Chapter 58 - Disorders of the Eye

Question 1

Anticholinergic Drugs

• atropine sulfate

Answer 1

 atropine sulfate
 MOA: Blocks the effects of acetylcholine. Produces mydriatic effects by relaxing the pupil of the eye; (use to get a good view of the back of the eye/dilates eye
 Use: Production of mydriasis (dilate the pupil)
 AE: Stinging
 Contra: Glaucoma (can worsen symptoms)

Question 2

Beta-blockers

• timolol maleate (Timoptic)

Answer 2

 timolol maleate (Timoptic)
 MOA: Blocks beta-1 and beta-2 adrenergic receptors to reduce the IOP by reducing aqueous humor production and increasing outflow (balances production and drainage of aqueous humor)
 Use: Glaucoma
 AE: Burning and stinging
 Use cautiously in patient with pulmonary diseases (if patients do not instill these eyedrops correctly they can get systemic effects (beta=sympathetic); blocking sympathetic in lungs  bronchoconstriction

Question 3

Alpha-2 Adrenergic Agonists

• brimonidine (Alphagan P)

Answer 3

 brimonidine (Alphagan P)
 MOA: Lowers IOP, reduces aqueous humor production and increases outflow
 Use: Glaucoma
 AE: CV effects, CNS effects, respiratory effects, local reactions, ocular effects
 Contra: If used MAOI in past 14 days

Question 4

Carbonic Anhydrase Inhibitors

–> ONLY PO drug (all others are topical)

• acetazolamide (Diamox)

Answer 4

 acetazolamide (Diamox)
 MOA: Inhibits carbonic anhydrase in the eye to reduce the rate of aqueous humor formation and lower IOP
 Use: Glaucoma
 AE: SJS, flaccid paralysis, agranulocytosis, hemolytic anemia, aplastic anemia, leukopenia, pancytopenia, metabolic acidosis

Question 5

Anti-Inflammatory

• diclofenac (Voltaren)

Answer 5

 diclofenac (Voltaren)
 MOA: COX 1 & 2 inhibitor decreases the formation of prostaglandin (decreases inflammation –> helps for irritation/swelling of eye, conjunctiva, etc)
 Use: Post op, inflammation
 AE: facial edema, dizziness, fever, headache, pain and insomnia, ocular effects