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CHAPTER 18 Ophthalmic Drugs Quiz Yourself1. Topical ophthalmic drug forms must be different from topical drug forms used onthe skin because they must be specially formulated to be nonirritating to the eye andthey are not interchangeable with topical drugs for the skin.2. Silver nitrate is a topical anti-infective drug applied to the eyes of newborn infants toprevent infection and possible blindness from gonorrhea (contracted from an infectedbirth canal). Silver nitrate has been used for many years and is the least expensive drug for this problem. However, it can cause conjunctival irritation/swelling in the newborn. Another topical anti-infective, erythromycin, is equally as effective in preventing gonorrhea. It can prevent newborn eye infections from chlamydia as well. It can also facilitate mother–child bonding because it does not produce conjunctival irritation and swelling like silver nitrate; however, erythromycin is more expensive.3. Histamine is produced when a foreign substance, such as pollen, animal dander, orother antigen, enters the body, and antibodies from the immune system attach to theantigen and form an antigen–antibody complex that the body can destroy. Histaminecauses vasodilation, and the blood vessels and tissues become swollen, inflamed, and red. Histamine also irritates tissues directly, causing pain and itching.4. Three categories of drugs that are used to treat allergy symptoms in the eyes are topical antihistamine drugs, topical mast cell stabilizer drugs, and topical decongestant drugs.5. Prostaglandin F agonist drugs for glaucoma stimulate prostaglandin F receptors, which increases the outflow of aqueous humor and decreases the intraocular pressure. Carbonic anhydrase inhibitor drugs block the enzyme carbonic anhydrase, which is active in the production of aqueous humor. Beta-blocker drugs block beta receptors in the eye and this decreases the production of aqueous humor. Alpha receptor stimulator drugs stimulate alpha receptors to decrease the productionof aqueous humor and increase its outflow. Sympathomimetic drugs mimic theaction of epinephrine to increase the outflow of aqueous humor. Miotic drugs actlike acetylcholine to cause the pupil to constrict and increase the outflow of aqueoushumor. Cholinesterase inhibitor drugs inhibit cholinesterase, an enzyme that destroys acetylcholine; with acetylcholine active, the pupil constricts and this increases the outflow of aqueous humor.6. Beta-blocker drugs have an advantage over other miotic drugs used to treat glaucoma in that they do not constrict the pupil and therefore do not cause blurring of vision or night blindness.7. Mydriatic drugs are used to dilate the pupil, paralyze the muscles of accommodation of the iris, and prepare the eye for internal examination.8. Antihistamine ophthalmic drugs block histamine receptors in the eye to block theeffects of histamine released during allergic reactions. Ophthalmic mast cell inhibitors stabilize the cell membrane of mast cells and prevent them from releasing any histamine.9. Botulinum toxin type A is a toxin that is injected into eye muscles to paralyze themuscle fibers and allow them to lengthen. It is used to treat blepharospasm, nystagmus, and strabismus.10. a. Topical antibiotic drug for bacterial infectionsb. Monoclonal antibody drug used to treat macular degenerationc. Prostaglandin F agonist drug used to treat glaucomad. Carbonic anhydrase inhibitor drug for glaucomae. Topical corticosteroid drug for eye inflammationf. Topical NSAID for eye inflammationg. Antiviral drug implant for CMV in patients with AIDSh. Topical mast cell stabilizer drug for eye allergiesi. Beta-blocker drug for glaucomaj. Topical decongestant drug for eye allergiesk. Topical antibiotic drug for bacterial eye infectionsl. Corticosteroid drug for eye inflammationm. Mydriatic drug to dilate the pupilClinical Applications Questions1. a. Timopticb. Beta-blocker drugc. It blocks beta receptors in the eye. This decreases the production of aqueoushumor to decrease the intraocular pressure.d. 0.25%e. Ophthalmic dropsf. Write on the label: 1 drop(s) in both eyes twice a day.2. a. Over-the-counter drug (label says “Available without a prescription”)b. naphazoline, pheniraminec. decongestant drug and antihistamine drugd. used to treat allergy symptoms in the eyes3. a. Garamycinb. Antibiotic drugc. Bacterial infections in the eye.d. Ophthalmic solution (liquid) ................
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