Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
112 Cards in this Set
- Front
- Back
|
Production of bicarbonate in the ciliary epi plays a key role in
|
aqueous humor production
|
|
|
Inhibition of ________ in the ciliary processes decreases bicarbonate, Na, and fluid movement into the posterior chamber
|
carbonic anhydrase
|
|
|
Contra-indicated in pts with COPD as a glacoma med b/c of excessive CO2 production
|
carbonic anhydrase inhibitors (CAI)
|
|
|
A systmeic CAI
|
Acetazolamide
|
|
|
trade name for systemic Acetazolamide
|
Diamox
|
|
|
Oral dosage for Acetazolamid (Diamox) systemic
|
250mg tab po QID
500mg cao (sequel) po BID |
|
|
Side effect of CAI
|
(1) Paresthesias (lip tingle)
(2) metallic taste (3) Depression (4) hypokalemia (5) acidosis |
|
|
Topical CAIs
|
(1) Dorzolamide
(2) Brinzolamide |
|
|
CAI that has a 20-25% reduction of IOP like systemic B blocker and alpha-2 agonist
|
TruSopt
|
|
|
CAI effect on blood flow is clinically _________________.
|
insignificant. Prescribe to reduce IOP
|
|
|
Monotherapy of Dorzolamide RX
|
TID
|
|
|
Combination Dorzolamide and Timoptic XE
|
BID
|
|
|
Side effect of dorzolamide in severe corneal tissue toxicity for example_________
|
Fuch's dystrophy
|
|
|
CAI cap color
|
pumpkin range
|
|
|
Cosopt contains
|
timolol 0.5% and dorzolamide
|
|
|
Cospot ocular hypotensive effect equal to
|
lantanoprost
|
|
|
combo timolol 0.5% and dorzolamide 2% (Cosopt) make it
|
less expensive
more effective |
|
|
Brinzolamide is a more or less comfortable that dorzolamide
|
more
|
|
|
Brinzolamide is formulated as a
|
suspension
shake once a month |
|
|
Brinzolamide has equivalent effects on IOP with dosage of
|
BID or TID
|
|
|
Contraindications for Systemic CAIs
|
(1) lover disease
(2) Severe COPD (3) secondary glaucoma (4) renal disease, kidney stones (5) pregnancy (6) hypersensitivity to sulfonamides |
|
|
Sulfonamide antibiotics do not cross react with other sulfa drugs
T or F |
True
|
|
|
1st line of therapy for glaucoma
|
prostaglandin analogs
|
|
|
Prostaglandin, cannabinoids, and prostamide are part of the _____________family receptors
|
Lipid
|
|
|
Prostaglandin cap color
|
teal
|
|
|
Examples of prostaglandins
|
(1) Latanoprost
(2) Travoprost |
|
|
Example of prostamides
|
bimatoprost
|
|
|
The gold standard prostaglandin
|
Latanoprost (XALATAN)
|
|
|
The tradename for latanoprost
|
Xalatan
|
|
|
Prostaglandin pro-drugs initially don't work due to
|
must penetrate and react with esterase to become ACID form
|
|
|
target tissue of prostaglandin
|
CB
|
|
|
latanoprost activates_____________, increases ______________, and reaches peak effect at ___________.
|
(1)FP receptors for prostaglandin F2alpha
(2) uveoscleral outflow (3) 8 hours |
|
|
lantanoprost is an effective drug for acute angle glaucoma?
T or F |
F
peak effect is 8 hours after dose. Reason take at bedtime. |
|
|
Prostaglandin should not be used for what form of uveitis?
|
inflammatory glaucoma uveitis due to increase inflammation with prostaglandin
|
|
|
Prostaglandin reduces IOP by _____________ by mechanism of increased _____________
|
30-25%
uveoscleral outflow |
|
|
Darken iris color; benign
|
latanoprost
|
|
|
Reduction of IOP effectively during the night and day
|
latanoprost
|
|
|
Effective against Primary Open Angle G, Normal Tension Glaucoma, Pigmentary G, and Sturge-Weber syn
|
latanoprost
|
|
|
Trade name for dorzolamide
|
Trusopt
|
|
|
Trade name for brimonidine
|
alphagan
|
|
|
First line therapy glaucoma___________
Second line therapy glaucoma _________________ |
(1) latanoprost then can add dorzolamide
(2) CAI |
|
|
Latanoprost require refrigeration. 1 drop daily at ____________.
