Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Opthamology > Ophtho Pharm > Flashcards

Ophtho Pharm Flashcards

1
Q

Wait how long between different ocular medications?

A

10minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When applying drops and ointment to the eyes which comes first?

A

apply drops first and then ointment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How long can you keep preservative and preservative free eye medication?

A

Preservative- 1 mo after opening

Preservative free- 1wk after opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Flurescein

  • indications
  • how to use
A
  • detect foerign bodies in the eye, abrasions, ulcers, infection, herpatic dendrites
  • a piece of blotting paper w/ dye is touched to surface of eye. Dye coats tear film. Blue woods lamp, any problems on the surface of the cornrea will be stained by the dye and appear green under the blue light.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of combo anesthetic and fluoroscein medications?

A
  • flluoroscein/Benoxinate
  • -eyeflur, fluress, flurox
  • Fluorescein/Proparacaine
  • -flucaine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indications for topical anesthetics

A
  • measurement of IOP
  • removal of foreign bodies and sutures from the cornea
  • facilitate exam of the eye
  • for anesthesia for surgical procedures
  • temporary pain relief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of Topical Anesthetics and MOA

A
  • Proparacaine (Alcaine)
  • Oxybuprocaine AKA Benoxinate(Novesin, Novesine)
  • Tetracaine (altacaine, Tetcaine, TetraVisc)

MOA:
-block initiation and conduction of nerve impulses by decreasing the neuronal membranes permeability to NA, K, and other ions resulting in inhibition of depolarization»> blockade of conduction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Topical Anesthetics

  • duration to onset
  • duration
A

-very short acting, within seconds

-10-20 minutes
except Tetracaine 30mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SE & CI of Topical Anesthetics

A 
-stinging
SE
-irritation
-hypersensitivity rxn
-prolonged use may slow healing

CI

  • any hypersensitivity to anesthetics
  • liver disease
  • dry eye
  • perforating eye( of globe) injury
  • if pt taking anticholinesterases, specifically drugs to treat myasthenia gravis, alzheimers, and glaucoma. * can make your eyes more dry
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What will you never do with ocular topical anesthetics?

A

-write a Rx, because you lose the protective pain reflex and may continue to damage the cornea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clyclopegics

  • what are they?
  • what are they used for?
  • MOA
A
  • Atropine (Isopto Atropine)
  • Scopolamine (Isopto Hyoscine)
  • Homatropine
  • Clyclopenolate (Cyclogyl)
  • Mydriacyl (Tropicamide)
  • this one is mixed with amphetamine causing vasoconstriction, will have longer duration of action.

-used to dilate the eye

-Moa:
block action of Ach resulting in paralysis of the ciliary muscles» dilation of the pupil
*anticholinergic or antimuscarinic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clycloplegic indications of use

A
  • dilation before eye examinations*
  • before and after eye surgery
  • provide pain relief to patient with corneal abrasion and iritis/uveitis. (every time the eye constricts or dilates this causes pain, this drug takes away vasoconstriction reducing their pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CI of Clycloplegics

Cautions of Cycloplegics

A
  • angle closure glaucoma
  • people with narrow angles
  • these angles are where the canal of schlemm resides, if this becomes blocked fluid is unable to drain causing increased intraocular pressure.

Caution:
-children and elderly patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most potent cycloplegic? How long is it duration of action?

A

Atropine

- 12days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Scopolamine duration?

A

wears off within 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Homatropine duration

A

-wears off in 1-3 days

17
Q

Tropicamide and Cyclopentolate

  • use
  • duration
A

used only for diagnostic testing

-duration of 6hrs

18
Q

SE of Cycloplegics

A
  • blurred vision
  • burning or stinging
  • eye irritation
  • increased sensitivity of eyes to light
  • swelling of the eyelids

Systemic side effects: (if too much medication is used)

  • clumsiness
  • confusion
  • dryness of skin
  • fast/irregular HR
  • fever
  • skin rash
  • slurred speech
  • thirst or unusual dryness of mouth
  • drowsiness
19
Q

Medications for Allergic Conjunctivitis

A
  • decongestants
  • antihistamines
  • NSAIDS
  • Mast Cell stabalizers
20
Q

Decongestants

  • MOA
  • indications
  • OTC drugs, SE, & CI
A

MOA: cause pupil dilation, increase outflow of aqueous humor and vasoconstriction

Indications:
-allergic conjunctivitis: redness of conjunctiva, increased tearing, itchiness, burning sensation, blurred vision

-OTC:
Naphazoline/Pheniramines maleate (Visine A, Naphcon-A, Opcon-A)
Naphazoline Hydrochloride (Murine)
-SE: burning, blurred vision, pupil dilation
-CI: use longer than 2weeks, pt w/ narrow anterior chamber angles or narrow-angle glaucoma

21
Q

Antihistamines

  • Prescription and OTC
  • SE
  • Can contact wearers use these?
A

-Prescription:
olopatadine (pantanol, pataday)
bepotastine (Bepreve)
Alcaftadine (Lastacraft)

OTC: 
Aselastine (Optivar) 
Epinastine (Elastat) 
Pemirolast (Alamast) 
Ketotifen
  • SE: Eye irritation, stinging* (sting the most) upon instillation of drops
  • yes, they just need to take out their contacts when applying the medication and wait at least 10minutes after medication to wear contacts.
22
Q

Mast Cell Stabalizer

  • medication name
  • indication
  • SE
A
  • Comolyn Sodium (Opticrom)
  • allergic conjunctivitis
  • SE:
  • burning, dry eyes
  • not many systemic SE, good for children
23
Q

Antihistamine/Mast Cell Stabilizer Combo

A

Azelastine (optivar)
Epinastine (Elestat)
Ketotifen (Zaditor, Claritin Eye, Zyrtec Itchy Eye)
Oloptadine (Pantanol, Pataday)

24
Q

MOA of Antihistamine/Mast Cell Stabalizer

A

competes with histamine for H1 receptor sites on effector cells and inhibits the release of histamine and other mediators involved in the allergic response.

