3) Ocular Flashcards

1
Q

What is the class for Acetylcholine (Miochol)

A

Direct muscarinic agonist

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2
Q

What is the mechanism for Acetylcholine (Miochol)

A

Pupillary constriction

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3
Q

What are the therapeutics for Acetylcholine (Miochol)

A

Used in cataract surgery to constrict pupil intraoperatively

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4
Q

What are the other side effects for Acetylcholine (Miochol)

A

Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating

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5
Q

What is the class for Pilocarpine HCl (Salagen)

A

Direct muscarinic agonist

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6
Q

What is the mechanism for Pilocarpine HCl (Salagen)

A

Pupillary constriction, increased aqueous outflow

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7
Q

What are the therapeutics for Pilocarpine HCl (Salagen)

A

Treatment of glaucoma (both open angle and acute closed angle); used less today due to side effects

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8
Q

What are the important side effects for Pilocarpine HCl (Salagen)

A

Decreased vision when patient has cataracts due to miosis and headache

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9
Q

What are the other side effects for Pilocarpine HCl (Salagen)

A

Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating

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10
Q

What are the miscellaneous for Pilocarpine HCl (Salagen)

A

Requires frequent dosage QID

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11
Q

What is the class for Carbachol

A

Direct muscarinic agonist

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12
Q

What is the mechanism for Carbachol

A

Pupillary constriction, increased aqueous outflow

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13
Q

What are the therapeutics for Carbachol

A

Treatment of glaucoma; used less today due to topical side effects

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14
Q

What are the important side effects for Carbachol

A

Decreased vision due to miosis and headache

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15
Q

What are the other side effects for Carbachol

A

Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating

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16
Q

What is the class for Echothiophate iodide (Phospholine iodide)

A

Indirect muscarinic agonist

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17
Q

What is the mechanism for Echothiophate iodide (Phospholine iodide)

A

Irreversibly binds cholinesterase

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18
Q

What are the therapeutics for Echothiophate iodide (Phospholine iodide)

A

Treatment of glaucoma; used less today due to topical side effects

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19
Q

What are the other side effects for Echothiophate iodide (Phospholine iodide)

A

Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating

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20
Q

What is the class for Atropine

A

Antimuscarinic

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21
Q

What is the mechanism for Atropine

A

Pupillary dilatation; paralysis of ciliary body

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22
Q

What are the therapeutics for Atropine

A

Improve discomfort during active eye inflammation (ueveitis)

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23
Q

What are the other side effects for Atropine

A

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention

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24
Q

What are the miscellaneous for Atropine

A

Very long acting so not used unless severe inflammation

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25
Q

What is the class for Scopolamine

A

Antimuscarinic

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26
Q

What is the mechanism for Scopolamine

A

Pupillary dilatation; paralysis of ciliary body

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27
Q

What are the therapeutics for Scopolamine

A

Improve discomfort during active eye inflammation (ueveitis)

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28
Q

What are the other side effects for Scopolamine

A

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention

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29
Q

What is the class for Homatropine

A

Antimuscarinic

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30
Q

What is the mechanism for Homatropine

A

Pupillary dilatation; paralysis of ciliary body

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31
Q

What are the therapeutics for Homatropine

A

Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)

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32
Q

What are the other side effects for Homatropine

A

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention

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33
Q

What is the class for Cyclopentolate (Cyclogyl)

A

Antimuscarinic

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34
Q

What is the mechanism for Cyclopentolate (Cyclogyl)

A

Pupillary dilatation; paralysis of ciliary body

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35
Q

What are the therapeutics for Cyclopentolate (Cyclogyl)

A

Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)

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36
Q

What are the other side effects for Cyclopentolate (Cyclogyl)

A

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention

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37
Q

What is the class for Tropicamide (Mydriacyl)

A

Antimuscarinic

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38
Q

What is the mechanism for Tropicamide (Mydriacyl)

A

Pupillary dilatation; paralysis of ciliary body

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39
Q

What are the therapeutics for Tropicamide (Mydriacyl)

A

Most commonly used cycloplegia for eye exams

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40
Q

What are the other side effects for Tropicamide (Mydriacyl)

A

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention

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41
Q

What is the class for Edrophonium (Enlon)

A

Nm agonist

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42
Q

What is the mechanism for Edrophonium (Enlon)

A

Destroys acetylcholinesterase

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43
Q

What are the therapeutics for Edrophonium (Enlon)

A

Diagnose myasthenia gravis

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44
Q

What is the class for Ephinephrine

A

Direct adrenergic agonist

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45
Q

What is the mechanism for Ephinephrine

A

Dilation of episcleral vessels –> increased aqueous outflow

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46
Q

What are the other side effects for Ephinephrine

A

Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating

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47
Q

What is the class for Dipivefrin HCl (Propine)

A

Direct adrenergic agonist

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48
Q

What is the mechanism for Dipivefrin HCl (Propine)

