Question | Answer |
Name the four cardinal sign of inflammation | Redness
Heat
Pain
Swelling |
Steroids block the inflammatory process where | Arachidonic acid |
NSAIDs block where | The COX cycle into the prostaglandins |
How do Steroids work | ARACHNOID ACID
Block the production of inflammatory agents
Decrease dilation and permeability of vessels
Decrease WBC proliferation and mast cell degranulation ( Allergic response) |
Name two inflammatory agents | Prostaglandins
Inflammatory mediators |
Name three inflammatory mediators | Cytokines
Leukotrienes
complement |
What are the SYSTEMIC side effects/ Complication of steroids | stomach ulcers
more susceptible to infections-herpes
mask underlying disorders
delay wound healing
psychoses
moon face
muscle and bone weakness
growth retardation in children |
How do you discontinue steroid Rx | Taper- Gradually |
What are the main ocular side effects of steroids? | posterior sub-capsular cataract (PSC)
Increased in IOP
Reactivate herpes |
Is PSC (posterior sub-capsular cataract)Reversible? | No |
**Increased IOP due to steroids** | More common in patients with Glaucoma
may Raise as high as 10mm Hg
Generally reversible after 1-3 weeks |
What are two forms of prednisolone gtts? Which one is stronger? | Acetate-strongest
Phosphate |
What is the strongest and most effective topical steroid? | Difluprednate
*perdnisolone is the next strongest |
Which is the least effective and weakest topical steroid? | Medrysone |
Which topical steroid have the most and strongest side effects and which have to least? | Strongest- Difluprednate, prednisone acetate, Dexamthasone
Weakest- Medrysone weakest- Fluorometholone |
Steroids combined with what are frequently used to treat blepharitis and OSD? | Antibiotics |
Name ocular disorders topical steroids commonly used to treat? | Blepharitis and OSD
severe allergic blepharitis
Phlyctentules
stromal herpes simplex
herpes zoster (Shingles)
corneal transplant immune reactions
post-operative cataract and glaucoma surgeries
uveitis
sclerities
chemical burns |
Name SYSTEMIC ocular disorders treated with steroids | Optic Neuritis
Temporal Arteritis (Giant Cell Arterities-GCA)
Graves Ophthalmopathy |
Intravitreal steroids are used for? | CSME in diabetes, Vascular occlusion, WET ARMD |
The body produces antibodies in response to what? | Antigens |
What are Antigens? | Any substance that stimulates production of antibodies. |
Anti-histamines block the allergic response where? | H-1 receptor site |
Mast cell stabilizers act by during what? | Preventing granulation of Mast cells |
Mast cell deanulation produce what? | Histamine, Cytokins, and prostaglandins |
The lowest level of treatment of allergic conjunctivitis is what? | Astringents, AF, and other OCULAR Decongestants |
Mild allergic conjunctivitis is treated how? | Antihistamines |
Moderate allergic conjunctivites is treat with what? | Combination: antihistamines and mast cells stabilizers |
Name some of the ocular decongestants | Phenylephrine 1/8%, Naphazoline 1/8%, Tetrahydrozoline 1/8% |
What is the weakest decongestant? | Phenylephrine |
Name three mast cell stab/anti-histamine drugs | Olpatadines, Ketotifens, Bepotastine |
Which combination drug (mast cell stab/anti-histamine) is OTC | Ketotifens |
Name a good anti-histamine? | Alcaftadine- works in minutes and last up to 16hrs |
When a drug has '-A' at the end what kind is it? | Decongestant with antihistamine |
what do you tell patients about the use of Anti-histamines | stings
dry eye
use for short time, because of rebound |
pure mast cells destabilizes are primary use for what and how long does it take to be effective? | vernal conjunctives and Giant papillary conjunctives-4 weeks |
what are the side effects of pure mast cells destabilizes? | Unpleasant taste, cough, runny nose, throat irritation |
what is vernal keratoconjunctities? what are it's sign and symptoms? | Severe form of allergic conjunctivitis. GPC & phlctentules |
what is atopic keratoconjunctivites | form of allergic skin lesions with ocular symptoms. |
What are the anti-VEGF drugs used for? Name them | CSME in diabetes
wet ARMD
Vadcular occlusion
to treat neovascularization |
Name the anti-VEGF drugs | ranibizumab
bevacizumab
aflibercept |
what three drugs are used to treat Retinal/choroidal diagnosis? | fluoroscein
Indocyanine green
Infracyanine green |
WHAT IS THE DIFFERENCE BETWEEN Indocyanine Green AND Infracyanine Green | Indocyanine Green AND Infracyanine Green- USED IN THE CHOROID
Infracyanine Green- DOES NOT HAVE IODINE |
WHAT DRUG IS INJECTED INTRAVITREAL FOR CSME | STEROIDS |
WHAT DRUG IS USED FOR PDT | VERTEPORFIN |
WHAT DRUG IS USED TO STAIN THE ANTERIOR CAPSULE AND MACULAR MEMBRANES? | METHYLENE BLUE |
WHAT ARE THE SIGNS OF DRY ARMD | ATROPHY AND PIGMENTARY CHANGES OF THE RPE AND RETINA, LARGE SOFT DRUSEN |
TERMS OF DRUGS AFFECTING THE SYMPATHETIC NS | ADRENERGIC |
TERMS OF DRUGS AFFECTING THE PARASYMPATHETIC NS | CHOLINERGIC |
TERMS WHICH MEANS STIMULATE OR INCREASE THE ACTION | AGONIST
MIMETIC |
TERMS WHICH MEAN INHIBIT OR STOP THE ACTION | ANTAGONIST
BLOCKER
LYIC |
YOU CAN GET ESSENTIALLY THE SAME EFFECT IF SYMPATHOMIMETIC DRUGS BY USING WHAT KIND OF DRUGS | PARASYMATHOLYIC |
WOULD THE EFFECTS OF A SYMPATHOMIMTIC DRUG AND A PARASYMATHOLYTIC BE THE SIMILAR OR DIFFERENT? | SIMILAR |