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OMS - 2 Neuro Final > Ophthalmologic Agents > Flashcards

Ophthalmologic Agents Flashcards

1
Q

Routes of administration of ocular drugs on the eye (5)

A
  1. Topical
  2. Oral
  3. Systemic (aka parenteral)
  4. Periocular
  5. Intravitreal
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2
Q

Topical drugs for the eye typically treat ____ diseases.

A

anterior segment

(cornea, conjunctiva, sclera, iris, ciliary body)

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3
Q

_____ barrier is a major barrier for anterior segment ocular drug delivery; _______ barrier is a major barrier for posterior segment ocular drug delivery.

A
  1. Blood–aqueous
  2. Blood–retinal

(systemic or parenteral route of administration)

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4
Q

______ or _____ routes are used to transport molecules through the choroid into deeper layers of the retina (due to blood-retina barrier)

A
  • oral
  • intravenous
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5
Q

Periocular and intravitreal drug administration is used to overcome ________

A

inefficiency of topical and systemic dosing for delivery to posterior segment

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6
Q

Topical medications must be dosed based on _____

A

pigmentation; some drugs can bind to melanin in the iris stroma

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7
Q

_______ or _____ is used for both angle closure glaucoma (emergency) and open angle glaucoma.

A
  • timolol
  • pilocarpine
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8
Q

_______ is used before surgery for angle closure glaucoma and ______ is used for open angle glaucoma.

A
  • carbonic anhydrase
  • pilocarpine

(timolol is used for both)

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9
Q

______ is a B2 blocker that treats glaucoma by acting on the ciliary blood vessels.

A

timolol & betaxolol

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10
Q

Timolol & betaxolol are contraindicated in patients who ______ (3)

(used to tx glaucoma)

A
  1. asthma
  2. bradycardia
  3. heart block
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11
Q

Latanoprost and travoprost promote aqueous humor outflow from the anterior chamber via the ______

A

uveoscleral pathway

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12
Q

Latanoprost & Travoprost are used to treat ______.

A

ocular hypertension

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13
Q

Latanoprost & Travoprost adverse reactions (3)

A
  1. darkening of iris pigmentation
  2. discolored eyelids
  3. eyelash thickening
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14
Q

Which ophthalmologic agent is contraindicated in pregnancy?

A

Latanoprost & Travoprost

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15
Q

Apraclonidine & Brimonidine MOA

A

a2 agonism → reduced aqueous production from ciliary body & increased uveoscleral outflow

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16
Q

Apraclonidine & Brimonidine contraindications (4)

A
  1. heart disease
  2. MAOI therapy
  3. closed-angle glaucoma
  4. hypertension
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17
Q

Apraclonidine & Brimonidine AE (5)

A
  1. oral dryness
  2. headache
  3. fatigue/drowsiness
  4. orthostatic hypotension
  5. vasovagal syncope

(sympathomimetics)

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18
Q

________ (3 Rx) that inhibit carbonic anhydrase → decreasing production of aqeous humor

A
  1. acetazolamide
  2. brinzolamide
  3. dorzolamide
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19
Q

Which ophthalmologic agent causes N/V, diarrhea and/or diuresis

A

carbonic anhydrase inhibitors

(acetazolamide, brinzolamide, dorzolamide)

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20
Q

Which ophthalmologic agent causes headache, brow ache, blurred vision and hypersalivation?

A

muscarinic agonists (pilocarpine)

(sympathomimetics causes oral dryness)

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21
Q

Pilocarpine contraindications (3)

A
  1. acute iritis
  2. anterior uveitis
  3. asthma
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22
Q

Pilocarpine MOA

A

M3 R activation → constricts ciliary muscles → drain aqueous humor

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23
Q

______ is used to treat resistant/serious cases of closed-angle glaucoma

A

mannitol and glycerol

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24
Q

Combined ______ ointment is often used prophylactically after corneal foreign body removal.

A

bacitracin-polymyxin

(treats both gram + and -)

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25
Q

The most effective broad-spectrum antibiotics for severe ocular infections are _____ (2)

A
  1. aminoglycosides
  2. cephalosporins

(most treated with a single abx)

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26
Q

Antibiotics with _____ should only be used under the direction of an ophthalmologist.

A

corticosteroids

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27
Q

_______ binds to the 50S ribosomal subunit → inhibit protein synthesis

A

erythromycin

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28
Q

Erythromycin ocular indications (4)

A
  1. corneal abrasion
  2. blepheritis
  3. post intraocular surgery
  4. post chalazeon removal
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29
Q

_________ bock protein synthesis at the 30S ribosomal subunit → inhibits initiation of peptide synthesis → misread of genetic code

A

aminoglycosides

(erythromycin blocks the 50S subunit)

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30
Q

Which ocular antibiotic is ineffective against anaerobes?

A

aminoglycosides

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31
Q

________ (antibiotic) is indicated for superficial eye infections.

A

aminoglycosides

32
Q

_____ inhibit bacterial DNA synthesis by inhibiting DNA gyrase and topoisomerase IV → rapid cell death

A

Fluoroquinolones

33
Q

Erythromycin is _______ (bacteriostatic/bactericidal), while fluoroquinolone and vancomycin are ________ (bacteriostatic/bactericidal).

A
  • bacteriostatic
  • bactericidal
34
Q

Which 2 antibiotics treat corneal ulcers?

