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Backup 2 > 12 Pharm of the Eye > Flashcards

12 Pharm of the Eye Flashcards

1
Q

dipivefrin?

A
  • mixed alpha, beta agonist

- prodrug metabolized to Epi

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2
Q

epinephrine family?

A

mixed alpha, beta agonist

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3
Q

apraclonidine family?

A

alpha 2 selective agonist

-Only use for extreme ocular cases

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4
Q

betaxolol family, etc?

A

-B1 selective antagonist
-reduce aqueous humor production
-
-block B1 on ciliary body

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5
Q

Carteolol family?

A

B non-selective antagonist

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6
Q

levobunolol family?

A

B non-selective antagonist

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7
Q

metipranolol family?

A

B non-selective antagonist

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8
Q

timolol family?

A

B non-selective antagonist

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9
Q

carbachol special info?

A
  • cholinergic agonist (miotic)

- miotic, drain glaucoma by stim . M3 receptor on iris & ciliary body, improving uveoscleral outflow

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10
Q

pilocarpine special info?

A

-cholinergic agonist (miotic)
-miotic, drain glaucoma by stim . M3 receptor on iris & ciliary body, improving uveoscleral outflow
[tears, saliva on your “pillow”]

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11
Q

atropine class, clinic use, side effect, mech, bonus

A

-cholinergic antagonist
-Mydriasis (7-10 days)
-acute glaucoma!
-
-

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12
Q

cyclopentolate family & length?

A
  • cholinergic antagonist

- Mydriasis (1 day)

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13
Q

homatropine family & length?

A
  • cholinergic antagonist

- Mydriasis (1-3 days)

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14
Q

scopolamine family & length?

A
  • cholinergic antagonist

- Mydriasis (3-7 days)

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15
Q

tropicamide family & length?

A
  • cholinergic antagonist

- Mydriasis (1/4 day)

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16
Q

acetazolamide family?

A

carbonic anhydrase inhibitor

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17
Q

dichlorphenamide family?

A

carbonic anhydrase inhibitor

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18
Q

dorzolamide family?

A

carbonic anhydrase inhibitor

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19
Q

botulinum toxin A family?

A

miscellaneous agents

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20
Q

Don’t forget picture of eye anatomy in your notes.

A

Yay, good job looking at it.

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21
Q

Mydriasis is?

A

dilation

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22
Q

Miosis is?

A

constriction

[think of cells undergoing meiosis constricting till they split in half]

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23
Q

Consensual pupil response assesses?

A

“brain damage”

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24
Q

What muscle does mydriasis?

A

-Radial smooth muscle contracts

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25
Q

What happens to sympa/parasympa when mydriasis occurs? (2)

A
  • inhibit para (M3 muscarinic antagonists in iris) [strong dilation]
  • stimulate sympa (alpha 1 agonists in iris) [weak dilation]
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26
Q

What muscle does miois?

A

constrictor pupillae contracts

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27
Q

What things happen with sympa/parasympa when miosis occurs? (3)

A
  • stimulate para (M3 muscarinic agonists in iris) [strong contract]
  • inhibit symmpa (alpha 1 antagonist in iris) [weak contraction]
  • stimulate (agonist) opioid receptor in the CNS -> “pinhole” pupil [strong contraction]
28
Q

Of the things that affect refractive power, what are the 2 (of the multiple) ways we need to know?

A
  • air:cornea interface

- lens curvature

29
Q

What suspends the lens?

A

“suspensory ligaments” (I think these are zonular fibers) attached to ciliary muscle.

30
Q

When ciliary muscle contracts what happens?

A

Relaxation of lens -> decreased radius -> see close up

31
Q

What receptor agonist contracts the ciliary muscle?

A

Muscarinic agonsits (carbachol & pilocarpine?)

32
Q

What is cyloplegia?

A

Blocked accomodation reflex. (muscarinic antagonists, ex atropine)

33
Q

Atropine side?

A

Acute glaucoma

34
Q

T/F Ciliary muscle is influenced by sympa?

A

F. No adrenergic receptors.

35
Q

What is presbyopia?

