eye treatment Flashcards
effect of muscarinic antagonists?
which two drugs?
loss of accomodation(cycloplegia) and adaptation (mydriasis)
scopalamine and atropine
what do scopalamine and atropine treat?
iris/uveal tract inflammatory conditions and eye examination
what are the 4 ADEs of muscarinic antagonists (scopalamine and atropine)? (PBS)
two contraindications?
increased intraocular presssure, transient stings, burns
c/I in glaucoma w/sulfite preservative allergy
if drainage of aqueus humor impaired, pressure w/in eye may increase and compress retina and damage the optic nerve –> ?
glaucoma
what is the normal pressure range in glaucoma?
10-21 mmHg
which glaucoma tx inthe following way:
decrease aqueous humor production and/or increase aqueous humor outflow
open angle glaucoma
which glaucoma tx in following way:
surgical iridectiomy; short term medical management to decrease IOP and clear cornea prior to surgery
closed angle
which drugs are first line for glaucoma tx(2)?
prostaglandins (PGF2alpha analogs) - _latanoprost + bimatoprost _
which 3 drug classes used to treat glaucoma?
1st line: prostaglandin analogs (PGF2): bimatoprost and latanoprost
beta-receptor antagonists (timolol and carteolol)
carbonic anhydrase(isoenzyme II) inhibitors (dorzolamide)
MOA of prostaglandin analogs latonoprost and bimatoprost?
mech unclear: thought to faciliate aqueous outflow via accesory uveoscleral outflow pathway
NOTE: isopropyl ester pro-drugs undergo in situ hydrolysis after penetrating cornea
the 3 ADEs of bimatoprost and latonoprost (BIV)+ the ONE major chronic one
ADE: blurred vision, burning/stinging, itching
CHRONICALLY: slow+ permanent brown pigmentation of iris, eyelid skin, and eyelashes; also increases their growth, including length, thickness
which comsetic condition are bimatoprost and latanoprost used to tx?
hyoptrichosis (marketed as Latisse)
75-90% of ciliary body epithelium and BV receptors are ______
beta-2
how do the beta-blockers timolol and carteolol function in the tx of glaucoma?
- decrease aqueos humor prodution by decreased cAMP-PKA stimulation
- decrease ocular blood flow and ultrafiltration producing humor
are b-blockers detected in systemic circulation following topical use?
yes
what can co-formulated preservatives(benzalkonium chloride) damage?
soft contact lenses
what type of beta blockers used to inhibit production of aqueous humor?
beta-2 antagonists
how do carbonic anyhyrase inhibtiros reduce intraocular pressure?
by reducing bicarbonate secretion and fluid transport
what are the two signifcant ADEs of carbonic anyhyrdase inhibitors?
- taste disturbance(dysgeusia = bitter taste) from inhibition of carbonic anyhydrase in the oral cavity
- SULFMONAMIDES –> ALLERGIC RXN.
blurred, vision, lacrimation, photophobia, and xeropthalmia as well as allergic rxns such as: agranulocytosis, aplastic anemia, fulminant hepatic necrosis, SJEN, and TEN, and allergic ocular manifestations such as: bacterial keratitis and are all ADEs of
carbonic anhydrase inhibitors = DORZOLAMIDE
what are direct acting miotics that increase aquus humor flow?
muscarinic agonists and cholinesterase inhibitors
which two muscarinic agonists used for tx of OPEN angle glaucoma but C/I in closed angle?
carbachol and pilocarpine
which 3 conditions are muscarinic agonists and cholinesterase inhibitors C/I in? b/c constriction undesirable
iritis, uveitis, and inflammatory condition of anterior chamber
what are the three ADEs of muscranic agonists(pilocarpine and carbachol) and cholinesterase inhibitors?(STN)
transient stinging, tearing, decreased night vision
cholinesterase inhibitors are MORE potent, longer-acting than direct-acting miotics + ADE MC. they have additive effects with carbamate + organophosphate toxicity. Which condition are they C/I b/c they Increase IOP?
what is the ONE drug from thisclass?
CLOSED-angle glaucoma.
Echothiophate
which 4 drugs considered sympathomimetics and used in the tx of glaucoma?(P TAB)
P-phenylephrine
T-tetrahyrozoline
A- apraclonidine
B- brimonidine
what is the receptor for phenylephrine? indication (3 MVD)
alpha
inidcation: Mydriasis, vasconstriction, decongestion
receptor for apraclonidine? what is the one indication for this drug?
apraclonidine - alpha2 for ocular HTN
Brimonidine receptor and indication(2 GO)
brimonidine - alpha 2 and glaucoma and ocular HTN
tetrahyrozoline receptor and indication
alpha and decongestation
what is the common MOA for all sympathomimetis and their ocular ADE(3) ?
MOA: decrease IOP by increasing outflow of aqueous humor from the eye.
Systemic effects rare but include: used w/caution in HTN, hyperthyroidisim, Diabetes, arteriosclersosi and ASTHMA
3 ADEs: photosensitivity, conjuctival hyperemia, and hypersensitivity
sympathamomimetic drugs used for a # of clinical conditions in addition to glaucoma such as: (2)
glaucoma
produce mydriasis
decongestants
what causes the ADE of bitter taste of carbonic anahydrase inhibitor dorzolamide
inhibition of carbonic anyhydrase in oral cavity