A
  1. vancomycin
  2. fluoroquinolones
35
Q

Fluoroquinolone ocular indications (3)

A
  1. corneal ulcer
  2. pre-op prophylaxis
  3. bacterial conjunctivitis
36
Q

_______ blocks peptidoglycan synthesis → inhibits cell wall mucopeptide formation

A

Vancomycin

37
Q

_______ is an ocular antibiotic that treats gram positive multi-drug resistant organisms.

A

vancomycin

38
Q

Oral vancomycin treats _____and topical vancomycin treats _______.

A
  • orbital cellulitis
  • corneal ulcers
39
Q

Central corneal ulcers are treated with ________ and noncentral corneal ulcers are treated with ______.

A
  • vancomycin (gram +) and tobramycin (gram -)
  • Besifloxacin (fluoroquinolone)
40
Q

bacterial conjunctivitis is treated based on the _______.

A

organism

41
Q

______ are the first-line treatment for bacterial keratitis.

A

Fluoroquinolones

42
Q

Bacterial keratitis caused by gram positive cocci are treated with _______.

A

cefazolin

43
Q

Bacterial keratitis caused by gram negative bacilli are treated with _______.

A

tobramycin (aminoglycoside)

44
Q

_________ is used when bacterial keratitis is caused by an agent resistant to fluoroquinolones.

A

aminoglycoside and cephalosporin

45
Q

Erythromycin or _______ can be used to treat blepharitis.

A

bacitracin

46
Q

________ treats allergic conjunctivitis by stabilizing mast cells to prevent release of inflammatory mediators.

A

Cromolyn, nedocromil

47
Q

____ treats allergic conjunctivitis as an antihistamine (decreases eosinophil chemotaxis)

A

Ketotifen

48
Q

_______ is an NSAID (anti-inflammatory) used to treat allegic conjunctivitis.

A

Ketorolac

49
Q

Corticosteroids are used for pain relief of which ocular conditions (3)?

A
  1. corneal lesions
  2. uveitis
  3. keratoconjunctivitis
50
Q

Ocular corticosteroids (5)

A
  1. Diclofenac
  2. Detrolac
  3. nepafenac
  4. Bromfenac
  5. Flurbiprofen
51
Q

______ drops are used when inflammatory condition causes the dry eye syndrome.

A

Cyclosporine

(lubricating)

52
Q

Cyclosporine inhibits the growth of ______.

A

T cells

53
Q

_______ effective in treating herpes simplex viral ocular infections

A
54
Q

_________ treats viral ocular infection by inhibiting viral DNA synthesis

A

Trifluridine (Viroptic)

(tx: viral herpes symplex, NOT zoster)

55
Q

Acyclovir or gancyclovir treats herpes simplex keratitis or ______ can be used fro resistant disease or allergy.

A

Famciclovir

56
Q

In addition to acyclovir, famcyclovir and gancyclovir, ______ treats herpes simplex keratitis

A

Trifluridine

57
Q

Before starting acyclovir, famcyclovir, valacyclovir, you must _______.

A

assess renal function

58
Q

_______ is used for acyclovir resistant herpes zoster keratitits

A

Foscarnet

59
Q

Cidofovir is a ______ anti-viral agent and may cause _______ toxicity

A
  • broad-spectrum
  • renal
60
Q

______ is an antiviral used for CMV retinitis that may cause hematologic abnormalities (i.e. neutropenia, anemia, thrombocytopenia)

A

Gancyclovir

61
Q

________ is a prodrug of ganciclovir, but has higher bioavailability. It may cause hematologic and GI side effects.

A

Valacyclovir

62
Q

_______ is a pyrophosphate analog, which interferes with binding of the diphosphate to the viral DNA polymerase

A

Foscarnet

63
Q

Foscarnet may cause _______ toxicity.

A

nephron (kidney)

(cidofovir causes renal toxicity)

64
Q

_______ is a cardiac arrhythmia drug associated with optic neuritis

A

amiodorone

65
Q

Amiodorone side effects (3)

A
  1. visual field defect
  2. vision decrease
  3. whorl-shaped deposits on cornea
66
Q

Bisphosphates (tx of osteoporosis) may cause side effects (7)

A
  1. conjunctivitis
  2. scleritis
  3. uveitis
  4. orbital inflammation
  5. red eye
  6. photophobia
  7. decreased vision
67
Q

Chloroquines (tx malaria) ocular side effects (2)

A
  1. corneal deposits
  2. retinopathy
68
Q

Corticosteroid use: ocular side effects

A

posterior subcapsular cataracts

69
Q

Digoxin (Digitalis; antiarrythmic drug): ocular side effects (2)

A
  1. blurred vision
  2. abnormal color vision (yellow green halos)
70
Q

Ethambutol (tx TB): ocular side effects

A

optic neuropathy

(dose related)

71
Q

Cycloplegic/Mydriatic drugs allow for eye examination by ________(3).

A
  1. dilate the pupil
  2. paralysis of the ciliary muscle (cycloplegia)
  3. reduce drainage of aqueous humor
72
Q

Muscarinic antagonists (tropicamide, cyclopentolate, atropine) block ______ (eye structure)

A

parasympathetic control of iris sphincter muscle

73
Q

3 local anesthetics for the eyes (topical)

A
  1. proparacaine
  2. lidocaine
  3. tetracaine)
74
Q

2 Local infiltrative anesthetics for the eyes

(in addition to lidocaine and proparacaine which are also used topically)

A
  1. mepivacaine
  2. bupivacaine
75
Q

Fluorescein dye is administered with ______ to examine for corneal abrasion.

A

local topical anesthetic

76
Q

Eye Stinging, irritation and N/V are adverse effects of which ocular agent?

A

fluorescein dye

OMS - 2 Neuro Final (36 decks)

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