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84 Cards in this Set
- Front
- Back
preservatives used in ophthalmic dosage forms
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- benzalkonium chloride
- benzethonium chloride - thimerosal - chlorobutanol - phenylmercuric acetate - phenylmercuric nitrate |
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which preservative can irritate the eye during long term usage?
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- benzalkonium chloride
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viscosity enhancers for ophthalmics (3)
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- methylcellulose
- polyvinyl alcohol - hydroxypropyl methylcellulose |
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what do viscosity enhancers do?
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- keep medicine in the eye for some period of time
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inflammation of the eyelid
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- blepharitis
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droopy upper eyelid
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- blepharoptosis
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different pupil sizes
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- anisocoria
- anisoCORia |
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double vision
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- diplopia
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abnormal protrusion of the eyeball
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- exophthalmos
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distant objects appear blurred - nearsightedness
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- myopia
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near objects appear blurred - farsightedness
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hyperopia
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farsightedness in middle-aged/older people
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presbyopia
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pupil constriction
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miosis
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pupil dilation
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mydriasis
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inflammation of the conjunctiva
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conjunctivitis
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what is the conjunctiva?
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- a thin, transparent membrane covering the sclera
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what do preservatives do?
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maintain sterility
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the white, fibrous covering of the eye
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- sclera
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2 allergic conjunctivitis symptoms
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- pruritis - itching
- lacrimation - tearing |
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bacterial conjunctivitis symptoms
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- pruritis
- lacrimation - matting |
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pink eye treatement
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- self-limiting (will go away in 2 weeks)
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four classes of anti-glaucomal agents
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- beta-blocking agents
- miotics - carbonic anhydrase inhibitors - ophthalmic prostaglandins |
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3 beta blocking agents
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- betaxolol -- Betopic, Betopic S
- levobunolol -- Betagan - timolol -- Timoptic, Timoptic XE, Betimol |
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miotics (1)
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- pilocarpine -- Isopto Carpine, Pilopine HS (gel)
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carbonic anhydrase inhibitors (2)
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- dorzolamide
- brinzolamide -- Azopt |
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opthalmic prostaglandins (3)
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- bimatoprost -- Lumigan, Latisse
- latanoprost -- Xalatan - travoprost - Travatan, Travatan Z |
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glaucoma
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- increased intra-ocular pressure
- caused by increased production of aqueous humor - OR decreased outflow of aqueous humor |
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beta blocking agent mechanism
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- decrease production of aqueous humor - mechanism unknown
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miotics mechanism
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- cause myosis (pupil constriction)
- increases outflow |
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carbonic anhydrase inhibitors mechanism
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- decrease production of aqueous humor
- carbonic anhydrase is an enzyme necessary for production of aqueous humor |
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ophthalmic prostaglandins mechanism
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- increase outflow
- mechanism not understood |
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TTN - timolol preparations
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- each is a solution
- XE - forms a gel when administered to the eye, which increases activity. |
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TTN - pilocarpine preparations
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- Pilopine HS - is a gel
- Isopto Carpine - drop - both can decrease night vision (they disable dilation) |
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TTN - latanoprost
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- Xalatan
- popular - refrigerate to stabilize - patient can keep at room temp for 6 weeks |
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TTN - Travatan Z
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- does not contain benzalkonium chloride
- allows for continuous use - contains a buffered preservative |
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anti-glaucomal
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- theraputic category
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therapeutic categories (9)
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- anti-glaucomal
- mydriatic agents - ophthalmic NSAID's - ophthalmic corticosteroids - ophthalmic antihistamines - ophthalmic mast cell stabilizers - ophthalmic antihistamines/mast cell stabilizers - ophthalmic antibiotics - ophthalmic antivirals |
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mydriatic agents (use/adverse afffects)
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- used before eye exam to cause mydriasis (dilation)
- causes light sensitivity and blurred vision |
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mydriatic agents (3)
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- atropine sulfate -- Isopto Atropine
- tropicamide -- Mydriacyl - cyclopentolate -- Cyclogyl |
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ophthalmic NSAIDs mechanism and side effects
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- cyclo-oxygenase inhibition
- stops production of prostaglandins - can cause keratitis - inflammation of the cornea |
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ophthalmic NSAID's (5)
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- diclofenac sodium -- Voltaren
- ketorolac -- Acular, Acuvail (different strengths) - flurbiprofen -- Ocufen - bromfenac -- Xibrom - nepafenac -- Nevanac |
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ophthalmic corticosteroids (usage and side effects, TTN, 4)
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- treat inflammation
- indicated for short term only - long term use can cause glaucoma - all are suspensions (shake well) (except S.O.P. (ointment)) |
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ophthalmic corticosteroids (4)
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- prednisolone -- Pred Mild, Pred Forte
- fluorometholone -- FML, FML Forte, Flarex, FML S.O.P. - rimexolone -- Vexol - loteprednol -- Lotemax, Alrex |
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ophthalmic antihistamines (usage and mechanism)
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- treat allergic conjunctivitis
- antihistamine - block H1 receptor - do not decrease production of histamine - histamine is an inflammatory mediator and must bind its receptor to cause inflammation |
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ophthalmic antihistamines (2)
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- emedastine -- Emadine
- azelastine -- Optivar |
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ophthalmic mast cell stabilizers (usage and mechanisms)
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- treats allergic conjunctivitis
- inhibit the release of inflammatory mediators from mast cells - mast cells are inflammatory cell type - THIS class decreases the production of histamine |
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three inflammatory mediators
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- histamines
- prostaglandins - leukotrienes |
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three main dosage forms given through the eye
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- solutions
- suspensions - ointments |
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lacrimal - definition
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- pertaining to the tears
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preparations given through the eye must be?
