Drugs-Ophthalmic

Question 1

Classes of drugs used to treat glaucoma by decreasing production of aqueous humor

Answer 1

1. B-Blockers
   - lol
2. CA Inhibitors
   - zolamide
3. a2 Agonists
   - nidine

Question 2

Classes of drugs used to treat glaucoma by increasing outflow of aqueous humor

Answer 2

1. 3. a2 Agonists
      - nidine
2. PGF-2 Analogs
   - prost
3. M3 Agonists
   - Carbachol
   - Pilocarpine
4. AchE Inhibitors
   - Echothiophate
   - Physostigmine

Question 3

MOA of Beta Blockers for Glaucoma

Answer 3

Block b-adrenergic receptors in Ciliary Body Epithelium to reduce production of aqueous fluid

Question 4

B/c of its MoA, beta blockers should be used with caution in patients with

Answer 4

1. asthma/copd

2. bradycardia/arrhythmias/hypotension

Question 5

MOA of Carbonic Anhydrase Inhibitors for Glaucoma

Answer 5

Blocks the movement of Na+ and water into the eye

Question 6

Toxicities of CA Inhibitors

Answer 6

Paresthesia
Ocular irritation 
Transiet myopia
Frequent urination
Metabolic acidosis

Question 7

MOA of Alpha-2 Agonists for Glaucoma

Answer 7

1. Dec. aqueous fluid production

2. Inc. rate of fluid outflow via uveoscleral outflow

Question 8

Toxicities of a2 agonists

Answer 8

Blepharitis (eyelid inflammation)
Dizziness
Fatigue/Somnolence

Question 9

Since a2 agonists of glaucoma act like clonidine (anti-hypertensive), they should be cautiously used in patients taking

Answer 9

other anti-hypertensives

Question 10

Apraclonidine is a non-selective alpha adrenergic agonists so they have special toxicities such as

Answer 10

Mydriasis (pupil dilation) & Conjunctival Blanching (실핏줄)

Eyelid retraction (due to muller’s muscle contraction)

Question 11

MOA of PGF-2 analogs

Answer 11

inc. rate of fluid outflow from the eye by inc. uveoscleral outflow

Question 12

Toxicities of PGF-2 analogs

Answer 12

Uveitis
Macular Edema
Discoloration of iris
Longer eyelash
Reactivation of herpes Keratitis (eye infection)

Question 13

Contraindication for using Prostaglandin Analogues for Glaucoma

Answer 13

Herpes Keratitis

Question 14

Toxicities of M3 agonists and AchE inhibitors

Answer 14

anti-cholinergic effects

Question 15

Classes of drugs that can induce MIOSIS (pupil constriction)

Answer 15

1. M3 agonists (“CAR”)
   - Carbachol
   - Pilocarpine
2. AchE Inhibitors
   - Echothiophate

Question 16

Classes of drugs that can induce Mydriasis (pupil dilation)

Answer 16

1. a1 agonists (NE)
   Phenylephrine
2. M3 antagonists (“Trophy”)
   - Atropine
   - Tropicamide