Pharmacology: Anti-Inflammatory Steroids Basics
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Questions and Answers

Which steroid formulation has the greatest anti-inflammatory effect compared to the others?

  • Steroid acetate derivatives (correct)
  • Steroid alcohol derivatives
  • Steroid salt formulations (sodium phosphate, hydrochloride)
  • All steroid formulations have equal anti-inflammatory effects

How does the presence of an intact corneal epithelium and inflammation affect the penetration of different steroid formulations into the anterior chamber?

  • Phosphate formulations have greater penetration than acetate formulations in the presence of an intact epithelium and inflammation.
  • Alcohol formulations have the greatest penetration regardless of epithelial integrity or presence of inflammation.
  • Acetate formulations have greater penetration than phosphate formulations in the presence of an intact epithelium and inflammation. (correct)
  • Steroid formulation penetration is not affected by the presence of an intact epithelium or inflammation.

Why are steroid suspensions commonly used for ophthalmic formulations?

  • Most steroids are inherently delivered as suspensions. (correct)
  • Suspensions provide a more stable formulation.
  • Suspensions improve patient compliance.
  • Suspensions allow for better drug solubility.

Which steroid formulation property is associated with greater corneal penetration?

<p>Increased lipophilicity/fat solubility (B)</p> Signup and view all the answers

How does the presence of an intact epithelium affect the bioavailability of different steroid formulations?

<p>Intact epithelium increases the bioavailability of acetate and alcohol formulations, but decreases the bioavailability of phosphate formulations. (D)</p> Signup and view all the answers

Which steroid formulation has the highest anti-inflammatory efficacy when the epithelium is intact?

<p>Prednisolone acetate 1% (B)</p> Signup and view all the answers

Which steroid property contributes to increased affinity for the receptor?

<p>Increased lipophilicity (C)</p> Signup and view all the answers

Why is the phosphate derivative of prednisolone less preferred for treating anterior segment inflammation compared to the acetate derivative?

<p>The phosphate derivative has higher corneal penetration. (B)</p> Signup and view all the answers

Which steroid formulation has the highest anti-inflammatory efficacy when the epithelium is absent?

<p>Dexamethasone alcohol 0.1% (B)</p> Signup and view all the answers

Which steroid is considered the exception to being ketone-based?

<p>Loteprednol (D)</p> Signup and view all the answers

Which of the following is the primary reason why steroids may mask the symptoms and underlying disease?

<p>Steroids go after the inflammation, not the actual disease (B)</p> Signup and view all the answers

What is the primary reason why topical or periocular steroid administration has fewer systemic adverse effects compared to intralesion injection?

<p>Topical and periocular steroids have lower bioavailability (C)</p> Signup and view all the answers

Which of the following is the most likely explanation for the paradoxical exacerbation of uveitis with steroid treatment?

<p>The underlying mechanism for the paradoxical effect is not well understood (D)</p> Signup and view all the answers

Which property of steroids is most likely responsible for the observed difference in corneal epithelial healing between black and white patients?

<p>Lipid solubility (C)</p> Signup and view all the answers

Which of the following is the most likely reason for the temporary mydriasis observed with topical steroid administration?

<p>The vehicle used in the topical steroid formulation (A)</p> Signup and view all the answers

Which of the following statements about steroid bioavailability is correct?

<p>Lipid-soluble steroids have higher bioavailability than water-soluble steroids when administered topically. (D)</p> Signup and view all the answers

Which of the following factors primarily determines the anti-inflammatory efficacy of a steroid?

<p>The glucocorticoid receptor binding affinity. (C)</p> Signup and view all the answers

Which of the following steroid formulations is most suitable for the treatment of posterior segment inflammation?

<p>Intravitreal injections. (B)</p> Signup and view all the answers

Which of the following properties of steroids contributes to their potential for causing cataracts?

<p>Their ability to disrupt lens protein structure. (D)</p> Signup and view all the answers

Which of the following statements about steroid formulations is correct?

