optho drugs exam 3 Flashcards

1
Q

what are the ways we increase drug absorption across the cornea? (there are many)

A

frequent (slow elimination), high doses, lipophilic, unionized, decrease corneal thickness, increase [] to a point, increase contact time

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2
Q

when is systemic drugs most prefered

A

anterior segment, ulcers that rupture through the membrane, maybe corneal stroma-depends on inflam

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3
Q

what are 2 of the systemic drugs that reach high [] in the eye

A

minocycline and enrofloxacin

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4
Q

what are the two antifungals we administer systemically for ocular use?

A

fluconazole, voriconazole

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5
Q

it is best to send patient home with a ______(solution or ointment)

A

ointment because they increase contact time and have to be given less frequently

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6
Q

polymixin B. what bacti? what route?

A

G- bacteria. almost exclusively topical because it is nephrotox (maybe ok for endotoxemia)

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7
Q

bactitracin/gramicidin. what bacti? what route?

A

G+/-. not absorbed orally, topically/opth only.

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8
Q

why do we not want to treat corneal ulcers with triple + hydrocortisone?

A

the steroid can allow for infection in a corneal ulcer by suppressing the immune system.

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9
Q

what are our two topical antifungals

A

natamycin and voriconazole

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10
Q

what is the main difference between natamycin and voriconazole?

A

natamycin is best for more superficial infections of the cornea. does not penetrate cornea. voriconazole is good for stromal or deeper fungi

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11
Q

which topical antifungal has synergism with tobramycin and cefazolin

A

natamycin

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12
Q

what is the drug we can use subconjunctively for refractory fungal infections. commonly for fusarium

A

amphotericin B

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13
Q

what are the two virostatic drugs we can use for herpesvirus keratitis and conjunctivitis flare ups?

A

trifluridine and idoxuridine

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14
Q

what are the two topical antibacterials that we reach for?

A

polymixin B and bacitracin/gramicidin

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15
Q

three main categories of antinflammatories for ocular use

A

glucocortocoids, NSAIDs, immunomodulators (cyclosporine A)

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16
Q

what are the three major topical GCs we use for eyes

A

topical prednisolone acetate, dexmethasone sodium phosphate, or hydrocortisone.

17
Q

which GC penetrates the intact cornea?

A

dexmethasone SP.

18
Q

which GC is available in a topical ointment?

A

Dexmethasone SP

19
Q

how do the three GCs compare in potency/peneration?

A

prednisolone acetate is basically the same as dexmethasone SP. hydrocortisone is way weaker.

20
Q

when are topical optic GCs contraindicated?

A

in the presence of corneal ulcers and with Fungal infections

21
Q

when are systemic GC and NSAIDs used?

A

topical steroids are often combined with systemic NSAIDs. like flunixin in the horse

22
Q

what is our topical immunomodular? mech of action?

A

cyclosporine A. blocks IL-2 production

23
Q

when is cyclosporine A indicated for treatment?

A

in lymphocytic infiltrates. or eosinophilic keratitis.

24
Q

t/f cyclosporine A penetrates an intact cornea?

A

FALSE. it is best for surface diseases.

25
Q

unique way we can treat anterior uveitis in equine patients?

A

suprachoroidal implants of cyclosporine A. can deliver drug for months to years

26
Q

for the Autonomic NS, what receptors are in the eye that drugs can act on?

A

A1, B, muscarinic

27
Q

what type of ANS drug do we use most commonly?

A

tropicamide and atropine.

28
Q

when is it appropriate to use tropicamide (ANS drug)

A

used to dilate the eye prior to exam. only works for 1-2 hours. not as a treatment but to work on eye.

29
Q

when do you use atropine?

A

long acting. to relieve pain when inflammation is constantly trying to constrict the pupil. can prevent synechiae (adhering), or preventing glaucoma.

30
Q

negative side effect of atropine?

A

decreased tear production- monitor dry eye. ileus?

31
Q

what are our three drugs that cause miosis

A

pilocarpine, carbachol, demecarium bromide.
these are cholinergic agonist

32
Q

which miosis inducing drug is most commonly used? for what?

A

pilocarpine. used to treat dye eye in dogs that have a neurogenic cause.

33
Q

which two drugs are commonly used to treat glaucoma together

A

timolol, and dorzolamide. decrease aqueous humor production/secretion.

34
Q

what is latanoprost used for? what species is it not useful in?

A

used for glaucoma because it increases outflow of aqueous humor. doesn’t work in cats.

35
Q

when are topical anesthetics contraindicated?

A

as therapy for ulcerative keratitis. toxic to the epithelium and won’t heal.

36
Q

how does latanoprost treat glaucoma?

A

lowers intraocular pressure by increasing outflow of aqueous humor.