A

Prodrug of epinpehrine

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49
Q

What are the therapeutics for Dipivefrin HCl (Propine)

A

Treatment of glaucoma

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50
Q

What is the class for Hydroxyamphetamine (Paredrine)

A

Indirect adrenergic agonist

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51
Q

What is the mechanism for Hydroxyamphetamine (Paredrine)

A

Release NE

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52
Q

What are the therapeutics for Hydroxyamphetamine (Paredrine)

A

Separates 1st and 2nd from 3rd order neuron dysfunction in Horner’s syndrome; positive dilation means 1st or 2nd order, an ominous sign

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53
Q

What is the class for Cocaine

A

Indirect adrenergic agonist

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54
Q

What is the mechanism for Cocaine

A

Prevent reuptake of NE

55
Q

What are the therapeutics for Cocaine

A

Use initially to confirm diagnosis of Horner’s Syndrome

56
Q

What is the class for Apraclonidine (Iopidine)

A

Direct ?-agonist

57
Q

What is the mechanism for Apraclonidine (Iopidine)

A

Amino derivative of clonidine; does not cross blood-brain barrier –> minimal effect on systemic blood pressure

58
Q

What are the therapeutics for Apraclonidine (Iopidine)

A

Treatment of open angle glaucoma

59
Q

What is the class for Phenylephrine (Neo-Synephrine)

A

Direct ?1-agonist

60
Q

What are the therapeutics for Phenylephrine (Neo-Synephrine)

A

Dilate pupil for eye exam and cataract surgery

61
Q

What are the other side effects for Phenylephrine (Neo-Synephrine)

A

Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating

62
Q

What are the miscellaneous for Phenylephrine (Neo-Synephrine)

A

Caution in elderly patients: at 10% can cause cardiac side effects

63
Q

What is the class for Clonidine (Catapres)

A

Direct ?2-agonist

64
Q

What is the mechanism for Clonidine (Catapres)

A

Lowers intraocular pressure through central nervous system effects

65
Q

What is the class for Brimondine tartrate (Alphagan)

A

Direct ?2-agonist

66
Q

What is the mechanism for Brimondine tartrate (Alphagan)

A

Suppresses aqueous humor production through action of cAMP in non-pigmented ciliary epithelium

67
Q

What are the therapeutics for Brimondine tartrate (Alphagan)

A

Primary agent for treatment of glaucoma

68
Q

What are the miscellaneous for Brimondine tartrate (Alphagan)

A

May cause follicular conjunctivitis; use with MAOi can cause fatigue/drowsiness

69
Q

What is the class for Dapiprazole

A

?-antagonist

70
Q

What is the mechanism for Dapiprazole

A

Blocks alpha-adrenergic receptors in smooth dilator muscle of iris

71
Q

What are the therapeutics for Dapiprazole

A

Reverses tropicamide, phenylephrine

72
Q

What are the miscellaneous for Dapiprazole

A

Not currently available

73
Q

What is the class for Tamsulosin (Flomax)

A

?1-antagonist

74
Q

What is the mechanism for Tamsulosin (Flomax)

A

Antagonist

75
Q

What are the therapeutics for Tamsulosin (Flomax)

A

Prostate hypertrophy

76
Q

What are the important side effects for Tamsulosin (Flomax)

A

Floppy iris syndrome

77
Q

What are the miscellaneous for Tamsulosin (Flomax)

A

Blocks iris dilator muscle, making cataract surgery much more difficult and with a much higher incidence of complications

78
Q

What is the class for Timolol (Timoptic)

A

?-blocker

79
Q

What is the mechanism for Timolol (Timoptic)

A

Reduce intraocular pressure by reducing aqueous production at the ciliary process

80
Q

What are the therapeutics for Timolol (Timoptic)

A

Second line treatment of glaucoma

81
Q

What are the other side effects for Timolol (Timoptic)

A

Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression, fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia

82
Q

What are the miscellaneous for Timolol (Timoptic)

A

Contraindicated in CHF, asthma; bradycardia over time may produce tachyphylaxis

83
Q

What is the class for Levobunolol (Betagan)

A

?-blocker

84
Q

What is the mechanism for Levobunolol (Betagan)

A

Reduce intraocular pressure by reducing aqueous production at the ciliary process

85
Q

What are the therapeutics for Levobunolol (Betagan)

A

Second line treatment of glaucoma

86
Q

What are the other side effects for Levobunolol (Betagan)

A

Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression, fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia

87
Q

What is the class for Metipranolol (OptiPranolol)

A

?-blocker

88
Q

What is the mechanism for Metipranolol (OptiPranolol)

A

Non-selective ?1+2 blocker without significant intrinsic sympathomimetic activity (weak membrane stabilization, weak mycoardial depressant)

89
Q

What are the therapeutics for Metipranolol (OptiPranolol)

