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BOARDS!! > Glaucoma and opioid pharm FA > Flashcards

Glaucoma and opioid pharm FA Flashcards

1
Q

how do glaucoma drugs work?

A

decrease intraoccular pressure via decrease amt of aqueous humor (inhib synth/secretion or increase drainage)

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2
Q

2 alpha-agonist glaucoma drugs

A
  1. epinephrine

2. brimonidine (alpha-2)

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3
Q

epinephrine (alpha agonist) for glaucoma uses what mech?

A

decrease aqueous humor synthesis via vasoconstriction

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4
Q

Brimonidine (alpha-2) for glaucoma uses what mech?

A

decreased aqueous humor synthesis

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5
Q

Epinephrine, used for glaucoma, has what side effects (1) and what contraindication?

A

mydriasis (a dilation of the pupil); do not used in closed angle glaucoma!

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6
Q

when should you not used epinephrine for glaucoma?

A

Do not use in closed angle glaucoma!

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7
Q

side effects of Brimonidine (alpha-2), used for glaucoma (5)?

A
  1. Blurry vision
  2. ocular hyperemia
  3. foreign body sensation
  4. ocular allergic reactions
  5. ocular pruritus
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8
Q

What 3 beta blockers are for glaucoma?

A
  1. timolol
  2. betaxolol
  3. carteolol
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9
Q

what is the mechanism of the 3 beta blockers used to treat glaucoma (timolol, betaxolol, or carteolol)?

A

decrease aqueous humor synthesis

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10
Q

what are the side effects of the 3 beta blockers used to treat glaucoma (timolol, betaxolol, or carteolol)?

A

no pupillary or vision changes

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11
Q

what diuretic is used to treat glaucoma?

A

acetazolamide

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12
Q

mech of acetazlamide?

A

decrease aqueous humor synthesis via inhibition of carbonic anhydrase

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13
Q

acetazolamide is what type of drug? what does it treat?

A

diuretic used to treat glaucoma

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14
Q

timolol is what type of drug? what does it treat?

A

beta blocker, glaucoma

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15
Q

betaxolol is what type of drug? what does it treat?

A

beta blocker, glaucoma

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16
Q

carteolol is what type of drug? what does it treat?

A

beta blocker, glaucoma

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17
Q

cholinomimetics used to treat direct glaucoma? (2)

A
  1. pilocarpine

2. carbachol

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18
Q

pilocarpine is what kind of drug? it treats what?

A

cholinomimetic - treats direct glaucoma

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19
Q

carbachol

A

cholinomimetic - treats direct glaucoma

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20
Q

mech of pilocarpine in direct glaucoma

A

increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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21
Q

mech of carbachol in direct glaucoma

A

increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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22
Q

2 cholinomimetics used for indirect glaucoma

A
  1. physostigmine

2. echothiophate

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23
Q

physostigmine is what kind of drug? it treats what?

A

cholinomimetics, indirect glaucoma

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24
Q

echothioophate is what kind of drug? it treats what?

A

cholinomimetics, indirect glaucoma

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25
Q

what is the mech of physostigmine in indirect glaucoma

A

increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

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26
Q

what is the mech of echothioophate in indirect glaucoma

A

increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

27
Q

which drug for glaucoma should you use in emergencies?

A

pilocarpine: very effective at opening meshwork into canal of Schlemm

28
Q

how does pilocarpine work in emergencies?

A

very effective at opening meshwork into canal of Schlemm

29
Q

what prostaglandin drug is used for glaucoma?

A

Latanoprost (PGF-2alpha)

30
Q

Latanoprost (PGF-2alpha) is what type of drug for what?

A

prostaglandin, to txt glaucoma

31
Q

what is the mech of latanoprost (PGF-2alpha) used for glaucoma?

A

increase outflow of acqueous humor

32
Q

side effects of latanoprost, a prostaglandin used to txt glaucoma?

