Pharm T2

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Author:
flyboy248
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177580
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Pharm T2
Updated:
2012-10-15 16:09:15
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Pharmacology
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Stuff for the Pharm Test 2
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  1. Adverse actions can occur where
    in the eye or organ systems
  2. Main goal
    Identify early the ocular drug adverse reactions OADR's and report any OADR's to www.eyedrugregistry.com
  3. Determinants in Toxicology (8)
    • Amounts of drug administered
    • Nature of the drug
    • Route of administration
    • Pathophysiologic variables
    • Age and Gender
    • Multiple drug therapy
    • Hx allergy to drugs
    • Individual idiosyncrasy
  4. Adverse effects in the eyelids (5)
    • Urticaria or angioedema
    • Allergic contact dermatitis
    • Cumulative deposition
    • Melanotic hyperpigmentation or hypopigmentation
    • Microbial imbalance
  5. Adverse effects in the Conjunctiva (5)
    • Follicular irritative or toxic conjunctivitis
    • Cumulative deposition
    • Anaphylactic conjunctivitis
    • Non-specific papillary irritative conjunctivitis
    • Microbial imbalance
  6. Adverse effects on the Cornea (6)
    • Anaphylactic karatitis
    • Allergic contact keratitis
    • Irritative or toxic keratitis
    • Phototoxic keratitis
    • Cumulative deposition
    • Toxic calcific band keratopathy
  7. Adverse effects on the Uvea (4)
    • Hypertophy of pupillary frill
    • Iridocyclitis
    • Iris sphincter atrophy
    • Iris color changes
  8. Adverse effects in IOP (2)
    • Elevation- steriods
    • Reduction- prostaglandins
  9. Adverse effects on the Crystalline lens
    • Anterior subscapsular opacification
    • Posterior subscapsular opacification
  10. Adverse effects on the Retina (3)
    • Detachment
    • Cystoid macular edema
    • Maculopathy
  11. Systemic Medications that cause Dry eyes
    ODAAA
    ocular diseases are anoying and agrivating
    • Oral retinoid
    • Diuretics
    • Antihistamines
    • Antocholinergics
    • Anticholinergic effect
  12. Indication of Oral retinoid
    Cystic acne
  13. Indication of Antihistamines
    Allergic rhinitis/sinusitis
  14. Indication of Anticholinergics
    Parkinsons disease
  15. Indication of Diuretics
    Hypertension
  16. Indication of Anticholinergic effect
    Psychosis, anxiety
  17. Systemic medicatons that cause Blepharoconjunctivitis
    IAGRPM
    I ate gold and redness proceeded monthly
    • Isotretinoin
    • Amioradone
    • Gold salts
    • Rifampin
    • Potassium penicillin
    • Methotrexate
  18. Indication of Isotretinoin
    Cystic acne
  19. Indication of Amioradone
    Cardiac arrhythmias
  20. Indication of Gold salts
    Arthritis
  21. Indication of Methotrexate
    Neoplastic disease/ Arthritis
  22. Indication os Potassium penicilin
    Antibiotic
  23. Indications of Rifampin
    Tuberculosis
  24. Drugs that cause corneal toxicity
    CPA
    corneal problems anytime
    • Chloroquine/Hydroxychloroquine
    • Phenothiazines/Chlorpromazine
    • Amiodarone
  25. What is the drug that produces whorl-like epihelial deposits below the horizontal midline
    Chloroquine/ Hydroxychloroquine
  26. What is the drug that causes endrothelial dusting
    Phenothiazines/ Chloropromazine
  27. What is the drug that causes whorl-like epithelial deposits (periphery)
    Amiodarone
  28. What are the drugs that affect the pupil
    PCAACOA
    pupils can annoy and carry ocular adversions
    • Phenotiazides
    • CNS stimulants (Amphetamines, Methylphenidate, cocaine)
    • Anticholinergic agents
    • Antihistamines
    • CNS depresents (Barbituates, Anxiety agents)
    • Opiates (Heroin, codeine, morphine)
    • Anticholinesterase (neogistigmine)
  29. Which drugs cause Mydriasis
    • Anticholinergic agents
    • CNS stimulants (Amphetamines, Methylphenidate, Cocaine)
    • CNS depressants (Barbituates and Anxiety agents)
    • Antihistamine
    • Phenothiazides
  30. Which drugs cause Miosis
    • Opiates (heroin, codine, morphine)
    • Anticholiestinerase (Neogistigmine)
  31. Drugs that induce refractive changes (all myopia but oral hypoglycemic)
    CAN O HO
    • Chorticosteroids
    • Acetazolamide
    • NSAIDS
    • Oral hypoglycemic
    • Hydrochlorothizide
    • Oral controceptives
  32. Which drugs alter color perception
    DALICI
    Dogs are least in color intensity
    • Digitalis gycosides
    • Amioradone
    • LSD/mescaline
    • Isoniazid/ Ethambutol
    • Chloroquine/Thioridazine
    • Indomethacin
  33. What drugs case a Tritin defect (color anomaly)
    Indomethacin and Chloroquine/Thioridazine
  34. Which drug gives a red-green defect
    Isoniazid/ Ethambutol
  35. Which drug causes Xanthopsia
    digitalis glycosides
  36. Which drug causes colored halos
    Amioradone
  37. Which drug has variable color anomalys
    LSD/mescaline
  38. Which drugs induce retinal changes
    NACOI
    Never a change of ideas
    • NSAIDS
    • Antineoplastics
    • Chloroquine/Hydroxychloroquine
    • Oral contraceptives
    • Indomethacin/Phenothiazides
  39. What retinal changes does chloroquine/hydroxychloroquine cause
    Bull's eye maculopathy
  40. What retinal changes does NSAIDs cause
    Retinal hemmorhages
  41. What retinal changes does oral controceptives cause
    Vascular occlusive disease
  42. What retinal changes does Antineoplastics cause
    Exudates posterior pole
  43. What retinal changes does Indomethacin/Phenothiazides
    Pigmentary retinopathy
  44. What drugs cause ocular nerve changes
    LEEASOU
    Let everybody eat anything satisfying oral erges
    • Lithium
    • Ethambutol/ Isonaxid
    • Ethanol
    • Amioradone
    • Sildenafil (viagra)
    • Oral contraceptives
    • Estrogen therapy
  45. Which drugs cause Papilledema
    • Lithium
    • Oral contracetives
    • Amioradone
    • Estrogen therapy
  46. Which drugs cause Optic neurtits
    • Ethambutol/Isonazid
    • Sildenafil (viagra)
  47. Which drug causes oxic neuropathy
    Ethanol
  48. What herbal and nutritional suppliments cause ocular side effects
    NECGEC
    Never eat chamomile going in expensive cars
    • Niacin
    • Echinocea pupura
    • Camomile
    • Ginkgo biloba
    • Excess Vitamen A
    • Canthaxantihn
  49. What does Canthaxantihn cause
    Crystals macular region
  50. What do Camimule and Echinacea purpura cause
    Conjunctivitis
  51. What does Ginko bilaba cause?
    Hyphema, Retinal Hemorrhages
  52. What does Niacin cause?
    Macular edema, lid edema and dicoloration
  53. What does Excess Vitamen A cause
    DES, night blindness
  54. Detection and Provention
    • Medical history
    • Drug History
    • Elderly
    • Pregnancy
    • Children
    • Record any side effect observed
    • Take immediate action
    • Monitor patient closely
    • If not previously reported, notify the FDA
  55. B andrenoreceptors antagonists
    • B blockers
    • Ocular hypotensive drugs
    •       -Glaucoma
    •       -Ocular hypertension
  56. 5 drugs used as adrenergic antagonists in the eye
    • Timolol
    • Levobutanolol
    • Metipranolol
    • Carteolol
    • Betaxolol

