Term
| What is included in the orbit? |
|
Definition
Orbital bones
Extraocular mm., vessels, nn., fat |
|
|
Term
| What is included in the adnex? |
|
Definition
Eyelids
Third Eyelid
Conjunctiva
Lacrimal Glands
Nasolacrimal System |
|
|
Term
| What is included in the globe? |
|
Definition
Fibrous, Vascular, & Neural Tunics
Aqueous & Vitreous Humor
Lens
Anterior & Posterior Segments |
|
|
Term
| What is included in the fibrous tunic? |
|
Definition
|
|
Term
| What is included in the vascular tunic? |
|
Definition
| Iris, Ciliary Body, Choroid |
|
|
Term
| What is included in the neural tunic? |
|
Definition
|
|
Term
| What can be detected in the eye with nitrate poisoning? |
|
Definition
| Nitrite in the aqueous humor |
|
|
Term
| What are the protective mechanisms of the eye? |
|
Definition
Eyelids
Third Eyelid
Conjunctiva
Cornea
Pre-corneal tear film |
|
|
Term
| What are the refractive structures of the eye? |
|
Definition
Cornea
Lens
Optical Clarity (from H2O) |
|
|
Term
| What is the function of aqueous humor? |
|
Definition
Nutrition & waste removal from cornea & lens
Maintain intraocular pressure |
|
|
Term
| What is the formation of aqueous humor? |
|
Definition
| Corneal barrier epithelium (protective) |
|
|
Term
| What is the flow of aqueous humor? |
|
Definition
| Posterior Chamber, Pupil, Anterior Chamber |
|
|
Term
| What does blockage of aqueous humor drainage lead to? |
|
Definition
|
|
Term
| What is the drainage of aqueous humor? |
|
Definition
Iridocorneal angle (conventional)
Uveo-scleral (unconventional) |
|
|
Term
| What are some ocular barriers to drug delivery? |
|
Definition
| Cornea (hydrophobic epithelium, stroma & endothelium) |
|
|
Term
| What are best able to cross the cornea membrane? |
|
Definition
| Biphasic (hydrophilic, lipophilic properties) |
|
|
Term
| What is included in the blood-aqueous barrier of the eye? |
|
Definition
Ciliary body epithelium
Iris vascular endothelium |
|
|
Term
| What does the blood-aqueous barrier of the eye do? |
|
Definition
| Keeps what's in the blood in the blood, not in front of the eye |
|
|
Term
| What are the blood retinal/vitreous barriers? |
|
Definition
Retinal pigmented epithelium
Retinal vascular endothelium |
|
|
Term
| What is the hyaloideo-scapsular ligament? |
|
Definition
| Barrier btw anterior segment (lens) & posterior segment (vitreous) |
|
|
Term
| What is the barrier btw anterior segment (lens) & posterior segment (vitreous)? |
|
Definition
|
|
Term
| What does the blood retinal/vitreous barrier do wrt drugs? |
|
Definition
| Limits penetration of topically applied drugs into posterior segment |
|
|
Term
| When is the blood retinal/vitreous barrier disrupted? What is the consequence? |
|
Definition
Lens dz (subluxation/luxation) & Sx;
Topically applied drugs may penetrate |
|
|
Term
| What are 3 solubility properties? |
|
Definition
| Lipophilic, Hydrophilic, Biphasic |
|
|
Term
| What is the importance of pH in ocular drug delivery? |
|
Definition
Influences tearing, ionized/unionized fraction;
Can be altered by use of buffers |
|
|
Term
| What is the importance of MW in ocular drug delivery? |
|
Definition
| influences penetration, efflux of drugs from the eye |
|
|
Term
| What is the main concern with commercially available formulations of ophthalmic medication? |
|
Definition
| Which formulation works best (all factors seem taken into account) |
|
|
Term
| What are 3 topical ophthalmic drug formulations? |
