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Year 2 Ophthalmology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Why does the topical route of admission pose difficulties?

A

The drug has to both be lipophilic and hydrophilic in order to pass through the aqueous components and the lipid bound epithelium.

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2
Q

Give an example of both a lipophilic and hydrophobic drug?

A

Chloramphenicol

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3
Q

Why does an inflamed eye improve the uptake of drugs?

A

Inflammation creates gaps between the epithelial cells allowing less lipophilic drugs a site of entry.

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4
Q

Why do ointments have a higher uptake of the drug through the eye than drops?

A

Ointments are not washed or blinked away as easily so stay for longer on the surface of the eye.

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5
Q

In regards to steroids what can be added to make them more hydrophilic?

A

Phosphate groups

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6
Q

In regards to steroids what can be added to make them more lipophilic?

A

Acetate groups

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7
Q

Give an example of a hydrophobic steroid.

A

Prednisolone Acetate

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8
Q

When is prednisolone acetate used and why?

A

Used post operatively

Good penetration of the eye

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9
Q

Give an example of a hydrophilic steroid and explain how this impacts its usage.

A

Prednisolone Phosphate

Doesn’t penetrate the eye so used for surface level inflammation

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10
Q

What drug increases the uptake of other drugs through the eye?

A

Benzalkonium

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11
Q

How does benzalkonium work?

A

It disrupts the lipid bilayer allowing the drug entry.

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12
Q

How can topical applications be systemically absorbed?

A

The lacrimal duct empties into the nasopharynx.

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13
Q

How can systemic absorption be limited in topical applications?

A

Pinch the bridge of the nose to obstruct the lacrimal duct for a period of time after application.

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14
Q

When treating infections of the posterior eye why can drugs not be administered systemically?

A

The Blood retinal barrier prevents the drugs from entering the optic environment.

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15
Q

How are drugs administered to the posterior chamber?

A

Intravitreal injection

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16
Q

How are drugs administered into the front of the eye?

A

Intracameral injection

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17
Q

What anti inflammatories are commonly used for the eye?

A

Steroids
NSAIDs
Antihistamines
Mast Cell stabilisers

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18
Q

When are steroids used?

A

Post Operative Cataracts
Uvietis
Prevention of corneal graft rejection

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19
Q

When are IV steroids used in a clinical setting?

A

Suspicion of temporal arteritis

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20
Q

What are some local effects of steroid use?

A

Cataracts
Glaucoma
Exacerbation of viral infection - corneal melt

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21
Q

What are some systemic effects of steroid use?

A

Gastric ulcers
Osteoporosis
Weight gain

22
Q

List some of the commonly used steroid in order from least to most potent.

A

FML
Prednisilone - Phosphate
Beclamethasone
Dexamethasone - Acetatae

23
Q

Glaucoma can be completely stopped. T/F

A

False

We are only able to slow the progression of the disease.

24
Q

List the types of drugs available for the treatment of a glaucoma.

A 
Prostanoids
Beta Blockers
Carbonic Anhydrase inhibitors
Alpha Adrenergic Agonist
Parasympathimimetics
25
Q

Give an example of a Prostanoid.

A

Latanoprost

26
Q

How do Prostanoids work?

A

Latanoprost
Increases the drainage
1x daily

27
Q

How do Beta Blockers work?

A

Tinnolol Betaxolol

Reduces production of aqueous fluid.

28
Q

Give an example of beta blockers.

A

Tinnolol

Betaxolol

29
Q

Give some examples of Carbonic anhydrase inhibitors

A

Dorzolamide - Topical

Acetazolamide - Systemic

30
Q

How do Carbonic Anhydrase inhibitors work?

A

Reduce the production

31
Q

When is Acetazolamide used?

A

In an acute glaucoma

32
Q

Give an example of an Alpha Adrenergic Agonist.

A

Brimonidine

33
Q

How do Alpha Adrenergic Agonists work?

A

Reduce production

Widens the trabeculae

34
Q

What drug used in the treatment of Glaucoma is contraindicated in children?

A

Alpha Adrenergic Agonists.

35
Q

What are some of the side effects of Alpha Adrenergic Agonists?

A

Red eye
Many people become allergic
In adults causes extreme fatigue

36
Q

Give an example of an Parasympathomimetic

A

Pilocarpine

37
Q

How do parasympathomimetic work?

A

Massively constrict the pupil

38
Q

What is a commonly used combination therapy?

A

Dorzolamide

Timolol

39
Q

What is the treatment for someone with Wet Macular Degeneration?

A

Intravitreal Anti-VEGF

40
Q

What is the most commonly used diagnostic dye?

A

Flourescin

41
Q

When is fluorescin used?

A

Corneal Abrasions
Dendritic Ulcers
Identify leaks
Diagnosing Naso-Lacrimal duct obstruction

42
Q

How do local anaesthetics work?

A

They block Na+ channels so prevent the conduction of action potentials across the axon.

43
Q

When are local anaesthetics used?

A 
Foreign Body Removal
Tonometry
Corneal Scraping
Comfort 
Cataract surgery
44
Q

What is the name of the pupil dilating drugs?

A

Mydriatics

45
Q

List two commonly used mydriatics.

A

Cyclopentolate

Tropicamide

46
Q

How do mydriatics work?

A

They over stimulate the sympathetic system resulting in dilation of the pupil.

47
Q

What drug used to treat bradycardia can be used topically to dilate the eye, but why is it not widely used?

A

Atropine ACh competitor

Effects last too long a time

48
Q

What drug used in the treatment of TB has side effects affecting the eye?

A

Ethambutol - optic nerve neuropathy

49
Q

What drug used in the treatment of heart failure has side effects affecting the eye?

A

Digoxin - causes yellow tinting

50
Q

Which drug used in rheumatology has some evidence of side effects after long term usage?

A

Hydrochloroquine

Pinpoint Maculopathy

Year 2 Ophthalmology (10 decks)

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