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Opthalmology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Epithleium and stroma, which is lipophilic?

A

Epithelium is lipophilic/hydrophobis

Stroma is lipophobic/hydrophilic

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2
Q

What is special about chloramphenicol?

A

It has both lipophilic and hydrophilic properties and penetrates cornea

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3
Q

How can you modify steroids?

A

Alcohol or acetate makes steroid more hydrophobic

Phosphate makes it more hydrophilic

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4
Q

Prednisolone acetate

A

hydrophobic
Good penetration in uninflamed cornea
Used post-operatively

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5
Q

Prednisolone phosphate

A

Hydrophilic
Poor penetration in uninflamed cornea
Used for cornea disease or when want low dose steroids

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6
Q

What is benzalkonium?

A

Benzalkonium is a preservative.
Also disrupts lipid layer of tear film
Aids penetration of some drugs

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7
Q

Acute angle-closure glaucoma and IOP

A

In acute angle-closure glaucoma, the intraocular pressure rises rapidly because the iris blocks the angle in the front of the eye where the anterior chamber fluid normally drains out.

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8
Q

Drug used to lower IOP in glaucoma?

A

Bimatoprost

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9
Q

Systemic absorption of topical drugs

A

Tears are pumped out of lacrimal sac rapidly
Excess gains systemic absorption at nasopharynx
Limited by punctal occlusion

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10
Q

How do you stop excess drug getting absorbed at nasopharynx?

A

Punctal occlusion e.g. sticking your fingers in your eyes

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11
Q

Routes of administration for drug into eyes?

A

Subconjunctival and subtenons

Subconjunctival
(prevents from exiting from tear film, but painful)

Subtenons
(don’t have to use needle, make cut and put in canula to get to back of eye. How you give local anaesthtic for surgery. Procedure is much less painful but only good for back of the eye)

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12
Q

Ocular Injetions

A

Intravitreal
(injecting into vitreous cavity, gets to macula. Have to be carfeul so you don’t hit retina –> retinal detachment)
Intracameral
(safer but more difficult, put needle through cornea –> anterior cavity)

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13
Q

Main antibiotic used in eye infections?

A

Chloramphenicol

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14
Q

Side effects of chloramphenicol?

A

Allergy
Irreversible aplastic anemia
Grey baby syndrome (not for topical, only for systemic chloramphenicol)

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15
Q

Which antibiotic inhibits peptidyl transferase?

A

Chloramphenicol

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16
Q

Chloramphenicol

A 
Most commonly used topical antibiotic
Ointment or drops
Inhibits peptidyl transferase enzyme (therefore stops bacterial protein being made)
Bacterocidal for strep and haemophilus
Bacterostatic for staph
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17
Q

Give an example when you would not use chloramphenicol?

A

Corneal ulcer

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18
Q

Antibiotic that inhibits protein synthesis?

A

Chloramphenicol

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19
Q

Talk to me about ofloxacin?

A

Inhibits DNA synthesis

Ofloxacin is a quinolone

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20
Q

Why do you like the beta lactam ring?

A

It inhibits the enzyme which makes bacterial cell wall?

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21
Q

Which antibiotics have a common B lactam ring?

A

Penicillins and cephalosporins

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22
Q

How would you treat corneal ulcer?

A

Anti-virals e.g. Zovirax

DO NOT USE STEROID DROPS

23
Q

What does zovirx mimic?

A

Zovirax mimics guanine

24
Q

When might you see Keratoprecipitates?

A

You might see keratoprecipitates in inflammation

They are remnants of WBC or something

25
Q

When are steroids used in the eye?

A

1) Post op cataracts
2) uveitis
3) to prevent corneal graft rejection

26
Q

What type drugs could you use:
Post op cataratcs
Uveitis
To prevent corneal rejection

A

Steroids

27
Q

Side effects of steroids

A 
cataract
glaucoma
exacerbation of viral infection
Gastric ulceration
Immunosuppression
Osteoporosis
Weight gain
Diabetes
Neuropsychiatric effects
28
Q

Eye side effects of steroids?

