ch 57 ophthalmic drugs

Question 1

what are the six muscles that keep the eye held in place?

Answer 1

Rectus muscles-inferior(downward movement),superior(upward movement),medial(inward movement),lateral (outward movement)
Oblique muscles-inferior (upward and outward)superior(downward outward)

Question 2

echothiophate

Answer 2

(Indirect acting) long lasting

Question 3

mydriatics

Answer 3

dilate pupil (apraclonidine)-prevents ocular vasoconstriction, inhibit perioperative IOP
(Dipivefrin)- prodrug of epinephrine, when applied topically hydrolyzed to epinephrine penetrates tissues better

Question 4

miotics

Answer 4

constricts pupil

Question 5

cycloplegics

Answer 5

drugs that paralyze the ciliary body

Question 6

Acetylcholine

Answer 6

(Direct acting Cholinergic)use for constriction during surgery

Question 7

pilocarpine

Answer 7

treatment for glaucoma Used once a week

Question 8

echothiophate

Answer 8

(indirect acting) long lasting
Treats high pressure in the eye

acetylcholinesterase inhibitor

Question 9

sympathomimetics Indication

Answer 9

chronic, open -angle glaucoma( to reduce IOP)
- reduction of perioperative IOP
-reduce of ocular hypertension

Question 10

sympathomimetics Adverse effects

Answer 10

Burning eyes, eye pain, lacrimation
rare- hypertension, tachycardia, faitness

Question 11

Beta adrenergic blockers

Answer 11

-reduce IOP-reducing aqueous humor formation
Don’t affect pupil size or night vision

Question 12

Indications of beta blockers

Answer 12

Chronic open angle, glaucoma, ocular hypertension sometimes angle closure

Question 13

Administration of oral beta blockers with high doses of ophthalmic beta blockers may result in

Answer 13

additive effects

Question 14

Timolol

Answer 14

increases outflow of aqueous humor as well as decrease its formation act at both beta 1 and beta 2 receptors

Question 15

Carbonic anhydrase Inhibitor

Answer 15

inhibits the enzyme carbonic anhydrase which reduces aqueous humor formation
(Brinzolamide, Dorzolamide)
Treatment for glaucoma
-open angle
-angle closure
-preoperatively IOP reduced

Question 16

Carbonic anhydrase inhibitor adverse effects

Answer 16

rare- keratitis, nausea, acidosis
oral drowsiness, paresthesia in the finger’s toes face

Question 17

osmotic diuretics

Answer 17

-create ocular hypotension by producing an osmotic gradient
-water is forced from aqueous &vitreous humor into blood stream

Question 18

Glycerin

Answer 18

usually tried first but can cause hyperglycemia (oral)

Question 19

Manitol

Answer 19

(IV)
used if glycerin unsuccessful

Question 20

Isosorbide or urea are used when?

Answer 20

when other methods have failed

Question 21

Prostaglandin agonists

Answer 21

Newest class of drugs for glaucoma
-latanoprost
-travoprost
-bimatoprost
(Drug allow for single daily dosing because of effects last for 20-24 hrs)
-Eyes can change colors permanently to brown

Question 22

Antimicrobial drug

Answer 22

-use of opthalmic antibiotics with corticosteroids may make more difficult to rid eye infections
Aminoglycosides - gentamicin and tobramycin
Macrolide antibiotics - erythromycin/ azithromycin
Quinolone antibiotics - ciprofloxacin
Sulfonamides - sulfacetamide
Antifungal -Natamycin
Antiviral -trifluridine

Question 23

Ocular antiflammatory

Answer 23

NSAIDS-reduces pain, erythema, etc. / seasonal conjunctivitis

bromfenac/ ketorolac/ flurbiprofen/ diclofenac
Corticosteroids-reduce inflammation and itching/ dexamethasone (used after surgery to prevent scarring)

Question 24

Topical ophthalmic anesthetics

Answer 24

Tetracaine-used to prevent eye pain during surgery, removal of foreign bodies
-not recommended for self admin

Question 25

cycloplegia

Answer 25

paralysis of the ciliary muscle of the eye

Question 26

Atropine sulfate(diagnostic)

Answer 26

dilates pupil preventing accommodation

Question 27

cyclopentolate (diagnostic)

Answer 27

used for diagnostic examinations
mydriatic and cycloplegic drug

Question 28

Fluorescein (diagnostic)

Answer 28

diagnostic dye/ foreign bodies & corneal defects/ highlighted green or yellow-orange/ applicator strips

Question 29

ophthalmic antiallergic drugs

Answer 29

-used to treat symptoms of allergic conjunctivitis (hay fever)
-can be used for seasonal allergies

Question 30

Restasis (eye drop)

Answer 30

treats dry eyes
- can be used together with artificial tears (drugs given 15 mins apart)