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Opthamology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

how do topical agents work?

A

can act on the surface

can penetrate the cornea

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2
Q

2 types of topical agent?

A

drops

ointment

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3
Q

describe the layers of the cornea

A

lipid:water:lipid sandwich

90% of the cornea is water

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4
Q

how does the structure of the cornea relate to cornea penetrating drugs?

A

epithelium is lipophilic/hydrophobic and stroma is lipophobic and hydrophilic
therefore
to penetrate epithelium, drug must be lipid soluble
to penetrate stroma, drug must be water soluble

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5
Q

give an example of a type of drug which penetrates cornea?

A

LMW drugs

chloramphenicol has lipophilic and hydrophilic properties to can penetrate

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6
Q

what can influence drug penetration in the cornea?

A

ocular surface inflammation (can reduce hydrophobic nature of endothelium)
lipid layer of tear film can impede penetration
hydrophillic drugs limited by epithelium
hydrophobic drugs limited by stroma

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7
Q

what area of the eye limits absorption of hydrophilic drugs?

A

epithelium

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8
Q

what are of the eye limits absorption of hydrophobic drugs?

A

stroma

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9
Q

describe the features of prednisolone acetate?

A

hydrophobic
good penetration of uninflamed cornea
used post op in cataract surgeery

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10
Q

what are the features of prednisolone phosphate?

A

hydrophilic
poor penetration in uninflamed cornea
used for cornea disease or when want low dose steroid
more used in surface inflammation

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11
Q

what is benzylkonium?

A

type of ammonia which destroys bacteria which can culture in eye drops
keeps bottle of drops sterile

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12
Q

how does benzalkonium work?

A

disrupts lipid layer of tera film

aids penetration of some drugs

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13
Q

give an example of a glaucoma drug and 2 side effects?

A

bimatoprost

lack of benzalkonium can cause red eyes and darkening around eyes

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14
Q

how are topical drugs systemically absorbed?

A

tears are pumped out of lacrimal sac rapidly
excess gains systemic absorption at nasopharynx
limited by punctal occlusion

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15
Q

give 2 non-topical routes of administration

A

subconjunctival

subtenons

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16
Q

give 2 types of ocular injection

A

intravitreal (into the back of the eye)

intracameral (into the front of the eye)

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17
Q

name 4 anti-inflammatory agents used in the eye

A

steroids
topical NSAIDs
anti-histamines
mast cell stabilisers

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18
Q

what do steroids do and what 3 conditions are the used in?

A 
suppress inflammation, allergy and immune response
used topically in
- post op cataract
- uveitis
- to prevent corneal graft rejection
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19
Q

what can indicate a corneal graft rejection?

A

vessels approaching the cornea
vision blurred
white line appears in the cornea

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20
Q

how does temporal arteritis relate to the eye?

A

can cause vague visual symptoms

can lead to blindness

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21
Q

how is temporal arteritis managed?

A

systemic steroids

22
Q

non-pressure related cause of optic disc swelling?

A

anterior ischaemic neuropathy

loss of blood supply to the optic nerve

23
Q

name 3 local side effects of steroids

A

cataract
glaucoma
exacerbation of viral infection

24
Q

name 6 systemic side effects of steroids?

A 
gastric ulcer
immunosuppression
osteoporosis
weight gain (moon face)
diabetes
neuropsychiatric effects
25
Q

4 strengths of steroid?

A

FML (weak)
Predsol (prednisolone phosphate) = moderate
betamethasone = potent
dexamethasone/prednisolone acetate = very potent

26
Q

when might NSAIDs be used in the eye?

A

can be used for pain relief in post laser eye surgery or in conreal abrasion (in place of local anaesthetic which can reduce healing)

27
Q

what is glaucoma?

A

group of dieases characterised by progressive optic neuropathy resulting in characteristic field defects

28
Q

what is the only modifiable risk factor in glaucoma?

A

raised intra-ocular pressure

29
Q

features of glaucoma?

A

usually asymptomatic unless in late stage
chronic disease
usually slowly progressive

30
Q

how does the optic disc change in glaucoma?

A

cup increases in size as the number of nerve fibres surrounding the cup decreases so it occupies the space
can impact vessels

31
Q

characteristic visual field of glaucoma?

A

tunnel vision

brain only sees central vision but brain fills in the periphery with what it thinks is there

32
Q

how do glaucoma drops work?

A

either close the tap or open the drain for aqueous humor

33
Q

name 5 common glaucoma medications

A

prostanoids (latanoprost/xalatan) = most common
beta blockers
carbonic anhydrase inhibitors (“…zolamide”)
alpha2 adrenergic agonist (brimonidine/alphagan)
parasympathomimetic (Pilocarpine)

34
Q

how does intravitreal administration work?

A

delivers effective concentration of drug at target site instantly
but many drugs are toxic to retina

35
Q

what is intravitreal administration for?

A

used as method of administration of antibiotics in endopthalmitis
used to deliver intra-ocular steroids
anti VEGF delivery

36
Q

sign of endopthalmitis?

A

hypopyon

37
Q

how does local anaesthetic work?

A

blocks sodium channels and impedes nerve conduction

38
Q

name 5 uses for local anaesthetic in the eye

A 
FB removal
tonometry (IOP measurement)
corneal scraping
comfort
cataract surgery
39
Q

what is the most commonly used diagnostic dye and in what 6 cases may it be used?

A

fluorescein

  • shows corneal abrasion
  • dendritic ulcer
  • indentify leaks
  • tonometry
  • diagnosing nasolacrimal duct obstruction
  • angiography
40
Q

what are mydriatics?

A

cause pupil dilation by blocking parasympathetic supply to the iris

e. g
- tropicamide
- cyclopentolate

41
Q

name 2 side effects of mydriatics

A

blurring (cycloplegia) - stop the lens from focusing

AACG

42
Q

signs of acute angle closure glaucoma?

A

sudden onset headache
vomiting
pupil mid-dilated
red sclera

43
Q

what are sympathomimetics?

A

another class of pupil dilators

44
Q

how do sympathomimetics work and name a side effect

A

acts on sympathetic system
causes pupil to dilate
some can cause cycloplegia (e.g atropine)
some don’t cause cycloplegia (phenylephrine)

45
Q

in what condition must steroid never be given?

A

herpetic keratitis

46
Q

name a drug which can cause irreversible constriction of visual fields?

A

vigabatrin (anti convulsant)

47
Q

name a drug which can cause cataract

A

steroids

48
Q

name a drug which can cause optic neuropathy

A

ethambutol (for TB)

49
Q

name a drug which can cause maculopathy

A

chloroquine (hydroxychloroquine can cause if an accumulated dose)

50
Q

what drug can cause vortex keratopathy?

A

amiodarone

Opthamology (18 decks)

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