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Pharmacology Exam 4 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

2 ways to treat glaucoma

A 
increase drainage (outflow)
decrease aqueous humor
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2
Q

Open angle glaucoma

A

chronic
painless
decrease aq drainage

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3
Q

How do you treat open angle glaucoma?

A

drugs, reducing IOP

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4
Q

closed narrow angle glaucoma

A

angle between iris and cornea reduced
block outflow
acute
ocular pain

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5
Q

How do you treat closed angle glaucoma?

A

surgically

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6
Q

What type of glaucoma has IOP >30?

A

closed angle

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7
Q

Which type of glaucoma is more common?

A

open angle

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8
Q

Beta blocker role in glaucoma

A

decrease formation

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9
Q

Alpha 2 agonist role in glaucoma

A

decrease formation

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10
Q

prostaglandin role in glaucoma

A

increase outflow

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11
Q

What is a BB used for glaucoma?

A

timolol

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12
Q

What is an alpha 2 agonist used in glaucoma?

A

brimonidine

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13
Q

What is a prostaglandin used in glaucoma?

A

latanoprost

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14
Q

timolol MOA

A

nonselective BB
decrease IOP
unclear

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15
Q

Why is a nonselective BB okay for glaucoma?

A

B2 predominate in ciliary body, so non selective is better than B1 selective

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16
Q

List in order the most common used agents for glaucoma

A
  1. prostaglandin
  2. BB
  3. alpha 2 agonist
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17
Q

Timolol CI

A

asthma

cardiac insufficiency

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18
Q

brimonidine MOA

A

a2 selective
decrease aq humor production
increase outflow long term
decrease IOP

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19
Q

brimonidine uses

A

open angle glaucoma

ocular HTN

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20
Q

t/f brimonidine is okay for long term use

A

true

21
Q

ADE brimonidine

A

dry mouth
ocular hyperemia (red eye)
foreign body sensation
local burning/stinging

22
Q

Systemic effects of brimonidine

A

hypotension
drowsiness
fatigue

23
Q

latanoprost MOA

A

increase outflow through uveoscleral pathway

bind FP receptors (relax ciliary muscle)

24
Q

latanoprost uses

A

glaucoma

increase diameter of eyelashes

25
Q

ADE latanoprost

A

well tolerated

darkening pigment of iris

26
Q

Pheochromocytoma

A

tumor of adrenal medulla that secretes catecholamines

27
Q

symptoms of pheochromocytoma

A

severe HTN
HA
palpitations
sweating

28
Q

What are used for pheochromocytoma until surgery?

A

alpha receptor antagonists

29
Q

Phentolamine

A

competitive antagonist
reversible blockade
short DOA

30
Q

Phenoxybenzamine

A

covalent binding
irreversible blockade
long DOA

31
Q

What does phentolamine do to curve with BP and log dose NE?

A

shift curve right

32
Q

What does phenoxybenazmine do to curve with BP and log dose NE?

A

decrease max response

33
Q

Phentolamine/phenoxybenzamine effects

A 
attenuate vasoconstriciton (decrease MAP)
increase NE release
34
Q

phenoxybenzamine use

A

long term management (1-3 weeks)

prior to surgery for pheo-related HTN

35
Q

phentolamine use

A

rapid reverse of dental anesthesia

short term management for pheo-related HTN

36
Q

ADE of phentomlamine/phenoxybenzamie

A
  • orthostatic hypotension

- reflex tachycardia

37
Q

overdose of phentolamine/phenoxybenzamine

A

treat with NE (not Epi)

**NE dose not stimulate vascular B2 receptors

38
Q

prevent orthostatic hypotension with phentolamine/phenoxybenzamine drugs

A

BB may be given, but admin alone to pheo patients

39
Q

Modafinil MOA

A

CNS psychostimulant

unclear

40
Q

How does modafinil differ from amphetamine?

A
  • differ in structure, neurochemical profile, behavioral effects
41
Q

Where does modafinil bind?

A

NE and DA transporters

- block reuptake

42
Q

What can modafinil activate?

A

orexin neurons: hypocretin (promote wakefullness)

43
Q

FDA use for modafinil

A

narcolepsy
shift work sleep disorder
sleep apnea

44
Q

Off label use for modafinil

A

ADHD
fatigue from MS and PD
cognitive enhancement

45
Q

Military use for modafinil

A

alternative to amphetamine for prolonged combat missions

46
Q

T/F modafinil has same abuse potential as amphetamine

A

less

47
Q

ADE for modafinil

A 
hypersensitivity reactions (SJS)
dose reduction necessary with hepatic dysfunction
48
Q

What receptors do you want to block to increase outflow?

A

stimulate M3

49
Q

What receptors do you want to block to decrease aqueous humor?

A

block B2

Stimulate a1

Pharmacology Exam 4 (7 decks)

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