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neuro.psych.optho > optho pharm > Flashcards

optho pharm Flashcards

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1
Q

What is the first line treatment for glaucoma?

A

prostaglandin analogs
beta-blockers are #2
-can also use: alpha-agonists, Carbonic anhydrase inhibitors, miotics, sympathomimetics,

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2
Q

prostaglandin analogs

A

Xalatan

  • used to dec. intraocular pressure
  • MOA: inc. uveoscleral outflow
  • first line for glaucoma
  • side effects: increased in melanin pigment in iris, hypertrichosis (long eyelashes), darkening of perioorbital skin
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3
Q

beta-blockers

A

timoptic=timolol, carteolol, betoptic

  • used to decrease intraocular pressure
  • blockade of beta-receptors in ciliary body decreases aqueous production
  • side effects: bradycardia, bronchospasm/SOB, depression, dec. libido
  • contraindications: asthama, severe COPD, bradycardia, heart block, CHF, myasthenia gravis
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4
Q

how can you decrease the amount of eye drop that enters the nasolacrimal system?

A

punctal occlusion
the nasolacrimal system is where drugs get systemic access, blocking this helps reduce systemic side effects and decreases “Tasting the drops”

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4
Q

how can you decrease the amount of eye drop that enters the nasolacrimal system?

A

punctal occlusion
the nasolacrimal system is where drugs get systemic access, blocking this helps reduce systemic side effects and decreases “Tasting the drops”

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5
Q

how long should you wait in between administering eye drops?

A

5 minutes

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5
Q

how long should you wait in between administering eye drops?

A

5 minutes

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6
Q

carbonic anhydrase inhibitors

A
  • used to decrease intraocular pressure
  • MOA: Inhibit carbonic anhydrase in pigmented and non-pigmented epithelium of ciliary body → decreased aqueous humor production
  • side effects: kidney stones, paresthesias, unpleasant taste, acidosis
  • contraindications: Sulfa allergy, Renal stones, Liver or kidney disease, Addison’s disease, Adrenal insufficiency, Thiazide diuretics, Steroids, Digitalis, Aspirin
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6
Q

carbonic anhydrase inhibitors

A
  • used to decrease intraocular pressure
  • MOA: Inhibit carbonic anhydrase in pigmented and non-pigmented epithelium of ciliary body → decreased aqueous humor production
  • side effects: kidney stones, paresthesias, unpleasant taste, acidosis
  • contraindications: Sulfa allergy, Renal stones, Liver or kidney disease, Addison’s disease, Adrenal insufficiency, Thiazide diuretics, Steroids, Digitalis, Aspirin
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7
Q

alpha adrenergic agonists

A

Used to decrease intraocular pressure
oMOA: Decrease aqueous production
oSide Effects: Allergic reaction (redness, itching), Allergic conjunctivitis
oContraindications: MAOIs, Children (can cause syncope)
oAgents: Alphagan P, Iopidine

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7
Q

alpha adrenergic agonists

A

Used to decrease intraocular pressure
oMOA: Decrease aqueous production
oSide Effects: Allergic reaction (redness, itching), Allergic conjunctivitis
oContraindications: MAOIs, Children (can cause syncope)
oAgents: Alphagan P, Iopidine

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8
Q

Miotics

A
  • used to decrease intraocular pressure
  • MOA: cause pupillary muscle constriction, which pulls open trabecular meshwork and increases trabecular outflow
  • direct cholinergic: pilocarpine
  • indirect cholinergic: AchEI
  • Side effects: Intense miosis and accommodative spasm, iritis, iris cysts, lens induced myopia and anterior chamber shallowing, pupillary block, corneal haze
  • Pilocarpine toxicity: salivation, lacrimation, sweating, N/V/D, bronchiolar spasm/pulmonary edema
  • Worsens Parkinson’s disease
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8
Q

