OC Pharm Mt II

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  • 1/61 Questions

    Pts with glaucoma should NOT use ocular decongestants without the advice of an eye doctor.

    • True
    • False
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About This Quiz

The 'Oc Pharm MT II' quiz assesses knowledge on ocular pharmacology, focusing on ocular decongestants. It covers drug interactions, adverse effects, usage guidelines, and specific concentrations, crucial for students and professionals in medicine and ophthalmology.

OC Pharm Mt II - Quiz

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  • 2. 

    The maximum about of time one should use an ocular decongestant without seeing an eye doctor  is ____hours.

    Explanation
    The maximum amount of time one should use an ocular decongestant without seeing an eye doctor is 48 hours. This is because prolonged use of ocular decongestants can lead to rebound congestion, where the blood vessels in the eyes become dependent on the medication and worsen the symptoms. It is important to consult an eye doctor if the symptoms persist beyond 48 hours to ensure proper treatment and avoid any potential complications.

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  • 3. 

    Steroid use in contraindicated in active ocular herpes simplex infections.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Concern with corneal perforation

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  • 4. 

    What type of antibiotic is Azasite (Azithromycin)?

    • Macrolide

    • Fluroquinolone

    • Cephalosporin

    • Penicillin

    Correct Answer
    A. Macrolide
    Explanation
    MOA: binds to 50s ribosomal subunit of susceptible micorbes to interfere with PROTEIN SYNTEHSIS

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  • 5. 

    Pts should NOT occlude their puncta when administering glaucoma drops because there needs to be some drainage of the drops to avoid corneal toxicity

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Pts SHOULD occlude puncta btw drops in and to wit several minutes btwn drops in order to maximize the amount of med reaching target receptors and to minimize systemic absorption.

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  • 6. 

    The PREG category for antihistamines is ___.

    Correct Answer
    C
    Explanation
    The PREG category for antihistamines is not provided in the question. Therefore, it is not possible to determine the correct answer or provide an explanation.

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  • 7. 

    How often are prostaglandins taken?

    • 1x daily

    • BID

    • TID

    • QID

    Correct Answer
    A. 1x daily
    Explanation
    Prostaglandins are the 1st DOC for tx'ing Glaucoma due to: 1) ease of use (1x daily), 2) good safety profile, 3) superior efficacy

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  • 8. 

    Corticosteroids are more effective in chronic, rather than acute conditions.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Steroids are more effective in ACUTE cases..degenerative diseases are usually refractory to steroids

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  • 9. 

    Related to dry eye, underlying cyctokine and receptor-mediated inflammatory processes affecting the ocular surface and _____ resulting in decreased tear production and clearance.

    • Lacrimal gland

    • Palpebral fissure

    • Palpebral conjunctiva

    • Corneal epithelium

    Correct Answer
    A. Lacrimal gland
    Explanation
    The lacrimal gland is responsible for producing tears, which help to keep the ocular surface lubricated and protected. In cases of dry eye, there is an underlying inflammatory process that affects the ocular surface and the lacrimal gland. This inflammation can lead to a decrease in tear production and clearance, resulting in the symptoms of dry eye.

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  • 10. 

    Fluroquinolones generally have better gram + spectrum of activity at this time, gram negative spectrum of activity is alos demonstrating some shift amont the fluroquinolones.  Some highly probelmatic gram negative bacteria (e.g. Psuedomonas) are increasingly demonstrating resistance.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    p. 110

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  • 11. 

    Prolonged topical ophthalmic steroid use can cause:

    • Ocular hemorrhage

    • Ocular HTN & glaucoma

    • Corneal melt

    • Neovascularization of the iris

    Correct Answer
    A. Ocular HTN & glaucoma
    Explanation
    IOP elevation RARELY occurs within in first 2 hours unless the pt is a STEROID RESPONDER
    Withdrawal of the steroid usually results in return to baseline IOP within 2-4 weeks

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  • 12. 

    3-5% of persons with allergies to penicillins may cross react to _______.

    Correct Answer
    cephalosporins
    Explanation
    Some people who are allergic to penicillins may also have a cross-reactivity to cephalosporins. This means that if they are exposed to cephalosporins, they may experience an allergic reaction similar to the one they would have with penicillins. This cross-reactivity occurs because penicillins and cephalosporins have a similar chemical structure. However, it is important to note that not all individuals with a penicillin allergy will necessarily have a cross-reactivity to cephalosporins, as the percentage is relatively low at around 3-5%.

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  • 13. 

    Which of the following antibitoics can precipitate in 15% of patients treated for bacterial keratitis?

    • Azithromycin

    • Penicillin-G

    • Moxifloxacin

    • Ciprofloxacin

    Correct Answer
    A. Ciprofloxacin
    Explanation
    This can SLOW epithlelialization by more than 50%

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  • 14. 

