Vision and Ophthalmology Pharmacology and Medications 2 — Questions and Answers
Question 1: Bevacizumab (Avastin) used off-label in ophthalmology is an example of which drug class?
- Corticosteroid
- Anti-VEGF monoclonal antibody (Correct answer)
- Carbonic anhydrase inhibitor
- Prostaglandin analog
Correct answer: Anti-VEGF monoclonal antibody
Bevacizumab is a full-length humanized monoclonal antibody against VEGF-A, used off-label intravitreally for wet AMD, diabetic macular edema, and retinal vein occlusions.
Question 2: Steroid-induced glaucoma is most commonly associated with which route of administration?
- Oral steroids only
- Topical ophthalmic steroids (especially potent ones like prednisolone) (Correct answer)
- Inhaled steroids only
- IV steroids only
Correct answer: Topical ophthalmic steroids (especially potent ones like prednisolone)
Topical ophthalmic corticosteroids, particularly potent ones like prednisolone acetate 1%, most commonly cause steroid-induced IOP elevation due to direct trabecular effects.
Question 3: Brimonidine (Alphagan) reduces IOP by which dual mechanism?
- Blocks beta receptors and blocks alpha-1 receptors
- Stimulates alpha-2 receptors to reduce aqueous production and increase uveoscleral outflow (Correct answer)
- Inhibits carbonic anhydrase and prostaglandin synthesis
- Blocks muscarinic receptors and beta receptors
Correct answer: Stimulates alpha-2 receptors to reduce aqueous production and increase uveoscleral outflow
Brimonidine is a selective alpha-2 adrenergic agonist that reduces IOP by both decreasing aqueous production and increasing uveoscleral outflow.
Question 4: Which antiviral medication is first-line treatment for herpes simplex virus keratitis?
- Acyclovir or ganciclovir (topical/oral) (Correct answer)
- Ciprofloxacin
- Voriconazole
- Tobramycin
Correct answer: Acyclovir or ganciclovir (topical/oral)
Topical trifluridine or ganciclovir gel, or oral acyclovir/valacyclovir, are first-line treatments for HSV epithelial keratitis.
Question 5: Natamycin eye drops are the treatment of choice for which type of keratitis?
- Bacterial keratitis
- Fungal keratitis (especially filamentous fungi like Fusarium) (Correct answer)
- Viral keratitis
- Acanthamoeba keratitis
Correct answer: Fungal keratitis (especially filamentous fungi like Fusarium)
Natamycin, a polyene antifungal, is the only FDA-approved topical antifungal eye drop and is first-line for filamentous fungal keratitis such as Fusarium.
Question 6: Which class of medication is used to treat posterior uveitis by suppressing intraocular inflammation?
- Antiglaucoma agents
- Corticosteroids (topical, periocular, or systemic) (Correct answer)
- Antivirals
- Mast cell stabilizers
Correct answer: Corticosteroids (topical, periocular, or systemic)
Corticosteroids are the primary treatment for non-infectious uveitis, administered topically for anterior disease, periocularly or intravitreally for intermediate/posterior disease.
Vision and Ophthalmology Pharmacology and Medications 2
Bevacizumab (Avastin) used off-label in ophthalmology is an example of which drug class?