Pharmacology Flashcards
topical drugs of the eye require _______ penetration
topical drugs of the eye require CORNEAL penetration
look at the cornea as a _____:_____:_____ sandwich
look at the cornea as a LIPID:WATER:LIPID sandwich
corneal penetration is good for ___ drugs
corneal penetration is good for LMW drugs
the epithelium is lipophilic/hydrophilic and and the storm is lipophilic/hydrophilic
epithelium = lipophilic
stroma = hydrophilic
_____ soluble drugs penetrate the epithelium
_____ soluble drugs penetrate the stroma
LIPID soluble drugs penetrate the epithelium
WATER soluble drugs penetrate the stroma
name the antibiotic that has both lipophilic and hydrophilic properties and can penetrate the cornea easily
Chloramphenicol
hydrophilic/phobic drugs are limited by the epithelium
hydrophilic/phobic drugs are limited by the stroma
HYDROPHILIC drugs are limited by the epithelium
HYDROPHOBIC drugs are limited by the stroma
what drugs have both hydrophobic and hydrophilic capability?
topical steroids
the addition of what makes a steroid more hydrophobic?
alcohol or acetate
the addition of what makes a steroid more hydrophilic?
phosphate
prednisolone _______ is hydro______ and so has ____ penetration in an __________ cornea and is used post-operatively (cataracts)
prednisolone ACETATE is hydroPHOBIC and so has GOOD penetration in an UNINFLAMED cornea and is used post-operatively (cataracts)
prednisolone _______ is hydro______ and so has ____ penetration in an __________ cornea and is used for ______ disease
prednisolone PHOSPHATE is hydroPHILIC and so has POOR penetration in an UNINFLAMED cornea and is used for DORNEA disease
what is benzalkonium added to eye drops for?
keep the bottle sterile and enhances corneal penetration
benzalkonium is a ____________
benzalkonium is a PRESERVATIVE
name 4 other routes of administration related to the eye
subconjunctival
subtenons
intravitreal
intracameral
first 2 for steroids in uveitis
name 2 drugs used to treat infection of the eye
chloramphenical
zovirax
name 2 drugs used to treat inflammation of the eye
predsol-N
maxidex - dexamethasone
steroids
topical NSAIDs
anti-histamines
mast cell stabilisers
steroids are used to suppress ____________ and immune _________
steroids are used to suppress INFLAMMATION and immune RESPONSES
steroids are used topically in:
(a) post op _________
(b) ?
(c) prevent _______ _____ _________
steroids are used topically in:
(a) post op CATARACTS
(b) UVEITIS
(c) prevent CORNEAL GRAFT REJECTION
drug used to treat someone with temporal arteritis
high dose corticosteroid such as prednisolone
list the local and systemic side effects of steroids
local:
cataract
glaucoma
exacerbation of viral infection
systemic:
gastric ulceration immunosuppression osteoporosis weight gain (moon face) diabetes...
what drug is good for pain relief in post refractive laser if local anaesthetic cannot be used?
NSAIDs
define glaucoma
a group of diseases characterised by a progressive optic neuropathy resulting in characteristic fields defects
what is the only current modifiable risk factor in glaucoma?
raised IOP
name the 5 types of glaucoma medication
- prostanoids - latanoprost
- beta blockers
- carbonic anhydrase inhibitors - dorzolamide
- alpha2 adrenergic agonists - brimonidine
- parasympathomimetic - pilocarpine
for each of the following glaucoma medications, name whether they ‘open the drain’ or whether they ‘turn off the tap’:
- prostanoids - latanoprost
- beta blockers
- carbonic anhydrase inhibitors - dorzolamide
- alpha2 adrenergic agonists - brimonidine
- parasympathomimetic - pilocarpine
- prostanoids - latanoprost - OTD
- beta blockers - TOT
- carbonic anhydrase inhibitors - dorzolamide - TOT
- alpha2 adrenergic agonists - brimonidine TOT AND OTD
- parasympathomimetic - pilocarpine - OTD
what are intravitreal injections used for?
- antibiotics in endophthalmitis
- intra-ocular steroids
- anti-VEGF in wet ARMD
pus at the bottom of the cornea is called what? what is it seen in?
hypopyon
endopthalmitis
what diagnostic dye is used in corneal abrasion? what else is it used in?
fluorescein
dendritic ulcer nasolacrimal duct obstruction tonometry angiography identify leaks
what is tropicamide and cyclopentolate?
mydriatics - block parasympathetics so causes pupil dilation
sudden onset of high IOP with vomiting
diagnosis?
closed angled glaucoma
what do sympathomimetics do?
dilate the pupil
some cause cycloplegia - atropine
what do you not give to herpetic keratitis?
steroids!
what important drug constricts fields?
vigabatrin
what drug can cause cataract?
steroids
what drug can cause optic neuropathy?
ethambutol - for TB
what drug can cause a vortex myopathy?
amiodarone
what drug can cause maculopathy?
chloroquine
remember some people may be ________ to eye drops
remember some people may be ALLERGIC to eye drops
define cycloplegia
paralysis of the ciliary muscle of the eye
