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Ocular Pharma # 7

Retina and Antihistimines

Name the 3 diagnostic retinal dyes. Fluorescein, Indocyanine Green, and Infracyanine Green
What is the most common retinal dye that's utilized and what are the side effects? Fluorescein Sodium / Yellow or orange urine, Nausea, Headache, Upset Stomach
What is the name of the drug used in PDT (Photo Dynamic Therapy)? Verteporfin (Visudyne®)
What are the main side effects for Verteporfin(Visudyne®)? Headache, Skin and eyes light sensitivity, blurred vision
What does VEGF stand for? Vascular Endothelial Growth Factor
What are the brand names of the two most commonly used Anti-VEGF drugs? Avastin® and Lucentis® (Eyelea® is the newest)
What types of issues may indicate a problem with VEGF? CSME- Leakage of blood vessels in maculae and New blood vessel growth (Neovascularization (Diabetes, Vein occlusions, etc)
What are some complications that arise with Anti-VEGF usage? Increased IOP, Vitreous hemorrhage, Uveitis, Endophthalmitis
What is PRP and what is it used to treat? Pan Retinal Photocoagulation. Treats areas of ischemia (Areas of non-perfusion) to reduce stimulus for neovascularization in retina or iris..
What dye is used to stain the anterior lens capsule or epiretinal membranes? Methylene Blue (Trypan Blue® and Vision Blue®)
What is the difference between ICG and IFCG? ICG (Indocyanine Green) has iodine and IFCG (Infracyanine Green) has no iodine and is more isotonic
Can you draw the Simplified Allergic Reaction? **DRAW THIS***
How do anti-histimines act? Block H-1 receptors at their site
How do mast cell stabilizers act? Prevent mast cell degranulation
What are the symptoms of allergies? Itching, swelling, redness- mainly itching
What class drugs are used for the lowest level allergy treatment? Astrigents, artificial tears, ocular decongestants
What class drugs are used for mild allergy treatment? Antihistamines
What class drugs are used for moderate allergy treatment? Mast cell stabilizers (tendency is to use the newer ones which combine antihistamine for faster action and mast cell stabilizers for stronger (but delayed) action.
What class drugs are used for severe allergy treatment? Topical steroids may be required for short term use
Name three vasoconstrictor/decongestants? Phenylephrine (neosynephtrine), Naphazoline, Oxymetazoline, Tetrahydrozoline (All end in -zoline except the first. All very weak solutions- about 1/8%)
What are the possible side effects of vasoconstrictors and decongestants? Dilation of iris in a compromised cornea, stinging, rebound with overuse.
What is the generic name of the newest antihistimine, which is used only once/day? Alcaftadine.
How long does it take for Alcaftadine to work and how long does it last? In minutes. Lasts 16 hours.
What are the side effects of oral anti-histamines? Dry eyes, drowsiness, blurred vision, dry mouth, headache
What are pure mast cell stabilizers used for? Long term use against allergic conjunctivitis.
How long does it take for pure mast cell stabilizer to take full effect? These take several weeks.
What do you tell the patient about pure mast cell stabilizers and their side effects? They sting and take several weeks to work. use prophylactically before symptoms begin. Do not use with contacts in place. Side effects: Unpleasant taste, cough, throat irritation, and they sting.
What is the advantage of the mast cell stabilizer/antihistamine combination? Fast action along with good effect for chronic use. They are the most effective but they cost more. Work both prophylactically and during allergic flare ups.
What are three generic names of mast cell stabilizers/antihistamine combination new drugs? Olpatadine, Ketotifen, Bepotastine (Bepreve®)
Which mast cell stabilizers/antihistamine combination is available over the counter? Ketotifen
Vernal and atopic conjunctivitis long term treatment is with what? Mast cell stabilizers- pure mast cell stabilizers are cheaper.
What do we treat chronic soft contact lens intolerance with? Mast cell stabilizers
What do you tell patients about mast cell stabilizers used for vernal and atopic conjunctivitis and chronic soft contact lens intolerance? Takes 3-4 weeks to act. Should be used prophylactically, not for acute attack (now primarily using the combined newer combo ones)
Created by: Leequa