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Therapeutics 2 - Exam 4 > ophthalmology > Flashcards

ophthalmology Flashcards

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1
Q

what is the purpose of the cornea?

A

primary absorptive site

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2
Q

what is the conjunctiva?

A

thin mucus membrane that covers the sclera

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3
Q

what is the main purpose of the ciliary body?

A

make aqueous humor

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4
Q

what is the nasolacrimal duct?

A

connection where the drug drains from the eye to the nasal cavity

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5
Q

what are all parts of the eye?

A

optic nerve
retina
sclera
vitreous
iris
lens
pupil
cornea

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6
Q

what is step 1 in administering eye drops and eye ointments?

A

wash hands with soap and water
remove contacts if applicable

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7
Q

what is the proper administration of eye drops?

A

1) wash hands. remove contacts
2) tilt head back. form pocket in lower eyelid
3) hold dropper to eye without touching it
4) look up and squeeze a singular drop into the pocket
5) close eyes for 2-3 minutes with head down
6) apply pressure to tear duct with finger

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8
Q

what is the proper administration of eye ointment?

A

1) wash hands. remove contact.
2) hold tube between thumb and forefinger and place near eye without touching it
3) tilt head back and form pocket of lower lid
4) squeeze into pocket
5) blink eye gently and then close for 1-2 minutes
6) wipe excess from eye
7) wipe tip of tube clean

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9
Q

what are some general rules about contacts when it comes to administration of ocular medications?

A

wait 15 minutes after eye drops to reinsert contacts
ointments are not recommended with contacts

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10
Q

how long should one wait between eye drops?

A

if same medication, wait 5 minutes
if different medication, wait 5-10 minutes

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11
Q

how long should one wait between two ointments?

A

30 minutes

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12
Q

how long should one wait between ointment and a drop?

A

use the drop first then wait 5-10 minutes

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13
Q

how is bacterial conjunctivitis presented?

A

redness
discharge
unilateral
purulent discharge (yellow, white, or green

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14
Q

what is the non-pharmacologic treatment of bacterial conjunctivitis?

A

avoid sharing products
remove contacts

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15
Q

what is the first line treatment of bacterial conjunctivitis?

A

antibiotics specifically polytrim and erythromycin

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16
Q

what does erythromycin treat?

A

staphylococci (bacterial) conjunctivitis

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17
Q

what does moxifloxacin and ofloxacin treat?

A

pseudomona conjuncitivitis

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18
Q

what does polytrim treat?

A

gram-negative and gram-positive (bacterial) conjunctivitis

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19
Q

what is the generic name of polytrim?

A

trimethoprim-polymyxin B

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20
Q

what does viral conjunctivitis present like?

A

watery eyes
burning, sandy, gritty feeling in the eye
both eyes

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21
Q

what is a common cause of viral conjunctivitis?

A

adenovirus (highly contagious)

22
Q

what is the non-pharmacologic treatment of viral conjunctivitis?

A

remove contact lenses until no discharge for 24 hours
avoid sharing products
warm or cool compress

23
Q

what is the pharmacologic treatment of viral conjunctivitis?

A

topical decongestants for acute use only - up to 72 hours
naphazoline or tetrahydrozoline

24
Q

how is allergic conjunctivitis presented?

A

bilateral redness
watery discharge
itching

25
Q

what are non-pharmacologic treatments of allergic conjunctivitis?

A

don’t rub eyes
cool compress
avoid contact with known allergen

26
Q

what are the pharmacologic treatments of allergic conjunctivitis?

A

depends on type
in general, antihistamines and mast cell stabilizers

27
Q

how is acute allergic conjunctivitis treated?

A

non-medicated artifical tears (to remove allergen and provide relief)
topical antihistamines/decongestant combination (pheniramine/naphazoline)
topical antihistamine with mast cell stabilizer properties (use prior to exposure if anticipated)

28
Q

how is seasonal allergic conjunctivitis treated?

A

topical antihistamine with mast cell stabilizer properties are preferred (start 2-4 weeks before anticipated onset of symtpoms)
ketotifen then olopatadine

29
Q

how does acute allergic conjunctivitis present?

A

sudden onset caused by environmental exposure to allergen (like cat dander)

30
Q

how does seasonal allergic conjunctivitis present?

A

onset developing over days to weeks in response to season allergens (like pollen)
frequently associated with rhinitis

31
Q

how does perennial allergic conjunctivitis present?

A

mild, chronic, waxing and waning allergic conjunctivitis related to environmental exposure to year-round allergens (like dust mites or mold)

32
Q

what are low corticosteroids?

A

dexamethasone 0.05%
dexamethasone 0.1%
medrysone 1%

33
Q

what are intermediate corticosteroids?

A

dexamethasone alcohol 0.1%
difluprednate 0.05%
fluorometholone 0.1%
fluorometholone 0.25%
loteprednol 0.2%
loteprednol 0.5%
prednisolone acetate 0.12%
prednisolone sodium phosphate 0.125%
prednisolone sodium phosphate 1%

34
Q

what are high corticosteroids?

A

fluorometholone acetate 0.1%
prednisolone acetate 1% (pred forte)
rimexolone 1%

35
Q

what is uveitis?

A

intraocular inflammation

36
Q

how does uveitis present?

A

patterned wagon wheel redness associated with iritis
dilated pupil
discomfort and sensitivity to light

37
Q

how is uveitis treated?

A

refer to opthalmologist or optometrist for 4-6 weeks long treatment

38
Q

what are some side effects of uveitis?

A

steroid toxicity –> secondary infections, secondary open-angle glaucoma, and increase intraocular pressure (IOP)

39
Q

how does dry macular degeneration present?

A

common over the age of 50 yo
90% of MD cases
bilateral
gradual loss of vision

40
Q

what is the treatment goal of dry macular degeneration?

A

slow progression
prevent severe visual impairment or blindness

41
Q

how are supplements related to macular degeneration?

A

used in dry MD
PreserVision AREDS Lutein and AREDS 2
contains beta-caroetene which has an increased risk of lung cancer in smokers

42
Q

how is macular degeneration treated?

A

with vascular endothelial growth factor (VEGF) inhibitors to slow disease progression and moderate gains in vision

43
Q

what are the basics of VEGF inhibitors?

A

antineoplastic agents typically used to treat certain forms of cancer and prevent tumors from creating blood vessels
drugs –> bevacizumab, ranibizumab, aflibercept, pegaptanib, verteporfin

44
Q

what are some side effects of VEGF inhibitors?

A

increased BP
retinal detachment
increased IOP
eye infection
vitreous floaters

45
Q

how is wet macular degeneration presented?

A

advanced care
vision loss may be rapid
loss of central vision due to abnormal growth of new blood vessels

46
Q

how is wet macular degeneration treated?

A

similar to age-related MD, but less focused on supplement usage

47
Q

what is the first step in treatment of dry eyes?

A

tear supplementation
warm compress
address environmental factors
d/c medications that may worsen dryness

48
Q

what is the second step in treatment of dry eyes?

A

topical treatment (secretagogoues –> lifitegrast and cyclosporine)
in office procedures

49
Q

what is the third step of treatment of dry eyes?

A

oral drug therapy? (antioxidants and omega-3 fatty acids)
sclera contact lenses
surgery
investigation drugs

50
Q

what are some non-pharmacologic treatments of dry eyes?

A

increase blinking frequency
schedule breaks from computer work or reading
warm compress
smoking cessation
humidifier
protective eyewear in windy environment
minimize exposure to wind or fans
sufficient oral fluid intake

Therapeutics 2 - Exam 4 (9 decks)

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