|
Definition
Ointment
Suspension
Solution |
|
|
Term
| Increasing frequency of ocular drug admin increases _______. |
|
Definition
| Local drug levels & penetration |
|
|
Term
| How often should ocular drugs be administered prophylactically? |
|
Definition
|
|
Term
| How often should ocular drugs be administered therapeutically? |
|
Definition
|
|
Term
| Why may systemic MIC be inapplicable for ocular therapeutics? |
|
Definition
| Ability to reach higher local drug levels |
|
|
Term
| Where can topical ocular drugs be administered? |
|
Definition
High eyelid, conjunctival & corneal drug levels
Variable intraocular drug levels |
|
|
Term
| Where can systemic ocular drugs be administered? |
|
Definition
| High eyelid, Orbital, Posterior segment drug levels |
|
|
Term
| Inflammation/breakdown of ocular barriers _______ drug penetration. |
|
Definition
|
|
Term
| Describe intravitreal injection. |
|
Definition
Indicated for some posterior segment dz (glaucoma);
Once administered, can not be removed |
|
|
Term
| Describe sub-conjunctival drug admin. |
|
Definition
Comparable to frequent topical dosing;
Drug levels maintained for days to weeks;
Difficult to treat pt |
|
|
Term
| What is the therapy route for the eyelid? |
|
Definition
|
|
Term
| What is the therapy route for the conjunctiva? |
|
Definition
|
|
Term
| What is the therapy route for the cornea? |
|
Definition
|
|
Term
| What is the therapy route for the anterior segment? |
|
Definition
|
|
Term
| What is the therapy route for the posterior segment? |
|
Definition
|
|
Term
| What is the therapy route for the orbit? |
|
Definition
|
|
Term
Adrenergic innervation:
CNS --> _____ --> _____ (NTs) |
|
Definition
|
|
Term
Cholinergic innervation:
CNS --> _____ --> _____ (NTs) |
|
Definition
|
|
Term
Adrenergic innervation:
CNS --> _____ --> _____ (structures) |
|
Definition
| Superior cervical ganglion; effector cell |
|
|
Term
Cholinergic innervation:
CNS --> _____ --> _____ (Structures) |
|
Definition
| Ciliary ganglion; effector cell |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Paralyze ciliary body mm. |
|
|
Term
| What are the classes of mydriatics & cycloplegics? |
|
Definition
| Sympathomimetic & Parasympatholytic |
|
|
Term
| What are the diagnostic indications for mydriatics & cycloplegics? |
|
Definition
|
|
Term
| What are the therapeutic indications for mydriatics & cycloplegics? |
|
Definition
| Anterior uveitis, intraocular Sx |
|
|
Term
| Name 3 sympathomimetic agents. |
|
Definition
| Epinephrine, Dipivalyl epinephrine, Phenylephrine |
|
|
Term
| What is the mechanism of sympathomimetics? |
|
Definition
| Stimulation of alpha-receptors on iris dilator m. |
|
|
Term
| What are the uses of sympathomimetic agents? |
|
Definition
| Intraocular Sx (mydriasis, vasoconstriction); Dx of Horner's Syndrome; Lower intraocular pressure (adjunct therapy) |
|
|
Term
| Name 2 parasympatholytic agents. |
|
Definition
|
|
Term
| What is the mechanism of parasympatholytic agents? |
|
Definition
| Anticholinergic blockade of iris sphincter & CB mm. |
|
|
Term
| What are the diagnostic uses of parasympatholytic agents? |
|
Definition
| Complete eye exam (mydriasis) |
|
|
Term
| What are the therapeutic uses of parasympatholytic agents? |
|
Definition
| Anterior uveitis (mydriasis & cycloplegia) |
|
|
Term
| What are some elements of variability with parasympatholytics? |
|
Definition
| Species, Inflammation, Pigmentation |
|
|
Term
|
Definition
|
|
Term
| What is the general mechanism of miotics? |
|
Definition
| Potentiate muscarinic activation of pupillary sphincter |
|
|
Term
| What is the direct acting mechanism of miotics? Give examples. |
|
Definition
| mimic ACh; Pilocarpine & Carbacol |
|
|
Term
| What is the indirect acting mechanism of miotics? Give examples. |
|
Definition
| inhibit AChase (Demecarium bromide, Ecothiophate, Physostigmine) |
|
|
Term
| What are some uses of miotics? |
|
Definition
| Glaucoma (miosis pulls peripheral iris out of irido-corneal angle --> increase outflow post-op), Maintain posteriorly luxated lens posteriorly (Sx removal not req'd) |
|
|
Term
| What is the mechanism of local ocular anesthetics? |
|
Definition
| Inhibit movement of Na+ into nerve axon; Prevent depolarization |
|
|
Term
| What are the topical indications of local ocular anesthetics? |
|
Definition
|
|
Term
| What are the therapeutic indications of local ocular anesthetics? |
|
Definition
| Injectable (motor & sensory blockade) |
|
|
Term
| What are contraindications of local ocular anesthetics? |
|
Definition
| Not as therapy for any ocular dz |
|
|
Term
| What are 2 types of tear replacers/stimulants? |
|
Definition
| Lacrimomimetics & Lacrimogenics |
|
|
Term
| What do lacrimomimetics do? |
|
Definition
|
|
Term
| What do lacrimogenics do? |
|
Definition
| Stimulate tear film production |
|
|
Term
| What is the therapeutic indication for tear replacers/stimulants? |
|
Definition
| Tea film quantity/quality disorders |
|
|
Term
| What formulations are available for lacrimomimetics? |
|
Definition
| eye wash, hyaluronate preparations, ointments; variable effect (contact time, prep) |
|
|
Term
| Name 4 lacrimogenic drugs. |
|
Definition
| cyclosporin, tacrolimus, pimecrolimus, pilocarpine |
|
|
Term
| What does cyclosporin do? |
|
Definition
| Stimulates mucin & aqueous production |
|
|
Term
| What is cyclosporin used for? |
|
Definition
| Topical therapy (immune-mediated keratoconjunctivitis sicca) |
|
|
Term
| What is pilocarpine & what does it do? |
|
Definition
| Direct acting parasympathomimetic; Stimulates lactimal glands directly |
|
|
Term
| What is pilocarpine indicated for? |
|
Definition
| Neurogenic keratoconjunctivitis sicca |
|
|
Term
| What is Neurogenic keratoconjunctivitis sicca? |
|
Definition
| Normal lacrimal glands & abn/absent neurologic input; no stim. of tear production |
|
|
Term
| What are SEs of oral admin of pilocarpine? |
|
Definition
| SLUD; Similar to cholinesterase inhibition |
|
|
Term
| What is the mechanism of glaucoma? |
|
Definition
| Increases intraocular pressure --> retinal & optic n. damage |
|
|
Term
| What causes increased intraocular pressure in glaucoma? |
|
Definition
| Poor drainage (primary/secondary) |
|
|
Term
| What is the goal of glaucoma therapy? |
|
Definition
| Preserve vision & control pain |
|
|
Term
| Name some drug categories used in the Tx of Glaucoma. |
|
Definition
| Beta-blockers, CA inhibitors, PG analogs, Hyperosmotic agents |
|
|
Term
| What are 2 types of topical beta-blockers, and 1 example of each? |
|
Definition
| Nonselective (Timolol); B1 selective (Betaxolol) |
|
|
Term
| What is the mechanism of beta-blockers? |
|
Definition
| Specific mech unknown; thought to decrease production of cAMP |
|
|
Term
| What are the indications of Beta-blockers? |
|
Definition
| Primary & secondary; Prophylaxis |
