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Pharm Flashcards

1
Q

What is the proper name of vitamin B2?

A

Riboflavin

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2
Q

Why is Riboflavin (B2) important?

A

Metabolism of nutrients

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3
Q

What are the ocular complications of a Riboflavin (B2) deficiency?

A

Photophobia
Corneal neo
KCS

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4
Q

What are the systemic manifestations of a Riboflavin (B2) deficiency?

A

Dry, cracked lips
Ulcers of the mouth
Sore throat

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5
Q

How are large, hydrophilic drugs absorbed ocularly?

A

Transconjunctival route

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6
Q

How are small, lipophillic drugs absorbed ocularly?

A

Transcorneal route

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7
Q

Which class of glaucoma drugs should not be prescribed when there is active inflammation?

A

Prostaglandins

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8
Q

What would be the best glaucoma drug to prescribe to a pt with active inflammation?

A

Brimonadine - often used after trabeculoplasty

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9
Q

What are the 2 major complications with Ethambutol therapy?

A

Retrobulbar optic neuritis

Blue/yellow color defects

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10
Q

How long after beginning Ethambutol to ocular side effects typically arise?

A

2-5 months

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11
Q

What is the proper name of vitamin B1?

A

Thiamine

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12
Q

Why is Thiamine (B1) important?

A

Carbohydrate metabolism

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13
Q

What disease occurs in Thiamine (B1) deficiency?

A

Beriberi

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14
Q

What are the symptoms of Beriberi from Thiamine (B1) deficiency?

A 
Difficulty walking
Peripheral neuropathy
Paralysis
Nystagmus
Speech difficulty
Mental confusion
Ophthalmoplegia
CHF
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15
Q

Beriberi can also arise due to malnutrition from what lifestyle choice?

A

Alcoholism

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16
Q

What is the proper name of Vitamin B3?

A

Niacin

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17
Q

What is Niacin (B3) responsible for?

A

Carbohydrate metabolism

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18
Q

Pellagra is caused by a deficiency of what?

A

Niacin (B3)

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19
Q

What are the symptoms of Pellagra?

A

Diarrhea
Dementia
Dermatitis

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20
Q

Which vitamin can be used to treat hyperlipoproteninemia?

A

Niacin (B3)

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21
Q

What is the proper name of vitamin B6?

A

Pyridoxine

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22
Q

What is the purpose of pyridoxine (B6)?

A

Coenzyme for formation of hemoglobin

Amino acid and protein metabolism

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23
Q

The aminoglycoside antibiotics are known for corneal toxicity. Which is worse over the same period of time, Tobramycin or Gentamycin?

A

Gentamycin

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24
Q

Why were aminoglycosides frequently used in the past?

A

Broad spectrum coverage

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25
Q

What class of drug and generation is diphenhydramine?

A

H1 blocker

1st generation

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26
Q

What are the side effects of 1st generation H1 blockers?

A

CNS dysfunction resulting in impairment of cognitive function or performance

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27
Q

Which generation of H1 blockers is sedating?

A

1st generation

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28
Q

Name at least 3 2nd generation H1 blockers.

A

Cetirizine (Zyrtec)
Fexofenadine (Allegra)
Loratidine (Claritin)

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29
Q

What class of drug is Erythromycin?

A

Antibiotic - Macrolide

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30
Q

What gram does Erythromycin cover?

A

(+)

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31
Q

Name at least 4 opoid analgesics.

A

Codeine
Hydrocodone
Oxycodone
Morphine

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32
Q

Which of the opioid analgesics is most associated with constipation?

A

Codeine

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33
Q

What is the common name of acetylsalicylic acid?

A

Aspirin

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34
Q

Patients with which color irides are most likely to have increased pigmentation with prolonged prostaglandin use?

A

Light brown

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35
Q

Scurvy results from a deficiency of what vitamin?

A

C

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36
Q

Vitamin C facilitates the absorption of what?

