Ocular Anti Inflammatory Drugs

Front 1

What do Corticosteroids do?

Back 1

Reduce the manifestation of inflammation

Front 2

Rule for these medication:

Back 2

Use the smallest amount of the drug that can inhibit inflammation

Front 3

To penetrate the cornea, corticosteroids come in what preparation

Back 3

Biphasic

comes in different bases

Front 4

Lipophilic bases are:

Back 4

Acetate- prefered one in prednisolone

alcohol

and they come as suspensions

Front 5

Hydrophilic bases are:

Back 5

Sodium phosphate

HCL

they come as solutions

Front 6

between acetate and phosphate form which one inhibits inflammation more?

Back 6

Acetate

Front 7

After what time do corticosteroids start having significant side effects?

Back 7

14 days

before that they relatively have no systemic complications

Front 8

Corticosteroids don't need to be tapered down...

true or false

Back 8

FALSE!!!

both topical and iv have to be tapered down to reduce rebound inflammation

Front 9

For this condition you have to use oral med as well as topical

Back 9

Uveitis

Front 10

This is the most expensive corticosteroid

Back 10

Loteprednol

its also the newest one

Front 11

These areas have to be treated with meds with minimal corticosteroid activity (the lowest percentage of the med)

Back 11

Optic neuritis

Chorioretinitis

Orbit

this is because to get to these areas the med has to be administered intravitreally or systemically so the potential for s.e is gonna be higher because it will be entering the system more easily

Front 12

What do corticosteroids do to diabetic pts

Back 12

Increase their glucose levels

remember the name glucocosteroid

Front 13

Bad thing about intravitreal implant of corticosteroid Retisert

Back 13

raises IOP even more

Front 14

Some systemic s.e for systemic corticosteroids

Back 14

adrenal sufficiency

cushings syndrome

peptic ulceration

mood changes

activation of infection

delay in wound healing

Front 15

Never use steroids alone in infectious diseases because

Back 15

the steroid will reduce the immune system so the infection is going to get worse.

you use the steroid with the anti infective agent to reduce scarring

Front 16

This corticosteroid at 1% is considered the most effective for anterior segment inflammation

Back 16

Prednisolone

Front 17

this drug comes in solution for pediatric population

Back 17

Prednisolone

Front 18

This drug also comes in combination with sulfacetamide (antibiotic)

Back 18

Prednisolone

Front 19

Second most potent corticosteroid

Back 19

Dexamethasone

analog of cortisol

Front 20

Dexamethasone is available in alcohol suspension and phosphate solution forms, which one will you prefer?

Back 20

alcohol

bc its liposoluble so it will penetrate better the cornea

the bad thing is its not available in ointment

Front 21

Dexamethasone is available in combo with:

Back 21

Tobramycin

neo/poly/dexamethasone

(antibiotics)

Front 22

Progesterone analog available in alcohol suspension, ointment, and acetate suspension

Back 22

Fluorometholone

always select acetate, reduces inflammation more than alcohol

Front 23

This drug is has a comparable action to prednisolone acetate but

it does not affect the IOP a lot

Back 23

Fluorometholone

Front 24

This is a Prednisolone soft drug

Back 24

Loteprednol

has the best qualities of prednisolone but not the adverse effects

does not affect (increase) iop

Front 25

This corticosteroid comes in Gel

Back 25

Loteprednol

also in ointment, suspension

and in combo with tobramycin

Front 26

This drug comes in combination with sulfacetamide

Back 26

Fluorometholone

Front 27

This drug similar to loteprednol is ONLY used to

reduce inflammation after cataract surgery

Back 27

Rimexolone

since its similar to loteprednol it does not affect IOP

Front 28

Reduction of inflammation during ocular surgery and uveitis

Back 28

Difluprednate

Front 29

This medication is available as an EMULSION

Back 29

Difluprednate

Front 30

This derivate of prednisolone will have an effect in IOP after 10 days

Back 30

Difluprednate

Front 31

General tx schedule for corticosteroids

Back 31

1 or 2 drops in conjunctival sac every hour during day and every 2 hrs during the night

then reduce to 1 drop every 4 hrs

then 1 drop TID or QID

post surgery:

1-2 drops 4 times a day for 14 days

Front 32

Some Side effects of Corticosteroids

Back 32

POSTERIOR SUBCAPSULAR CATARACT

increase IOP

Increased susceptibility to infections

Retardation of corneal healing

Mydriasis and Ptosis

Front 33

Ditinctive features of corticosteroid cataracts

Back 33

both eyes will have a symetric manifestation

of the cataract

Front 34

How do corticosteroids increase IOP

Back 34

thru outflow resistance

you will see it after 2-8 weeks of therapy

increase is around 4.6-6.6 mmhg

history is important:

probabilities increase if you already have glaucoma

have a myopia of 5D or more

have krukenberg's spindles

Front 35

What drug increases IOP more

Back 35

Prednisolone

Front 36

This side effect of corticosteroids is more common in black ppl

Back 36

Corticosteroid Uveitis

Front 37

Do you use corticosteroid for superficial foreign body removal?

Back 37

Nop because of delayed corneal healing and the higher risk of aquiring infections

Front 38

Concurrent meds that potentiate corticosteroids

Back 38

Barbiturates,

phenytoin

meds that reduce: anticoagulants

Front 39

Caution with these pts when using corticosteroids:

Back 39

Diabetic

hypertensive

infectious disease

renal

CHF

peptic ulcer

osteoporosis

psychosis

glaucoma

Front 40

Monitor these while using corticosteroids:

Back 40

Cornea

Lens

IOP

blood glucose levels