Medications Flashcards
prodrugs
latanoprost and travoprost
B2 selective
betaxolol
B-blockers mechanism
decrease cAMP,
B-blockers side effects
worsening depression and myasthenia, increase serum lipids, masks hypoglycemia
alpha-adrenergic mechanism
aqueous suppressant and lowers EVP
alpha-adrenergic selective
brimonidine more alpha2 selective than apraclonidine
alpha-adrenergic side effects
dry mouth, lethargy, blepharodermatitis, follicular conjunctivitis, MAO contraindicated
carbonic anhydrase inhibitors - side effects
bitter taste, worsening corneal edema, metabolic acidosis,
avoid oral diamox in patients using
thiazide and loop diuretics
miotics - mechanism
contracting the longitudinal ciliary muscle, pulls scleral spur, tightens TM, increases outflow
miotics - side effects
brow ache, RD, cataract, iris cysts in children, epiphora, increased bleeding during surgery, lacrimal duct stenosis, worsening pupillary block
pregnancy - drugs which categories and actions
all category C except brimonidine (B). latanoprost - uterine contractions. dorzolamide - teratogenic.
breastfeeding - which contraindicated
brimonidine (CNS depression)
not reversible side effect of latanoprost
increase in iris pigmentation
medications that may induce angle closure
adrenergic (sympathomimetic) or anticholinergic (parasympatholytic): allergic and cold remedies, antidepressants, urological medications
Collaborative normal-tension glaucoma study
lowering IOP by 30% reduces visual field progression 35-12%
Netarsudil - most common side effect
conjunctival hyperemia without irritation
Advantage of using combination of timolol and brimonidine (Combigan)
less conjunctival hyperemia
Mannitol - dose
1-2 g/kg body weight over 30-45 minutes = 250ml bag of 20% mannitol given over 30 mins
Which med is contraindicated in infants <3yo and why
brimonidine –> CNS depression
Beta-blockers and serum lipids
increase LDL and decrease HDL
Iris darkening - mechanism
Increased number of melanosomes
Microspherophakia - what drops and mechanism of treatment
dilating drops; they flattten the lens and pull it back more posteriorly in the capsular bag
Nonselective adrenergic agonists - examples and when contraindicated
Epinephrine, dipivefrin. CME, posterior capsule rupture.
Nonselective adrenergic agonists - examples and side effects
Epinephrine, dipivefrin. adrenochrome deposits, staining of soft CL, hypertension, tachycardia, headache
Beta-blockers which has intrinsic sympathomimetic activity
carteolol (less cardiac effect)
What percentage of cliliary epithelial carbonic anhydrase needs to be ingibited to decrease aqueous production sufficiently to reduce IOP
90%
Which drug reduces rebleeding rates after traumatic hyphema?
aminocaproic acid
Angle closure - Which medications is contraidicated and why
apraclonidine. pupil dilation and iris ischemia
Używki - decrease IOP
alcohol, cannabis, heroin
Używki - increase IOP
LSD, ketamine
alcohol - increase or decrease IOP
decrease
cannabis - increase or decrease IOP
decrease
heroin - increase or decrease IOP
decrease
LSD - increase or decrease IOP
increase
ketamine - increase or decrease IOP
increase
Best locally tolerated topical IOP-lowering medications
beta-blockers
Which drops does NOT come in a BAK-free form
brinzolamide
Topiramate angle-closure - treatment
cyclopentolate 1%
anhydrase inhibitors - which more irritation, which blurring
irritation - dorzolamide; brinzolamide - blurring
latanoprostene bunod 0.024% - mechanism of action
conventional and nonconventional routes
Prostaglandines - when contraindicated
when a history of herpetic keratitis (risk of reactivation)
“indirect” parasympathomimetic medication
echothiophate iodide
Betaxolol - selective which receptor? Good for whom?
beta 2. for asthmatics
Goniolenses which can be used for dynamic gonio
Zeiss, Posner, Sussman
Goniolenses which cannot be used for dynamic gonio
Goldmann
Which drug has the highest incidence of periocular blepharitis/dermatitis
apraclonidine 40%
prolong the paralyzing effect of depolarizing medications like succinylcholine
echothiophate iodide
methazolamide - when better than acetazolamide
kidney problems (metabolised by liver), produces less acidosis
Which general anesthetic does not affect IOP
chloral hydrate. ketamine increases. other lower