A

Dietary iron

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37
Q

What are the symptoms of scurvy?

A 
General weakness
Anemia
Brown spots on skin
Spongy gums
Petechial hemorrhage of skin/mucous membranes
Proptosis
Feelings of paralysis
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38
Q

Name 3 conditions that atropine can be used to treat.

A

Amblyopia
Anterior uveitis
Posterior synechiae

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39
Q

What class of drug is atropine?

A

Anti-cholinergic

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40
Q

What are the 2 ocular alpha-2 agonists?

A

Apraclonidine

Brimonidine

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41
Q

How do alpha-2 agonists work in glaucoma therapy?

A

Increases uveoscleral outflow

Decreases production of aqueous

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42
Q

How do alpha-2 agonists reduce production of aqueous?

A

Constricting ciliary body vessels

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43
Q

Which class of antibiotics has a risk of causing idiopathic intracranial hypertension?

A

Tetracyclines

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44
Q

How do tetracyclines function as an antibiotic?

A

Disrupt bacteria protein synthesis by disrupting the 30s subunit

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45
Q

Which of the tetracyclines carries the highest risk of IIH?

A

Minocycline

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46
Q

Why does minocycline have the highest risk of IIH amongst the tetracyclines?

A

High lipid solubility gives it a higher affinity to pass into the CSF

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47
Q

What category of drug is Fluticasone?

A

Corticosteroid

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48
Q

What is the MOA of Salmeterol?

A

Long acting Beta-2 agonist

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49
Q

What is Salmeterol most frequently used for?

A

Asthma - to relax smooth muscle in/near the bronchioles, allowing for bronchodilation

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50
Q

What is the most common OTC decongestant?

A

Pseudoephedrine

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51
Q

What is the MOA of pseudoephedrine?

A

Adrenergic agonist

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52
Q

Pseudoephedrine should be used with caution in persons with what condition?

A

Cardiovascular disease

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53
Q

Which of the topical anti-cholinergics has the shortest duration of mydriatic effect?

A

Phenylephrine

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54
Q

What is the duration of action of phenylephrine?

A

3 hours

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55
Q

What is the duration of action of tropicamide?

A

6 hours

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56
Q

What is the duration of action of cyclopentolate?

A

24 hours

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57
Q

What is the duration of homatropine?

A

2 days

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58
Q

What is the duration of atropine?

A

2 weeks

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59
Q

1st generation cephalosporins have cross-sensitivity with what drug class?

A

Penicillins

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60
Q

Why do penicillins and cephalosporins have cross reactivity?

A

They both have a beta-lactam ring

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61
Q

If an organism is listed as “susceptible” on a sensitivity report, what does that mean?

A

The organism is sensitive to the standard dose

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62
Q

It is important to measure BP and pulse before prescribing which class of glaucoma meds?

A

Beta-blockers

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63
Q

Which drop carries a risk of retinal detachment?

A

Pilocarpine

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64
Q

What are the possible ocular side effects of pilocarpine?

A

Early cataracts
RD
Brow ache
Myopic shift

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65
Q

Why might a drop that is close to physiological pH increase the efficacy of a topical drug?

A

Less stinging, producing less reflex tearing, keeping more of the drug on the eye

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66
Q

Which type of drop is typically more efficacious, suspension or emulsion? Why?

A

Emulsion

Pts don’t remember to shake the suspension

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67
Q

What typically causes talc retinopathy?

A

IV drug use

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68
Q

If talc retinopathy is present, where else in the body may have talc accumulated?

A 
Small blood vessels of:
Lungs
Liver
Spleen
Kidneys
Lymph nodes
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69
Q

What condition may be caused stemming from talc retinopathy?

A

Ischemia from blocked vessels

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70
Q

Which glaucoma med may have a neuroprotective effect?

A

Brimonidine

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71
Q

Acetazolamide should be used with extreme caution in persons with what condition?

A

Sickle-cell anemia

72
Q

What is drug class does acetazolamide belong to?

