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Questions and Answers
What is the primary mechanism by which steroids regulate inflammation?
What is a contraindication for NSAID usage?
What is a common side effect of topical NSAID usage?
What is a use of NSAIDs in ophthalmology?
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What should be considered when prescribing NSAIDs to patients?
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What is a type of NSAID used in ophthalmology?
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What is a potential interaction with NSAIDs?
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What is a use of steroids in ophthalmology?
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What is the primary mechanism of action of immunomodulatory agents?
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What is a common side effect of systemic steroids?
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What is a contraindication for the use of steroids?
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What is a use of steroids in ophthalmology?
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Which of the following is a local side effect of steroids?
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What is an interaction to be aware of when using steroids?
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What is an example of a topical steroid used in ophthalmology?
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What is a precaution for the use of steroids in ophthalmology?
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What is a common side effect of corticosteroids in ophthalmology?
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What type of immunomodulatory agent targets specific molecules involved in the immune response?
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What is a precaution to consider when prescribing immunomodulatory agents to patients with a history of tuberculosis?
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What is a use of calcineurin inhibitors in ophthalmology?
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What is a contraindication for immunomodulatory agents in ophthalmology?
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What is a treatment indication for immunomodulatory agents in ophthalmology?
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What is a potential interaction between immunomodulatory agents and other medications?
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What is a common use of corticosteroids in ophthalmology?
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Study Notes
COX-2 and NSAIDs
- COX-2 is involved in producing prostaglandins that cause inflammation, pain, and fever
- NSAIDs can be selective or non-selective, with non-selective NSAIDs inhibiting both COX-1 and COX-2, and selective COX-2 inhibitors only inhibiting COX-2
Types of NSAIDs
- Topical NSAIDs are applied directly to the eye
- Systemic NSAIDs are taken orally or by injection
Uses of NSAIDs
- Treatment of pain and inflammation
- Prevention of cystoid macular edema (CME)
- Treatment of dry eye syndrome
- Intraoperative miosis
Side Effects of NSAIDs
- Ocular: tingling, burning, irritation, corneal toxicity, delayed corneal healing
- Systemic: allergic reactions, gastrointestinal bleeding, renal dysfunction, bronchospasm, cardiovascular events
Precautions and Contraindications of NSAIDs
- Use with caution in patients with a history of gastrointestinal bleeding, renal dysfunction, and cardiovascular disease
- Contraindicated in patients with a history of hypersensitivity to NSAIDs, asthma, and ulcers
Steroids
Mechanism of Action of Steroids
- Steroids bind to specific receptors in cells and regulate gene expression to control inflammation and immune function
- Steroids inhibit the production of prostaglandins and other inflammatory mediators
Types of Steroids
- Topical steroids are applied directly to the eye
- Systemic steroids are taken orally or by injection
Clinical Uses of Steroids
- Treatment of inflammation
- Prevention of scarring
- Treatment of macular edema
Side Effects of Steroids
- Local: elevated intraocular pressure, cataract formation, delayed wound healing
- Systemic: osteoporosis, weight gain, immunosuppression
Precautions and Contraindications of Steroids
- Use with caution in patients with a history of glaucoma, cataracts, and corneal ulcers
- Contraindicated in patients with a history of hypersensitivity to steroids, active infections, and certain types of cancers
Immunomodulatory Agents
Mechanism of Action of Immunomodulatory Agents
- Immunomodulatory agents work by altering the activity of the immune system
- They can enhance or suppress the immune response, depending on the drug and indication
Types of Immunomodulatory Agents
- Corticosteroids (e.g. prednisolone, dexamethasone): suppress the immune response and reduce inflammation
- Calcineurin inhibitors (e.g. cyclosporine, tacrolimus): inhibit T-cell activation and cytokine production
- Immunomodulatory biologics (e.g. adalimumab, infliximab): monoclonal antibodies that target specific molecules involved in the immune response
Uses of Immunomodulatory Agents
- Treatment of uveitis, scleritis, ocular surface diseases like dry eye syndrome and Stevens-Johnson syndrome, and some types of ocular tumors
Side Effects of Immunomodulatory Agents
- Corticosteroids: increased intraocular pressure, cataracts, glaucoma
- Calcineurin inhibitors: burning and stinging sensations in the eyes, increased risk of infection
- Immunomodulatory biologics: increased risk of infection, allergic reactions, and infusion reactions
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Description
Learn about the different types of NSAIDs used in ophthalmology, including topical and systemic NSAIDs, and their effects on COX-1 and COX-2.
