ch 57 ophthalmic drugs Flashcards
what are the six muscles that keep the eye held in place?
Rectus muscles-inferior(downward movement),superior(upward movement),medial(inward movement),lateral (outward movement)
Oblique muscles-inferior (upward and outward)superior(downward outward)
echothiophate
(Indirect acting) long lasting
mydriatics
dilate pupil (apraclonidine)-prevents ocular vasoconstriction, inhibit perioperative IOP
(Dipivefrin)- prodrug of epinephrine, when applied topically hydrolyzed to epinephrine penetrates tissues better
miotics
constricts pupil
cycloplegics
drugs that paralyze the ciliary body
Acetylcholine
(Direct acting Cholinergic)use for constriction during surgery
pilocarpine
treatment for glaucoma Used once a week
echothiophate
(indirect acting) long lasting
Treats high pressure in the eye
acetylcholinesterase inhibitor
sympathomimetics Indication
chronic, open -angle glaucoma( to reduce IOP)
- reduction of perioperative IOP
-reduce of ocular hypertension
sympathomimetics Adverse effects
Burning eyes, eye pain, lacrimation
rare- hypertension, tachycardia, faitness
Beta adrenergic blockers
-reduce IOP-reducing aqueous humor formation
Don’t affect pupil size or night vision
Indications of beta blockers
Chronic open angle, glaucoma, ocular hypertension sometimes angle closure
Administration of oral beta blockers with high doses of ophthalmic beta blockers may result in
additive effects
Timolol
increases outflow of aqueous humor as well as decrease its formation act at both beta 1 and beta 2 receptors
Carbonic anhydrase Inhibitor
inhibits the enzyme carbonic anhydrase which reduces aqueous humor formation
(Brinzolamide, Dorzolamide)
Treatment for glaucoma
-open angle
-angle closure
-preoperatively IOP reduced
Carbonic anhydrase inhibitor adverse effects
rare- keratitis, nausea, acidosis
oral drowsiness, paresthesia in the finger’s toes face
osmotic diuretics
-create ocular hypotension by producing an osmotic gradient
-water is forced from aqueous &vitreous humor into blood stream
Glycerin
usually tried first but can cause hyperglycemia (oral)
Manitol
(IV)
used if glycerin unsuccessful
Isosorbide or urea are used when?
when other methods have failed
Prostaglandin agonists
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
Antimicrobial drug
-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
Ocular antiflammatory
NSAIDS-reduces pain, erythema, etc. / seasonal conjunctivitis
bromfenac/ ketorolac/ flurbiprofen/ diclofenac
Corticosteroids-reduce inflammation and itching/ dexamethasone (used after surgery to prevent scarring)
Topical ophthalmic anesthetics
Tetracaine-used to prevent eye pain during surgery, removal of foreign bodies
-not recommended for self admin
