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Ophthalmology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

When is the topic route of administration used in eye diseases?

A

Required to act on surface

Require corneal penetration

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2
Q

What is the cornea made up from?

A

Lipophilic epithelium

Lipophobic stroma

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3
Q

What are the chemical properties of chloramphenicol?

A

Lipophilic and hydrophilic

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4
Q

What effect can ocular surface inflammation have on the nature of the endothelium?

A

Reduce the hydrophobic nature

Lipid layer of tear film may impede drug penetration

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5
Q

What are hydrophilic drugs limited by?

A

Epithelium

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6
Q

What are hydrophobic drugs limited by?

A

Stroma

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7
Q

How are steroids made more hydrophobic?

A

Addition of an alcohol or acetate

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8
Q

How are steroids made more hydrophilic?

A

Phosphate

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9
Q

When is prednisolone acetate used?

A

Good penetration in uninflamed cornea

Used post-op in cataract surgery

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10
Q

When is prednisolone phosphate used?

A

Poor penetration in uninflamed cornea

Used for cornea disease or when low dose steroids are wanted

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11
Q

What is benzalkonium?

A

Used as a surfactant and bacterial agent in prescription bottles to prevent growth of pseudomonas

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12
Q

What is the downside/ benefit of benzalkonium?

A

Disrupts lipid layer of tear film which can aid penetration of drugs but also can cause a dry eye

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13
Q

What is bimatoprost?

A

Drug used to lower IOP in glaucoma

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14
Q

How can topical eye drops by systemically absorbed?

A

Tears are pumped out of lacrimal sac and can be absorbed systemically at the nasopharynx

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15
Q

What can be done to prevent systemic absorption of topical drugs?

A

Punctal occlusion

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16
Q

How can injections in the eyes be given?

A

Subconjunctival
Subtenons
Intravitreal
Intracameral

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17
Q

What drops are commonly given for treatment of infections?

A

Chloramphenicol in the drop and ointment form
Aciclovir
Ofloxacin

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18
Q

How is ocular inflammation treated?

A 
Dexamethasone drops 
Prednisolone drops
Topical NSAIDs
Anti-histamines
Mast cell stabilisers
19
Q

When are ocular steroids used?

A

Post op cataracts
Uveitis
Prevention of corneal graft rejection

20
Q

What are the local ocular side effects of steroids?

A

Cataract
Glaucoma
Exacerbation of herpes simplex conjunctivitis - corneal melt

21
Q

What are the systemic side effects of steroids?

A 
Gastric ulceration - prescribe with proton pump inhibitor
Immunosuppression
Osteoporosis
Weight gain
Diabetes
Neuropsychiatric effects
22
Q

What is glaucoma?

A

A group of diseases characterised by a progressive optic neuropathy resulting in characteristic field defects
Raised IOP only modifiable risk factor

23
Q

What can be seen on the optic disc in glaucoma?

A

Cupping

24
Q

What meridian line will glaucoma tend to respect?

A

The horizontal line - affects the superior or inferior fields

25
Q

What glaucoma drugs will work to open the trabecular meshwork/ canal of schlemm?

A

Prostanoids e.g. latanoprost
Alpha adrenergic agonists e.g. brimonidine
Parasympathomimetic e.g. pilocarpine

26
Q

What glaucoma drugs will work to reduce the production of aqueous humor?

A

Beta blockers e.g. timolol
Carbonic anhydrase inhibitors e.g. dorzolamide
Alpha adrenergic agonists e.g. brimonidine

27
Q

What are the advantages to intravitreal injections?

A

Delivers effective concentration of drug at target site but many drugs are toxic to the retina
Used as a method of administration of antibiotics in endophthalmitis
Intra-ocular steroids
Anti-VEGF in wet ARMG

28
Q

What can be seen in endophthalmitis?

A

Hypopyon - pus fluid level in eye

Surgical complication

29
Q

What are common diagnostic drops?

A

Proxymetacaine hydrochloride

Fluorescein

30
Q

What are common dilating drops used?

A

Tropicamide
Phenylephrine
Atropine
Cyclopentolate

31
Q

How do local anaesthetic drops work?

A

Blocks sodium channel to impede nerve conduction

32
Q

When are local anaesthetic drops used?

A 
FB removal
Tonometry (IOP measurement) 
Corneal scraping
Comfort
Cataract surgery
33
Q

When are fluorescein drops used?

A 
Corneal abrasion 
Dendritic ulcer (herpes simplex keratitis)
Identify leaks - seidel's test 
Tonometry
Diagnose nasolacrimal duct obstruction
Angiography
34
Q

How do mydriatics (tropicamide, cyclopentolate) work?

A

Cause pupil dilation by blocking parasympathetic supply to iris
Cause cycloplegia

35
Q

What are the symptoms of acute angle closure glaucoma?

A 
High pressure in eye
Acute red eye
High pain 
N+V
Headache
Dilated pupil that is not reactive
36
Q

How do sympathomimetics (atropine and phenylephrine) work to dilate the eye?

A

Acts on symp system to cause dilation

Atropine will cause cycloplegia

37
Q

What is cycloplegia?

A

Can’t accomodate

38
Q

What is the max effect and recovery from atropine drops?

A

Max effect: 30-40 mins

Recovery: 7-9 days

39
Q

What is the max effect and recovery from cyclopentolate?

A

Max effect: 30-60 mins

Recovery: 8 hours

40
Q

What is the max effect and recovery from phenylephrine?

A

Max effect: 20-60 mins

Recovery: 6 days

41
Q

What is the max effect and recovery from tropicamide?

A

Max effect: 20-40 mins

Recovery: 6hrs to 1 day

42
Q

What TB drug can cause optic neuropathy?

A

Ethambutol

43
Q

What drug can cause maculopathy?

A

Chloroquine - never see this now as only prescribe hydroxychloroquine

44
Q

What can amiodarone cause in the eye?

A

Vortex keratopathy

Ophthalmology (14 decks)

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