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 (KCS); hypertension + inc IOP (glaucoma); salivation; mydriasis (lens luxation)
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 (KCS); hypertension + inc IOP (glaucoma); salivation; mydriasis (lens luxation)
3
Q
Intracameral tPA
A
- Tissue plasminogen activator -> blood clot lysis
- Resolves blood clot - if clot substantial, severe or threatening
- 25 ug
- Hyphaema; uveitis
4
Q
Prednisolone (Prednisolone acetate)
A
- Corticosteroid
- Oral/topical
- 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
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
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
7
Q
Acular, Keratolac, Naclof/Voltaren, Ocufen
A
- NSAIDs
- Topical drops
- Acute uveitis/when corticosteroids contraindicated
8
Q
Rimidyl
A
- NSAID
- Acute uveitis/when corticosteroids contraindicated
9
Q
Metacam
A
- NSAID
- Acute uveitis/when corticosteroid contraindicated
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
11
Q
Epinephrine, 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
12
Q
N-Acetylcysteine (Stromease), EDTA
A
- Antiproteolytic agent - autologous serum
- Stromal corneal ulceration; melting ulcer
13
Q
Fluoroquinolones, Gentamicin, Tobramycin, Neomycin, PolymyxcinB
A
- Pseudomonas infection - melting ulcer
- Companion animal
- Gentamicin = equine
14
Q
Bacitracin, Gramicidin, Cephalosporins, Penicillins
A
- Streptococcus spp. (G+) infection - melting ulcer
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
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
17
Q
Famciclovir
A
- Antiviral
- FHV-1 keratitis; corneal sequestrum
- Expensive
- Cat
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
19
Q
Cyclosporine (Optimmune)
A
- Immunosuppressant/immune-modulator - inhibits T-cells
- Stimulates tear production (direct lacrostimulant)
- Licensed
- Feline eosinophilic keratitis; tear film deficiency (KCS)
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
21
Q
Fusidic acid - Isathal
A
- Narrow spectrum AB, bacteriostatic
- Penetrates through cornea into anterior chamber
- Staphylococcus (particularly S. pseudintermedius), streptococcus
- Conjunctivitis
- Companion animal
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
23
Q
Polymyxin B (polyfax ointment, mazitrol)
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
24
Q
Cloxacillin
A
- Topical AB
- Infectious bovine keratoconjunctivitis (IBK); pink eye (sheep) infectious keratoconjunctivitis (IKC) = orbenin + opticlox