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Small Animal Opthalmology > Pharmacy > Flashcards

Pharmacy Flashcards

1
Q

Ocular Antibiotics

A

Chloramphenicol - broad spectrum

  • surface infections of the eye
  • poor activity against pseudomonas so not indicated for ulcerative keratitis

Fusidic acid - narrow spectrum, for staphylococcus causing cainine conjunctivitis only

Gentamycin - very good broad spectrum, good for ulcerative keratitis as good activity against pseudomonas

Ciprofloxacin / Ofloxacin - very broad spectrum

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2
Q

Corticosteroids

A

Betamethasone
Dexamethasone
Prednisolone Acetate

NEVER ON ULCERATIVE KERATITIS

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3
Q

Antibiotic and steroid combinations

A

Maxitrol

Good for pre and post op tx follows eye surgery
And dry eye

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4
Q

Dry eye treatment

A

Ciclosporin
Immunosuppressive, anti inflammatory, increases tear production

Good for pannus too

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5
Q

NSAIDs

A

Acular

Good topical NSAID for pre cataract surgery

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6
Q

Mydriasis

A

Atropine - for use in uveitis only
Never examination - lasts a very long time in the non inflamed eye

Tropicamide - used to dilate the pupil to facilitate fundic exam
Dilates for 4-6 h

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7
Q

Anti-glaucoma medications

A

Dorzolamide and lantanoprost
- topical carbonic anhydrase inhibitors

Lantanoprost / travoprost - prostaglandin - open up the drainage angle

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8
Q

Eye lubricants

A

Lubrithal - water-based lubricant in gel form, apply 4-6 x a day

Lacrilube - ointment with a longer duration, use if going out for the day

Artelac - added lipid to reduce evaporation

Hycare

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9
Q

What sutures should you use in the eye?

A

5/0 6/0 vicryl or polysorb

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10
Q

Dow what surgeries is no clipping required and what should you do after a clip?

A

Not required for Corneal, conjunctival or 3rd eyelid surgery

After clipping irrigate the eyelid with saline

Prep with 1:50 povodine iodine

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11
Q

How can you medically manage keratoconjunctivitis sicca?

A

Cyclosporin BID
Lubrithal 4-6 times a day
Lacrilube at bedtime

Can also try
Maxitrol - steroid and antibiotic
Tacrolimus monohydrate

Parotid duct transposition can be attempted if medical management unsuccessful

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12
Q

How can you manage ulcerative keratitis?

A

Antibiotics - gentamycin, Fluoroquinolones (ciprofloxacin, Ofloxacin) every 4-6h initially

Lubrithal QID
Atropine - 1 drop to effect - secondary uveitis
Serum / EDTA
Contact lens

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13
Q

How can you surgically manage ulcerative keratitis?

A

Indications

  • large deep ulcers
  • no vascular ingrowth
  • mechanical weakness and risk of perforation
  • brachycephalics

Surgical procedures

  • 3rd eyelid flap - not very good
  • pedicel grafts
  • free grafts
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14
Q

How should you treat indolent ulcers?

A

Will not respond to medical treatment or 3rd eyelid flaps
Remain static with no improvement

DEBRIDEMENT - only for SCCED ulcers

  • with a cotton bud (punctate keratotomy)
  • grid keratotomy under GA

Lubrication
Tetracyclines / doxycycline - increases corneal epithelial healing
Buster collar

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15
Q

How can you treat pannus?

A

= chronic superficial vascular keratitis occurring in the ventro-lateral direction

Tx: topical steroids (6 times a day for the first week), reducing to every other day maintenance
Cyclosporin

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16
Q

How can you treat paracentral lipid dystrophy?

A

Superficial keratotomy

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17
Q

How can you treat a prolapsed third eyelid? Cherry eye

A

Pocket technique - surgery to replace the gland

Don’t remove - lose the aqueous portion of the tear film

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18
Q

How can you treat anterior uveitis?

A

Mydriatics / cycloplegics - atropine to effect

  • reduces the risk of synechiae
  • relieves pain from pupillary spasm

Anti-inflammatories - dexamethasone / prednisolone acetate q 2-4h

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19
Q

How can you treat anterior uveal melanoma?

A

= most common intra-ocular neoplasm of all the species

Enucleation often curative

20
Q

What are the 3 possible ways of treating primary drainage angle closure glaucoma?

A
  1. Acute - mannitol, paracentesis, refer
    - maximum medication -
    latanoprost (prostaglandin increases drainage)
    dorzolamide (carbonic anhydrase inhibitor)
  2. Normotensive but narrow angle - prophylaxis
  3. Chronic - pain relief enucleation

Mannitol - diuretic that dehydrates the vitreous

21
Q

How can you medically manage glaucoma?

A

Latanoprost - prophylactic - increases the size of the drainage angle by causing pupil constriction

Dorzolamide - carbonic anhydrase inhibitor - reduces aqueous production

Timolol - beta blocker - reduces aqueous production

Pilocarpine - muscarinic cholinergic - causes pupil constriction to increase the drainage angle

22
Q

How can you surgically manage glaucoma?