A

lens loses accomodation (flexibility) w/ age

[12 diopter accomodation young adult, 1 diopter by age 50]

36
Q

What secretes aqueous humor?

A

blood vessels of ciliary body!

37
Q

What path does aqueous humor take?

A

thru anterior chamber/pupil, drains to:

  • trabecular meshwork ->
  • canal of Schlemm ->
  • Episcleral vein ->
  • Uveoscleral outflow
38
Q

What is carbonic anhydrase?

A

H2O and CO2 to HCO3 and H+

39
Q

What decreases aqueous humor production? (3)

A
  • alpha 1 stim. (stimulation) (on blood vessels, reduces blood flow) [same as other vessels!]
  • alpha2 stim. (on ciliary body)
  • Carbonic anhydrase inhibitors

[see “what increases?” flashcard for 1 more method of decreasing]

40
Q

How do carbonic anhydrase inhibitors reduce production of aqeous humor?

A

Reduce HCO3 procution ->

active transport of HCO3 & Na is req’d for making the humor.

41
Q

What increases aqueous humor production?

A

-B1 stim. (on ciliary body, by epinephrine)

[Note antagonist would decrease] [recall B1’s are also on the heart]

42
Q

What is the essential property for an ophthalmic drug?

A

-lipophilic/uncharged

43
Q

Eye color (melanin) has what affect on drugs?

A

Binds some drugs (atropine!) in darker eyes ->

slower onset, longer action, tendency to overdose to achieve effect quickly

44
Q

T/F local application to eye will not affect systemic function?

A

F. (side effects still possible, though minimized)

45
Q

Eye drop preservative side effect?

A

toxic/allergic (benzalkonium chloride!)

46
Q

T?F local anesthetic for cornea is effective?

A

T

47
Q

How would you detect a corneal lesion?

A

Fluorescent dye (taken up by injured cells)

48
Q

For muscarinic antagonist class, what receptor is acted on to produce mydriasis?

A

-M3 (on iris & ciliary muscle)

49
Q

How is drug choice determined for creating mydriasis?

A

Duration & cycloplegia or not

50
Q

Which class creates mydriasis but not cycloplegia?

A

Adrenoreceptor agonists

51
Q

Glaucoma is thought of as intraocular pressure over? What is normal?

A

21 mmHg (normal 12-20)

[Note pressure is a result of production minus outflow, so affecting either can help glaucoma]

52
Q

Open angle glaucoma is a problem with?

A

Drainage into canal of Schlemm

53
Q

Which classes help reduce humor production? (3)

A

Beta antagonists, alpha agonists, carbonic anhydrase inhibitors (diuretic)

54
Q

Which class increases humor drainage?

A

miotics

55
Q

Mech. of how B antagonists reduce humor production?

A

block B1 receptors on ciliary body

56
Q

Mech. of how alpha agonists reduce humor production?

A

stim alpha2 on ciliary body &/or alpha1 on ciliary vessels

57
Q

Mech. of how miotics increase humor drainage?

A

stim M3 on iris & ciliary body, which may improve uveoscleral outflow

58
Q

Closed angle glaucoma is?

A

peripheral iris balloons forward against cornea, reduces flow

59
Q

Closed angle glaucoma acute treatment? (2)

A

systemic mannitol/glycerol to up blood osmolarity and thus down intraocular pressure
-topical miotic, to tighten iris temporarily

60
Q

Closed angle glaucoma cure?

A

YAG laser to create a small hole in iris (iridectomy)

61
Q

Cautions about closed angle glaucoma?

A

-No mydriatics or cycloplegics.

62
Q

What does myasthenia gravis cause in eyes/lids?

A

fatigue-able, double vision, lid drooping (But pupil is always spared!!)

63
Q

How can squint & blepharospasm be treated?

A

botulinum toxin A (relaxes muscle for 3-6 wks) by blocking ACh vesicles from moving to nerve terminal to be released

64
Q

how is botulinum toxin A administered?

A

Needle under EMG (electromyography)

65
Q

How can myasthenia gravis LID problems be treated?

A

AChE (acetylcholine esterase) inhibitors

[note this is for lid problems, doesn’t specify if effective for eye problems or not]

Backup 2 (9 decks)

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