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Neuro II Exam I - Pharm > Neuro: Drugs for Glaucoma > Flashcards

Neuro: Drugs for Glaucoma Flashcards

1
Q

suffix of all B-blockers

A

-lol

Timolol

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2
Q

How do B-blockers work for glaucoma?

A

They decrease production of aqueous humor by the ciliary epithelium

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3
Q

Suffix for the a2 agonists?

A

-nidine

Bromonidie is the main

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4
Q

How do the a2 agonists work for glaucoma?

A

Decrease production of Aqueous humor

and

Increase uveoscleral outflow through relaxation of ciliary muscle

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5
Q

Suffix for all prostaglandin analogs?

A

-oprost

bimatoprost is most effective

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6
Q

How do the prostaglandin analogs treat glaucoma?

A

Improve uveosceral, or unconventional, outflow

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7
Q

Suffix for the carbonic anhydrase inhibitors?

A

-amide

Brinzolamide and Dorzolamide are long term

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8
Q

How do the carbonic anhydrase inhibitors treat glaucoma?

A

they decrease production of AQ humor

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9
Q

What are the cholinergic agonists used in glaucoma and how do they treat?

A

Carbachol and pilocarpine

contract ciliary muscle and iris circular muscle-improved conventional (trabecular) outflow

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10
Q

What inhibitor of cholinesterase is used for glaucoma and how does it work for treatment?

A

Echothiophate

contract ciliary muscle and iris circular muscle-improved conventional (trabecular) outflow

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11
Q

What muscle constricts the pupil to cause miosis? What ANS control is it under?

A

Iris circular muscle

-M3 (Gq)

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12
Q

What muscle dilates the pupil to cause mydraisis? What ANS control is it under?

A

Iris radial muscle

-a1 (Gq)

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13
Q

What branch of ANS contracts the ciliary muscle to cause outflow of Aqueous humor?

A

M3

-induces accomadation for near vision

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14
Q

What branch of ANS increases aqueous humor production and what branch decreases?

A

B2 increases

a2 decreases

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15
Q

What role does a1 have on the eye?

A

contracts radial muscle=mydriasis

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16
Q

What role does a2 have on the eye?

A

relaxes ciliary muscle=increases outflow

decreases aqueous humor production

17
Q

Which drug categories reduce aqueous humor production? (3)

A

B blockers
a2 agonists
carbonic anhydrase inhibitors

18
Q

Which drug categories increase aqueous humor outflow? (4)

A

Prostaglandin analogs (1st line)
a2 adrenergic agonists
M3 cholinergic agonists
Indirect inhibitors of cholinesterase

19
Q

Which B-blocker is the one most chosen for glaucoma and why?

A

Timolol

-lacks lock anesthetic effect, has generic, and full antagonist

20
Q

Adverse effects of brimodine

A

headache, fatigue, dry mouth, and allergic rxn

21
Q

Which carbonic anhydrase inhibitors are for long term use and which are short term only?

A

Long term: topicals
-brinzolamide and dorzolamide

Short: systemic
-acetazolamide and methazolomide

22
Q

What drugs are the most effect at treating glaucoma?

A

Prostaglandins
-Brimatoprost**, latanoprost, and travoprost

More expensive though

23
Q

Which drugs can cause iris hyperpigmentation, hypertrichosis, and hyperpigmentation around the eyelashes?

A

Prostaglandin analgogs

Iris hyperpigmentation is irreversible

24
Q

Adverse effects of the cholinergic agonists (both direct and indirect)

A

Local

-headaches, miosis, eyelid twitching, myopia

25
Q

What technique is used by some people with glaucoma to increase the efficacy of the drugs?

A

the nasolacrimal duct occlusion technique

-apply pressure for about 3 minutes over the duct after eye drops are applied

26
Q

Which glaucoma is abrupt onset and extremely painful?

A

Closed angle glaucoma

27
Q

Treatment of closed angle glaucoma

A

“Throw the kitchen sink”.. Any combo of:

  • mannitol or glycerin
  • pilocarpine
  • B-blocker
  • a2 agonists
  • carbonic anhydrase inhibitor

before laser iridectomy

28
Q

Which drugs increase IOP in patients with open angle glaucoma?

A

glucocorticoids

topical antimuscarinics

29
Q

Which drugs may make closed angle glaucoma worse?

A

a1 agonsits
antimuscarinic drugs

Both cause mydraisis, which makes the pupil dilate and worsens closed angle glaucoma

Neuro II Exam I - Pharm (5 decks)

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