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Pathology And Pharmacy 309 > Unit 5: Ophthalmic Pharmaceuticals > Flashcards

Unit 5: Ophthalmic Pharmaceuticals Flashcards

1
Q

Uses of topical anaesthetic

A

-Assessment of eye trauma
-Measurement of intraocular pressure
-Removal of superficial foreign bodies
-Ophthalmic surgery
-Reduce stinging from dilating drops


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2
Q

Sensory nerve pathway from cornea to brain

A

-Corneal nerves
-Long ciliary nerves
-Nasociliary nerves
-Ophthalmic nerve
-Trigeminal nerve (CNV)

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3
Q

Examples of topical anaesthetic

A

-Alcaine (proparacaine hydrochloride)
-minims tetracaine hydrochloride (preservative free)
-fluress (Benoxinate & fluorescein sodium)
-10% cocaine (For Horner’s syndrome diagnosis)

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4
Q

ADRs to topical anaesthetic

A

Hives, difficulty breathing, swelling of face. Blurred vision, redness of eye, light sensitivity, tearing, throbbing, pain, itching.

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5
Q

Contra indications for anaesthetic drops

A

-Perforating injuries
-Self administration (may cause corneal breakdown)
-Some dry eye testing
-Some culture collections

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6
Q

Adverse effects of long term use of anaesthetic drops

A

-Epithelial defects
-Stroma edema (swelling)
-Endothelium damage
-Corneal thinning
-Corneal ulcers
-Corneal perforation


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7
Q

Mydriasis

A

Dilates pupils

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8
Q

Cycloplegia

A

Temporary Loss of accommodation

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9
Q

Something that’s worth noting

A

All mydriatics don’t have cycloplegic effects, but all cycloplegics have mydriatic effects

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10
Q

Use of mydriatics and cycloplegics

A

-Dilation
-Cycloplegic refraction
-Amblyopia therapy
-Pain management for uveitis

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11
Q

Contraindications for dilating drops

A

-Allergy to preservatives
-Narrow anterior chamber angle
-Iris fixed intraocular lens
-Pupil evaluation

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12
Q

Adverse effects for dilating drops

A

-Blurred vision
-Stinging
-Photophobia
-Glare
-Risk of angle closure glaucoma
-Longer lasting for light coloured eyes

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13
Q

Dilating drops mechanism of action

A

Cholinergic (parasympathetic)
-Antagonist (Leads to dilation)
Adrenergic (sympathetic)
-Agonist (Leads to dilation)

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14
Q

Cholinergic antagonist (anticholinergic)

A

Blocks muscarinic receptors to inhibit pupillary sphincter (dilation)
-Inhibits ciliary body (cycloplegia)

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15
Q

Examples of cholinergic antagonist

A

-Mydriacyl (tropicamide)
-Cyclogyl (cyclopentolate)
-isopto homatropine
-isopto atropine

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16
Q

Mydriacyl (tropicamide)

A

-Routine eye exam dilation
-0.5% or 1%
-Minimal cycloplegic effect
May cause transient IOP increase

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17
Q

Cyclogyl (cyclopentolate)

A

-Routine cycloplegic refractions
-0.5% and 1%
-Must wait 45 minutes for cycloplegic effect
-May cause hallucinations and strange behaviour
-Accommodation recovers before mydriasis

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18
Q

Isopto Homatropine

A

-Manage pain associated with anterior uveitis
-Strong mydriatic effect
-Weak cycloplegic effect

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19
Q

Isopto Atropine

A

-Most potent mydriatic/cycloplegic
-Amblyopia treatment
-Slow myopia progression
-May cause dry mouth and flush skin, rapid pulse, or disorientation.
-Caution with elderly children and down syndrome

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20
Q

Mechanism of action of adrenergic agonist

A

Binds to alpha receptor causing mydriasis

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21
Q

Mydfrin (phenylephrine)

A

Adrenergic agonist
-Used in combination with mydriacyl
-2% & 10% concentrations
-May cause cardiovascular events

