Pharm

Question 1

Preservative free solution

Answer 1

discard 1 week

Question 2

Preservative solution

Answer 2

discard 4 weeks

Question 3

Fluorescein

Answer 3

Orange dye used to detect foreign bodies in the eye as well as abrasions, ulcers and infection, herpatic dendrites.

Question 4

topical anesthetics MOA

Answer 4

Blocks the initiation and conduction of nerve impulses by decreasing the neuronal membrane’s permeability to sodium, potassium and other ions which results in inhibition of depolarization with resultant blockade of conduction

Question 5

Topical Anesthetic Meds

Answer 5

Proparacaine (Alcaine)
Oxybuprocaine AKA Benoxinate (Novesin, Novesine)
Tetracaine (Altacaine, Tetcaine, TetraVisc)

Question 6

Topical Anesthetic CI

Answer 6

any hypersensitivity to anesthetics, liver disease, taking anticholiesterases*, dry eye, perforating eye injury

Question 7

Cycloplegics Meds

Answer 7

Atropine (Isopto Atropine)
Scopolamine (Isopto Hyoscine)
Homatropine
Cyclopentolate (Cyclogyl)
Mydriacyl (Tropicamide)

Question 8

Cycloplegics MOA

Answer 8

Block the action of acetylcholine resulting in paralysis of the ciliary muscles therefore causing dilatation of the pupil
Anticholinergic or antimuscarinic drugs

Question 9

Cycloplegics Indications

Answer 9

Dilation before eye examinations
Before and after eye surgery
Provide pain relief to patient with corneal abrasions and iritis/uveitis

Question 10

Cycloplegics CI

Answer 10

Angle closure glaucoma
People with narrow angles

Caution:
Children and elderly patients

Question 11

Atropine

Answer 11

Most potent

Duration of action lasting up to 12 days

Question 12

Scopolamine

Answer 12

Shorter duration of cycloplegia than atropine

Wears off within 3 days of treatment

Question 13

Tropicamide and cyclopentolate

Answer 13

Use limited to diagnostic testing
Don’t use if need cycloplegia for an inflammatory condition as duration of action is too short
Except cyclopentolate is used for cycloplegia in children
Duration of action about 6 hours

Question 14

Decongestants

Answer 14

MOA:
Cause pupil dilation
Increase in outflow of aqueous humor
Vasoconstriction

Indications:
Allergic conjunctivitis
Redness of the conjunctiva 
Increased tearing 
Itchiness 
Burning sensation 
Blurred vision due to the increase in tearing
Ex:
Naphazoline/Pheniramine maleate (Visine A, Naphcon-A, Opcon-A, etc.)
Naphazoline hydrochloride (Murine)

Question 15

Antihistamines

Answer 15

Topical antihistamines with mast cell stabilizing properties
Prescription
Olopatadine (Patanol, Pataday) 
Bepotastine (Bepreve)
Alcaftadine (Lastacraft)
OTC
Azelastine (Optivar)
Epinastine (Elestat)
Pemirolast (Alamast
Ketotifen *generic and most commonly found OTC

Question 16

Mast cell stabilizer

Answer 16

Cromolyn Sodium (Opticrom)
Inhibits mast cell degranulation
Need to take QID and takes 1-2 weeks to work

Indications: Allergic conjunctivitis

Side effects:
Burning
Dry eyes

Question 17

Antibiotics

Answer 17

Sulfonamides
Fluoroquinolones
Aminoglycosides
Macrolides
Polypeptides

Question 18

Sulfonamides MOA

Answer 18

Inhibits synthesis of folic acid
Bacterostatic

Mainly effective against gram-negative bacteria
(Pneumocystitis carinii)
Some gram-positive bacteria (Staph aureus (but high resistance with S aureus) and toxoplasma

Question 19

Fluoroquinolones MOA

Answer 19

Inhibits DNA synthesis

Bactericidal

Question 20

Sulfonamides Indications

Answer 20

Lid infections, Conjunctivitis, Corneal abrasion, ulcer, Prevent infections after removing foreign bodies

Question 21

Sulfonamides CI

Answer 21

SULFA Allergy

Question 22

Fluoroquinolones Indications

Answer 22

Lid infections
Conjunctivitis (not for use as 1st line therapy)
Corneal abrasion, ulcer
Prevent infections after removing foreign bodies
Should be used for sure if a pseudomonas infection is suspected.

Gram negative

Question 23

Aminoglycosides MOA

Answer 23

Bind to ribosomes and inhibit RNA synthesis

Question 24

Aminoglycosides Indications and examples

Answer 24

Dosed TID to QID
Local toxicity (corneal epithelium)
Generally reserve use for severe infections that should NOT be treated in primary care

Gentamycin (Garamycin)
Tobramycin (Tobrex)
Neomycin

Question 25

Macrolides

Answer 25

Erythromyocin!
MOA:
Inhibits tRNA synthesis
Bacteriostatic

Good for first line tx. of bacterial conjunctivitis

Question 26

Polypeptides

Answer 26

Bacitracin ointment
MOA:
Inhibits bacterial cell wall synthesis
S. aureus, streptococcus pneumoniae, H. influenzae
Up to 10% of people with have a hypersensitivity reaction

Question 27

Herpes

Answer 27

Always refer to an Ophthalmologist for treatment.  Do not try to treat this yourself
Antivirals:
Idoxuridine (dendrid)
Trifuridine (Viroptic)
Vidarabine (Vira-a)

Question 28

Idoxuridine (Dendrid)

Answer 28

Used for herpes simplex keratitis
Blocks reproduction of HSV
May cause irritation, pain photophobia
Recurrence may be seen
If no lessening of fluorescein staining in 14 days, start different therapy with Trifluridine (Viroptic)

Question 29

Trifuridine (Viroptic)

Answer 29

Used for keratoconjnctivitis, keratitis
May cause burning, stinging
Used if Vidarabine is ineffective

Question 30

Vidarabine (Vira-a)

Answer 30

Used for ketatoconjunctivitis, superficial keratitis
May cause temporary visual haze, foreign body sensation and burning
Use if Viroptic is ineffective