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Pharmacology > Unit 3: Eye and Ear > Flashcards

Unit 3: Eye and Ear Flashcards

1
Q

Blepharitis

A

Eyelid margin infection

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2
Q

Causes of blepharitis

A

Usually due to staphylococcus infections, inflammation or hypersecretion of sebaceous glands or meibomian gland dysfunction

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3
Q

S/S blepharitis

A

Irritated red eyes, burning sensation, increase in tearing, blinking and phototobia

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4
Q

First line tx for blepharitis

A

Erythromycin 0.5% ointment, bacitracin 500U/g ointment or opthalmic fluoroquinolone (besifloxacin, gatifloxacin, levofloxacin, moxifloxacin)

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5
Q

Conjunctivitis

A

External surface ocular infection

Eye inflammation of bulbar conjunctiva

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6
Q

Most common organisms causing bacterial conjunctivitis

A

Staph, Strep, Moraxella + Haemophilus

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7
Q

most common cause of conjunctivitis in neonates

A

N. Gonorrhoeae + C. Trachomatis

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8
Q

Viral conjunctivitis

A

Most common
Usually adenovirus
Very contagious

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9
Q

S/S conjunctivitis

A

Itching, burning sensation of eye, discharge, sensation of foreign body

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10
Q

S/S bacterial conjunctivitis

A

Eyelids stuck together in morning

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11
Q

S/S N. Gonorrhoeae conjunctivitis

A

Copious purulent discharge

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12
Q

S/S viral conjunctivitis

A

Profuse watery discharge

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13
Q

S/S allergic conjunctivitis

A

Itching is hallmark

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14
Q

Antibiotics for bacterial conjunctivitis

A

Erythromycin or bacitracin/polymyxin B ointment usually most effective
Some fluoroquinolones have good coverage (besifloxacin, gatifloxacin, levofloxacin, moxifloxacin)

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15
Q

Antibiotic for gonoccocal conjunctivitis

A

immediate IM injection of ceftriaxone and single dose oral azithromycin

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16
Q

Antibiotic for chalmydial conjunctivitis

A

Single dose azithromycin or 7 days doxycyline

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17
Q

Antihistamine for conjunctivitis

A

Alcaftadine + Emedastine

Useful for allergic conjunctivitis

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18
Q

Mast cell stabilizers for conjunctivitis

A

Bepotastine, cromolyn, lodoxamide, nedocromil

For allergic conjunctivitis

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19
Q

NSAID ophthalmic drug

A

Ketorolac

Treatment of itch with allergic conjunctivitis

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20
Q

First line tx for bacterial conjunctivitis

A

Erythromycin ointment of bacitracin/polymyxin B ointment

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21
Q

Second line tx for bacterial conjunctivitis

A

Ophthalmic fluoroquinolones

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22
Q

First line tx for seasonal conjunctivitis

A

Topical antihistamines

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23
Q

Second line tx for seasonal conjunctivitis

A

Topical antihistamines + low potency topical corticosteroid

24
Q

First line tx for viral conjunctivitis

A

Topical antihistamines or artificial tears

25
Q

Second line tx for viral conjunctivitis

A

Low potency topical corticosteroid <2 weeks

26
Q

Dry eye syndrome

A

Keratoconjunctivitis
Bilateral disruption of tear film on ocular surface
Can be due to decreased tear production, increased tear evaporation, or combination

27
Q

when to refer to ophthalmologist for dry eye syndrome

A

If moderate to severe pain, vision loss, corneal infiltration/ulceration

28
Q

Cholinergic agonists for dry eye syndrome

A

Pilocarpine + Cevimeline
Increases secretions
May cause excess sweating

29
Q

Topical cyclosporine for dry eye syndrome

A

Increases aqueous tear production and decreases ocular irritation

30
Q

First line tx for dry eye syndrome

A

Artificial tears 4x a day

31
Q

Second line tx for dry eye syndrome

A

Cyclosporine emulsion 2x a day

32
Q

Glaucoma

A

Irreversible damage to optic nerve and retinal ganglion cells
Results in loss of visual sensitivity and field
Due to increased IOP due to decrease in outflow of aqueous humor

33
Q

Beta blockers for glaucoma

A

Topical
Decreases adenylyl cyclase activity which decreases production of aqueous humor in ciliary body
Timolol, levobunolol, carteolol, metipranolol, betaxolol

34
Q

Prostaglandins for glaucoma

A

Bimatoprost, latanoprost, tafluprost, travoprost
Decrease IOP by increasing aqueous outflow
More effective at bedtime
May cause irreversible iris discoloration

35
Q

Topical Carbonic anhydrase inhibitors for glaucoma

A

Brinzolamide + Dorzolamide
Decrease bicarbonate formation so decreases movement of fluid into posterior chamber of eye and decreases production of aqueous humor
Less effective but less systemic SE

36
Q

Systemic carbonic anhydrase inhibitors for glaucoma

A

Acetazolamide, methazolamide, dichlorphenamide

More potent but more severe SE- paresthesias, GI distress, metallic taste, renal calculi

37
Q

Adrenergic agonists for glaucoma

A

Apraclonidine + Bromonidine

Activate alpha 2, inhibiting release of NE which decreases aqueous humor production

38
Q

Cholinergic agonists for glaucoma

A

Pilocarpine
Stimulates parasympathetic muscarinic receptor site to increase aqueous outflow
May cause eye pain, brow ache, blurred vision, decreased night vision

39
Q

First line agent for glaucoma

A

Prostaglandin ophthalmic solution

40
Q

Second line agent for glaucoma

A

Ophthalmic beta blocker or addition of beta blocker to prostaglandin solution

41
Q

Third line agent for glaucoma

A

Addition of carbonic anhydrase inhibitor or brimonidine

42
Q

Most common infection in children requiring antibiotics

A

otitis media

43
Q

Most frequent bacteria present in middle ear fluid

A

Strep pneumoniae, H. Influenzae, moraxella catarrhalis

Less common: GAS and Staph aureus

44
Q

Most cases of Acute otitis media

A

Follow viral URI since it facilitates bacteria

45
Q

Most otitis externa caused by

A

Pseudomonas and Staph aureus

46
Q

Dx criteria for AOM

A

Abrupt fever, otalgia, irritability, tugging on ear, tympanic membrane is red, bulging and immobile

47
Q

OTC therapy for OM

A

NSAIDs and acetaminophen to decrease pain

48
Q

First line therapy for AOM

A

High dose amoxicillin

Can use augmentin if bacteria is penicillin resistant

49
Q

2nd line therapy for AOM

A

Use if penicillin allergy
2nd generation cephalosporin: cefuroxime
3rd generation cephalosporin: cefdinir + cefpodoxime

50
Q

Otitis externa S/S

A

ear pain, itching, fullness, tenderness

Rapid onset of s/s within 48 hours in past 3 weeks

51
Q

Mainstay OE tx

A

Topical antibiotics

52
Q

Antibiotics that can be used for OE

A

Fluoroquinolones: ciprofloxacin and ofloxacin
Aminoglycosides: Neomycin

53
Q

First line tx for OE

A

Fluoroquinolone drops

54
Q

Second line tx for OE

A

Neomycin/polymyxin B combos

55
Q

Third line tx for OE

A

Antifungal drops

Systemic antipseudomonal/antistaph agent

Pharmacology (56 decks)

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