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General Ocular Pharmacology > Mydriatics > Flashcards

Mydriatics Flashcards

1
Q

What are mydriatic drugs used for ?

A

Induce Pupil dilation

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2
Q

What is function of pupil?

A

regulate amount of light entering the eye and reaching retina

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3
Q

List purposes of using mydriatic drugs

A
  • obtain better view of fundus
  • therapeutic use in anterior uveitis - breaking posterior synechia
  • get iris out of way in surgical procedure
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4
Q

List indications for using mydriatic drugs

A
  • ocular dysfunction - reducation in VA , doubt about the cause
  • stereoscopic view required
  • Pts at risk of ocluar disease , RD in high myopes
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5
Q

What sx may a pt present with that would indicate you would need to do a dilated fundus exam

A

flashing light and increased floaters

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6
Q

Advantages of optoms using mydriatic drugs include

A
  • Large FOV
  • 3d view of retina
  • peripheral exam of retina
  • peripheral exam of lens and vitreous
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7
Q

explain the pharmacological methods of mydriasis

A
  • blockage of parasymtphamic branch of ANS
  • stimulate sympathetic branch of ans
  • combination of antimuscarinic and sympathomimetic in eye
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8
Q

List pre dilation checks that should be carried out in a pt

A 
Measure ...
IOP
AC angles 
VA 
pupil responses 
previous adverse/allergy to drug 
4d test
other contraindications - IRIS FIXATED IOL
preganancy ?
discuss tasks that need to be avoided
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9
Q

List post dilation checks …

A 
IOP 
AC angles 
VA 
pupil response 
Given written material to pt
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10
Q

contraindications of using mydriatic drugs

A
  • previous allergic reaction
  • narrow AC angles
  • iris fixated IOL
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11
Q

What should be discussed with your pt when using a mydriatic drug?

A 
why u are putting drops in 
effect of drug 
how long effect will last 
tasks that should be avoided 
possible side effect 
what do to inacse of ADR
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12
Q

what is the key risk you should be mindful of when using a mydriatic drug on a pt

A

acute angle closure glaucoma

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13
Q

sx of acute angle closure glaucoma …

A

Headache
haloes around lights
nausea
ocular pain

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14
Q

At pt at risk of angle closure will have a van hericks ratio of

A

1.0.25 or less

Grade 2

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15
Q

How would you know if a patient is at risk of angle closure galucoma

A

check IOP post dilation and increase in 5mmHg unilateral - treat with suspicion

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16
Q

What mydriatic drugs are available to optoms ?

A

Tropicamide

Phenylephrine hydrochloride

17
Q

What concentration is tropicamide avail in

A

0.5 and 1%

18
Q

What is the legal classification of tropicamide

A

POM

19
Q

What concentration in Phenylephrine hydrochloride in

A

2.5 and 10%

20
Q

Legal classification of phenylephrine hydrochloride is

A

P

21
Q

How does tropicamide work in the eye

A

antimuscarinic agent
competitive antagonist for muscarinic receptors
prevents acetylcholine binding - prevents contraction of sphincter muscle - unopposed action of dilator muscle = causes dilation

22
Q

Tropicamide drug type :

A

Mydriatic and cycloplegic

23
Q

Tropicamide Onset

A

15-20mins

24
Q

Recovery of Tropicamide

A

6-8 hours

25
Q

After how long does the dilation begin to wear of off tropicamide

A

after 2H

26
Q

In which situation would u use the conc available of tropicamide

A

0.5% - commonly used in all pts - good mydriases and minimal cycloplegia
1% - pts with high melanin pigmentation in iris

27
Q

Reversal of tropicamide can be done with

A

2% Pilocarpine - stimulates PNS
not avail to optoms
risk of psuedomyopia

28
Q

Phenylephrine hydrochloride works by

A

stimulating Sympathetic branch
- sympathomimetic drug
acts directly on a1 adrenoreceptors , stimulates the radial muscles of iris = causes dilation

29
Q

what effects does PH have on the eye

A
  • blanching of conj blood vessels - whiter due to narrowing of vessels
  • increased palpebral aperture due to stimulation of mullers muscle
  • pupil dilation - asymmetric ?
30
Q

State pupil reflex of when using Tropicamide and PH on eye

A

T- wont get reponse when light shone in eye , will stay dilated
PH - pupil will close up as sphincter muscle is unaffected

31
Q

onset of PH

A

approx 1 Hour

32
Q

Recovery of PH

A

3-4 Hours

33
Q

reversal of PH

A

Thymoxine
not avail - blocks SNS
antagonist

34
Q

List contraindication for USE OF PH

A

8

35
Q

Indication for using phenylephrine hydrochloride

A

fundus photogrpahy
use in isolation when moderate dilation req
sector dilation

36
Q

state other uncommon mydriatics

A

cyclopentolate hydrochloride ‘
cocaine
hydroxy amphetamine

37
Q

cocaine was historically used to investigate

A

horners syndrome

38
Q

onset of recovery of cocaine and hydroxyamphetamine

A

20-40 mins , last 6 hours

45 mins , lasts 3-6 hours

General Ocular Pharmacology (6 decks)

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