optho drugs exam 3 Flashcards
what are the ways we increase drug absorption across the cornea? (there are many)
frequent (slow elimination), high doses, lipophilic, unionized, decrease corneal thickness, increase [] to a point, increase contact time
when is systemic drugs most prefered
anterior segment, ulcers that rupture through the membrane, maybe corneal stroma-depends on inflam
what are 2 of the systemic drugs that reach high [] in the eye
minocycline and enrofloxacin
what are the two antifungals we administer systemically for ocular use?
fluconazole, voriconazole
it is best to send patient home with a ______(solution or ointment)
ointment because they increase contact time and have to be given less frequently
polymixin B. what bacti? what route?
G- bacteria. almost exclusively topical because it is nephrotox (maybe ok for endotoxemia)
bactitracin/gramicidin. what bacti? what route?
G+/-. not absorbed orally, topically/opth only.
why do we not want to treat corneal ulcers with triple + hydrocortisone?
the steroid can allow for infection in a corneal ulcer by suppressing the immune system.
what are our two topical antifungals
natamycin and voriconazole
what is the main difference between natamycin and voriconazole?
natamycin is best for more superficial infections of the cornea. does not penetrate cornea. voriconazole is good for stromal or deeper fungi
which topical antifungal has synergism with tobramycin and cefazolin
natamycin
what is the drug we can use subconjunctively for refractory fungal infections. commonly for fusarium
amphotericin B
what are the two virostatic drugs we can use for herpesvirus keratitis and conjunctivitis flare ups?
trifluridine and idoxuridine
what are the two topical antibacterials that we reach for?
polymixin B and bacitracin/gramicidin
three main categories of antinflammatories for ocular use
glucocortocoids, NSAIDs, immunomodulators (cyclosporine A)