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22
Q

Mydfrin Contraindications

A

-MAOIs
-Tricyclic antidepressants
-methyldopa
-respirine
-guanethidine

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23
Q

Other Methods for dilating meds

A

-spray bottle: Mist closed eyes and ask patient to blink. Dose amount is unknown possibly for children.
-pledget: Cotton swab saturated with drug solution and placed in eye to dilate section of iris

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24
Q

Something worth noting

A

Sympathomimetics are mydriatic with no cycloplegic effect

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25
Something else worth knowing
Anticholinergics Are mydriatic and cycloplegic
26
What do carbonic anhydrase inhibitors do?
Reduce the production of aqueous to decrease intraocular pressure When topical treatments don’t work
27
Four antibacterial mechanisms of action
Inhibits: -Folic acid synthesis -DNA synthesis -Protein synthesis -Cell wall synthesis
28
Sulphonamide mechanism of action
-Inhibits folic acid synthesis during nucleotide production -Broad spectrum -Bacteriostatic -Competitive inhibitor of PABA
29
PABA
P-aminobenzoic acid
30
Sulphonamides examples
Bleph-10 (sulphactetamide sodium) -mostly ointment
31
Sulphonamides adverse effects
-Allergic reactions -Stevens-Johnson syndrome -tetrogenic
32
Flouroquinolones mechanism of action
-Inhibits DNA synthesis -Broad spectrum -Bactericidal 
33
Flouroquinolones examples
-ciloxan (ciprofloxacin) -vigamox (maxifloxacin) - moxeza (maxifloxacin) -same but with xanthan gum -besivance (besifloxacin) -zymaxid (gatifloxacin)
34
Fluoroquinolones adverse effects
-Foreign body sensation -Itching and burning -Conjunctival hyperaemia
35
Fusidic acid mechanism of action
-Inhibits protein synthesis -Bactericidal or bacteriostatic
36
Fusidic acid example
Fusithalmic (fusidic acid)
37
Fusidic acid Adverse effects
-Stinging and irritation -Localized allergic reactions
38
Aminoglycosides Mechanism of action
Inhibits protein synthesis -Bactericidal
39
Aminoglycosides ophthalmic use
-Bacterial conjunctivitis -Corneal ulcer
40
Examples of aminoglycosides
-tobrex (tobramycin) (NOT Tobradex) -garamycin (gentamicin) -neomycin (neomycin sulfate)
41
Aminoglycosides adverse effects
-type IV delayed hypersensitivity -Itching, redness, swelling
42
Macrolides mechanism of action
-Inhibits protein synthesis -Bactericidal or bacteriostatic
43
Examples of macrolides
Odan-erythromycin (Erythromycin) -ointment AzaSite (Azithromycin) -solution
44
Macrolides adverse effects
-Blurred vision -Allergic reactions
45
Polypeptide antibiotic mechanism of action
Inhibits cell wall synthesis -Bactericidal for GRAM POSITIVE bacteria ONLY
46
Polypeptide antibiotic ophthalmic use
-Bacterial conjunctivitis -Blepharitis
47
Polypeptide antibiotic examples
AK-Tracin (bacitracin)
48
Polypeptide antibiotic adverse effects
Allergic reactions
49
Examples of combination antibacterials
Polytrim (trimethoprim and polymyxin B) Polysporin (bacitracin and polymyxin B)
50
Polymyxin B Mechanism of action
Breaks down cell membranes -Bactericidal for gram negative
51
Trimethoprim mechanism of action
Prevents DNA synthesis 
52
Bacitracin mechanism of action
Interferes with cell wall synthesis
53
Topical Antivirals mechanism of action
Inhibits synthesis of viral DNA
54
Examples of topical antivirals
Viroptic (trifluridine) -solution Zirgan (ganciclovir) -gel
55
Topical antiviral adverse effects
-Eye irritation -Conjunctival Hyperaemia -Blurred vision -Punctate keratitis (Damage to healthy cells on cornea) 
56
Types of antibacterial drugs