A

Cataract
Glaucoma
Exacerbation of viral infection

29
Q

Strength of topical steroids

A

FML
Predsol
Betamathasone
Dexamethasone/ prednisolone

30
Q

Other inflammatory agents

A

Antihistamines and mast cell stabilisers used in hayfever / allergic conjunctivitis
NSAIDS can be used for pain relief eg post refractive laser

31
Q

Drug you might give for pain relief e.g. post refractive laser?

A

NSAID

32
Q

Glaucoma medication

A

Bimatoprost
Prostanoids eg Latanoprost (‘Xalatan’). (don’t need to know_
Beta blockers (timolol, betaxolol, levobunolol carteolol etc)
Carbonic anhydrase inhibitors eg topical eg Dorzolamide (‘Trusopt’) or systemic – acetazolamide (Diamox)
Alpha2 adrenergic agonist Brimonidine (‘Alphagan’).
Parasympathomimetic - pilocarpine
Combination - (dorzolamide and timolol - Cosopt )

33
Q

Risk with intravitreal drugs?

A

Many drugs are toxic to retina

34
Q

How would you deliver antibiotics in endopthalmitis?

A

Intravitreal

35
Q

How would you deliver intra-ocular steroids or anti-VEGF?

A

Intravitreal

36
Q

Local anaesthetic in eyes

A

Blocks sodium channels and impedes nerve conduction

Used extensively in ophthalmology for

1) FB removal
2) Tonometry (IOP measurement)
3) corneal scraping
4) comfort

37
Q

Diagnostic dyes e.g. fluroscein

A

Uses

1) shows corneal abrasion
2) tonometry
3) diagnosing nasolacrimal duct obstruction
4) angiography

38
Q

Mydriatics

A

E.g. tropicamide, cyclopentolate (short acting 2-3 hours)

Cause pupil dilation by blocking parasympathetic supply to iris

Side effects – blurring, AACG

39
Q

Side effects of mydriatics?

A

Blurring, AACG

40
Q

Anterior ischemic neuropathy

A

Rapid, painless loss of vision in affected eye but may affect upper or lower field only (altitudinal defect)
Vision usually significantly impaired (counting fingers or less)
Disc swelling with haemorrhages around the posterior pole
No visual recovery

41
Q

Glaucoma

A

The glaucomas are generally related to reduced outflow of aqueous humor through the trabecular meshwork of the anterior chamber or iridocorneal angle

42
Q

Complication of intra-vitreal injection? (e.g. anti-VEGF)

A

Endopthalmitis (extreme inflammation)

43
Q

Which channels are blocked in a local anaesthetic injection in the eye?

A

Sodium channels blocked

44
Q

What might you use to diagnose a nasolacrimal duct obstruction?

A

A diagnostic dye

45
Q

Tropicamide, cyclopentolate?

A

Mydriatic drugs

Act on the parasympathetic system to dilate the eye

46
Q

Phenylephrine, atropine

A

Sympathomimetics

47
Q

Vigabatrin side effect?

A

Constricts visual fields

Not reversible

48
Q

Side effect of ethambutol?

A

Optic neuropathy

49
Q

Side effect of chloroquine?

A

Maculopathy

50
Q

Side effect of chloramphenicol?

A

Allergy
Irreversible aplastic anaemia
Grey baby syndrome

51
Q

Anti-inflammatory agents used in eye problems

A

Steroids
Topical NSAIDs
Anti-histamines
Mast cell stabilisers

52
Q

Latanoprost

A

Prostaglandin inhibitor

53
Q

Tinolol, betaxolol, levobunolol, carteolol

A

Beta blockers

54
Q

Dorzolamide (topical)

Acetazolamide (systemic)

A

Carbonic anhydrase inhibitors

Opthalmology (10 decks)

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