A

CAIs

73
Q

Why is acetazolamide contraindicated in sickle cell anemia?

A

CAIs can lead to metabolic acidosis, causing additional sickling of RBCs

74
Q

To which class of drug does ketorolac belong?

A

NSAIDs

75
Q

Percocet is a combination of what 2 drugs?

A

Oxycodone

Acetaminophen

76
Q

What may hydroxyurea be used to treat?

A

Sickle cell - to prevent sickling

77
Q

What class of medications can be used to treat myokmia?

A

H1 blockers

78
Q

H-1 antihistamines can be used to treat what type of hypersensitivity reaction?

A

Type I - immediate/anaphylactic

79
Q

What mediates type I hypersensitivity?

A

IgE

80
Q

What mediates type II hypersensitivity?

A

IgG/IgM

81
Q

What mediates type III hypersensitivity?

A

Antibody/antigen complex

82
Q

What mediates type IV hypersensitivity?

A

T cells

83
Q

Name a disinfectant that is both bactericidal and virucidal.

A

H2O2

84
Q

How does BAK function as a preservative?

A

Denatures bacterial cell membranes

85
Q

What solution can be used in intraocular surgical procedures?

A

Balanced salt solution (BSS)

86
Q

Why can thimerisol be toxic?

A

Contains mercury

87
Q

Why should BSS be used in intraocular surgical procedures?

A

To maintain the proper isotonicity of the corneal endothelium

88
Q

How do beta blockers work in hypertension?

A

Antagonize the beta receptors, allowing for vasodilation and diminished cardiac output

89
Q

How can renin be used to decrease blood pressure?

A

Reducing renin decreases amounts of angiotensin II, which is a vasoconstrictor

90
Q

How do ACE inhibitors work to lower blood pressure?

A

ACE converts angiotensin 1 to 2, which is a vasoconstrictor, so by inhibiting the conversion, BP is lowered

91
Q

What is the primary MOA of statins?

A

Decreasing LDL

92
Q

Why do elevated levels of LDL and triglycerides increase the risk of heart disease?

A

They can lead to plaque formation, narrowing the lumen of the vessels

93
Q

Name 2 MOAs to reduce cholesterol.

A 
Reduce LDL (statins)
Inhibit HMG-CoA reductase, ultimately reducing LDL
94
Q

What demographic of patient is most likely to be a steroid responder?

A

Kids under 10

95
Q

Which type of steroid poses the least risk of causing a steroid response?

A

Ester based steroids

96
Q

Name a topical ester based steroid.

A

Loteprednol

97
Q

Which glaucoma drop causes eyelash growth?

A

Bimatoprost (Lumigan)

98
Q

What are the potential ocular side effects of bimatoprost?

A 
Hyperemia
Iris color changes
SPK
CME
Pseudodendrites
Photophobia
Irritation
99
Q

Folic acid is required by the body to manufacture what?

A

RBCs

100
Q

Folic acid can be used to help treat what type of anemia?

A

Megaloblastic anemia

101
Q

Heparin and Warfarin decrease coagulation by binding to what?

A

Factor Xa

102
Q

How do aspirin and ibuprofen act as blood thinners?

A

Inhibiting the synthesis of THA2 (THA2 works with ADP for platelet adhesion)

103
Q

Oral contraceptives carry a risk of what cardiovascular issue?

A

Blood clot formation

104
Q

What do class I antiarrhythmic agents affect?

A

Sodium channels

105
Q

What do class II antiarrhythmic agents do?

A

Decrease sympathetic activity of the heart by blocking beta receptors, and helping prevent recurrent MI

106
Q

How do class III antiarrhythmic agents work?

A

Prolong repolarization by blocking K channels

107
Q

How do class IV antiarrhythmic agents work?

A

Block calcium channels, decreasing conduction through the AV node

108
Q

What is the mechanism that might cause topiramate to lead to glaucoma?

