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Pharmacology II > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the uses of proparacaine/tetracaine?

A

Topical local anesthetics

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2
Q

How does fluorescein stain work?

A

Stains the exposed stroma because the defect makes it hydrophilic. A normal cornea is lipophilic, so if fluorescein stain(hydrophilic) gets through, you know there is a defect
It will also stain mucous

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3
Q

What are you blocking with an auriculopalpebral nerve block?

A

You are blocking the motor function of the auriculopalpebral nerve to the orbicularis oculi which prevents blinking

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4
Q

What is the onset and duration of tropicamide?

A

Onset is 20-25 minutes

Duration: 4-6 hours for small animals, up to 12 hours for horses

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5
Q

Where do you give topical medications?

A

Anterior segment disease

Conjunctival and corneal epithelium = barrier

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6
Q

Where do you give subconjunctival medications?

A

Bypasses corneal epithelium for transcorneal absorption

Diffuses directly into cornea and sclera

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7
Q

Where do you give systemic medications?

A

Retina
Choroid
Periocular and retrobulbar tissues

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8
Q

Where do you give intracameral medications?

A

Anterior chamber

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9
Q

Where do you give intravitreal?

A

Endophtalmitis

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10
Q

What are the 5 most common routes used to treat ocular disease?

A 
Topical
Subconjunctival
Systemic
Intravitreal
Implants
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11
Q

What are the pros and cons of tobramycin?

A

Pros:
Staph susceptible
Least epitheliotoxic
More effective against Pseudomonas than gentamicin

Cons:
Strep is not susceptible which is the cause of most ulcers

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12
Q

What are the pros and cons of gentamicin?

A

Pros:
Good for gram negative infections
Conjunctivitis, blepharitis, and dacryocystitis

Cons:
Epitheliotoxic
0.3% inadequate for serious bacterial keratitis (but it can be fortified with parenteral formulations)

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13
Q

What are the pros and cons of ofloxacin?

A 
Pros:
Great corneal penetration
Now less expensive
Available as a generic formulation
Useful for infected ulcers

Cons:
Overuse encourages resistance

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14
Q

What are the pros and cons of Bacitracin/neomycin/polymyxin B?

A

Pros:
Excellent first choice
Bactericidal
Effective against many pseudomonas spp.

Cons:
Some resistance

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15
Q

What are the pros and cons of cefazolin?

A

Pros:
Great for staph and strep
Great for ulcers that are progressive because it gets the staph and strep that other drugs can’t get

Cons:
Don’t have a topical formulation (though it is easy to make)

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16
Q

Which medications are anti-proteases?

A

Anticollagenase agents:
Tetracyclines
EDTA
Serum

17
Q

What is keratomycosis?

A

Corneal fungal infection that mostly occurs in horses

18
Q

What are the common antifungals?

A

Azoles:
Fluconazole
Itraconazole/DMSO (compounded)
Voriconazole (intracorneal or subconjunctival)

Polyenes:
Natamycin
Nystain (poor)
Amphotericin B (intracorneal or subconjunctival)

Imidazoles:
Miconazole (compounded)
Ketoconazole

Silver sulfadiazine

19
Q

What are the 2 best steroid preparations for getting high concentrations into the eye?

A

Prednisolone acetate 1% (gold standard)

Dexamethasone alcohol

20
Q

Which steroid preparations will not be well-absorbed through intact cornea?

A

Dexamethasone sodium phosphate

Hydrocortisone

21
Q

What are the contraindications/precautions against topical ophthalmic use of a steroid?

A

Should not be used when the cornea is compromised

Can cause adrenocortical suppression especially in dogs less than or equal to 15 kgs

22
Q

What are indications for using topical NSAIDs?

A

Minor intraocular inflammation:
—Lens induced uveitis
—Mild anterior uveitis (especially in cats- chronic management)
—Allergic conjunctivitis
Pain control (post-operative, corneal, uveitis)
Less side effects
Necessary when there is corneal compromise

23
Q

What are 5 topical NSAIDs?

A 
Flubiprofen
Diclofenac
Ketorolac
Nepafenac (new)
Bromfenac (new)
24
Q

How does mannitol work to help treat glaucoma?

A

Causes rapid decrease of IOP with 1-2 hours if it works

Dehydrates the vitreous

25
Q

What are the primary indications for latanoprost?

A

Primary glaucoma in dogs

26
Q

What is the mechanism of action of latanoprost?

A

Decreases pressure quickly and increases uveoscleral outflow

27
Q

What is the drug class of latanoprost?

A

Prostaglandin analogue

28
Q

What are indications for timolol?

A

Primary and secondary glaucoma

29
Q

What is the mechanism of action of timolol?

A

Reduces IOP by 3-5 mmHg

30
Q

What is the drug class of timolol?

A

β-blocker

31
Q

What is the indication for dorzolamide?

A

Primary or secondary glaucoma

32
Q

What is the mechanism of action for dorzolamide?

A

Decrease production of aqueous humor

33
Q

What is the drug class of dorzolamide?

A

Carbonic anhydrase inhibitor

Pharmacology II (18 decks)

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