Miotics

A
  • used to decrease intraocular pressure
  • MOA: cause pupillary muscle constriction, which pulls open trabecular meshwork and increases trabecular outflow
  • direct cholinergic: pilocarpine
  • indirect cholinergic: AchEI
  • Side effects: Intense miosis and accommodative spasm, iritis, iris cysts, lens induced myopia and anterior chamber shallowing, pupillary block, corneal haze
  • Pilocarpine toxicity: salivation, lacrimation, sweating, N/V/D, bronchiolar spasm/pulmonary edema
  • Worsens Parkinson’s disease
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9
Q

sympathomimetics

A

-used to decrease intraocular pressure
o Phenylephrine (alpha agonist)
o Mydriatic without cycloplegia
o Side effects: Acute hypertension, pulmonary edema, arrhythmia, death
o Never use 10% in infants
o Avoid in patients with sympathetic denervation (MAOIs, diabetics with neuropathy)
o Can cause angle closure in patients with narrow angle

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9
Q

sympathomimetics

A

-used to decrease intraocular pressure
o Phenylephrine (alpha agonist)
o Mydriatic without cycloplegia
o Side effects: Acute hypertension, pulmonary edema, arrhythmia, death
o Never use 10% in infants
o Avoid in patients with sympathetic denervation (MAOIs, diabetics with neuropathy)
o Can cause angle closure in patients with narrow angle

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10
Q

mydriatics

A

anticholinergics used to dilate eyes

eg. atropine (toxicity=: hot as a hare, red as a beet, dry as a bone, blind as a bat, mad as a hatter )
- MOA: Paralyze the parasympathetic iris sphincter and circular muscle of ciliary body
- side effects: Decreased GI motility, increased gastric secretions, dry mucous membranes, urinary retention (careful elderly men with BPH), tachycardia, confusion, restlessness
- can precipitate angle closure attack in patients with narrow angle

10
Q

mydriatics

A

anticholinergics used to dilate eyes

eg. atropine (toxicity=: hot as a hare, red as a beet, dry as a bone, blind as a bat, mad as a hatter )
- MOA: Paralyze the parasympathetic iris sphincter and circular muscle of ciliary body
- side effects: Decreased GI motility, increased gastric secretions, dry mucous membranes, urinary retention (careful elderly men with BPH), tachycardia, confusion, restlessness
- can precipitate angle closure attack in patients with narrow angle

11
Q

anti-VEGF drugs

A

Drugs: Ranibizumab, Bevacizumab (mAbs)

  • used to inhibit vascular proliferation
  • used to treat anything that causes neovascularization: Macular degeneration, Diabetic retinopathy, Retinal vein occlusions
  • side effects: inc. ocular pressure, allergic rxn, possible risk thromboembolic event, cataract, infection, retinal detachment
11
Q

anti-VEGF drugs

A

Drugs: Ranibizumab, Bevacizumab (mAbs)

  • used to inhibit vascular proliferation
  • used to treat anything that causes neovascularization: Macular degeneration, Diabetic retinopathy, Retinal vein occlusions
  • side effects: inc. ocular pressure, allergic rxn, possible risk thromboembolic event, cataract, infection, retinal detachment
12
Q

ocular complications of steroids

A
  • Watch for steroid-induced glaucoma (accumulation of glycosaminoglycans in the trabecular meshwork)
  • Cataract (PSC)
  • Delayed wound healing, enhanced microbial/fungal proliferation, punctate keratopathy
12
Q

ocular complications of steroids

A
  • Watch for steroid-induced glaucoma (accumulation of glycosaminoglycans in the trabecular meshwork)
  • Cataract (PSC)
  • Delayed wound healing, enhanced microbial/fungal proliferation, punctate keratopathy
13
Q

cautions with NSAIDS

A
  • Worsens herpes

- Generic NSAID use associated with corneal melting

13
Q

cautions with NSAIDS

A
  • Worsens herpes

- Generic NSAID use associated with corneal melting

14
Q

what antibiotic should you use in contact-lens wearers?

A

In contact lens wearers, use fluoroquinolone, because it covers Pseudomonas

14
Q

what antibiotic should you use in contact-lens wearers?

A

In contact lens wearers, use fluoroquinolone, because it covers Pseudomonas

neuro.psych.optho (8 decks)

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