The right choice is prednisilone, spelled prednisolone in the textbook. Prednisolone is a corticosteroid, often shortened to steroid. Steroids are the chief drugs used to treat inflammation in the eye. Graft rejection is an inflammatory attack by the body's own defenses. A steroid drop calms that attack. It can sharply reduce swelling, redness, and scarring, which is what keeps a new cornea clear. Without that control, the donor cornea can cloud over and the graft can fail.
Corticosteroids are hormones. They come from the adrenal gland or are made in a lab. Most are applied as drops or ointment for the eyelid and the front of the eye. Steroid tablets are used when the back of the eye is involved. Common products include prednisolone acetate 0.12% and 1.0%, sold as Pred Mild and Pred Forte. Steroid and anti-inflammatory bottles carry a pink cap in the standard color code. The other three choices in this question are glaucoma drops. They lower eye pressure. None of them fights inflammation, so none of them can protect a graft.
Steroids must be used with care. Weeks to months of drops can cause glaucoma, cataract, and slower healing, and can let an infection grow. Check the chart for diabetes, high blood pressure, ulcer, or tuberculosis before a patient starts a steroid by mouth. Tell the doctor about new redness, pain, or blurred vision in a transplant patient right away. Matching a drug class to its purpose is a core part of the COA pharmacology content area.
Incorrect Answers
- A. Timolol is a beta-blocker. It lowers pressure by cutting aqueous production and has no effect on graft rejection.
- B. Latanoprost is a prostaglandin glaucoma drop given once each evening. It does not treat inflammation.
- D. Dorzolamide is a topical carbonic anhydrase inhibitor. It also lowers pressure rather than calming an immune attack.
Testing Pearls
- Corticosteroids are the main drugs for eye inflammation and allergy.
- Pred Forte is prednisolone acetate 1.0%; Pred Mild is 0.12%.
- Steroid and anti-inflammatory caps are pink in the color code.
- Long steroid use can cause glaucoma and cataract and slow wound healing.
- Timolol, latanoprost, and dorzolamide are all pressure-lowering glaucoma drops.
References
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 6, Basics of Ophthalmic Pharmacology.
- American Academy of Ophthalmology. Ophthalmic Medical Assisting: An Independent Study Course. Chapter 3, Abnormalities of the Eye.