-Sulphonamides -Fluoroquinolones -Fusidic acid -Aminoglycosides -Macrolides -Polypeptide antibiotic -Combination antibacterials
57
Types of antifungal drugs
-polyenes -azoles -antimetabolites
58
Polyenes: amphotericin B Mechanism of action
-Forms pores in cell membrane-Compounded product -Effective against yeasts and filamentary organisms
59
Polyenes: natacyn (natamycin) Mechanism of action
-Inhibits cell membrane function -Effective against filamentary organisms -Commercially available -Poor ocular penetration
60
Azoles Mechanism of action
Inhibit cell wall synthesis
61
Examples of azoles
-ketoconazole -fluconazole -variconazole
62
Antimetabolites mechanism of action
Inhibits DNA and RNA synthesis
63
Examples of antimetabolites
Flucytosine
64
Treatment for acanthamoeba
-Topical neomycin -Polyhexamethylene biguanide (PHMB) -Chlorhexidine
65
Treatment for Demodex mites
Cliradex (Tea tree oil) -Alters cell membrane
66
Arachidonic acid pathway
Pospholipase stimulates Phospholipid membrane to release AA, cyclooxygenase makes AA into prostaglandins, prostaglandins create inflammation
67
Cyclooxygenase
An enzyme that facilitates conversion of AA to prostaglandins
68
Prostaglandin
A natural chemical that creates inflammation
69
Cyclooxygenase-1 releases this
Prostaglandins and thromboxane
70
Cyclooxygenase-2 Releases this
Prostaglandins only
71
Cyclooxygenase-1 inhibitors do this
Thin blood by inhibiting the release of thromboxane -aspirin and naproxen
72
Corticosteroids inhibit the enzyme
Phospholipase
73
NSAIDs inhibit this enzyme
Cyclooxygenase
74
General characteristics of corticosteroids
-Man made -Mimics the effects of cortisol -Anti-inflammatory at low doses -Immunosuppressive at high doses
75
Ophthalmic use of corticosteroids
-iritis -Conjunctivitis -Ocular allergies -Inflammatory dry eye disease
76
Strong corticosteroids
-pred forte (prednisolone acetate suspension 1%) -durezol (difluprednate emulsion 0.05%) -Lotemax (Loteprednol etabonate 0.5%) (susp, gel, ung)
77
Mild corticosteroids
Alrex (loteprednol etabonate susp 0.2%) FML (fluoromethalone acetate gel, ung 0.1%)
78
Corticosteroids adverse effects
-elevated IOP -Cataracts with long-term use -Delayed wound healing -Increased risk of infection
79
Ophthalmic use of NSAIDs
-Treat pain and inflammation after cataract surgery -Treat cystoid macular edema (CME) -Off label use for pain management
80
Examples of NSAIDs
-acularLS (ketorolac tromethamine sol 0.4) -Voltaren (diclofenac sodium gel 1%) -Ilevro (nepafenac susp 0.3) -Prolensa (Bromfenac sol 0.07%)
81
General use of NSAIDs
Inhibits cyclooxygenase pathway -Prevents production of prostaglandins -Anti-inflammatory and analgesic
82
Adverse effects of NSAIDs
-Burning and stinging -Corneal ulceration -Possible corneal melts
83
Blephamide
Sulphonamide antibiotic with corticosteroid -sodium suphacetamide 10% -Prednisone acetate 0.2% -susp or ung
84
Adverse effects of Blephamide
-Allergic reaction -stevens-Johnson -Elevated IOP -Cataract formation
85
TobraDex
Aminoglycoside antibiotic with corticosteroid -Tobramycin 0.3% (aminoglycoside) -Dexamethasone 0.1% (corticosteroid) -susp, ung, or sol
86
Adverse effects of TobraDex
-Allergic reactions -Elevated IOP -Cataracts
87
Maxitrol
Aminoglycoside antibiotics with corticosteroid -neomycin (affects both gram-things) -polymyxin B (affects gram negative) -dexamethasone (corticosteroid) -susp or ung
88
Maxitrol adverse effects
-Allergic reactions -Elevated IOP -Cataracts
89
Zylet
Aminoglycoside and corticosteroid -tobramycin 0.3% -Loteprednol etabonate 0.5% 
90
Adverse effects of Zylet
-Less risk of IOP elevation -allergic reaction w tobramycin
