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Year 2 > Opthalmology pharmacology > Flashcards

Opthalmology pharmacology Flashcards

1
Q

What are the two requirements for topical ocular drugs?

A

Ability to act on the surface of the eye

Ability to penetrate the cornea

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2
Q

The epithelium of the cornea is hydrophilic and the stroma of the cornea is hydrophobic. T/F

A

False:
Epithelium = hydrophobic/lipid loving
Stroma = lipophobic/water loving

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3
Q

Which type of drugs penetrate the corneal epithelium and stroma respectively?

A

Epithelium - lipid soluble

Stroma - water soluble

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4
Q

Which ocular antibiotic possesses both lipophilic and hydrophilic qualities?

A

Chloramphenicol

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5
Q

What can alter the properties of the epithelium and in what way?

A

Inflammation can cause the epithelium to become more hydrophilic

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6
Q

What can alter the properties of the stroma and in what way?

A

The tear film can cause the epithelium to become more hydrophobic

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7
Q

How can topical steroids be altered to make them more 1) hydrophobic and 2) hydrophilic?

A

1 - alcohol/acetate

2- phosphate

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8
Q

When does prednisolone acetate penetrate the cornea best?

A

When it is uninflamed

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9
Q

When is prednisolone acetate used?

A

Post-operatively

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10
Q

When does prednisolone phosphate penetrate the cornea best?

A

When it is inflamed

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11
Q

When is prednisolone phosphate used?

A

In corneal disease or when low dose steroids are required

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12
Q

What chemical can alter the properties of the tear film? What else is it useful for?

A

Benzalkonium (makes it less hydrophobic). Also a preservative

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13
Q

Where can excess topical ocular drugs get systemically absorbed? How can this be halted?

A

Nasopharynx (via nasolacrimal duct). Punctal occlusion for five minutes

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14
Q

Other than topical, what are some routes of administration?

A

Subconjunctival, subtenons, intravetral, intracameral

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15
Q

Name some frequently used ocular antibiotics

A

Chloramphenicol, gentamicin, ofloxacin

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16
Q

Name an ocular antiviral

A

Zovirax

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17
Q

What are the types of anti-inflammatory agents used in the eyes?

A

Steroids, topical NSAIDs, anti-histamines and mast cell stabilisers

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18
Q

When are steroids used?

A

Post-op cataract surgery
Uveitis
Prevention of corneal graft rejection

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19
Q

What steroid is typically used in uveitis?

A

Prednisolone acetate

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20
Q

What are the local effects of steroids?

A

Cataract, glaucoma and exacerbation of viral infection

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21
Q

What are the systemic effects of steroids?

A

Osteoporosis, weight gain, gastric ulcers, immunosuppression

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22
Q

How is temporal arteritis treated?

A

Oral steroids

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23
Q

List the strengths of topical steroids from weakest to strongest

A

Fluorometholone (FML) >
Predsol (prednisolone phosphate) >
betamathasone >
dexamethasone/prednisolone acetate

24
Q

When are anti histamines or mast cell stabilisers used?

A

Hayfever, allergic conjunctivitis

25
Q

When might topical NSAIDs be used?

A

For pain e.g post laser surgery

26
Q

What is glaucoma?

A

A group of diseases which bring about progressive and irreversible optic neuropathy (often with raised IOP) resulting in visual field defects

27
Q

What is the only modifiable risk factor for glaucoma?

A

Raised IOP

28
Q

How does glaucoma typically present?

A

Asymptomatic

29
Q

Who screens for glaucoma?

A

Optometrists

30
Q

What is the relationship between glaucoma and age?

A

Glaucoma increases with age

31
Q

What are the categories of glaucoma medication?

A 
Prostanoids
Beta blockers
Carbonic anhydrase inhibitors
Alpha2 adrenergic agonist
Parasympathomimetric
Combination
32
Q

Name a prostanoid medication

A

Latanoprost

33
Q

Name beta blockers used in glaucoma

A

Timolol, betaxolol, levobunolol, carteolol

34
Q

Name a topic and systemic carbonic anhydrase inhibitor

A

Topical - dorzolamide

Systemic - acetazolamide

35
Q

Name an alpha2 adrenergic agonist

A

brimonidine

36
Q

Name a parasympathomimetric

A

pilocarpine

37
Q

Name a combination medication for glaucoma

A

dorzolamide and timolol (cosopt)

38
Q

What are the side effects of alpha2 agonists?

A

Red eye

39
Q

What is the main side effect of parasympathomimetric?

A

Night blindness

40
Q

Name three scenarios in which intra-vitreal injections are used

A

Antibiotic delivery in endopthalmitis
Intra-ocular steroids
Anti-VEGF in wet macular degeneration

41
Q

How does local anaesthetic work in the eye?

A

Blockage of sodium channels responsible for nerve conduction

42
Q

List scenarios when local anaesthetic would be used

A

Foreign body removal
Tonometry
Corneal scraping
Comfort

43
Q

What is a side effect of local anaesthetic?

A

Limited healing

44
Q

List scenarios where diagnostic dye would be used

A

Detecting corneal abrasions
Tonometry
Detecting nasolacrimal duct obstruction
Angiography

45
Q

What do mydriatic drugs do?

A

Dilate the pupil

46
Q

How do mydriatic drugs work?

A

Block parasympathetic supply to the iris

47
Q

What are the side effects of mydriatic drugs?

A

Vision blurring

AACG (acute angle closure glaucoma)

48
Q

What do sympanometrics do?

A

Dilate the pupil

49
Q

How do sympanometric drugs work?

A

Act on the sympathetic nerves suppling the iris causing them to dilate

50
Q

Do sympanometric drugs affect the accomodation reflex?

A

No

51
Q

Name some sympanometric drugs

A

Phenylephrine, atropine

52
Q

Name some mydriatic drugs

A

Tropicamide, cyclopentolate

53
Q

What is a side effect of the epilepsy medicine vigabatrin?

A

Constricted visual fields

54
Q

What is a side effect of the TB drub ethambutol?

A

Optic nerve neuropathy

55
Q

What is a side effect of the antimalarial/DMARD drug hydroxychloroquine?

A

Bullseye maculopathy when used long term

56
Q

What is a side effect of amiodarone?

A

Corneal verticillata

Year 2 (72 decks)

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