Eye Pharmacology

Question 1

Sympathetics fibers to the eye cause what?

Answer 1

Fibers travel along arteries from the superior cervical ganglion and cause mydriasis and ciliary relaxation

Question 2

What receptor type is involved with pupillary dilation?

Answer 2

a1

Question 3

What receptor type is involved with ciliary relaxation?

Answer 3

b2

Question 4

What receptor type is involved with secretion at the ciliary body?

Answer 4

a2b2

Question 5

Parasympathetics fibers to the eye cause what?

Answer 5

Travel w/ CN3 from edinger-­‐westphal nucleus. Causes miosis, accommodation, and lacrimal secretion

Question 6

What receptor type mediates pupillary constriction?

Answer 6

M3

Question 7

What receptor type mediates accommodation?

Answer 7

M3

Question 8

What receptor type mediates lacrimal secretion?

Answer 8

M2M3 via CN 7

Question 9

How do opiated affect the pupil?

Answer 9

Pinpoint pupils: block the inhibitory interneuorns of the edinger-­westphal nucleus so it’s always constricting

Question 10

How are most drugs delivered to the eyes?

Answer 10

Topical and go into the aqueous humor

Question 11

What drug properties do you need for corneal absorption?

Answer 11

Small lipophilic drugs

Question 12

What drug properties do you need for conjunctival absorption?

Answer 12

Large hydrophilic drugs

Question 13

Where can drugs be injected into the eye?

Answer 13

The conjunctiva, intraocularly (anterior chamber), or intravitreally (for the retina)

Question 14

A lot of eye drugs are what?

Answer 14

Prodrugs to increase absorption topically. The eye has lots of metabolic enzymes, particularly esterase

Question 15

What do muscarinic antagonists do?

Answer 15

Cause Mydriasis and loss of accommodation

Question 16

What are muscarinic antagonists used to Tx?

Answer 16

Iritis and uveitis and for eye exams

Question 17

ADEs of muscarinic antagonists?

Answer 17

Increased IOP, stings, if systematized then Anti-­‐SLUDGEBBB.
Contraindicated‐Glaucoma.

Question 18

What are the muscarinic antagonists?

Answer 18

Atropine and scopolamine

Question 19

What classes of drugs can be used to Tx glaucoma?

Answer 19

Prostaglandin Analogs, beta blockers, carbonic anhydrase inhibitors, muscarinic agonists, Ach-­esterase inhibitor, and sympathomimetics

Question 20

MOA of the prostaglandin analogs?

Answer 20

MOA unknown. Maybe increase aqueous outflow. Prodrugs with in situ hydrolysis

Question 21

ADEs of the prostaglandin analogs?

Answer 21

Blurred vision, stinging/itching. Longterm= increased brown pigmentation of iris, lid, lashes and increased eyelash growth (hypertrichosis)

Question 22

What are the PG analogs?

Answer 22

Latanoprost and bimatoprost

Question 23

MOA of beta blockers?

Answer 23

Blocks ciliary body production of aqueous by decreasing cAMP/PKA and decreasing occular blood flow. Rapid effect.

Question 24

Which beta blockers can be used to Rx glaucoma?

Answer 24

Timolol and carteolol

Question 25

MOA of carbonic anhydrase Inh?

Answer 25

Blocks the production of H2O and CO2 from Carbonic acid. Less water=Less aqueous humor

Question 26

ADEs of carbonic anhydrase Inh?

Answer 26

Irritation, burning/stinging, allergic rxn, bitter taste (dysgeusia), photophobia/dry eye. Sulfonamide allergic rxn.

Question 27

Which carbonic anhydrase inh. are used to Rx glaucoma?

Answer 27

Dorzolamide

Question 28

MOA of muscarinic agonists?

Answer 28

Cause mitosis and increased aqueous flow. Former DOC for glaucoma but not used anymore

Question 29

Contraindications for muscarinic agonists?

Answer 29

Iritis/uveitis, CV dz, Asthma, PUD.

Question 30

ADEs of muscarinic agonists?

Answer 30

stinging, tearing, and decreased night vision

Question 31

Which muscarinic agonists were used to Rx glaucoma?

Answer 31

Carbachol and pilocarpine,

Question 32

MOA of Ach­‐esterase inhibitor?

Answer 32

More potent and longer acting than direct muscarinic agonists. Toxic w/ insecticides.

Question 33

CI'd for Ach­‐esterase inhibitor?

Answer 33

Closed angle glaucoma

Question 34

ADEs of Ach­‐esterase inhibitors?

Answer 34

Stinging, tearing, and decreased night vision

Question 35

Moa of sympathomimetics?

Answer 35

Used in glaucoma for aqueous outflow. Also used to cause mydriasis, and as decongestants.

Question 36

ADEs of sympathomimetics?

Answer 36

Photophobia, conjunctival hyperemia, hypersensitivity. | Caution w/ HTN, Hyperthyroid, DM, CAD, Asthma.

Question 37

Which sympathomimetics can you use?

Answer 37

Phenylephrine, brimonidine, and tetrahydrozoline

Question 38

What's macular degeneration?

Answer 38

Blood vessels growing into the macula. Obscure vision

Question 39

Rx for MD?

Answer 39

Anti-VEGF

Question 40

ADEs of anti-VEGF drugs?

Answer 40

Bleeding, thrombosis, stroke, MI