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Pharm Exam II > Opthalmic Drugs > Flashcards

Opthalmic Drugs Flashcards

1
Q

T/F: topical preparations have low local concentration and high systemic absorption

A

FALSE, its the opposite

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2
Q

why should you wait 5 minutes between giving eye drops?

A

because the excess spills over or drains through nasolacrimal duct (absorbed by mucous membranes or swallowed) which impacts efficacy

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3
Q

what is the solution to a horse trying to kill you because you’re treating them with topical opthalmic medication 12x/day?

A

subpalpebral lavage systems

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4
Q

what animal is known to have more tear production and therefore more “washing” of the eye surface?

A

horses

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5
Q

miosis is due to contraction of what muscle?

A

iris sphincter muscle

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6
Q

T/F: SNS effects will contract the ciliary body

A

FALSE, PSNS

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7
Q

a 1500 lb kodiak bear is chasing you!! your SNS takes action and relaxes the ciliary bodies of your eyes resulting in what kind of vision?

A

far vision, so you can get the hell out of there

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8
Q

mydriasis is due to contraction of what muscle?

A

iris dilator muscle

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9
Q

T/F: the PSNS results in production of aqueous fluid

A

FALSE, SNS

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10
Q

T/F: miotics result in pupil constriction which opens the drainage angle

A

TRUE

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11
Q

what kind of aqueous outflow does the PSNS increase?

A

uveoscleral aqueous outflow

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12
Q

when would you not want to use miotics?

A

when a patient has anterior uveitis or an anterior lens luxation

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13
Q

what miotic is used primarily for diagnosis of parasympathetic lesions?

A

pilocarpine (direct acting parasympathomimetic)

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14
Q

remember our good old friend atropine? what is it’s MOA?

A

direct acting parasympatholytic (anticholinergic)

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15
Q

what does atropine cause when used topically?

A

mydriasis and cycloplegia

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16
Q

cycloplegia

A

paralysis of ciliary muscle leading to blurred vision

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17
Q

what is the effect of applying atropine topically in a patient with uveitis?

A

can break up synechiae by forcing the pupil open (little attachments where fibrosis and scarring cause the iris to be stuck on the lens)

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18
Q

T/F: atropine lasts longer than glycopyrulate

A

FALSE, opposite

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19
Q

what animal would you be concerned with when using atropine topically (leading to cycloplegia)?

A

horses!! they can’t handle blurred vision

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20
Q

what topical opthalmic drug can cause cats to froth at the mouth when given drops?

A

cats because of bitter taste

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21
Q

which has a faster onset and shorter duration, tropicamide or atropine?

A

tropicamide

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22
Q

what is the main indication for tropicamide?

A

dilating the pupil for opthalmic (funduscopic) exams

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23
Q

which has more effective pain control, tropicamide or atropine?

A

atropine

24
Q

T/F: using tropicamide can alter a Schirmer’s tear test

A

TRUE, do Schirmer’s test FIRST

25
Q

what can tropicamide help prevent post cataract surgery?

A

adhesions

26
Q

what opthalmic drug is used commonly for diagnosis and localization of Horner’s syndrome?

A

phenylephrine

27
Q

why is phenylephrine sometimes used for perioperative use in cataract surgery?

A

reduction of posterior synechiae formation

28
Q

T/F: phenylephrine is a good choice when you want to cause adequate mydriasis in cats and horses

A

FALSE, unlikely, need to use in combination w/ another agent

29
Q

what opthalmic drug would you use to prevent glaucoma in the contralateral eye?

A

timolol (opthalmic nonselective beta-antagonist)

30
Q

what mechanism does brinzolamide use?

A

reversible inhibition of carbonic anhydrase which decreases aqueous humor production resulting in reduced IOP

31
Q

what do you need to be cautious of when using sulfonamide derivatives?

A

hypersensitivities to sulfa

32
Q

which stings more, dorzolamide or brinzolamide?

A

dorzolamide

33
Q

what is the effect of inhibiting carbonic anhydrase?

A

decreases aqueous humor production which results in reduced IOP

34
Q

what topical opthalmic is useful in treating glaucoma in dogs but is NOT effective in horses and cats?

A

topical prostaglandin analogs (i.e. latanoprost)

35
Q

what is the mechanism of prostaglandin agonists?

A

they increase uveoscleral outflow by stimulating FP (prostaglandin) receptors in the eye

36
Q

what topical opthalmic is often used in emergency management of glaucoma?

A

latanoprost

37
Q

what are natural tears made up of?

A

mucin, water, lipid film

38
Q

T/F: lacrimomimetic agents provide lubrication by perfectly replicating natural tears

A

FALSE, natural tears are complicated, not perfect replication

39
Q

what topical opthalmic drug is use in the treatment of canine KCS (keratoconjunctivitis sicca)?

A

cyclosporine (lacrimogenic agent)

40
Q

what are the two effects of cyclosporine?

A

increased tear production and local immunosuppression

41
Q

T/F: dry eye is usually immune-mediated

A

TRUE, why you use immunosuppressors to treat

42
Q

what is the purpose of using topical glucocorticoids?

A

to manage inflammatory and immune-mediated conditions (i.e. non-infectious keratitis, uveitis)

43
Q

what type of drug is deamethasone?

A

topical glucocorticoid

44
Q

T/F: prednisolone is a topical mineralcorticoid used to manage inflammatory and immune-mediated conditions

A

FALSE, = topical GLUCOcorticoid

45
Q

why is the use of topical glucocorticoids contraindicated in patients with corneal ulcers?

A

because it impairs healing, also don’t use w/ infection or diabetes

46
Q

when would you choose to use an NSAID vs. topical steroid?

A

when higher local concentration and lower systemic concentration is needed

47
Q

why are topical NSAIDS contraindicated in corneal ulcerations, glaucoma, and coagulopathies?

A

they can be irritating and cause burning/stinging

48
Q

what are two examples of topical NSAIDS?

A

flurbiprofen and diclofenac

49
Q

what are good topical opthalmic drugs to use for managing inflammation associated w/ cataracts?

A

topical NSAIDS (flurbiprofen, diclofenac)

50
Q

T/F: antimicrobial agents are typically used to treat opthalmic conditions including uveitis, conjunctival/corneal infectious diseases and inflammation

A

FALSE, only typically used to treat conjunctival and corneal infectious diseases

51
Q

what might you be concerned about when using antimicrobial agents as topical therapies?

A

they can circumvent systemic toxicity issues (i.e. aminoglycosides and polymyxin)

52
Q

T/F: antibiotics are typically used as adjunct/preventative therapy

A

TRUE

53
Q

what two antibiotics can cause a rare anaphylactic rxn in some cats?

A

polymyxin and bacitracin

54
Q

what are the potential adverse effects of antiviral agents?

A

bone marrow, hepatic, and renal toxicity

55
Q

cuddles is having some eye troubles and you want to measure his IOP with a tonal pen, what would you typically use to decrease his corneal sensation so you don’t lose a finger?

A

proparacaine (topical anesthetic)

Pharm Exam II (6 decks)

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