T or F |
False
night due to red eye |
|
|
latanoprost 0.005% aqueous solution perserved with __________(Xalatan)
|
BAK
|
|
|
Which of the following has the least hyperemia:
latanoprost bimatoprost travoprost |
latanoprost
|
|
|
Can cause changes to pigment of iris, periorbital tissue (eye lid) and eyelashes. Also, growth of eyelashes.
|
Xalatan
|
|
|
Iris darkening with latanoprost occurs as high as ___% and as early as ____wks and only ________irides are affected
|
70%
4weeks mixed-colored |
|
|
Preexisting iris freckles or nevi do change shape or color with use of latanoprost?
T or F |
False
|
|
|
Increase number, length, thickness or darkening of eyelashes is called __________; with more obvious with _________ hair.
|
hypertrichosis
brown/black |
|
|
Unlikely in eyes with normal blood-ocular barrier. Linkage between prostaglandin and uveitis.
|
Cystoid Macular Edema
|
|
|
Disruption of blood-aqueous barrier is small and transient and reversible despite cont. therapy with this drug
|
latanoprost
|
|
|
Lesions that resemble HSV epi. keratitis but disappears with discontinue of prostaglandin.
|
Corneal Dendritiform Epi.
|
|
|
Treatment of corneal dendritiform epi includes ______________but does NOT include __________.
|
(1) preservative-free artificial tears and or topical antibodies
(2) anti-viral |
|
|
Herpes simplex blep can be induced by_________
|
Steroids
|
|
|
Contraindication of Latanoprost.
|
(1) history of uveitis or incisional ocular injury
(2) previous HSV keratitis (3) following cat surgery with risk factors for CME (4) Active intraocular inflammation (5) uveitic glaucoma |
|
|
PGF 2 alpha analog for the treatment of POAG and OHT; 0.004%
|
Travoprost (Travatan)
|
|
|
Trade name for Travoprost
|
Travatan
|
|
|
Reduces IOP from 6.8 to 8.3 mmhg over diurnal cycle; morn and eve dose effective
|
Travoprost
|
|
|
Overdose of a prostaglandin results in
|
Increase of IOP
|
|
|
Travatain is available in 2.5 ml and 5 ml and ____________ refrigeration.
|
DOES NOT
|
|
|
Replaces BAK with ionic buffered preservation system
|
Travatan Z (SofZia)
|
|
|
sofZia contains
|
(1) borate
(2) sorbitol (3) zinc |
|
|
The preseravtion system in sofZia in the eye is inactivated by ________
|
Na and K
|
|
|
Comparision of Travatan 0.004% and Xalantan 0.0005% showed
|
NO difference
|
|
|
Per Dr. Bartlett, ______________ works better for Normal Tension Glaucoma
|
Lumigan
|
|
|
Tradename of Bimatoprost
|
Lumigan
|
|
|
Side effect of Lumigan
|
(1) conjunctival hyperemia (make sure tell Pt)
(2)eyelash growth (3)iris color darken (4)ocular itch |
|
|
Lumigan preserved with BAK 0.005%. ____________refrigeration required
|
No
Pts sensitive to BAK can take this |
|
|
Treatment should be limited to ____________drugs and be based on efficacy, compliance, cost and few expected side effects.
|
no more than 3-4
|
|
|
________ change based on one-time sig. elevation of IOP or worsening of visual field.
If change is necessary, consider _______________ rather than ____________medication. |
(1)don't
(2)switching (3) adding |
|
|
ID noncompliance in pt by:
|
(1) look at bottles of meds
(2) look at pupils (miotic) (3) appt day dropper |
|
|
Systemic hyperosmotic agents for lowering acute elevation of IOP due to acute angle-closure glaucoma; post-op spikes.
|
(1) IV- mannitol
(2) oral- glycerin |
|
|
Sensitizes nociceptrs
|
prostaglandin
|
|
|
Abbrev. for aspirin
|
ASA
|
|
|
mild to mod pain use
|
aspirin
|
|
|
Describe drug interaction of NSAID (ASA) with oral hypoglycemic
|
NSAID bind protein and bump off oral hypoglycemic. Since not attached it is active to bind blood sugar. Result OD and sugar goes way down.