A

Second line treatment of glaucoma

90
Q

What are the other side effects for Metipranolol (OptiPranolol)

A

Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression, fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia

91
Q

What are the miscellaneous for Metipranolol (OptiPranolol)

A

Only b-blocker that doesn’t follow the rule

92
Q

What is the class for Carteolol (Ocupress)

A

?-blocker

93
Q

What is the mechanism for Carteolol (Ocupress)

A

Reduce intraocular pressure by reducing aqueous production at the ciliary process

94
Q

What are the therapeutics for Carteolol (Ocupress)

A

Second line treatment of glaucoma

95
Q

What are the other side effects for Carteolol (Ocupress)

A

Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression, fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia

96
Q

What is the class for Betaxolol (Betoptic)

A

?1-blocker

97
Q

What is the mechanism for Betaxolol (Betoptic)

A

Reduce intraocular pressure by reducing aqueous production at the ciliary process

98
Q

What are the therapeutics for Betaxolol (Betoptic)

A

Second line treatment of glaucoma

99
Q

What is the class for Latanoprast (Xalatan)

A

Prostaglandin analog

100
Q

What is the mechanism for Latanoprast (Xalatan)

A

Increase uveoscleral outflow

101
Q

What are the therapeutics for Latanoprast (Xalatan)

A

Primary agent for treatment of glaucoma

102
Q

What are the important side effects for Latanoprast (Xalatan)

A

Eyelash growth, change in iris color, intraocular inflammation

103
Q

What are the miscellaneous for Latanoprast (Xalatan)

A

May cause cystoid macular edema in cataract surgery and activate herpes

104
Q

What is the class for Travoprost (Travatan)

A

Prostaglandin analog

105
Q

What is the mechanism for Travoprost (Travatan)

A

Increase uveoscleral outflow

106
Q

What are the therapeutics for Travoprost (Travatan)

A

Primary agent for treatment of glaucoma

107
Q

What are the important side effects for Travoprost (Travatan)

A

Eyelash growth, change in iris color

108
Q

What are the miscellaneous for Travoprost (Travatan)

A

May cause cystoid macular edema in cataract surgery; more effective in African Americans

109
Q

What is the class for Bimatoprost (Lumigan)

A

Prostaglandin analog

110
Q

What is the mechanism for Bimatoprost (Lumigan)

A

Increase uveoscleral outflow

111
Q

What are the therapeutics for Bimatoprost (Lumigan)

A

Primary agent for treatment of glaucoma

112
Q

What are the important side effects for Bimatoprost (Lumigan)

A

Eyelash growth, change in iris color

113
Q

What are the miscellaneous for Bimatoprost (Lumigan)

A

May cause cystoid macular edema in cataract surgery and activate herpes

114
Q

What is the class for Unoprostone isopryl (Rescula)

A

Prostaglandin analog

115
Q

What is the mechanism for Unoprostone isopryl (Rescula)

A

Increase uveoscleral outflow

116
Q

What are the therapeutics for Unoprostone isopryl (Rescula)

A

Glaucoma

117
Q

What are the important side effects for Unoprostone isopryl (Rescula)

A

Eyelash growth, change in iris color

118
Q

What are the miscellaneous for Unoprostone isopryl (Rescula)

A

Least effective overall

119
Q

What is the class for Nifedipine (Procardia)

A

Ca-channel blocker

120
Q

What is the mechanism for Nifedipine (Procardia)

A

Increases ocular perfusion at nervehead

121
Q

What are the therapeutics for Nifedipine (Procardia)

A

May aid in treatment of glaucoma by systemic medications; not widely used

122
Q

What is the class for Dorzolamide HCl (Trusopt)

A

Carbonic anhydrase inhibitor

123
Q

What is the mechanism for Dorzolamide HCl (Trusopt)

A

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

124
Q

What are the therapeutics for Dorzolamide HCl (Trusopt)

A

Second line glaucoma therapy

125
Q

What are the other side effects for Dorzolamide HCl (Trusopt)

A

Red eyes, lid allergies

126
Q

What are the miscellaneous for Dorzolamide HCl (Trusopt)

A

Contraindicated in sulfonamide allergies

127
Q

What is the class for Acetazolamide (Diamox)

A

Carbonic anhydrase inhibitor

128
Q

What is the mechanism for Acetazolamide (Diamox)

A

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

129
Q

What are the therapeutics for Acetazolamide (Diamox)

A

Oral agent used for advanced glaucoma and with cataract surgery

130
Q

What is the class for Brinzolamide (Azopt)

A

Carbonic anhydrase inhibitor

131
Q

What is the mechanism for Brinzolamide (Azopt)

A

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

132
Q

What are the therapeutics for Brinzolamide (Azopt)

A

Second line glaucoma therapy

133
Q

What are the other side effects for Brinzolamide (Azopt)

A

Red eyes, lid allergies