A

Increased choroidal effusion, leading to swelling of the ciliary body, and a subsequent narrowing of the angle (angle closure glaucoma)

109
Q

What may topiramate be used to treat?

A 
Seizures
Migraines
Depression
Bipolar disorder
Weight loss promotion
110
Q

How long after beginning topiramate therapy do signs of angle closure typically appear?

A

3-14 days

111
Q

Patients with sulfonamide allergy shouldn’t be prescribed which combo antibiotic?

A

Bactrim (trimethoprim and sulfamethoxazole)

112
Q

What makes up Bactrim?

A

Trimethoprim

Sulfamethoxazole

113
Q

Which drop is commonly used to help treat Fuch’s dystrophy?

A

Muro-128

114
Q

What class of drug is Muro-128

A

Hyperosmotic

115
Q

What do topical anesthetics do the the cornea?

A

Loosen epithelium

116
Q

Which drug softens the corneal epithelium more, proparacaine or tetracaine?

A

Tetracaine

117
Q

Which drug is most known to cause crystalline retinopathy?

A

Tamoxifen

118
Q

What is tamoxifen used to treat?

A

Breast cancer

119
Q

Where do the crystals in crystalline retinopathy typically accumulate?

A

Paramacular region

120
Q

What are the potential ocular side effects of tamoxifen?

A 
Corneal deposits
CME
Gray lesions of RPE
Retinal hemes
Optic disc edema
121
Q

What may Plaquenil be used to treat?

A

SLE
RA
Malaria

122
Q

What is the most well-known ocular side effect of Chloroquine?

A

Bull’s eye maculopathy

123
Q

Why does chloroquine cause bull’s eye maculopathy?

A

The drug binds to melanin and accumulates in the retina

124
Q

What type of drug is Amiodarone?

A

Anti-arrhythmic

125
Q

What are the potential ocular side effects amiodarone?

A

Vortex keratopathy

NAION

126
Q

What is the major risk with oral fluoroquinolones?

A

Tendon rupture

127
Q

Name 4 relative contraindications of topical phenylephrine.

A

Arteriosclerosis
Cardiac disease
Orthostatic hypotension
Hypertension

128
Q

Which oral antibiotic is capable of inhibiting collagenase?

A

Doxycycline

129
Q

Which class of glaucoma drugs shouldn’t be used in a patient with sulfonamide allergy?

A

CAIs

130
Q

Why shouldn’t CAIs be prescribed to pts with sulfa allergy?

A

CAIs are sulfonamide derivatives

131
Q

Which of the NSAIDs is potentially hepatotoxic?

A

Acetaminophen

132
Q

Acetaminophen lacks which property that most NSAIDs possess?

A

Blood thinning

133
Q

Which NSAID is least harmful to the stomach?

A

Celecoxib

134
Q

What meds make up Vicodin?

A

Acetaminophen and hydrocodone

135
Q

What trade names are combinations of acetaminophen and hydrocodone?

A

Vicodin
Percocet
Percodan
Lortab

136
Q

How do tetracyclines help in posterior blepharitis?

A

Inhibit bacterial lipase production, reducing the concentration of free fatty acids

137
Q

What is the MOA of cyclosporin?

A

Inhibition of activated T cells

138
Q

Name the 5 things that may cause whorl (vortex) keratopathy.

A 
Fabry's disease
Tamoxifen
Chlorpromazine
Chloroquine
Indomethacin
139
Q

What are the 2 major routs of drug loss via topical instillation in the eye?

A

Spillover onto the cheek

Drainage via nasolacrimal sac

140
Q

About how long does it take for a steroid responder to “respond”?

A

3-4 weeks

141
Q

Alcohol consumption may lead to what type of nystagmus?

A

End gaze nystagmus

142
Q

Which drug has potential to cause a serious interaction with amiodarone?

A

Warfarin - enhanced blood thinning

143
Q

Why do you taper steroids?