25
Q

SE of Mast Cell/Antihistamine combos

A

burning, stinging, dry eye, HA, blurred vision

26
Q

NSAIDs for allergic conjunctivitis

  • MOA
  • use
A

-inhibits the synthesis of prostaglandin by decreasing the activity of the enzyme cyclooxygenase

-UNIQUE!! You normally dont think about using NSAID in allergy but in this case we do.
decrease inflamm and itching associated with allergic conjunctivitis.

27
Q

Antibiotic Classes

A 
sulfonamides
fluoroquinolones
aminoglycosides
macrolides
polypeptides
28
Q

Sulfonamides

  • MOA
  • Indications
  • effective against what type of bacteria?
  • SE
  • drug name
A

MOA- inhibits synthesis of folic acid, folic acid important for bacterial cell wall membranes
Bacteriostatic: it inhibits the further reproduction of more bacteria.

Indications:

  • lid infections
  • conjunctivitis
  • corneal abrasion, ulcer
  • prevent infection after removing foreign bodies

Effective: gram-negative bacteria–pneuomocystitis carinii and some gram-positive bacteria (Staph aureus)

SE:
-local irritation, stinging, burning

CI- sulfa allergy

Drug name: sulfacetamide

29
Q

Fluoroquinolones

  • MOA
  • Indications
  • Protects against what type of bacteria?
  • SE
A

MOA- inhibits DNA synthesis & is bactericidal

Indications;

  • lid infections
  • conjunctivitis (not 1st line)
  • corneal abrasion, ulcer
  • prevent infection after removing foreign bodies
  • if pseudomonas infection is suspected

-Protects against gram-negative organisms:
H. flu, P. aeruginosa, Neisseria gonorrheoa, chlamydia

SE:
burning, stinging, foreign body sensation, photophobia

30
Q

What patients need to be protected against pseudomonas especially?

A

-If you are thinking corneal ulcer this is your go to for those who wear contacts. It kills pseudomonas, this is the bug you are trying to catch in contact lens wearers. Pseudomonas is water loving and the contact lens cleaner may inhabit pseudomonas.

31
Q

Name the broadest and narrowest coverage of bugs in the flouroquinolone class.

A

Narrowist: ciprofloxacin (Ciloxan)

Broadest: Moxifloxacin Vigamox)

32
Q

Aminoglycosides

  • MOA
  • General recommendation
  • Indications
  • Types
  • SE
A

MOA-Bind to ribosomes and inhibit RNA synthesis

Recommendation-Don’t use these in primary care! they can cause toxiticty and these patients probably need a higher level or care.

Indications

  • Lid infections
  • conjunctivitis
  • corneal abrasion, ulcer
  • prevent infections after removing foreign bodies
  • usually used in combination with a bata-lactam antibiotic due to resistance

Types

  • Gentamycin (Garamycin)
  • Tobramycin (tobrex)
  • Neomycin *high incidence of allergy to neomycin in the general population

SE

  • burning, itching, erythema
  • can be toxic to corneal epithelium and can cause a reactive keratoconjunctivits after several days of use. Refer!
33
Q

Macrolides

  • MOA
  • Indications
  • Types
A

MOA

  • inhibits tRNA synthesis
  • bacterostatic (it inhibits the further reproduction of more bacteria. )

Indications:

  • lid infections
  • conjunctivitis
  • corneal abrasion, ulcer
  • prevents infections after removing foreign bodies
  • used as prophylaxis of gonococcal ophthalmia Neonatroeum*** (unique)
  • given to babies to cover for eye infections after vaginal birth, ok for any age group

Types:
erythromycin ointment (cheaper)
azithromycin drop

34
Q

Polypeptides: Bacitracin Ointment

  • MOA
  • indications
A

MOA- inhibits bacterial cell wall synthesis (s. aureaus, streptococcus pneuomoniae, H. flu)

Indications:

  • lid infections
  • conjunctivitis
  • corneal abrasion, ulcer
  • prevent infections after removing foreign bodies
35
Q

Polypeptide: Trimethoprim Sulfate & Polymyxin B Sulfate (Polytrim)

  • MOA
  • indications
A

MOA- bactericidal

IIndications:

  • lid infections
  • conjuncitivits
  • corneal abrasions, ulcer
  • prevent infection after removing foreign bodies
  • ** can cover pseudomonas
  • not as good as cipro, if pt has lenses then use cipro.
36
Q

Ophthalmic Abx Tx:

  • how to prescribe?
  • what is the drug of choice for corneal ulcers or for contact lens users to treat pseudomonas?
  • avoid _____ d/t toxicity to the corneal epithelium, this may cause what?
A

start w/ cheapest drug w/ best coverage: erythromycin or polytrim

  • FLUOROQUINOLONES**
  • aminoglycosides, reactive keratoconjuncitvitis
37
Q

ointment or drops have a higher frequency of application?

A

drops

38
Q

Herpes of the Eye

  • tx
  • drugs
  • what does this look like?
A

-always refer to Ophtho

  • idoxuridne (Dendrid)
  • Trifuridine (Viroptic)
  • Vidarabine (Vira-a)

-fern. alien, dendrite

39
Q

Antivirals:
-what medications might you see on a med list that would lead you to believe the pt has herpetic infection of the eye.

SE of these drugs.

A

Idoxuridine (dendrid)

Trifuridine (Viroptic)

Vidarabine (Vira-a)

  • all cause burning stinging sensation

Opthamology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions