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VMS3011 Veterinary Medicine 2 > Special Senses Therapeutics > Flashcards

Special Senses Therapeutics Flashcards

1
Q

Atropine 1%

A
  • Mydriatic; cycloplegic - paralyses ciliary mm., relieves intraocular pain + decongestant of iris (parasympathomimetic)
  • Longer onset + duration
  • Hyphaema; uveitis; ciliary spasm; cataract management; reflex uveitis in corneal ulceration
  • Contradicted in glaucoma - tonometry before Tx
  • Consider: dec tear production - dry eye (KCS); hypertension + inc IOP (glaucoma); salivation - bitter taste; mydriasis (lens luxation)
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2
Q

Tropicamide (Mydriacyl, Mydriaticum)

A
  • Anticholinergic medication
  • Short-acting mydriatic
  • Paralyses smooth muscles or iris + ciliary body (holds lens in place) = cycloplegic agent (parasympathomimetic)
  • Hyphaema; uveitis; dilate pupil to look at retina
  • Consider: dec tear production = dry eye (KCS); hypertension + inc IOP (glaucoma); salivation - bitter taste; mydriasis (lens luxation)
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3
Q

Intracameral tPA

A
  • Tissue plasminogen activator -> blood clot lysis
  • Resolves blood clot - if clot substantial, severe or threatening
  • 25 ug
  • Hyphaema; uveitis
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4
Q

Prednisolone (Prednisolone acetate)

A
  • Corticosteroid
  • Oral/topical (1% drops)
  • Good corneal penetration
  • Acute uveitis; hypertensive retinopathy; optic neuritis; perioperative Tx in cataract Sx
  • AE: systemic absorption -> PUPD, difficulty stabilising diabetic patients, subcapsular cataracts in cats + corneal lipidosis
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5
Q

Dexamethasone

A
  • Corticosteroid
  • Topical drops (4 - 6 x daily)
  • Acute uveitis; conditions of ocular surface e.g. eosinophilic keratoconjunctivitis (cats)
  • AE: systemic absorption -> PUPD, difficulty stabilising diabetic patients, subcapsular cataracts in cats + corneal lipidosis
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6
Q

Aspirin

A
  • NSAID
  • Oral dogs - 10 mg/kg 3 x weekly in chronic cases
  • Cats - 75 mg every 48 - 72 h
  • Acute uveitis/when corticosteroid contraindicated
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7
Q

Acular, Keratolac, Naclof/Voltaren, Ocufen

A
  • NSAIDs
  • Topical drops
  • Acute uveitis/when corticosteroids contraindicated
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8
Q

Rimidyl

A
  • NSAID
  • Acute uveitis/when corticosteroids contraindicated
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9
Q

Metacam

A
  • NSAID
  • Acute uveitis/when corticosteroid contraindicated
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10
Q

Azathioprine (Imuran)

A
  • Immunosuppressive
  • Refractory cases of uveitis (to corticosteroids) - canine uveodermatological syndrome, long-term therapy in combo w/ prednisolone
  • AE: hepatotoxicity, BM suppression - don’t give to cats
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11
Q

Epinephrine (adrenaline), phenylephrine (preferred option)

A
  • Adrenergic drug
  • Localisation of Horner’s syndrome/Dx (denervation hypersensitivity) - if mydriasis in <20 min = post-ganglionic lesion = Horner’s
  • Uveitis (mydriatic) - AE: risk of 2y glaucoma
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12
Q

N-Acetylcysteine (Stromease), EDTA

A
  • Antiproteolytic agent - autologous serum
  • Stromal corneal ulceration; melting ulcer
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13
Q

Fluoroquinolones, Gentamicin, Tobramycin, Neomycin, PolymyxcinB

A
  • Pseudomonas infection - melting ulcer
  • Companion animal
  • Gentamicin = equine
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14
Q

Bacitracin, Gramicidin, Cephalosporins, Penicillins

A
  • Streptococcus spp. (G+) infection - melting ulcer
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15
Q

Ciprofloxacin (Ciloxan)

A
  • Fluoroquinolone AB, bactericidal, conc dependent, broad spectrum
  • G+ - staphylococcus; G- - Pseudmonas aeruginosa
  • Melting ulcer - first line; reserved for cases where other AB ineffective; complicated (infectious keratitis) corneal ulceration, melting ulcers
  • May cause local irritation
  • Companion animal, equine
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16
Q

Ofloxacin (Exocin)

A
  • Quinolone AB, bactericidal, conc dependent, broad spectrum
  • G+ - staphylococcus; G- - Pseudmonas aeruginosa
  • Better corneal penetration than ciprofloxacin, reserved when other AB are ineffective
  • Melting ulcer (second line) - when AB ineffective; complicated (infectious keratitis) corneal ulceration
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17
Q

Famciclovir

A
  • Antiviral
  • FHV-1 keratitis; corneal sequestrum
  • Expensive
  • Cat
  • AE: GI signs
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18
Q

L-lysine

A
  • Essential AA
  • Replaces/antagonises arginine AA in virus, slows down replication, reduces in-vitro replication of FHV-1, may reduce viral shedding latently infected cats
  • BID bolus, not added to food
  • FHV-1; corneal sequestrum
  • Cats
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19
Q

Cyclosporine (Optimmune)

A
  • Immunosuppressant/immune-modulator - inhibits T-cells
  • Stimulates tear production (direct lacrostimulant)
  • Licensed
  • Feline eosinophilic keratitis; tear film deficiency (KCS)
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20
Q

Chloramphenicol

A
  • Broad spectrum AB, bacteriostatic
  • G+: Streptococcus, Staphylococcus
  • G-: Brucella, Salmonella, Haemophilus
  • E. coli, enterobacter spp, proteus, mycoplasma spp (unreliable), clostridium, bacteroides
  • Conjunctivitis; uncomplicated + complicated (infectious keratitis); corneal ulceration
  • Equine, companion animals
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21
Q

Fusidic acid - Isathal

A
  • Narrow spectrum AB, bacteriostatic
  • Penetrates through cornea into anterior chamber
  • Staphylococcus (particularly S. pseudintermedius), streptococcus
  • Conjunctivitis
  • Companion animal
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22
Q

Gentamicin (Tiacil, clinagel vet)

A
  • Aminoglycosides broad spectrum, bactericidal AB, conc dependent
  • Requires O2-rich environment (ineffective in abscesses, exudates)
  • Pseudomonas aeruginosa, E. coli, enterobacter spp, proteus spp, G-
  • Some G+: staphylococcus + streptococcus (S, faecalis)
  • Conjunctivitis; complicated (infectious keratitis) corneal ulceration
  • (Resistant = all anaerobes + haemolytic Streptococcus)
  • Epitheliotoxic, don’t use for > 7 d or will delay healing = toxic to corneal epithelial cells
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23
Q

Polymyxin B (polyfax ointment, maxitrol)

A
  • Cyclic polypeptide, broad spectrum, bactericidal AB, cationic surface acting agent - interacts w/ phospholipids in cell mem (G+ bacteria resistant)
  • Requires O2-rich environment (ineffective in abscesses, exudates)
  • Contains steroids
  • G-: Pseudomonas aeruginosa, E. coli, Klebsiella
  • Some G+: Staphylococcus + Streptococcus (S. faecalis)
  • Resistant to all anaerobes + haemolytic streptococcus
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24
Q

Cloxacillin

A
  • Topical AB
  • Infectious bovine keratoconjunctivitis (IBK); pink eye (sheep) infectious keratoconjunctivitis (IKC) = orbenin + opticlox
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25
Q

Penicillin, oxytetracycline

A
  • Sub-conjunctival injection AB
  • Infectious bovine keratoconjunctivitis (IBK); listeria uveitis (ruminants)
26
Q

Oxytetracycline

A
  • Single dose long-acting
  • (+/- dexamethasone)
  • Silage eye/listeria uveitis (cattle); IBK
27
Q

Mannitol

A
  • Osmotic diuretic - hyperosmotic agent
  • IV over 20 min
  • Glaucoma
  • (Reduced efficacy in uveitis due to breakdown of blood aq barrier)
28
Q

Trusopt, cosopt

A
  • Carbonic anhydrase inhibitors -> inc fluid transport into corneal endothelium
  • Glaucoma
29
Q

Iopidine

A
  • Alpha-adrenergic agonist
  • Dec production of aq, dec outflow, reduces episcleral venous pressure, dec HR
  • AE - V+
  • Glaucoma
30
Q

Timolol

A
  • Beta-2 adrenergic blocker
  • Miosis, aggravate pupil block glaucoma
  • Glaucoma
  • AE; miosis, conjunctival hyperaemia, local irritation, bradycardia
  • Contraindicated: uveitis, anterior lens luxation, heart failure
31
Q

Demecarium bromide

A
  • Cholinesterase inhibitor -> inc aqueous flow
  • Miotic
  • Drops
  • Glaucoma
32
Q

Latanoprost/xalatan, travoprost/travatan, bimatoprost/lumigan

A
  • Prostaglandin analogue - reduce IOP through interaction w/ PG F receptors in uvea + trabecular meshwork -> inc uveoscleral outflow
  • Drops
  • Glaucoma
  • Don’t use when there is concurrent uveitis + anterior lens luxation
  • AEs: conjunctival hyperaemia, marked miosis, disruption of blood aq (latanoprost), vitreous entrapment in pupil -> inc IOP
  • Ineffective in most cats (latanoprost)
  • Dogs + primates
33
Q

Dextropmethophortan, memantine

A
  • Neuroprotection
  • Glaucoma
34
Q

Lutein, xeazanthin, grape seed extract, lycopene (eyes Rx plus), ocuglo)

A
  • Antioxidant medication
  • Inherited Retinal Degenerations (Progressive Retinal Atrophy/PRA)
35
Q

Amlodipine

A
  • Calcium channel blocker
  • Hypertensive retinopathy
36
Q

Fortekor

A
  • Contains benazepril (ACE inhibitor)
  • Hypertensive retinopathy
36
Q

Amox-clav (amoxicillin/clavulanate), cephalosporin

A
  • Broad spectrum systemic AB
  • Infection e.g. orbital abscessation/bacterial cellulitis
37
Q

Tacrolimus (Proptopic)

A
  • Calcineurin inhibitor (immunosuppressant) -> dec T-cell activation -> dec inflammatory response
  • Unlicensed
  • (2nd line Tx of tear film deficiency, if unresponsive to cyclosporine)
38
Q

Pilocarpine

A
  • Cholinergic agonist - direct parasympathomimetic -> tear stimulation
  • Unlicensed
  • Neurogenic KCS only (when innervation affected) - tear film deficiency
  • Anti-glaucoma
  • Inc dose until improvement/GI signs
  • Eye drops orally
  • Contradicted: uveitis, anterior lens luxation
39
Q

Tetracaine, lidocaine, proxymetacaine

A
  • Local anaesthetic
  • Onset 5 min; duration 1 - 2 h
  • Dx purposes only - tonometry, exploration of conjunctiva, Dx sampling
  • Consider: dec corneal sensation -> inc risk of trauma; reduced reflex tearing; epitheliotoxic if long-term; systemic toxicity if in small patients
40
Q

Celluvisc, Ocry-gel, Remend, Viskyal, Lacrilube

A
  • Tear substitutes
41
Q

Chlorotetracycline (Ophtocycline)

A
  • Bacteriostatic AB, inhibits protein synthesis, conc dependent
  • Staphylococcus, streptococcus, proteus, pseudomonas
  • Keratitis; conjunctivitis; blepharitis; feline chlamydial conjunctivitis
  • Cornea ulceration - inhibits collagenolytic degradation of the cornea
42
Q

Doxycycline

A
  • Systemic AB
  • Oral
  • Feline chlamydial conjunctivitis
43
Q

Cefalexin + metronidazole

A
  • Orbital abscessation/bacterial cellulitis
44
Q

Cefalexin + clindamycin

A
  • Orbital abscessation/bacterial cellulitis
45
Q

Trifluorothymidine (Trifluridine)

A
  • Antiviral - virostatic, nucleoside analogue
  • Cats - x 5 daily
  • May be extremely irritating to eye
  • V expensive
  • FHV-1
46
Q

Betamethasone sodium phosphate, prednisolone sodium phosphate, fluoromethalone, hydrocortisone

A
  • Less commonly used corticosteroids
47
Q

Carprofen, meloxicam, tepoxalin

A
  • NSAIDs - non-selective COX-2 inhibitors
  • Systemic
  • Dog
  • Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
48
Q

Firocoxib, robenacoxib, mavacoxib

A
  • NSAIDs - COX-2 inhibitors
  • Systemic
  • Dog
  • Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
49
Q

Carprofen, meloxicam, robenacoxib

A
  • Systemic NSAIDs for cats
  • Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
50
Q

Keratolac, flurbiprofen, diclofenac

A
  • Topical NSAIDs, when corticosteroids contra-indicated (unauthorised)
  • Diclofenac and Flurbiprofen increase IOP significantly in cats - avoid in cats with ocular hypertension
  • Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
51
Q

Chlorphenamine

A
  • Oral antihistamine
  • Dogs
  • Allergic conjunctivitis
52
Q

Sodium cromoglicate

A
  • Anti-allergy - mast cell stabiliser
  • Dogs, cats
  • Allergic conjunctivitis
53
Q

Glycerol

A
  • Osmotic diuretic
  • Oral
  • Glaucoma
54
Q

Dorzolamide hydrochloride

A
  • Carbonic anhydrase inhibitor
  • Drops
  • Glaucoma
55
Q

Acetazolamide

A
  • Carbonic anhydrase inhibitor
  • Oral, IV, IM
  • Glaucoma
55
Q

Brinzolamide

A
  • Carbonic anhydrase inhibitor
  • Drops
  • Glaucoma
56
Q

Dichlorphenamide

A
  • Carbonic anhydrase inhibitor -> dec aq production
  • Oral
  • Glaucoma
57
Q

Metipranilol, levobunolol, betaxolol

A
  • Beta-adrenergic blocker
  • Glaucoma
58
Q

Bromfenac

A
  • Topical anti-inflam
  • Acute uveitis (equine)
59
Q

Enilconazole, voriconazole

A
  • Anti-fungal (ringworm wash)
  • Non-healing corneal ulcer (equine)
60
Q

Ciclosporin

A
  • Calcineurin inhibitor (immunosuppressant) -> dec T-cell activation
  • Direct lacrostimulant
  • Licensed 0.3% BID
  • Expensive
  • For KCS

VMS3011 Veterinary Medicine 2 (20 decks)

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