhibitors examples

A

Dorzolomide (Trusopt)

** available with timolol in combination product called Cosopt**

50
Q

prostaglandin analogs MOA

A

Increased outflow of aqueous humor via uveoscleral route → Decreased IOP

51
Q

prostaglandin analogs precautions

A

Irreversible eye pigment changes

52
Q

prostaglandin analogs ADRs

A

Local: blurred vision, burning, stinging, eye pigment changes
Systemic: URI, muscle pain, rash

53
Q

prostaglandin analogs examples

A

Latanoprost (Xalatan)

54
Q

sympathomimetics examples

A

Oxymetazolone (B)
naphazoline (B)
tetrahydrozoline (B)
phenylephrine (B)

55
Q

sympathomimetics MOA

A

alpha 1 agonist, vasoconstriction/ decongestant

56
Q

antivirals examples

A

Herpes Keratitis Tx:
*Vidarabine (C)
*Trifluridine (C)
Idoxuridine (C)

CMV retinis Tx:
ganciclovir implant
fomiversin (C) inj

57
Q

antifungals examples

A

*Natamycin susp

Amphotericin (B)

58
Q

immunomodulators example

A

Cyclosporine (C)

used as anti-inflammatory for keratoconjunctivitis and chronic dry eye

Pharmacology Test 2 (7 decks)

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