|
|
Term
| What are SEs of Beta-blockers? |
|
Definition
| Caution (sm dogs) w/ pre-existing cardiac Dx/problems |
|
|
Term
| What are contraindications for corticosteroids? |
|
Definition
| Corneal ulcers; Caution w/ systemics, pre-existing endocrine conditions & sm pt's |
|
|
Term
| What are the indications of ocular corticosteroids? Is each systemic or topical? |
|
Definition
| Anterior segment inflam. (topical); Eyelids, posterior segment inflam (Systemic) |
|
|
Term
| Name 2 topical CA inhibitors. |
|
Definition
| Dorzolamide; Brinzolamide |
|
|
Term
| Name 2 oral CA inhibitors. |
|
Definition
| Methazolamide; Acetazolamide |
|
|
Term
| What is the mechanism of CA inhibitors? |
|
Definition
|
|
Term
| What are the indications for CA inhibitors? |
|
Definition
| Primary/Secondary; Prophylaxis |
|
|
Term
| What are the SEs of CA inhibitors? |
|
Definition
| Metabolic acidosis, Diuresis |
|
|
Term
| Name 3 topical PG analogs. |
|
Definition
| Latanoprost; Bimatoprost; Travoprost |
|
|
Term
| What is the mechanism of PG anaolgs? |
|
Definition
| Increased drainage uveoscleral; Miosis |
|
|
Term
| What are the indications of ocular PG analogs? |
|
Definition
|
|
Term
| What happens w/ PG analogs in cats? Horses? |
|
Definition
|
|
Term
| Name an IV Hyperosmotic agent. |
|
Definition
|
|
Term
| What is the mechanism of Mannitol? |
|
Definition
| Decreased production & increased drainage |
|
|
Term
| What are the indications of Mannitol? |
|
Definition
| Primary (acute congestive) |
|
|
Term
| What are the contraindications of hyper-osmotic agents? |
|
Definition
| Uveitis, cerebral or pulmonary edema, dehydration |
|
|
Term
| What have hyper-osmotic agents largely been replaced by? |
|
Definition
|
|
Term
| What are some topical parasympathomimetics used in Tx of Glaucoma? |
|
Definition
| Pilocarpine, Demecarium Bromide |
|
|
Term
| What are some adrenergic agonists used in Tx of Glaucoma? |
|
Definition
| Epinephrine (nonselective), Apraclonidine, Brimonidine (alpha-2 agonist) |
|
|
Term
| What is characteristic of adrenergic agonists used in Tx of glaucoma? |
|
Definition
| Poor efficacy & potential ocular/systemic SEs, therefore not commonly used in vet med |
|
|
Term
| What is the effect of inflammation on the eye? |
|
Definition
| Either protective or deleterious |
|
|
Term
| What is the goal of Tx of ocular inflam? |
|
Definition
| Treat to minimize inflam., discomfort, & secondary ocular changes |
|
|
Term
| What is frequency/route of admin/drug used in therapy for ocular inflam. determined by? |
|
Definition
|
|
Term
| What are topical ocular corticosteroids effective in treating? |
|
Definition
Conjunctivitis
Keratitis
Anterior Uveitis |
|
|
Term
| What is the mechanism of topical ocular corticosteroids? |
|
Definition
| AA cascade to minimize inflam. |
|
|
Term
| What are primary considerations in selecting corticosteroids to be used? |
|
Definition
| Potency & intraocular penetration |
|
|
Term
| What is characteristic of formulations of acetate & alcohol? |
|
Definition
| Superior intraocular penetration to phosphate preparations |
|
|
Term
| Name some topical corticosteroids. |
|
Definition
| Dexamethazone Na- P; Prednisolone Acetate; Hydrocortisone (no intraocular penetration) |
|
|
Term
| Rank the topical corticosteroids from most to least intraocular penetration. |
|
Definition
| Prednisolone Acetate>Dexamethazone>Hydrocortisone |
|
|