    A white, crystalline precipitate located in the superficial portion of a corneal defect is seen in approx 20% of pts being treated with which topical antibiotic?

    • Ciprofloxacin

    • Moxifloxacin

    • Clarithromycin

    • Tetracycline

    Correct Answer
    A. Ciprofloxacin
    Explanation
    Onset: 1-7 d after starting therapy
    Resolves: 2 weeks
    Does not affect clinical course or outcome, but prescribers should note that streptococcal corneal ulcers are often resistant to ciprofloxacin.

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  • 15. 

    Antihistamines are often used (although not recommeded) as a sleeping aid (esp. in elderly) due to it's potentially sedating effects

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Antihistamines have sedating effects, which can make them effective for promoting sleep. While they are not recommended as a sleeping aid, they are often used in elderly individuals who may have difficulty sleeping. Therefore, the statement that antihistamines are often used as a sleeping aid, especially in the elderly, is true.

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  • 16. 

    Corneal ulcers are associated with gram _____ 75% of the time.

    Correct Answer
    positive
    +
    Explanation
    Corneal ulcers are commonly caused by bacterial infections, and 75% of the time, these infections are associated with gram-positive bacteria. Gram-positive bacteria have a thick peptidoglycan layer in their cell walls, which makes them more resistant to antibiotics and more likely to cause infections. Therefore, it is likely that corneal ulcers are primarily caused by gram-positive bacteria.

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  • 17. 

    What % reduction in IOP is expected with prostaglandins?

    • 10%

    • 20%

    • 30%

    • 40%

    Correct Answer
    A. 30%
    Explanation
    e.g. Latanoprost and Travoprost

    If target pressures not met, re-edu pt, have pt demonstrate instillation techniques and punctal occlusion. Schedule pt for a re-check

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  • 18. 

    NSAIDs can decrease the effectiveness of HTN meds & can caus vasoconstriction of renal vessles

    • True

    • False

    Correct Answer
    A. True
    Explanation
    NSAIDs, or nonsteroidal anti-inflammatory drugs, can indeed decrease the effectiveness of hypertension medications and cause vasoconstriction of renal vessels. This is because NSAIDs inhibit the production of prostaglandins, which play a role in maintaining blood flow to the kidneys and regulating blood pressure. By inhibiting prostaglandins, NSAIDs can lead to vasoconstriction and reduced blood flow to the kidneys, potentially worsening hypertension. Additionally, NSAIDs can interfere with the effectiveness of certain antihypertensive medications, making them less effective in controlling blood pressure. Therefore, it is true that NSAIDs can decrease the effectiveness of HTN meds and cause vasoconstriction of renal vessels.

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  • 19. 

    What is the most common type of ADE for NSAIDs?

    • Blurry vision

    • Inc'd IOP

    • Corneal edema

    • Stinging & burning on instillation

    Correct Answer
    A. Stinging & burning on instillation
    Explanation
    Diclofenac and Ketorolac have their own specific ADEs (p. 93)

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  • 20. 

    Dry eye secondary to aqueous deficiency is called _____

    • Meibomian gland dysfunction

    • Lacrimal gland dysfuncion

    • Cytokine-induced dry eye

    • Keratoconjunctivitis sicca

    Correct Answer
    A. Keratoconjunctivitis sicca
    Explanation
    aqueous deficient dry eye is secondary to disorder of the lacrimal gland funciton or failure of lacrimal fluid transfer

    evaporative dry eye demonstrates normal lacrimal function, but MGD or increased palpebral fissure width leads to increased evaporation or an anomaly of tear distribution

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  • 21. 

    What type of antibiotic is Besivance?

    • Macrolide

    • Fluroquinolone

    • Cephalosporin

    • Penicillin

    Correct Answer
    A. Fluroquinolone
    Explanation
    MOA: interfere with DNA replication by inhibiting DNA gyrase

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  • 22. 

    Topical antibiotic preparations containing antibiotics not ordinarily administered sysmteically are not preferrerd.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Use of topical antibiotics may contraindicate (due to sensitization) the drug's later systemic use in serious infections. Topical preparations containing antibiotics not ordinarily administered systemically are preferred. (p. 125)

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  • 23. 

    What is the concentration of phenyl that is used for ocular decongestants?

    • 0.05%

    • 0.12%

    • 0.2%

    • 0.5%

    Correct Answer
    A. 0.12%
    Explanation
    1-2 gtt upto QID x 48 hours max

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  • 24. 

    Which ocular decongestant is found in decongestant/anti-H combos?

    • Naphazoline

    • Phenylephrine

    • Oxymetazoline

    • Tetrahydrozoline

    Correct Answer
    A. Naphazoline
    Explanation
    Anti-A Component: PHENIRAMINE or ANTAZOLINE

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  • 25. 

