Routes of Ocular Delivery Flashcards

1
Q

Most commonly used mode of delivery for topical ocular medication

A

SOLUTIONS & SUSPENSIONS

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2
Q

Dispersion of drugs with low water solubiliy in finely divided forms and must be resuspended by shaking

A

Suspensions

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3
Q

Preferred than ointments which easily instilled and interfere less with vision

A

Solutions

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4
Q

4 Disadvantages of solutions and suspension

                SIFP
A
  1. Short ocular contact time
  2. Imprecise and inconsistent delivery of drug
  3. Frequent contamination
  4. Possibility of ocular injury with dropper tip
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5
Q

Techniques in Storage and Instillation of Solutions and suspensions

A

Stored in examination room
Inspection of drug every time medication is used
Refrigerator is needed

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6
Q

What minimizes nasolacrimal drainage or simple eyelid closure alone

A

pressure to the puncta and canaliculi for 2-3mins

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7
Q

Beta Blockers (Anti Glaucoma Drugs, Ocular Hpn and open angle glaucoma

A

Yellow or Blue or Both

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8
Q

Mydriatics and Cycloplegics (Papillary dilation, refraction in younger childern and anterior uveitis

A

Red

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9
Q

Miotics (managment of primary open angle glaucoma, reucs IOP)

A

Green

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10
Q

Non steroidal and Anti Inflammatory Drugs (alleviates pain and inflammation)

A

Gray

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11
Q

Anti-infective drugs (inhibits the spread of infection)

A

Tan/brown

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12
Q

Unit dose dispenser accommodates…

A

solution volume ranging from 0.1 - 0.6 mL

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13
Q

UNIT DOSE DISPENSERS:

A

Sprays
Ointments
Lid Scrubs
Gels
Hydrogel Contact Lenses
Collagen Shields
Filterpaper Strips
Cotton Pledgets
Artificial Tear Inserts
Membrane Boudn Inserts

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14
Q

10 Routes of Administration

A

Tropical Administration
Periocular Administration
Subconjunctival Infection
Anterior Sub Tenons Injection
Posterior Sub Tenons Injection
Retrobulbar Injection
Peribulbar Injection
Intracameral administration
Intravitreal Administration
Lontophoresis

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15
Q

An alternative method that maybe less irritating and less objectionable

A

SPRAYS

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16
Q

Can be produced by using a refillable perfume atomizer or???

A

Plastic spray bottle that has been sterilized with ethylene oxide gas or hydrogen peroxide

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17
Q

Contains mineral oil and a petroleum base when applied to the inferior conjunctival sac

A

Ointments

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18
Q

Acts as a reservoir and enhances drug contact time

A

ointments on the lid margin, mao na siya result rommmm

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19
Q

how many cm of ointment should you se at bedtime?

A

1cm

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20
Q

contact dermatitis, blurred vision and interference in wound healing.

A

complications of ointments

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21
Q

To aid in the removal of oils, debris or desquamanted akin associated with inflamed eyelid

A

LID SCRUBS

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22
Q

Can also be used for hygienic eyelid cleansing for contact lens wearers

A

LID SCRUBS

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23
Q

The practiced advantage of this sustained pulse delivery systems is the once daily dosage regimen, usually administered at bedtime

A

GELS

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24
Q

Minor side effects of GELS

A

Superficial corneal haze and SPK (superficial punctate keratitis)

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25
Q

SOLID DELIVERY DEVICES

A

Hydrogel Contact Lenses,

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26
Q

Maximum drug delivery is obtained by pre soaking the lens and it uses disposable contsct lense

A

Hydrogel Conotional rin

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27
Q

appear to be of greatest clinical value in the treatment of BOLLUS KERATOPATHYM, dry eye syndrome and corneal conditions requiring protection

A

Hydrogel Contact Lens pud

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28
Q

A thin membrane of porcine and bovine sclera collagen that conform to the cornea when place on the eye which are packed hydrated state and require hydration before application

A

Collagen Shields

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29
Q

Sodium Flourescein and Rose Bengal are commercially available as drug impregnated filter paper strips

A

FILTER PAPER STRIPSs

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30
Q

easy administration to the eye in adequate amount of dosage and eliminates risks of solution contamination

A

FILTER PAPER STRIPS

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31
Q

Allows prolonged ocular contact time with solution

A

Cotton Pledgets

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32
Q

Clinical Use of Pledget

A

is usually reserves for administration of mydriatic solutions

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33
Q

Treatment for moderate to severe dry eye syndromes and is inserted to the inferior conjunctival sac

A

Artificial Tear Inserts

34
Q

Most annoying side effct of Artificial Tear Inserts

A

BOV after 4 to 6 hrs and local discomfort

35
Q

Thin, multi layered drg impregnated, copolymeric plastic devices placed into the conjunctival sac

A
36
Q

OCUSERT

A

only device available in the US

37
Q

How often is Membrane bound inserts inserted?