A

To reduce risk of rebound inflammation

144
Q

What is common side effect of oral and topical H1 blockers?

A

Headache

145
Q

What are the potential side effects of topical steroid use?

A 
PSC
IOP increase
Reduced resistance to fungal, viral, and bacterial infections
Delayed would healing
Mydriasis
Ptosis development
146
Q

Why might caffeine be added to NSAIDs?

A

Enhance their effects

-Typically added to acetaminophen or aspirin

147
Q

Which HTN drug is associated with transient myopia?

A

Diuretics (thiazides)

148
Q

Which topical steroid is least likely to cause PSC?

A

Loteprednol (ester=safer)

149
Q

Drugs with which property can cross the BBB?

A

Lipid solubility

150
Q

Which cycloplegic/mydriatic drugs are contraindicated in trisomy 21?

A

Atropine
Scopolamine
- may cause hypersensitivity reaction

151
Q

A deficiency of which vitamin causes rickets and osteomalacia?

A

Vitamin D

152
Q

What is the role of vitamin D in the body?

A

Regulation of calcium and phosphate levels

153
Q

FA should be performed with caution in people taking which meds?

A

Beta blockers

154
Q

Why is caution needed in FA when a patient is on beta blockers?

A

Rare anaphylactic reactions are harder to control when beta blockers are being used

155
Q

Which topical NSAID can be used for seasonal allergic conjunctivitis?

A

Ketorolac

156
Q

What conditions may ketorlac be used to treat?

A

Conj inflammation
Post cataract inflammation
CME
Seasonal allergic conjunctivitis

157
Q

What are the 5 drugs that may cause optic neuritis?

A 
Chloramphenicol
Ethambutol
Isoniazid
Digitalis
Ribavirin
158
Q

What are the 3 drugs that may cause NAION?

A

(VIA)
Viagra
Immatrex
Amiodarone

159
Q

Why can digitalis be harmful to the eye?

A

It works on Na/K pumps (for the heart), and there are a ton in the PRs, endo, and NPCE

160
Q

What are the 3 drugs that affect bone marrow?

A

Chloramphenicol
Trimethoprim
Retrovir

161
Q

What are the 7 causes of whorl keratopathy?

A 
(CCHAI-T and Fabry's)
Chloroquin
Chlorpromazine
Hydroxychloroquin
Amiodarone
Indomethacin
Tamoxifen
Fabry's disease
162
Q

What are the causes of bull’s eye maculopathy?

A

Chloroquin

Hydroxychloroquin

163
Q

What drugs cause pigment changes?

A

Indomethacin
Premoethazine
Thioridazine
Chlorpromazine

164
Q

What 3 drugs may cause SJS?

A

Amoxicillin
Trimethoprim
Celecoxib

165
Q

What drugs may cause oculogyric crisis?

A

Cetrizine
Chlorpormazine
Thioridizine

166
Q

What antibiotics shouldn’t be used during pregnancy?

A

(FAT)
Fluoroquinolones
Aminoglycosides
Tetracyclines

167
Q

What antibiotics are OK in pregnancy?

A

(PAC)
Penicillins
Azithromycin
Cephalosporins

168
Q

What are the common broad spectrum antibiotics?

A

Aminoglycosides
Tetracyclines
Fluoroquinolones

169
Q

What are the 5 X-linked disease?

A

Fabry’s
Alport
Albinism
Cone dystrophy

170
Q

What are the 3 hormones that will increase blood pressure?

A

Anti-diuretic hormone (ADH)
Angiotensin II
Aldosterone

171
Q

How does angiotensin II increase BP?

A

Causes vasoconstriction

172
Q

How does aldosterone increase BP?

A

Increases blood volume

173
Q

How does ADH increase BP?

A

Increases blood volume

174
Q

Which hormone is the most potent in terms of increasing BP?

A

Angiotensin II

175
Q

Where does ADH work?

A

On the collecting duct

OptoPrep (4 decks)

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