Pharmacology Flashcards
Antibiotic resistance that is rapidly spread within a population of bacteria is due to what mechanism?
conjugation — occurs btwn a donor and recipient bacteria
topical glaucoma medications thought to have neuroprotective effect in addition to lowering IOP
brimonidine —a2 agonist
- can enhance neuronal cell survival rates
how long does it take for topical steroids to cause IOP elevation?
1 month
common side effect of albuterol? what is it used to treat? is it short acting or long acting?
tremors*
others: nausea, tachycardia, hypertension, and anxiety
short acting b2 agonist
tx: asthma
which topical glaucoma meds reduce IOP by decreasing secretion of aqueous humor?
beta-blockers, CAIs
B-blockers work on the NPCE
which oral antibiotics possess the ability to protect the cornea from thinning due to inhibition of collagenase?
doxycycline
(tetracyclines)
what glaucoma meds causes lengthening and thickening of eyelashes as a side effect?
prostaglandins
what are side effects of prostaglandins?
eyelash extensions/thickening, pseudodendrites, photophobia, irritation, SPK, CME, hyperemia, iris color changes
concurrent conditions that can increase risk of retinal toxicity in pts taking hydrochloroquine?
tamoxifen use, renal disease, macular disease
what do adrenergic alpha-2 agonists end in?
“-nidine”
brimonidine, alpraclonidine
which medication would provide IMMEDIATE relief for acute allergic conjunctivitis?
lotemax
not BEZBOP
tx for seasonal allergic conjunctivitis
Alrex + mast cell stabilizer
tx for chronic allergic conjunctivitis
mast cell stabilizers (ALOEMAST)
BEZBOP side effects
stinging, headaches, adverse taste
what is used in combo with NaFl, known as Fluress?
Benoxinate, NOT Propracaine
most common complication that can occur during IV injection of fluorescein
hematoma at injection site
compounds added to amoxicillin to increase its effectiveness against bacteria that have demonstrated resistance to pencillin
clavulanic potassium
*Augmentin — resistantto beta-lactamase
what are 3 drug-based factors that allow for a better ability of a medication to pass thru plasma membranes?
lipid-soluble, non-ionized, smaller molecular structure
what disrupts bacterial cell membrane and is useful for prevention of dental cavities?
chlorhexidine
what is a very useful antiseptic & disinfectant, that is bactericidal and virucidal?
Hydrogen Peroxide (H2O2)
max # of days that Viroptic should be used continuously in order to avoid potential ocular toxicity
21 day
antibiotics whose mechanism of action results in bacterial cell death are considered what?
bactericidal
antibiotics whose mechanism of action is to inhibit or arrest the growth, development, or multiplcation of the infecting bacteria are considered what?
bacteriostatic
The effects of heparin can be reserved by the administration of which agent?
protamine
sedating antihistamines
diphenhydramine, chlorpheniramine, promethazine, hydroxyzine
non-sedating antihistamines
fexofenadine (allegra), loratadine (claritin), desloratadine (Clarinex), certizine (zyrtec)
which topical opthalmic drops has the shortest duration of mydriatic effect?
phenylephrine — 3 hrs (no cycloplegic effect)
which rate of elimination will result in a constant rate
zero-order kinetics
which rate of elimination will result in a drug- dependent rate
first-order kinetics
What class of glaucoma medications should be used as a last resort in infants due to the concern of CNS side effects? Why?
CAIs — Adrenergic agonists (e.g. apraclonidine, brimonidine)
CNS effects cause fatigue and lethargy.
Cholinergic antagonists are not used as a treatment for glaucoma
Which of the following drugs is well known for tachyphylaxis?
A. Xalatan
B. Lumigan
C. Apraclonidine
D. Timolol
C. apraclonidine
Apraclonidine provides a significant reduction in IOP (up to 40%) in ACUTE situations (acute angle closure, acutely elevated IOP due to uveitis or NVG, immediate post-op SLT or YPC to prevent an IOP spike). However, it loses its efficacy quickly when repeated doses are given, so it is NOT prescribed for long term care.
How long after instillation does it take for tropicamide to reach its maximum mydriatic effect?
A. 10-15 minutes
B. 20-30 minutes
C. 30-40 minutes
D. 40-60 minutes
B. 20-30 mins
All of the following are side effects of pilocarpine EXCEPT:
A. ciliary spasm
B. miosis
C. cataracts
D. dry eyes
D. dry eyes
Recall that PILOCARPINE is a CHOLINERGIC AGONIST. This mean you expect PARASYMPATHETIC ACTIONS, including lacrimation (not dry eye).`
All of the following are side effects of beta blockers EXCEPT:
A. bradycardia
B. bronchoconstriction
C. euphoria
D. impotence
E. GI distress
C. euphoria
side effects of beta blockers
bradycardia, bronchoconstriction, impotence, GI distress
Describe the mechanism of action (MOA) of prostaglandins. What receptors do they activate?
Prostaglandins increase aqueous outflow via the UVEOSCLERAL MESHWORK. They act on PGF2a receptors on the CILIARY MUSCLE, which activates METALLOPROTEINASES, causing a reduction in neighboring COLLAGEN.
Remember that prostaglandins cause an increase in eyelash length and growth due to activation of phospholipase C.
Which of the 4 classes of CNS drugs does NOT have an agent used for the treatment of glaucoma?
Cholinergic antagonists
Recall that this class has all the drugs we commonly use in clinic for dilation and cycloplegia, including tropicamide, atropine, homatropine, and cyclopentolate. The other three classes all have drugs used for glaucoma management. Cholinergic antagonists do NOT treat glaucoma.
What is the mechanism of action of cocaine?
A. Inhibits the action of acetylcholinesterase at preganglionic nerve terminals
B. Blocks the reuptake of norepinephrine at postganglionic nerve terminals
C. Blocks the release of norepinephrine at postganglionic nerve terminals
D. Blocks the reuptake of norepinephrine at preganglionic nerve terminals
B. Blocks the reuptake of norepinephrine at postganglionic nerve terminals
Which two drugs arguably have some neuroprotective capabilities?
Brimonidine (Alphagan) and betaxolol (Betoptic-S)
2 B’s for Brain
How long after instillation does it take for cyclopentolate to reach its maximum cycloplegic effect?
A. 10-15 minutes
B. 15-20 minutes
C. 40-60 minutes
D. 80-100 minutes
C
drug for loop diuretic; what are side effects?
furosemide
SE: hypokalemia,neurophrotoxicity, ototoxicity
side effect of spironolactone
hyperkalemia