A

only once per week

38
Q

Continuous Flow Devices

A

when what is required are large volumes of fluid such as in the treatment of acute chemical burns

39
Q

Conventional Irrigating Systems

A

used in the initial treatment of ocular foreign bodies or chemical burns in an effort to dislodge the foreign materials

40
Q

Also used to remove excessive drug from the eye after flourescein/rose bengal cl prcedure

ex. normal saline solution

A

conventional irrigating system

41
Q

when higher concentrations of drugs are required in the eye. particularly corticosteroid and antibiotics

A

conventiona irrigating system

42
Q

this drug delivery includes subcnj, sub tenons, retrobulbar and peribulbar administration

A

conventional irrigating system

43
Q

continuous irrigating system

mnemonics: EUT

A

enables continuos delivery o fluid on long term basis USUALLY FOR NON AMBULATORY PXs

44
Q

tubing is simple passed through the con fornix

A

continuous irrigating system

45
Q

PERIOCULAR ADMINISTRATION

A

Subconjunctival injection
Anterior Sub Tenons Injection
Posterior Sub Tenons Injection
Retrobulbar Injection
Peribulbar

46
Q

INTRAVITREAL ADMINISTRATION

A

injected directly on vitreous chamber which INCLUDES, antbacterial and antifungal agnets for endophthalmitis, antivirals for the treatment of vital retinitis, AIDS/CMV

47
Q

INTRACAMERAL ADMINISTRATION

A

injecting drug directly into the anterior chamber of the eye
Injection of viscoelastic substances into the Anterior Chamber during cataract extraction and glaucoma filtering surgeries

48
Q

LONTOPHORESIS

A

used in the earlier parts of the century for the treatment off ocular infection
ALMOST NEVER USED TODAY

49
Q

Antibacterial and ANTIFUNGAL for:

A

endophthalmitis

50
Q

Antivirals for:

A

treatment of vital retinitis, AIDS/CMV

51
Q

Silicone Oil

A

injeted intravitreally for tx of complicated retinal detachments

52
Q

PERIBULBAR INJECTION

A

consist of placing on or more injections of local anesthetic around the globe but not directly into the muscle cone

53
Q

Major disaadvantage of Peribulbar injection

A

v low tissue drug concentrations during intervals between injections

54
Q

The use of PERIOCULAR INJECTION less than 4-6weeks following cataract extraction is CONTRAINDICATED

A

TRUE

55
Q

Most significant complication of Peribulbar

A

Accidental perforation of the globe

56
Q

RETROBULBAR INJECTION
(injection thru the SKIN of LOWER LID with a needle inserted immediately above the inferotemporal rim and directed towards the orbital apex)

A

principal use to anesthesize the globe for cataract extraction and other intraocular surgeries

57
Q

POSTERIOR SUB TENONS INJECTION

(CONJUNCTIVA or SKIN)

A

Used in Tx of CHRONIC EQUATORIAL AND MIDZONE POSTERIOR UVEITIS, including inflammation of the macular region

58
Q

ANTERIOR SUB TENONS INJECTION (directly under the tenons capssule)

A

delivers lower quantities

greater risk of perforating the globe

occasionally used in the tx if SEVERE UVEITIS

59
Q

SUBCONJUNCTIVAL INJECTION

(between Anterior Conjunctiva and Tenons Capsule)

A

done in superotemporal quadrant

60
Q

Greatest Clinical Benefit of Subconj:

A

TX of SEVERE CORNEAL DISEASE such as BACTERIAL ULCERS

61
Q

4 Guidelines for clinical utilization of ointmentss

A
  1. after intraocular surgery under a conjunctival flap
  2. should not be used in surgery if there is a question in wound integrity
  3. for superficia corneal abrasions
  4. to corneal ulcers
62
Q

CYCLOPLEGICS

A

Atropine
Homatropine
Scopolamine
Cyclopentolate
Tropicamide

63
Q

HOMATTROPINE
(Solanaceae family)

1/10 as potent as atropine

A

1% sol, max mydriasis occurs 40mins: 1-3 days recovery

64
Q

for treatment of anterior uveitis

A

homatropine

65
Q

Weak action in dark pigmented irides pxn not for fundus exam and cyclorefraction

A

HOMATROPINE

66
Q

CONTRAINDICATIONS of HOMATROPINE

A

CNS toxicity in elderly

67
Q

derived from hyosyanamus niger

A

SCOPOLAMINE (HYOSINE)

68
Q

greater in size with atropine but shorter duration of mydriatic and cycloplegic

A

SCOPOLAMINE

69
Q

INDICATED FOR CYCLOPLEGIC RETINOSCOPY AS SUBSTITUTE TO ATROPINE ALLERGIC PXs

A

SCOPOLAMINE

70
Q

SIDE EFFECTS OF SCOPOLAMINE

A

CNS TOXICITY

PREVENTS MOTION SICKNESS (Thru transdermal delivery

71
Q

CYCLOPENTOLATE (1951)
DOES NOT ALTER IOP

onset begins:

A

in 5-20mins and reaches max in 20-30mins

72
Q

FOR ROUTINE CYCLOREFRACTION

A

CYCLOPENTOLATE

73
Q

SUPERIOR EFFECT TO THAT OF HOMATROPINE

A

CYCLOPENTOLATE

74
Q

TRANSIENT STINGING ON INITIAL INSTILLATION

A

OCULAR EFFECTS

75
Q

CYCLOPENTOLATE cns TOXICITY: caues more cns effects

A

SYSTEMIC EFFECTS

76
Q

CONTRAINDICATIONS OF CYCLO

A

Infants and young children with spastic paralysis or brain damage

77
Q

SYSNTHETC DERIVATIVE OF TROPIC ACID

A

TROPICAMIDE (1959)

USED primarily for pupillary dilation

78
Q

quickly diminished

A

TROPICAMIDE

79
Q

open angle g;aucoma may have significant increase in IOP

A

tropicamide

80
Q

CONTRAINDICATIONS OF TROPICAMIDE

A

PXS with narrow anterior chamber angles