Neuro Drugs (Opthalmic Agents)

Question 1

Cholinergics - Direct Acting - Pilocar, Ocusert, Miostat, Miochol-E

Cholinergics - Indirect Acting - Phospholine Iodine

Answer 1

Uses: reduce intra-ocular pressure, glaucoma, ocular surgery, and convergent strabismus. Adverse = local & limited to eye - blurred vision, drug induced myopia, local irritation, eye or brow pain, accommodative spasms.

Question 2

Sympathomimetics - Alphagan

Answer 2

Uses: reduce intra-ocular pressure, glaucoma, ocular surgery, tx of ocular HTN. Adverse = local & limited to eye - burning, eye pain, tearing, blurred vision, conjunctivitis. Rare = tachycardia, HTN, HA & light-headedness

Question 3

Beta Adrenergic Blockers - Betoptic, Timolol

Answer 3

Uses: reduce intra-ocular pressure, tx glaucoma, ocular HTN. may be used in combo w/ mitotic for glaucoma & emergency tx of acute angle closure glaucoma. Adverse = limited to eye - eye discomfort, transient burning, blurred vision, photophobia, dry eyes, conjunctivitis.

Question 4

Carbonic Anhydrase Inhibitors - BrinZOLAMIDE, DoroZOLAMIDE, AcetaZOLAMIDE

Answer 4

Uses: reduce intra-ocular pressure, glaucoma, ocular HTN. Absorbed systemically, Adverse = blurred vision, ocular stinging, tearing, photophobia, conjunctivitis, dry eyes, lid runs. Monitor for postural hypotension, bradycardia, dyspnea & bronchospasm. Contraindicated = Sulfa allergy

Question 5

Prostaglandin Agonists - LantanoPROST, TravoPROST

Answer 5

Uses: reduce intra-ocular pressure, glaucoma, ocular HTN. Adverse = limited to eye - foreign body sensation, stinging, conjunctival hyperemia (bloodshot eyes), blurred vision, itching, burning, punctuate epithelial keratopathy (irreversible brown pigment spots)

Question 6

Osmotic Diuretics - Glycerin (Opthalgan) - Given PO 1 hr before surgery. Mannitol

Answer 6

Uses: reduce intra-ocular pressure, acute glaucoma and pre and post-op ocular surgery to reduce intra-ocular pressure. Glycerin used first followed by Mannitol if needed.

Considerations w/ Mannitol = F&E imbalance, HA, irritation, thrombosis at injection site, marked diuresis, dehydration. Rebound intra-cranial or intra-ocular pressure. May crystallize in low temps, always administer through filter. Contraindicated = severe pulmonary congestion, anuria, dehydration