Term
Tear volume ~____ml
1 drop = ____ml |
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Definition
~0.007ml
0.05ml
so...wait 3-5 min b/t drops. the eye can't hold more than 1 at a time! |
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Term
| What is a technique to increase absorption of eye drop in the eye and decrease systemic absorption? |
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Definition
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Term
| What topical soln causes risk for airway obstruction during the first 12 mos of administration? |
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Definition
| Timolol (beta blocker - constricts bronchi). Nasolacrimal occlusion decreases risk b/c less absorbed systemically. |
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Term
| What are 4 advantages to using prodrugs? |
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Definition
1. enhance corneal absorption
2. prolong duration of action
3. minimize systemic effects
4. reduce ocular adverse effects |
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Term
| What is the role of Dipivefrin? |
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Definition
| it is a prodrug of epinephrine. dipivalyl ester helps epinephrine to enter the cornea. then esterase cleaves. this decreases systemic/adverse effects |
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Term
| What type of ocular pharmacological administration lasts longest? |
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Definition
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Term
| What are some additional factors affecting absorption? |
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Definition
volume.
surface tension - surfactants.
osmolality - hyper vs hypotonic.
pH - little buffering capacity.
viscosity.
suspensions |
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Term
| The lipid layer from what gland secretion minimizes evaporation of drugs for dry eye? |
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Definition
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Term
| What cells secrete mucin which stabilizes and helps spread tear film? |
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Definition
| conjunctival goblet cells |
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Term
| What are five types of drugs that induce ocular toxicity (inhibit tear secretion)? |
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Definition
1. anticholinergics
2. antihistamines
3. beta-blockers
4. isotretinoin
5. oral contraceptives |
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Term
| What are some treatments for dry eye? |
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Definition
| - minimize environmental triggers - artificial tears (symptomatic relief only) - topical cyclosporine (increases tear production) - topical corticosteroids (only for short time) - secretagogues & nutritional supps (clinical benefit?) - punctal occlusion conserves tears (can cause decrease prodcution) |
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Term
| What do artificial tears lack? |
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Definition
| the complex mixture of proteins, mucins, and other factors found in normal healthy tears. (contain only electrolytes) |
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Term
| What are some alternative tx for dry eye? |
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Definition
- OTC fatty acid supplements
- linoleic + y-linoleic acids
- possible adjunctive tx |
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Term
| What types of drugs treat allergy and inflammation? |
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Definition
| -decongestant -decongestant/antihistamine -antihistamine -mast cell stabilizer -dual acting antihistamine/mast cell stabilizer -corticosteroid -nonsteroidal anti-inflammatory |
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Term
| What are the top 3 types of drugs for glaucoma? |
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Definition
1. prostaglandin analogs
2. beta blocker
3. a-adrenergic agonist |
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Term
| What is the general goal when treating glaucoma? |
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Definition
| to increase outflow of aqueous humor and/or decrease formation of aqueous humor |
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Term
| What are the 4 components to successful comprehensive IOP management? |
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Definition
1. efficacy
2. tolerability
3. patient acceptance
4. safety |
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Term
| What types of drugs increase outflow of AH? |
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Definition
- prostaglandin analogs
- cholinergic receptor agonists (contract ciliary muscles) |
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Term
| What are adverse effects of prostaglandin analogs? |
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Definition
- iris and periorbital pigmentation
- eyelash increase number and length
- local irritation (itchy, dry, blurry) |
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Term
| What are the adverse effects of cholinergic receptor agonists? |
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Definition
LOCAL - corneal toxicity, inflammation, redness, ciliary spasm>brow ache, myopia, blurred vision
SYSTEMIC - sweating, nausea, salivation, changes in BP |
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Term
| What types of drugs decrease formation of aqueous humor? |
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Definition
- beta-adrenergic receptor antagonists
- alpha2-adrenergic agonists
- carbonic anhydrase inhibitors |
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Term
What are the names of 3 prostaglandin analogs?
LatBimTrav-oprost |
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Definition
*each given 1 drop qPM*
1. latanoprost - "Xalatan 0.005%"
2. bimatoprost - "Lumigan 0.03%"
3. travoprost - "Travatan 0.004%" "Travatan Z 0.004%" |
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Term
What are the names of 3 cholinergic receptor agonists?
PiloCarbEcho |
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Definition
1. pilocarpine 0.5 to 6% - "Isopto Carpine 1, 2, 4%" 1 drop qid
2. carbachol - "Carboptic 3%" "Isopto Carbachol 1.5-3.0%" 1 drop qid
3. echothiophate iodide 0.03, 0.06% - "Phospholine Iodide 0.125, 0.25" 1 drop bid |
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Term
What are the names of 5 beta-adrenergic receptor antagonists?
BetCartLevMetTim-olol |
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Definition
*all 1 drop qAM or bid*
1. betaxolol 0.5% - "Betoptic S 0.25%"
2. carteolol 1%
3. levobunolol 0.25, 0.5% - "Betagan 0.25, 0.5%"
4. metipranolol 0.3% - "OptiPranolol"
5. timolol 0.25, 0.5% - "Betimol 0.25, 0.5%" "Istalol 0.5%" "Timoptic 0.25, 0.5%" "Timoptic Ocudose 0.25, 0.5%" |
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Term
| What are adverse effects of beta-adrenergic receptor antagonists? |
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Definition
TOPICAL - stinging, itching, redness, burning, blurred vision
SYSTEMIC - depression, fatigue, dizziness, bradycardia, asthma, sexual dysfunction, mask hypoglycemia |
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Term
What are the names of 2 carbonic anhydrase inhibitors?
BrinDor-zolamide |
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Definition
*both 1 drop bid or tid*
1. brinzolamide - "Azopt 1% susp"
2. dorzolamide - "Trusopt 2% soln" |
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Term
| What are the adverse effects of carbonic anhydrase inhibitors? |
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Definition
systemic administration - too toxic
topical - better tolerated. stinging, redness, dry eye, blurred vision |
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Term
What are two alpha2-adrenergic receptor agonists?
ApraBrim |
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Definition
1. apraclonide - "Iopidine 0.5, 1%" 1 drop tid
2. brimonidine 0.2% - "Alphagan P 0.1, 0.15%" 1 drop bid or tid |
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Term
| What are the adverse effects of alpha2-adrenergic receptor agonists? |
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Definition
fatigue, local allergic rxns
TOPICAL - stinging, foreign body sensation, severe redness |
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Term
| Osmolality is increased in what conditions? |
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Definition
| DTS - Hyperthyroidism - Long term contact lens wearers |
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Term
| pH is high in what conditions? |
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Definition
| DTS - Ocular rosacea - Lacrimal stenosis - Cataract extraction - Newborns |
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Term
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Definition
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