91
Two categories of immunomodulators
-Immunostimulators -Immunosuppressive
92
Sjögren’s syndrome
Dry eyes and mouth caused by body attacking saliva and tear glands
93
Restasis Mechanism of action
-Inhibits inflammation in tear glands -Increases tear production
94
Restasis Ophthalmic use
-Dry eye -sjogren’s syndrome 
95
Restasis Adverse effects
-Conjunctiva hyperaemia -stinging, epiphoria, FBsensation -blurry vision
96
Xiidra (lifitegrast solition 5%)
Competitively interferes with inflammatory cycle
97
Xiidra Ophthalmic use
-Inflammatory dry eye disease -sjogrens syndrome
98
Xiidra adverse effects
-Metallic aftertaste -Burning stinging irritation -Blurry vision
99
What does histamine do in our body
-Allergic reactions -immune Response -Gastric acid secretion -Neurotransmitter in brain
100
Types of allergic conjunctivitis
-Seasonal -Perennial -Giant papillary conjunctivitis -Vernal keratoconjunctivitis -Atopic keratoconjunctivitis
101
OTC allergy pharmaceuticals
-Artificial tears -Vasoconstrictors (visine) -Mast cell stabilizers (opticrom) -Antihistamines (refresh eye allergy relief)
102
What do mast cell stabilizers do?
Prevents release of histamine from mast cells
103
Examples of mast cell stabilizer
Alomide (lodoxamide tromethamine solution 0.1%)
104
Examples of combination anti-histamine and mast cell stabilizers
-pataday (olapatidine hydrochloride sol) -zaditor (ketotifen fumarate solution) -bepreve (bepotasine besilate solution)
105
Classes of glaucoma drugs
-Cholinergic -Parasympathomimetic -anticholinesterase -Adrenergic -Beta blockers -Alpha adrenergic -Carbonic anhydrase inhibitors -Prostaglandin analogues -rho kinase inhibitors -combination glaucoma meds
106
Purpose of glaucoma medications
-Lower IOP -Increase drainage through TM and Uveoscleral pathway -Reduce aqueous production -neuroprotective
107
Parasympathomimetic drugs
-isopto carpine (pilocarpine hydrochloride)
108
Adverse effects of parasympathomimetic drugs
-Burning, stinging -miosis -Headache -May worsen angle closure by shallowing anterior chamber
109
Cholinesterase inhibitors example
Phospholine iodide (echithiopate iodide)
110
Cholinesterase inhibitors adverse effects
-Burning, stinging -Conjunctival and ciliary redness -Small pupil, brow ache -Induced myopia
111
Beta blockers mechanism of action
-Block beta adrenergic receptors -Reduce aqueous humour production
112
Beta blockers examples
-Timoptic (timolol maleate sol or gel) -betoptic (betaxolol) -betagan (levobunolol hydrochloride sol)
113
Beta blockers adverse effects
-Bradycardia -Shortness of breath
114
Alpha agonists mechanism of action
-Reduce aqueous humour production -Increase Uveoscleral outflow
115
Examples of alpha agonists
Alphagan (brimonidine solution 0.1%)
116
Adverse effects of alpha agonists
-Redness, itching -Dry mouth -Dysgeusia
117
Carbonic anhydrase inhibitor mechanism of action
-Inhibits carbonic anhydrase enzyme -Reduces aqueous production
118
Examples of carbonic anhydrase inhibitor
Azopt (brinzolamide sol) Trusopt (dorzalamide sol)
119
Prostaglandin analogues mechanism of action
-nitric oxide increases uveoscleral and TM outflow
120
Examples of prostaglandin analogues
-xalatan (latanoprost sol 0.005%) -lumigan (bimatoprost sol 0.03%) -travatan (travoprost sol 0.004%) -vyzulta (latanoprostene bunod sol 0.024%)
121
Mechanism of rho Kinase inhibitor
-Inhibit norepinephrine transport to reduce aqueous production -Increase TM outflow
122
Examples of rho kinase inhibitor
Rhopressa (netarsudil solution 0.02%)

Pathology And Pharmacy 309 (7 decks)

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