    What is the PREG category for NSAIDs?

    • A

    • B

    • C

    • D

    Correct Answer
    A. C
    Explanation
    The PREG category for NSAIDs is category C.

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  • 26. 

    There are only a few oral corticosteroids that can be Rx'd by ODs, but they are not often used.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Currently no ORAL corticosteroids in OD SOP

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  • 27. 

    Most mast cell stabalizers have a PREG category of B, however which of the following has PREG category C?

    • Cromolyn

    • Lodoxamide

    • Nedocromil

    • Pemirolast

    Correct Answer
    A. Pemirolast
    Explanation
    Mneumonic: PemiroLAST is the LAST MCS you want to take if you're prego

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  • 28. 

    Which of the following steroids has been approved for SAC and is preferred for pt's with glaucoma because it doesn't tend to increase IOP as much as others?

    • Prednisolone

    • Dexamethasone

    • Loteprednol

    • Rimexolone

    Correct Answer
    A. Loteprednol
    Explanation
    Both Rimexolone and Loteprednol have less effect on IOP, however only Loteprednol is is approved for SAC

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  • 29. 

    Epinastine is a dual antihistamine & mast cell stabalizer.  It has assocaited with increased risk of CNS effects and must be monitored closely.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Epinastine CANNOT cros the BB so there are minimal risks of CNS effects

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  • 30. 

    Which of the following is contraindicated when using antihistamines?

    • TCAs (Triacyclic Anti-depressants)

    • NSAIDs

    • Topical corticosteroids

    • MAOIs

    Correct Answer
    A. MAOIs
    Explanation
    MAOIs (Monoamine oxidase inhibitors) are contraindicated when using antihistamines. This is because MAOIs can inhibit the breakdown of histamine in the body, leading to an accumulation of histamine and potentially causing adverse effects such as increased sedation, drowsiness, and anticholinergic effects. It is important to avoid combining these medications to prevent potential interactions and side effects.

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  • 31. 

    Which popular artificial tear contains polyquaternium for a preservative?

    • Soothe XP

    • Refresh

    • Systane

    • Tears Again

    Correct Answer
    A. Systane
    Explanation
    Systane is the correct answer because it is a popular artificial tear that contains polyquaternium as a preservative. Polyquaternium is commonly used as a preservative in eye drops to prevent bacterial growth and maintain the sterility of the solution. Soothe XP, Refresh, and Tears Again are not known to contain polyquaternium as a preservative.

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  • 32. 

    Most routes of administration for steroids are PREG category C.  However, which of the following has a PREG category of D?

    • Topical

    • Oral

    • Suspension

    • Intravitrea injection

    Correct Answer
    A. Intravitrea injection
    Explanation
    C (corticosteroid) = C

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  • 33. 

    What is the PREG cat for Restasis?

    • A

    • B

    • C

    • D

    Correct Answer
    A. C
    Explanation
    The PREG cat for Restasis is C.

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  • 34. 

    Mast cell stabalizers have various MOAs, including intristic vasconstrictor activity, antihistaminic and anti-inflammatoyr activity.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    p. 82 --> Stabalize MCSs by inhbitig the degranulation of sensitized MCs after exposure to specific antigen. This prevent the release of histamine and other mediators involved in allergic rxns (they do NOT have the

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  • 35. 

    Dietary salt restriction and potassium supplementation may be necessary with topical steroid use.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    This is true for ORAL steroids, but not likely necesssary with topical formulations

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  • 36. 

    Which mast cell stabalizer has the fastest onset of action?

    • Cromolyn

    • Lodoxamide

    • Nedocromil

    • Pemiroast

    Correct Answer
    A. Nedocromil
    Explanation
    Nedocromil is the mast cell stabilizer with the fastest onset of action.

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  • 37. 

    Flurometholone is a steroid with many different formulations.  It is prescribed a lot of OD's and also has the convenience of many OTC options.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Flurometholone is Rx only

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  • 38. 

    Which of the following 2 drugs is involved in the off-label use for topical tx of CME after cataract sx?

    • Diclofenac

    • Flurbiprofen

    • Ketorolac

    • Bromfenac

    Correct Answer(s)
    A. Diclofenac
    A. Ketorolac
    Explanation
    Diclofenac and Ketorolac are both drugs that can be used off-label for the topical treatment of cystoid macular edema (CME) after cataract surgery. These drugs belong to the class of nonsteroidal anti-inflammatory drugs (NSAIDs) and can help reduce inflammation and swelling in the eye, which can contribute to the development of CME. While the other options, Flurbiprofen and Bromfenac, are also NSAIDs, they are not commonly used for the off-label treatment of CME after cataract surgery.