<p>Intravitreal injections are preferred over subconjunctival injections for posterior segment delivery. (B)</p> Signup and view all the answers

Which of the following statements about steroid formulations and bioavailability is correct?

<p>Water-soluble salts form solutions and do not require shaking, while lipid-soluble derivatives form suspensions that need to be shaken before use. (A)</p> Signup and view all the answers

Which of the following factors affects the penetration of steroids through the cornea?

<p>All of the above. (D)</p> Signup and view all the answers

Based on the anti-inflammatory efficacy data provided, which steroid formulation has the highest efficacy when the corneal epithelium is intact?

<p>Dexamethasone acetate 0.1% (D)</p> Signup and view all the answers

What is the primary difference between lipid-soluble and water-soluble steroid formulations in terms of their ability to penetrate the cornea?

<p>Lipid-soluble steroids penetrate better through the hydrophobic corneal epithelium and endothelium lipid layers, while water-soluble steroids penetrate better through the hydrophilic corneal stroma. (C)</p> Signup and view all the answers

According to the anti-inflammatory efficacy data, which steroid formulation has the lowest efficacy when the corneal epithelium is absent?

<p>Dexamethasone phosphate 0.1% (B)</p> Signup and view all the answers

Which statement about prednisolone acetate suspension is correct?

<p>The 1% suspension (Pred Forte) has smaller and more uniform particles than the 0.125% suspension. (B)</p> Signup and view all the answers

Which statement accurately describes the bioavailability of dexamethasone alcohol and dexamethasone phosphate?

<p>Dexamethasone alcohol has higher anti-inflammatory activity and bioavailability on intact epithelium compared to dexamethasone phosphate. (A)</p> Signup and view all the answers

Which property distinguishes dexamethasone from prednisolone?

<p>Dexamethasone is a ketone-based steroid, while prednisolone is an alcohol-based steroid. (C)</p> Signup and view all the answers

Which statement accurately compares the anti-inflammatory efficacy of lipid-soluble and water-soluble steroid formulations?

<p>Lipid-soluble steroid formulations have higher anti-inflammatory efficacy than water-soluble formulations. (C)</p> Signup and view all the answers

Which statement accurately describes the properties of prednisolone sodium phosphate 1% solution?

<p>It is a generic formulation with larger and less uniform particles compared to brand name versions. (D)</p> Signup and view all the answers

Which of the following is the primary reason that steroid suspensions are commonly used for ophthalmic formulations?

<p>Suspensions allow for controlled and sustained release of the steroid. (B)</p> Signup and view all the answers

Which steroid property contributes to its increased affinity for the glucocorticoid receptor?

<p>Lipophilicity (C)</p> Signup and view all the answers

Why is the phosphate derivative of prednisolone less preferred for treating anterior segment inflammation compared to the acetate derivative?

<p>The phosphate derivative is less lipophilic and has reduced corneal penetration. (A)</p> Signup and view all the answers

Which steroid formulation has the greatest anti-inflammatory effect in the presence of an intact corneal epithelium?

<p>Lipophilic steroid esters (C)</p> Signup and view all the answers

How does the presence of an intact corneal epithelium affect the bioavailability of different steroid formulations in the anterior chamber?

<p>Intact epithelium increases the bioavailability of lipophilic steroid formulations but decreases the bioavailability of hydrophilic steroid formulations. (C)</p> Signup and view all the answers

Which steroid is considered the exception to being ketone-based?

<p>Hydrocortisone (A)</p> Signup and view all the answers

Which steroid formulation property is associated with greater corneal penetration?

<p>Increased lipophilicity (C)</p> Signup and view all the answers

Which steroid formulation has the highest anti-inflammatory efficacy when the corneal epithelium is absent?

<p>Steroid solutions (C)</p> Signup and view all the answers

How does the presence of inflammation affect the penetration of different steroid formulations into the anterior chamber?

<p>Inflammation increases the penetration of all steroid formulations. (A)</p> Signup and view all the answers

Which steroid formulation has the greatest anti-inflammatory effect compared to the others?

<p>Lipophilic steroid esters (A)</p> Signup and view all the answers

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