A

Laser
Cryo
= reduced aqueous secretion and improved drainage

23
Q

Explain the emergency treatment for anterior lens luxation prior to surgery.

A

Maxitrol - steroid and antibiotic
Dorzolamide - carbonic anhydrase inhibitor

Surgery to remove the lens ASAP

24
Q

How can you treat cataracts and how can you establish whether your patient is a good candidate?

A

Phacoemulsification - uses ultrasound to break up the cataract which is then aspirated
A synthetic lens is then placed

Good candidate
PLR present
ERG response
Easily handled 
No history of visual impairment before cataract
25
Q

How can you treat a retro bulbar abscess?

A

Incise the oral mucosa, caudal to the last molar
- provides drainage

3-4 weeks of long acting antibiotics

26
Q

What is a common cause of retrobulbar neoplasia?

A

Retrobulbar meningioma

Partly mineralised mass surrounding the optic nerve

27
Q

How can you treat retrobulbar neoplasia?

A

Extended enucleation

Medical management for inflammatory masses, mast cell tumours, lymphoma

28
Q

How can you treat extra-ocular myositis?

A

Oral steroids

29
Q

How should you manage prolapse of the eye?

A 
Apply pressure to the surface of the eye with moist cotton wool
Lubricate the eye well
GA ASAP
Lateral canthotomy 
Suture the eyelids closed for 14 days
Systemic corticosteroids 
Antibiotics
30
Q

How should you treat feline herpes virus?

A

Famcyclovir
Cleaning of the eye
Broad spectrum antibiotics

31
Q

How should you treat chlamydophila in a cat?

A

Doxycycline or synulox

32
Q

How should you treat a corneal sequestrum?

A

Delayed healing of a corneal ulcer leads to necrosis of the stroma

May slough off
Grid keratotomy

33
Q

Anterior uveitis?

A

Frequently due to severe systemic disease - FIV, FeLV, FIP, toxoplasmosis

FeLV - anterior uveitis - main presenting sign of illness
+/- posterior segment inflammation and retinal detachment

FIP - anterior uveitis, retinochoroiditis, retinal vasculitis, retinal detachment

Toxoplasmosis - retinitis

Lyphoplasmacytic uveitis - low to medium grade uveitis seen in mature / older cats
- Bartonella thought to be a causative agent
- male outdoor cats, FIV +ve
- chronic uveitis = grey lymphoid nodules, keratic precipitates
- may lead to glaucoma / lens luxation
Tx: steroids, doxycycline, tropicamide (hate the taste of atropine)

34
Q

How should you manage a corneal laceration?

A

Examine the cornea for a wound
Atropine - minimise the risk of adhesions, reduce pain
Topical broad spectrum antibiotics - gentamycin
Systemic broad spectrum antibiotics
Re-examine
Consider referral

If the iris is damaged it can be repaired with 6/0 vicryl

35
Q

How should you treat dacryocystitis in the rabbit?

A

Flush the ducts with 1:50 povidone iodine

Topical and systemic antibiotics - gentamycin good against Pasteurella which lives in the rabbits nose (common cause)

36
Q

How should you treat encephalitazoon cuniculi abscesses in the eye?

A

= lens rupture creates a yellow mass in the anterior chamber

Fenbendazole for a month
Phacoemulsification to break down the yellow mass
Topical steroids
Poor px - consider enucleation

37
Q

What local anaesthetic drops can you use in the eye to facilitate?

A

Proxymetacaine

38
Q

How can you diagnose horners syndrome?

A

Phenylpropanolamine - pupil will dilate

39
Q

What local anaesthetic is useful for minor surgical procedures of the eye?

A

Tetracaine

40
Q

What does rose Bengal stain show?

A

Damage to the corneal epithelium

- useful to show dendritic / branching ulcers seen with feline herpes virus

41
Q

What is the normal intraocular pressure?

A

15-20 mmHg

42
Q

What are some pathognomic findings in FIP in the eye?

A

Oedema - dull appearance to the retina

Peri-vascular cuffing

43
Q

How should you treat a melting ulcer?

A

EDTA
Serum
Gentamycin - resistance will occur so switch to Fluoroquinolones in a couple of days
Doxycycline / tetracyclines - increase the healing rate of corneal epi
N-acetylcystine
Buster dollar

44
Q

How can you medically manage a lens luxation?

A

Dilate the pupil using tropicamide
Reduce aqueous production using carbonic anhydrase inhibitors
Dehydrate the vitreous using mannitol
Lift dogs head up - lens should go through pupil
Close the pupil using prostaglandin and maintain

45
Q

What can you give a dog ‘at risk’ of primary glaucoma to prevent the onset?

A

Carbonic anhydrase inhibitors

Can delay onset by two years

46
Q

What neuroprotectants can you use to protect the retina?

A

Dexmedetomidine
Amoldipine
Memantin - reduces glutamate levels

Small Animal Opthalmology (1 decks)

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