A

darkens the color of the eye

33
Q

8 opioid analgesics

A
  1. morphine
  2. fentanyl
  3. codeine
  4. heroin
  5. methadone
  6. meperidine
  7. dextromethorphan
  8. diphenoxylate
34
Q

morphine is what type of drug?

A

opioid analgesic

35
Q

fentanyl is what type of drug?

A

opioid analgesic

36
Q

codeine is what type of drug?

A

opioid analgesic

37
Q

heroin is what type of drug?

A

opioid analgesic

38
Q

methadone is what type of drug?

A

opioid analgesic

39
Q

meperidine is what type of drug?

A

opioid analgesic

40
Q

dextromethorphan is what type of drug?

A

opioid analgesic

41
Q

diphenoxylate is what type of drug?

A

opioid analgesic

42
Q

opioid analgesic mech:

A

agonist at opioid receptors to modulate synaptic transmission– open K+ channels, close Ca2+ channels —-> decrease synaptic transmission —> inhib release of ACh, NE, 5-HT, glutamate, substance P

43
Q

what are the 5 neurotransmitters are inhibited by opioids?

A
  1. ACh
  2. NE
  3. 5-HT
  4. glutamate
  5. substance P
44
Q

3 opioid receptors

A
  1. mu= morphine
  2. delta = enkephalin
  3. kappa = dynorphin
45
Q

what are opioid analgesics used for (5 things)?

A
  1. pain
  2. cough suppression (dextromethorphan)
  3. diarrhea (loperamide and diphenoxylate)
  4. acute pulmonary edema
  5. maintenance programs for addicts (methadone)
46
Q

which opioid is particularly helpful for cough suppression?

A

dextromethorphan

47
Q

which 2 opioids are particularly helpful for diarrhea?

A

loperamide and diphenoxylate

48
Q

which opioid analgesic is particularly helpful for maintenance programs for addicts?

A

methadone

49
Q

what are the effects of opioid analgesic toxicity? (5)

A
  1. addiction
  2. respiratory depression
  3. constipation
  4. miosis (pinpoint pupils)
  5. additive CNS depression with other drugs
50
Q

does tolerance develop to miosis and constipation related to opioid analgesics?

A

nope

51
Q

opioid toxicity is treated with (2)

A

naloxone and naltrexone (opioid receptor antagonists)

52
Q

naloxone is an

A

opioid receptor antagonist

53
Q

naltrexone is an

A

opioid receptor antagonist

54
Q

Mech of Butorphanol?

A

Mu-opioid receptor partial agonist and kappa-opioid receptor agonist —-> produces analgesia

55
Q

what does butorphanol do?

A

produces analgesia

56
Q

what is butophanol used for clinically?

A

severe pain (migraine, labor, etc)

57
Q

what is the good thing about using butophanol for severe pain?

A

causes less respiratory depression than full opioid agonists

58
Q

toxicity of butorphanol?

A

can cause opioid withdrawal symptoms if pt is also taking full opioid agonist (competition for opioid receptors).

59
Q

can naloxone be used for an overdose with Butorphanol?

A

overdose not easily reversed with naloxone

- butorphanol is a mu-opioid receptor partial agonist and kappa-opioid receptor agonist

60
Q

tramadol mech?

A

very weak opioid agonist. Also inhibits serotonin and NE reuptake (works on multiple neurotransmitter).

“tram it all” with tramadol

61
Q

tramadol is used for…

A

chronic pain

62
Q

which opioid specifically decreases the seizure threshold (so seizures are more common)?

A

tramadol

63
Q

what are the side effects/toxicities of tramadol (6)?

A
  1. decrease seizure threshold (increase seizure risk)
  2. similar to opioids
    (a. addiction
    b. respiratory depression
    c. constipation
    d. miosis (pinpoint pupils)
    e. additive CNS depression with other drugs)

BOARDS!! (23 decks)

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