Drugs Uses in Glaucoma (Konorev)

Question 1

What is the function of the iris circular muscle?

Its effect is due to activation of?

Answer 1

1) Constrict pupil to cause miosis

2) M3 receptors (GPCR coupled to Gq)

Question 2

What is the function of the iris radial muscle?

Its effect is due to activation of?

Answer 2

1) Dilates pupil to cause mydriasis

2) α1 adrenergic receptors (GPCR coupled to Gq)

Question 3

The ciliary muscle opens up trabecular meshwork, improves outflow of aqueous humor into the canal of Shlemm which causes?

What receptor is involved?

Answer 3

1) Decrease in intraocular pressure

2) M3 receptor

Question 4

What produces aqueous humor?

What receptor activation increases humor production?

What receptor activation decreases humor production?

Answer 4

1) Ciliary epithelium
2) β adrenergic receptor (GPCR coupled to Gs)
2) α2 adrenergic receptors (GPCR coupled to Gi)

Question 5

What improves outflow of aqueous humor?

Answer 5

1) Contraction of ciliary muscle

2) Contraction of iris circular muscle

Question 6

What decreases outflow of aqueous humor?

Answer 6

1) Contraction of iris radial muscle

2) Relaxation of ciliary muscle

Question 7

Which type of primary glaucoma is characterized by chronic progressive disease with no apparent mechanical blockage for the humor outflow?

Answer 7

Open angle glaucoma

Question 8

Which type of primary glaucoma is characterized by acute intermittent partial or complete blockage of the outflow, may have to be treated as an emergency to avoid vision loss?

Answer 8

Closed angle glaucoma

Question 9

In the treatment of open angle glaucoma, what drug classes reduce the aqueous humor production?

Answer 9

1) β-blocking drugs
2) α2 adrenergic agonists
3) Carbonic anhydrase inhibitors

Question 10

Betaxolol, Timolol, Metipranolol, Levobunolol, and Carteolol make up what drug class?

Answer 10

β-blocking drugs

Question 11

Apraclonidine and Brimonidine make up what drug class?

Answer 11

α2 adrenergic agonists

Question 12

Brinzolamide, Dorzolamide, Acetazolamide, and Methazolamide make up what drug class?

Answer 12

Carbonic anhydrase inhibitors

Question 13

In the treatment of open angle glaucoma, what drug classes are used to increase aqueous humor outflow?

Answer 13

1) Prostaglandin analogs
2) α2 adrenergic agonists
3) Direct cholinergic agonists
4) Inhibitors of cholinesterase

Question 14

Latanoprost, Bimatoprost, and Travoprost make up what drug class?

Answer 14

Prostaglandin analogs

Question 15

Carbachol and Pilocarpine make up what drug class?

Answer 15

Direct cholinergic agonists

Question 16

Echothiophate makes up what drug class?

Answer 16

Inhibitors of cholinesterase

Question 17

What is the MOA of Beta blockers?

Answer 17

Reduces aqueous humor production by the ciliary body

Question 18

Which beta blocker is favored because it lacks local anesthetic effects?

Answer 18

Timolol

Question 19

What is the MOA of α2 adrenergic agonists?

Answer 19

Decreases the rate of aqueous humor production by relaxing ciliary muscle

Question 20

Which α2 adrenergic agonists is more commonly used?

Answer 20

Brimonidine

Question 21

What is the MOA of carbonic anhydrase inhibitors?

Answer 21

Decrease osmotic pressure of the aqueous humor

Question 22

What is the MOA of prostaglandin analogs?

Answer 22

Reduce intraocular pressure

Question 23

Which prostaglandin analogs is the most effective in lowering intraocular pressure?

Answer 23

Bimatoprost

Question 24

What is the MOA of cholinergic agonists?

Answer 24

Activate M3 receptor by inhibiting cholinesterase which then elevates ACh levels

Question 25

In the treatment of open angle glaucoma what are the first line agents?

Answer 25

1) Beta blocker

2) Prostaglandin agent

Question 26

If contraindications to both Beta blockers and prostaglandins, you should switch to what alternative first line agents?

Answer 26

Brimonidine or topical carbonic anhydrase inhibitors

Question 27

In the treatment of closed angle glaucoma what systemic osmotic diuretics should be given in preparation for surgery?

Answer 27

1) Oral Glycerin

2) IV Mannitol

Question 28

In the treatment of closed angle glaucoma what is given before surgery to induce miosis?

Answer 28

Pilocarpine

Question 29

Glucocorticoids and topical antimuscarinic drugs can cause open angle glaucoma by?

Answer 29

Elevating the intraocular pressure

Question 30

In patients with closed angle glaucoma, angle closure may be triggered by any drug that causes?

Answer 30

Mydriasis

Question 31

What intermediate mediates the therapeutic effect of pilocarpine?

This causes the release of?

Answer 31

1) Inositol 3-phosphate

2) Calcium