Pharmacology

Question 1

Cyclosporine/Ciclosporin side effects

Answer 1

Ocular stinging,burning (most common)
Halitosis and gingival hyperplasia,hypertension,hyperlipidemia,nephro,neuro and hepatotoxicity,inreased risk of squamous cell carcinoma

Question 2

Most common ocular side effect of alpha 2 agonists-limiting usage?

Answer 2

Allergic conjunctivitis

Question 3

Phases of drug metabolism

Answer 3

Phase 1-oxidation using Cyt P450
Phase 2-conjugation with glucuronate, glutamine and acetate groups-makes molecules more water soluble for excretion

Question 4

MOA and side effects of Carbonic anhydrase inhibitors

Answer 4

Decrease aqueous production
Bitter taste, blurred vision, burning sensation,punctate keratopathy

Question 5

MOA of Botox

Answer 5

Blocks presynaptic release of acetylcholine-by binding irreversibly
Botox taken up only by cholinergic nerve endings

Question 6

Amiodarone ocular side effects

Answer 6

Cornea verticillata/vortex keratopathy
Optic neuropathy (AION)
Anterior sub capsular cataract
Reduced corneal sensation

Question 7

Prednisone type of drug

Answer 7

cytostatic anti-inflammatory agent

Question 8

Acetazolamide systemic side effects

Answer 8

Metabolic acidosis,Hypokalemia,hyponatremia,renal calculi, paresthesia of limbs,SJ syndrome

Question 9

Average time to onset of action of botox

Answer 9

Average time-2-3 days
Peak effect at 2-3 weeks

Question 10

Mechanism of action of Acyclovir

Answer 10

Inhibits DNA polymerase

Question 11

Corneal crystalline deposits side effect of which fluoroquinolone?

Answer 11

Ciprofloxacin-induced corneal crystalline precipitates

Prolonged use of ciprofloxacin may cause corneal crystalline deposits. These are probably due to precipitation of drug, which requires low pH for solubility.

Question 12

MOA cocaine

Answer 12

Indirectly acting adrenergic agonist-inhibits MAO reuptake at synapse

Question 13

Local anesthetics penetrate tissue best when?

Answer 13

Local anesthetics are weak bases and penetrate tissue best when administered with an alkaline solution where a greater proportion is non ionised(lipophilic)

Question 14

What is commonly added to penicillin to prevent its inactivation by beta-lactamase enzymes?

Answer 14

Clavulanic acid is a beta-lactamase inhibitor commonly added to amoxicillin (co-amoxiclav) to prevent its degradation by bacterial beta-lactamase enzymes.

Question 15

Drugs causing stellate anterior sub capsular cataract ?

Answer 15

Amiodarone,phenothiazine

Question 16

Systemic toxicity caused by imidazole group of anti-fungals?

Answer 16

Hepatotoxicity,LFT should be monitored with long term therapy

Question 17

Which medication is likely to increase the risk of myopathy in patients taking simvastatin?

Answer 17

Erythromycin,Clarithromycin

Question 18

Anti T2DM medication known for development/exacerbation of cystoid macular oedema?

Answer 18

Rosiglitazone

Question 19

Which medication acts on sympathetic and parasympathetic autonomic ganglia?

Answer 19

Acetylcholine (miochol)
Short t1/2 but fast onset- can produce mitosis for 20mins during complicated cataract surgery

Question 20

Which anti glaucoma meds are avoided in uveitis?

Answer 20

Prostaglandin analogues and miotics
Beta blockers-generally first line–can add alpha agonist/CAI if IOP not controlled

Question 21

Side effects of Digoxin?

Answer 21

Xanthopsia (yellow-blue discolouration of vision), rarely photopsia, pain on eye movements

Question 22

Medication that reduces lid retraction in TED?

Answer 22

Guanethidine-sympatholytic drug
Reduces release of catecholamines

Question 23

Role of alpha 1 antagonist in cataract surgery ?

Answer 23

Alpha 1 antagonists like tamsulosin,alfuzocin,prazosin,terazocin,doxazocin lead to floppy iris

Question 24

Effect of miotics/mydriatics on aqueous outflow?

Answer 24

Miotics-increase trabecular and decrease uveoscleral outflow
Mydriatics,cycloplegics,PGA,epinephrine increases uveoscleral outflow