Optha 1

Question 1

what are anesthetics

Answer 1

• reversible block of conduction through nerve fibers

- topic agents: proparacaine!!, tetracaine

Question 2

what are sympathomimetics

Answer 2

• alpha-agonists
• suppress aqueous production = lowers iop
• brimonidine
• decongests the conjunctival blood vessels

Question 3

what are beta antagonists/beta blockers

Answer 3

• suppress aqueous production = dec iop
• blocks beta 1 and 2 receptors in ciliary body
• timolol contra: asthma, copd, chf, arrythmias
• betaxolol: cardioselective beta1 antagonist

Question 4

what are cholinergics

Answer 4

• improves outflow
• direct acting muscarinic parasympathomimetic
• causes miosis
• increases axial length of lens
• increases permeability of blood-aqueous layer
• cheapest

Question 5

what are carbonic anhydrase inhibitors

Answer 5

• inhibits carbonic anhydrase = decrease aqueous production
• oral has many side effects, give as drops
• dorzolamide, brinzolamide

Question 6

what are prostaglandin analogs

Answer 6

• enhances aqueous outflow through uveroscleral pathway
• mainstay, first line, long acting
• “-prost”
• se: conjunctival hyperemia, darkening of lids, can change color of irises, thickening lashes

Question 7

what are hyperosmotics

Answer 7

• increase serum osmolality

- draws water from the eye

Question 8

moa of steroids

Answer 8

• inhibit phospholipase a2

- reduces production of prostaglandins and leukotrienes

Question 9

ocular complications of steroids

Answer 9

• glaucoma (gag accumulation in tm)
• cataract
• delayed wound healing
• enhanced microbial proliferation

Question 10

steroids available

Answer 10

• dexamethasone phosphate/alcohol
• prednisone acetate
• flurorometholone
• loteprednol

Question 11

moa of nsaids

Answer 11

• inhibits cyclooxygenase

- reduced prostaglandins, no effect on leukotrienes

Question 12

examples of nsaids

Answer 12

• ketorolac, diclofenac (anesthetic effect)

- nepafenac or nevanac

Question 13

indications for antibacterials

Answer 13

• conjunctivitis
• central microbial keratitis
• other external eye infection

Question 14

gram positive antibiotics

Answer 14

• try not to use
• chloramphenicol, erythromycin, sulfacetamide
• 2nd to 4th gen fluoroquinolone

Question 15

gram negative antibiotics

Answer 15

• basic polypeptides
• aminoglycosides
• neomycin, gentamicin, tobramycin

Question 16

broad spectrum antibiotics

Answer 16

• fluoroquinolones: ofloxacin, ciprofloxacin, moxifloxacin

Question 17

antiviral drugs

Answer 17

• ganciclovir: inhibits dna polymerase, less stinging and burning
• acyclovir: inhibits dna polymerase

Question 18

indications for antifungal drugs

Answer 18

• fungal keratitis

Question 19

types of antifungal drugs

Answer 19

• polyenes: binds to ergosterol and plasma membrane
• imidazoles: inhibit ergosterol synthesis, direct cell membrane damage
• flucytosine: blocks fungal thymidine synthesis

Question 20

what is natamycin

Answer 20

• only antifungal available
• poor ocular penetration, needs debridement
• can lead to toxicity

Question 21

anti-allergy drugs

Answer 21

• 1st gen ah: weak, for symptom relief; pheniramine, antazoline with naphazoline
• 2nd gen ah: blocks h receptor and icam-1, first aid; emedastine
• mast cell stabilizer: blocks histamine release; cromolyn sodium, pemirolast, ledozamide
• combination drops: olopatadine, ketotifen, epinastine, azelastine