|
|
|
Aspirin hypersensitivity + respiratory
|
Aspirin triad
(1) rhinitis (2) asthma (3) nasal polyps TYPE 1 rxn (1) redness (2) swelling (3) itching |
|
|
Hypersensitive to NSAIDS then allergis to all ___________ . Can give __________, __________.
|
Aspirin
tylenol, acetaminophen |
|
|
OTC nonacetylated salicylate that illicit less GI distress
|
Doan's Pills
other salicylate end name not quite as effective pain relief |
|
|
Contraindications to NSAIDS
|
(1) active upper GI disease
(2) history asthma, nasal polyps, aspirin allergy (3) following cat sx or other sx (4)chronic renal disease (5)HTN (6) pregnancy |
|
|
Nonsalicylate NSAIDS= Aspirin
T or F |
False
|
|
|
Nonsalicylate NSAIDS= Propionic Acid
T or F |
True
|
|
|
Examples of propionic acid
|
(1) ibuprofen
(2) naproxen (3) naproxen sodium (4) fenoprofen (5) ketoprofen (6) oxaprozin |
|
|
Excellent alternative for pts allergic to opoids such as codeine
|
ketoprofen
|
|
|
Ibuprofen dosage over 400mg is better treatment for _________and not for ____________
|
inflammation
pain; more does not give more releif; ceiling |
|
|
0 inflammation with hyphema and corneal abrasion can take ibuprofen. Inflammation take _______ and ___________
|
cyclo
steroid |
|
|
Ibuprofen has some anti-coag effects when there is a __________ dose in plasma; Aspirin in system for ________
|
therapeutic
1 week |
|
|
Can't take ibuprofen(NSAID) then can take_________ and ___________
|
Tylenol
Acetaminophen |
|
|
COC that is a good prostaglandin which lines the stomach
|
COX-1
|
|
|
Examples of COX-2 inhibitors
|
(1) celecoxib (celebrex)
(2) Rofecoxib (Vioxx) |
|
|
Treatment of osteoarthirits and adult rheumatoid arthritis
|
Celebrex
|
|
|
Treatment acute pain in adults
|
Vioxx
|
|
|
Clinical name for Acetaminophen
|
APAP
|
|
|
APAP does not:
|
(1) inhibit platelet aggregation
(2) affect prothrombin time (3) produce GI discomfort |
|
|
Dose ibuprofen at least _________min. after taking immedicate release aspirin
|
30 minutes
|
|
|
Dose ibuprofen more than ________ before aspiring ingestin
|
8 hours
|
|
|
High dosage of acetaminophen can cause
|
liver damage
|
|
|
Low dose of acetaminophen can cause damage to liver of ___________
|
alcholics
|
|
|
Dr. Bartlett: perfect reduce pain
|
tyelonol xtra strength 2 tabs and 400 mg ibupforen every 4-6 hours
|
|
|
Gold standard opioid
|
morphine
|
|
|
Agonist receptors for opioid
|
mu receptor
|
|
|
AL can RX Schedule_________ to ________ but not ________
|
III - not hydrocodone-lortab
V |
|
|
Safer for patients with contraindications to NSAIDS
|
Opioids
|
|
|
1tsp=____ml
|
5ml
|
|
|
Codeine #1 has 7.5 mg
Codeine #2 has _____ Codeine #3 has _____ |
#2 7.5x2=15
#3 15x2=30 |
|
|
Hydrocodone trade name
|
loratab
vicoden |
|
|
Should you work while you are on opiod?
|
No
|
|
|
Propoxyphene trade name
|
Darvocet
|
|
|
Meds instruct to take every 4 hours. What should you do if pain back in 3.
|
Go ahead and take the pill. More difficult to control too intense pain.
|
|
|
Side effects of opioid analgesics
|
respiratory depression- not indicated for astham; COPD pts.
|
|
|
Prevent nauseau and vomiting
|
phenergan
|
|
|
Allergy to an opioid then you can take another different name opioid.
T or F |
False!!!!
|
|
|
Contain Mu receptor and similar effect as opioid. Moderate to severe pain. Not a controlled substance. use DEA #
|
Tramadol (Ultram)
|