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- isotonic with lacrimal fluid
- isoionic - pH of tears is about 7.4 |
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ear drops in the eye
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- no
- eyedrops may be given through the ear, where isotonicity is not a concern - only 5 or 6 eardrops available |
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primary ingredient in artificial tears
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- viscosity enhancers
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artificial tears - usages
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- used to lubricate the surface of the eye
- used to treat xerophthalmia (dry eyes) |
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to minimize eye drop absorption into systemic circulation
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- press on lacrimal duct for a bout a minute
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TNN - betaxolol
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- Betopic
- Betopic S (suspension, SHAKE WELL) |
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- the amount of drug given
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- dosing
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number of times daily
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- dosing interval
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TTN - Timoptic and Betimol
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- both solutions (?)
- dosing interval is twice daily |
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TTN - Timoptic XE
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- solution (SHAKE WELL)
- forms a gel when administered - increases activity - dosing interval is once daily (better compliance) |
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TTN - Lumigan
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- bismatoprost - indicated for Glaucoma
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TTN - Latisse
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- bimatoprost - indicated for hypotrichosis (congenital deficiency of eyelash hair)
- apply at bedtime at the base of the eyelashes - increase length, darkness, thickness |
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TTN - ophthalmic prostaglandins
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- can increase brown pigmentation
- permanent - Latisse does not |
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two other anti-glaucomals (not in a class)
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- Cosopt -- dorzolamide/timolol combination
- Alphagan P -- brimonidine |
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- Alphagan P mechanism
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- brimonidine
- reduces production and decreases outflow |
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- first NSAID
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- aspirin
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- TTN - FML S.O.P
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- fluorometholone
- Sterile Ophthalmic Preparation - ointment |
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- therapeutic category of emadine
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- H1 receptor antagonist
OR - ophthalmic antihistamine |
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- TTN azelastine
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- azelastine
- available in two nasal spray products - Astelin and Astepro - Astepro includes sorbitol (sweet) - used to treat allergic rhinitis |
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allergic rhinitis symptoms
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- inflammation of the mucosa membranes of the nose
- rhinorrhea - runny nose |
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- do not give OTC ear medication (refer to physician) if there is
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- pain
- drainage |
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drops abbreviation
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- GTTS
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softening agent used to drain earwax
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- Colace
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ophthalmic mast cell stabilizers (2)
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- lodoxamide -- Alomide
- nedocromil -- Alocril |
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ophthalmic antihistamine/mast cell stabilizers (2)
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- olopatadine -- Patanol, Pataday
- epinastine -- Elestat (THESE WORK BY BOTH MECHANISMS) - indicated for AC |
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Patanol vs. Pataday
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- Patanol 0.1% soln. twice daily
- Pataday - 0.2% soln. once daily |
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ophthalmic antibiotics indication and mechanism
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- most are indicated for bacterial conjunctivitis
- mechanisms vary |
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OA's aminoclycosides (2)
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- tobramycin -- Tobrex
- gentamicin (ASK DUNN!) |
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OA's fluoroquinolones (6)
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ciprofloxacin -- Ciloxan
ofloxacin -- Ocuflox levofloxacin -- Quixin gatifloxacin -- Zymar moxifloxacin -- Vigamox besifloxacin -- Besivance |
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OA's sulfonamides
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- sodium sulfacetamide -- Bleph-10
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OA's macrolides
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- erythromycin (ointment, first macrolide)
- azithromycin -- AzaSite (zithromax) |
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TTN - azithromycin (a lot)
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- AzaSite
- 1 drop every 12 h for 2 days, then 1 drop daily for five days (total duration = 7 days) - contains duraSite - polymer that adheres to the eye surface and keeps drug from being washed out rapidly - extends duration of action - must be refrigerated in pharmacy - patient can keep at RT for 14 days |
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ophthalmic antivirals
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- trifluridine -- Viroptic
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- TTN trifluridine
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- Viroptic
- refrigerate in pharmacy - patients can store at room temp - preservatives can be absorbed by contacts and make them cloudy - patients should remove contacts and wait 15 minutes after instillation |
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OA' antibiotics (all - 11)
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- tobramycin
- ciprofloxacin - ofloxacin - levofloxacin - gatifloxacin - moxifloxacin - besifloxacin - gentamicin - sodium sulfacetamide - erythromycin - azithromycin |