Medical Mgmt of GL

Question 1

How does topical BB decrease IOP?

Answer 1

Inhibits cAMP production of the ciliary epithelium

Question 2

Which BB is NOT nonselective?

Answer 2

Betaxolol (selective B1 antagonist)

Question 3

Which BB has intrinsic sympathomimetic activity, reducing the effect on CV and respiratory systems?

Answer 3

Carteolol

Question 4

Abrupt withdrawl of ocular BB can exacerbate symptoms of what?

Answer 4

hyperthyroidism

Question 5

What is the only INDIRECT acting agent ?

Answer 5

Echothiophate iodide

Question 6

What drug has both direct and indirect cholinergic actions ?

Answer 6

Carbachol

Question 7

What % of ciliary epithelial enzyme activity must be abolished to decrease aqueous production and lower IOP for CAIs?

Answer 7

90%

Question 8

Which CAI causes renal stones?

Answer 8

Acetazolamide - not metabolized and is excreted in urine.

Methazolamide metabolized by the liver

Question 9

What are 3 ocular alpha 1 effects?

Answer 9

1. vasoconstriction
2. pupillary dilation
3. eyelid retraciton

Question 10

What are 2 ocular alpha 2 effects?

Answer 10

1. IOP reduction

2. neuroprotection

Question 11

Give 2 examples of selective alpha 2 agonists?

Answer 11

1. apraclonidine

2. brimonidine (much greater than apraclonidine)

Question 12

How does apraclonidine work?

Answer 12

Prevents release of NE.

Decreases aqueous production as well as EPISCLERAL VENOUS PRESSURE and improves trabecular outflow

Question 13

How do PGA work?

Answer 13

1. Increases uveoscleral outflow

2. Increases trabecular outflow (ONLY Lumigan/Bimatoprost DOES BOTH)

Question 14

What is the only class B agent?

Answer 14

Brimonidine (all others are class C)

Question 15

How does Brimonidine work?

Answer 15

Decreases aqueous production and INCREASES UVEOSCLERAL OUTFLOW

Question 16

How does Pilo work?

Answer 16

Increases trabecular outflow

Question 17

Which BB is likely to cause uveitis?

Answer 17

metipranolol