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Ophthalmology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

routes of drug administration for the eye?

A

topical
subconjunctival
subtenosis (under conjunctiva)
ocular injections e.g. intravitreal and intracameral (anterior chamber)

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2
Q

two layers in the cornea

A

lipid

water layer

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3
Q

chemical properties of the epithelium in the cornea

A

lipophilic/hydrophobic

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4
Q

chemical properties of the stroma in the cornea

A

lipophobic/hydrophilic

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5
Q

what parts of the cornea can lipid soluble drugs penetrate?

A

epithelium

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6
Q

what parts of the cornea can water-soluble drugs penetrate?

A

stroma

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7
Q

example of a drug that can penetrate both the epithelium and stroma

A

chloramphenicol

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8
Q

what can ocular surface inflammation cause?

A

reduce hydrophobia of epithelium

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9
Q

what drugs are limited by epithelium

A

hydrophilic

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10
Q

what drugs are limited by stroma

A

hydrophobic

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11
Q

examples of modifiers added to topical steroids to change characteristics

A

alcohol or acetate

phosphate

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12
Q

what does alcohol and acetate do when added to topical steroids?

A

makes steroids more hydrophobic

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13
Q

what does phosphate do when added to topical steroids

A

makes steroids more hydrophilic

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14
Q

examples of steroids used in the eye

A
  • prednisolone acetate= hydrophobic

- prednisolone phosphate= hydrophilic

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15
Q

what is benzalkonium chloride

A

antibacterial agent and preservative that can disrupt the lipid layer of the tear film aiding drug penetration

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16
Q

what is benzalkonium chloride added to?

A

bimatoprost

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17
Q

what happens if the dose of benzalkonium chloride is too high?

A

topical side effects/ allergic reaction with reddening around the eye

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18
Q

how can topical drugs be absorbed systemically

A

tears pumped out of lacrimal sac
systemic absorption at nasopharynx
limited by punctal occlusion (for 5 minutes after administration)

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19
Q

examples of anti-inflammatory agents

A

steroids
topical NSAIDs
antihistamines
mast cell stabilisers

20
Q

when are steroids used?

A

post-op cataracts (expose self-proteins in the eye to central immune system)
uveitis
prevention of corneal graft rejection (risk of new vessel formation)

21
Q

example of a condition when steroids are immediately needed?

A

temporal arteritis

22
Q

local side effects of steroids

A

cataracts
glaucoma
exacerbation of viral infections

23
Q

systemic side effects of steroids

A 
gastric ulcer
immunosuppression
osteoporosis
weight gain
diabetes
neuropsychiatric effects
overall reduced life expectancy
24
Q

when should you never give steroids alone?

A

hepatic keratitis as needs antiviral cover (dendritic ulcer)

25
Q

glaucoma medication categories

A
  • prostanoid
  • beta blockers
  • carbonic anhydrase
  • alpha2-adrenergic agonists
  • parasympathomimetic
26
Q

example of prostanoid

A

latanoprost

27
Q

why are beta blockers used in glaucoma?

A

inhibit enzyme responsible for producing aqueous

28
Q

examples of beta blockers given in glaucoma

A

timolol
bextaxolol
levobunolol
carteolol

29
Q

examples of carbonic anhydrase inhibitors

A

topical dorzolamide

systemic acetazolamide

30
Q

role of alpha2-adrenergic agonists

A

vasodilators

31
Q

side effect of brimonidine (alpha2-adrenergic agonist)

A

overwhelming fatigue

32
Q

example of parasympathomimetic

A

pilocarpine

33
Q

why is compliance an issue

A

side effects include red eye, dry, odd taste, stings, etc.

34
Q

when are intravitreal injections used?

A 
administering antibiotics (endophthalmitis)
intra-ocular steroids (diabetic retinopathy, retinal vein occlusion and uveitis)
anti-VEGF (wet ARMD, diabetic retinopathy and retinal vein occlusion)
35
Q

when is local anaesthetic used in the eye?

A

foreign body removal
tonometry (IOP measure)
corneal scraping
cataracts

36
Q

what does local anaesthetic have a risk of?

A

corneal melt

37
Q

how does local anaesthetic impede nerve conduction?

A

blocks Na+ channels

38
Q

when is the diagnostic dye fluorescein used?

A 
corneal abrasion
dendritic ulcers
identify leaks
tonometry
nasolacrimal duct obstruction
angiography
39
Q

examples of mydriatics

A

tropicamide

cyclopentolate

40
Q

action of mydriatics

A 
cause pupil dilation by blocking parasympathetic supply to iris
causes cycloplegia (stops lens from focusing)
41
Q

side effects of mydriatics

A

blurring

AACG

42
Q

action of sympathomimetics

A

cause the pupil to dilate by acting on the sympathetic system (some cause cycloplegia e.g. atropine) and some do not e.g. phenylephrine

43
Q

ocular side effect of vigabatrin

A

constricts fields

44
Q

ocular side effects of ethambutol

A

optic nerve stops functioning and appears pale

45
Q

ocular side effect of digoxin

A

affects ability to judge colour

46
Q

ocular side effect of chloroquine

A

maculopathy- screening

47
Q

ocular side effect of amiodarone

A

brown pigmentation at the cornea

Ophthalmology (28 decks)

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