    -These stimulate the B blockers in the ciliary epithelium which decrease the aq humor 
  57. Timolol Brand name
    • Timoptic Timolol Maleate
    • Timolol XE- Gelrite vehicle
    • Timoptic Ocudose PF 
    • Betimol- Hemihydrate salt
    • Istalol- Lipophilic action
  58. Pharm of Timolol
    • Conc- .25 or .5%
    • A non cardioselective B blocker
    • Negative ISA
    • B2 adrenoreceptor 
    • Decrease IOP 25% -7mm Hg
    • Admin- 1drop bid or 1 drop d
    • Max effect achieved in 3 weeks- Contralateral effect, Morning application
  59. Clinical uses of Timolol
    • Primary Open Angle Glaucoma
    • Ocular Hypertension
    • Pre and Post surgery
  60. Ocular side effects of Timolol
    • Blepharoconjunctivitis   - Erythema and edema
    • Decreased corneal sensitivity
    • Dry eye   - Superficial punctate keratopathy
  61. Systemic side effects of timolol
    • Amnesia
    • Alteration lipid plasma profile
    • Bradycardia
    • Bronchospasm
    • CHF
    • Diarrhea
    • Elderly special consideration
    • Heart block
    • Hypoglycemia
    • Systemic hypotension
  62. Contraindications of Timolol
    • Bradycardia
    • Bronchial asthma
    • COPD
    • Children and infants
    • Overt cardiac failure
    • Severe heart block
  63. Differences between Levobunolol and Timolol
    • Brand name-Betagan
    • Is cheaper
    • Differ in metabolic action
    • Ocular side effects- No DES, less allergic reactions

    Use for pts with not as high IOP- lowers 3-5 mm Hg
  64. Differences between Metipranolol and Timolol
    • Brand name- Optipranolol
    • Conc- .1-.6 normal 0.3%
    • Dose - 1 drop b/d
    • Cheaper

    Ocular side effects- 3 + Uveitis and preorbital dermatitis
  65. Carteolol
    • Brand name- Ocupress
    • Has + ISA
    • Conc- 1%
    • Clinical use for Ocular hypertension and POAG
    • Ocular side effests, the 3 + increased cornal anesthesia

    • Systemic- reduced side effects
    • Bronchial effect
    • Bocturnal bradycardia
    • High density lipoprotein
  66. Betaxolol Pharm
    • Name- Betoptic S
    • Affinity for B1 receptors - Cardioselective
    • Has some neuroprotective actions
    • Suspension- conc 0.25%

    • For ocular hypotension and POAG
    • -Use for COPD and asthma patients

    Ocular side effect- Discomfort
  67. Betaxolol systemic side effects
    • Slight reduction in systolic blood pressure
    • CHF
    • Myocardial Infarction
    • Some respiratory problems (caution in COPD)
    • Sinus brady
  68. Betaxolol Contraindications
    • Sinus brady
    • First degree AV block
    • Cardiogenic shock
    • Cardiac failure
  69. Cosopt
    Timolol maleate and Dorsolamide HCL
  70. Combigan
    Timolol and Brimonidine
  71. Azarga
    Timolol and Brinzolamide
  72. DuoTrav
    Timolol and Travaprost
  73. B blocker selection guide
    • Best IOP control- avoid Betaxolol
    • Cost- Timolol or metipranolol
    • Comfort- Carteolol
    • Hypercholesteremia- Carteolol
    • Allergies to preservative -Timoptic XE, or Ocudose
    • COPD and asthma- Betaxolol
    • Pregnancy - None

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