Eye Disorder Drugs (Walworth)

Question 1

Muscarinic Receptor Antagonists (targets, drugs-2, secondary use)

Answer 1

Targets: sphincter pupillae m. (preventing pupil constriction, causing mydriasis) and ciliary m. (preventing accommodation)

• Atropine, scopolamine
• also used vs. amblyopia (lazy eye) by inducing cycloplegia in strong eye, forcing weak one to work

Question 2

Effects of Antimuscarinic Excess (6), treatment

Answer 2

“dry as a bone, blind as a bat, mad as a hatter, hot as hell, red as a beet, full as a flask.”

1) decreased secretion/salivation
2) cycloplegia (lack of accommodation- cant see near objects)
3) CNS excitation (hallucinations, delirium)
4) Decreased sweat so heat buildup
5) Cutaneous vasodilation (to compensate for no sweat)
6) Urinary retention (bladder m. interference)
- more common in kids. Treat with cooling blankets, cholinesterase inhibitor, benzodiazepene to prevent seizures

Question 3

Tropicamide

Answer 3

Another antimuscarinic agent

-used in eye exams since cyclopegic, mydriatic but short duration

Question 4

Phenylephrine

Answer 4

å-agonist used in eye exam to cause mydriasis (cause pupillary dilation by stimulating dilator m.)

Question 5

Glaucoma-treating drugs (6 categories)

Answer 5

1) Prostoglandin analogs
2) ß-blockers
3) Carbonic anyhdrase inhibitors
4) å-2 agonists
5) Cholinergic agonists/cholinesterase inhibitors
6) Osmotic agents

Question 6

Latanoprost (drug class, function)

Answer 6

• ex of prostoglandin analog used to treat glaucoma

- targets prostoglandin receptors to increase uvea-sclera aqueous humor outflow

Question 7

Timolol (drug class, function)

Answer 7

• ex of ß blocker used to treat glaucoma

- target ß-receptors on ciliary epithelium (which produces aqueous humor) to decrease AH production

Question 8

Brinzolamide (drug class, function)

Answer 8

• ex of carbonic anhydrase inhibitors used to treat glaucoma

- Decrease AH production like ß-blockers

Question 9

Apraclonidine (drug class, function)

Answer 9

• ex of å-2 agonist used to treat glaucoma

- Decreases AH production, increases outflow

Question 10

Pilocarpine (drug class, function)

Answer 10

• ex of cholinergic agonist used to treat glaucoma

- contracts ciliary body m., causing increased AH outflow

Question 11

Echothiophate (drug class, function)

Answer 11

• ex of cholinesterase inhibitor used to treat glaucoma

- Contracts ciliary body m., causing increased AH outlflow

Question 12

Glycerol (oral), manitol (IV) (drug class, function)

Answer 12

ex of osmotic agents used to treat glaucoma

-Increase osmotic gradient between blood and AH, drawing fluid out of eye. Used to treat acute (closed angle) glaucoma

Question 13

Other eye disorders responsive to drugs (4), treatments

Answer 13

• age-related macular degeneration
• bacterial conjunctivitis (fluoroquinolones)
• dry eyes (give artificial tears, topical cyclosporine)
• allergic conjunctivitis (target histamine receptor, many options)