PHARM - Ocular Analgaesics - Week 10

Question 1

What is red eye generally associated with and what drug is usually adequate?

Answer 1

Occurs when tired or drinking, usually associated with soreness.
a-adrenoceptor agonists usually adequate

Question 2

What three things may cause persistent red eye?

Answer 2

Irritation due to FB
Allergic reaction
Infection

Question 3

What pathway do NSAIDs inhibit?

Answer 3

Prostanoid pathway only

Question 4

What are NSAIDs accepted as an alternative to?

Answer 4

Steroids

Question 5

What are NSAIDs contraindicated to (2)?

Answer 5

Aspirin

NSAID anaphylactic reaction

Question 6

List 8 potential adverse effects of topical NSAIDs (ocular related).

Answer 6

Burning
Stinging
Mild discomfort
Ocular irritation
Redness
Delayed epithelial growth and wound healing
Potential bleeding risk

Question 7

What patients should be monitored closely when giving NSAIDs?

Answer 7

Those with bleeding tendencies (haemophiliacs)

Question 8

List 12 systemic side effects of steroids.

Answer 8

Osteoporosis
Hypertension
Fat deposition - abdominal, face, neck
Thinning skin, arms legs
Muscle wasting
Behavioural disturbances
Peptic ulcers
Hyperglycaemia
Growth inhibition
Delayed/poor wound healing
Cataracts

Question 9

List two advantages of ocular topical steroids.

Answer 9

Minimises systemic effects

Treats uniocular disease

Question 10

List two disadvantages of ocular topical steroids.

Answer 10

Specific local reactions

• may leave white residue
• may affect vision

Question 11

List 4 common steroid side effects.

Answer 11

Ocular hypertension
Reduced corneal healing
Rebound inflammation
Cataract formation

Question 12

List 6 rare steroid side effects.

Answer 12

Corneal melt
Refractive changes
Ptosis
Lid swelling
Exophthalmus
Adrenal insufficiency

Question 13

Can ocular steroids be used freely or with caution.

Answer 13

With caution

Question 14

List 7 indications for ocular steroid use.

Answer 14

Allergic and selected inflammatory conditions of:
Lids
Conjunctiva
Cornea
Iris
Ciliary body

Question 15

What is a contraindication for ocular steroid use?

Answer 15

Ocular infection

Question 16

What three specific considerations must be given with topical steroids?

Answer 16

Glaucoma aggravation
Increasing risk of hypertension
Increased risk of cataract

Question 17

Can steroids be prescribed for longer than 2 weeks? Explain (2).

Answer 17

Shouldnt be unless you can monitor corneal epithelium and measure IOP

Question 18

What does cyclosporin act as?

Answer 18

Immunosuppressant

Question 19

What do cyclosporins inhibit?

Answer 19

Specific inhibition of T lymphocytes

Question 20

What is an effective corticosteroid substitute for conditions like dry eye and keratoconjunctivitis?

Answer 20

Cyclosporin

Question 21

What is a contraindication for cyclosporin (2)?

Answer 21

Known hypersensitivity

Active ocular infections

Question 22

What are 6 side effects of histamine receptor antagonists?

Answer 22

Headache
Blurred vision
Burning/stinging eye
Dry eye
Sore throat
Taste changes

Question 23

What should be used to remove foreign bodies?

Answer 23

Local anaesthetics

Question 24

Describe drugs for the following targets:
Mediator release (4)
Cell migration (2)
Vascular response (2)

Answer 24

Mediator release
Prostaglandins - inhibit formation with NSAIDs
Histamine - inhibit receptors

Cell migration - white blood/mast cells
-supress with steroids/cyclosporins

Vascular response - vasodilation
-a-adrenoceptor agonists (also some antihistamines in combo)