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  • 39. 

    What should one suspect in any persistent corneal ulceration where a steroid has been used or is being used?

    • Bacterial resistance to the steroid

    • Fungal invasion

    • Hypersensitivity to the steroid

    • Herpes simplex keratitis

    Correct Answer
    A. Fungal invasion
    Explanation
    In cases of persistent corneal ulceration where a steroid has been used or is being used, one should suspect fungal invasion. Steroids can suppress the immune response, making the cornea more susceptible to fungal infections. Fungal invasion can cause prolonged ulceration and may require specific antifungal treatment.

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  • 40. 

    When should therapy with ophthalmic mast cell stabalizers be initiated?

    • ?

    • ?

    • ?

    • ?

    Correct Answer
    A. ?
  • 41. 

    Which of the following dual antihistamine/mast cell stabalizer combos are available OTC?

    • 0.05% Azelastine SLN (Optivar)

    • 0.05% epinastine SLN (Elestat)

    • 0.1% olopatadine SLN (Patanol)

    • 0.025% ketotifen fumarate SLN (Alaway, Zatidor)

    Correct Answer
    A. 0.025% ketotifen fumarate SLN (Alaway, Zatidor)
    Explanation
    Ktotifen is the only anti-H/MCS that was presented in lecture that is available OTC; all others (Azelastine, Epinastine, and Olapatdine) are by Rx only

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  • 42. 

    What are the most common tear supplement products used in dry eye tx's?

    • Vinyl derivatives

    • Polysaccharides

    • Electrolyes

    • Buffers

    Correct Answer
    A. Polysaccharides
    Explanation
    e.g. cellulose esthers (methylcellulose, hydroxypropylcelluluse) and viscoelastic agents (sodium hyaluronate, sodium chondroitin)

    - dissolve in water to produce varying degress of VISCOSITY
    - lack of toxicity+ viscous props + beneficial effects on TF stability = useful in ATs

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  • 43. 

    Topical Anti-As may produce what ADE?

    • Iritis

    • Posterior synechiae

    • Angle closure

    • Reduced IOP

    Correct Answer
    A. Angle closure
    Explanation
    p. 78 --> caution in pts with narrow angles or hx of glc

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  • 44. 

    Which of the following NSAIDs has been banned in Europe due to concern of ocular hemorrhage?

    • Bromfenac

    • Diclofenac

    • Flurbiprofen

    • Ketorolac

    Correct Answer
    A. Ketorolac
    Explanation
    Nepafenac has a lower incidence of bleeding compared to Ketorolac & Diclofenac

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  • 45. 

    Which NSAID is the best for SCL wearers?

    • Diclofenac

    • Bromfenac

    • Flubiprofen

    • Ketorolac

    Correct Answer
    A. Ketorolac
    Explanation
    SCL wearers experienced redness and irritation with Diclofenac & Ketorolac

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  • 46. 

    Steroids are usually not appropriate for use in mild ocular allergies because they are particularly damaging to ocular tissue with prolonged use.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    The reason steroids aren't used for mild ocular allergies is because other modalities (with less ponteially serious comlications) are effective and widely available

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  • 47. 

    Pure mast cell stabalizers are used for which type(s) of conjuctivitis?

    • Perennial conjunctivitis

    • Seasonal conjunctivitis

    • GPC

    • VKC

    Correct Answer(s)
    A. Seasonal conjunctivitis
    A. VKC
    Explanation
    Pure mast cell stabilizers are used for seasonal conjunctivitis and VKC (vernal keratoconjunctivitis). Mast cell stabilizers work by preventing the release of histamine and other inflammatory mediators from mast cells, which are involved in the allergic response. Seasonal conjunctivitis, also known as hay fever or allergic conjunctivitis, is an allergic reaction to airborne allergens such as pollen. VKC is a chronic allergic condition that primarily affects children and is characterized by inflammation of the conjunctiva. Therefore, pure mast cell stabilizers are effective in managing the symptoms of both seasonal conjunctivitis and VKC.

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  • 48. 

    What is the 2nd most common drug Rx'd by ODs (after Fluroquinolones)?

    • Loteprednol

    • Fluorometholone

    • Difluprednate

    • Dexamethasone

    Correct Answer
    A. Loteprednol
    Explanation
    The correct answer is Loteprednol. This drug is the second most commonly prescribed by ODs after Fluroquinolones.

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  • 49. 

    The PREG category for Phenyl is C.  What is the PREG category for tetrahydrozoline?

    • A

    • B

    • C

    • D

    • Undetermined

    Correct Answer
    A. Undetermined
    Explanation
    The PREG category for tetrahydrozoline is undetermined because the given information does not provide any information about its PREG category.

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  • Mar 19, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • May 05, 2012
    Quiz Created by
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