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Pharmacology > ! Neuro Eye Pharm > Flashcards

! Neuro Eye Pharm Flashcards

1
Q

B blocking drugs

A 
Betaxolol
Timolol
Metripranolol
Levobunonol
Carteolol
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2
Q

A2 adrenergic agonists

A

Apraclondine

Brimonidine

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3
Q

Prostagladin analogs

A

Latanoprost
Bimatoprost
Travoprost

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4
Q

Carbonic anhydrase inhibitors

A

Topical-brinzolamide, dorzolamide

Systemic-acetazolamide, methazolamide

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5
Q

Muscarinicagonists

A

Carbachol

Pilocarpine

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6
Q

Inhibitors of cholinesterase

A

Demecarium

Echothiophate

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7
Q

Iris circular muscle

A

Constricts pupil to cause miosis

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8
Q

Iris radial muscle

A

Dilated pupil to cause mydriasis

Effect is due to activation of a1 adrenergic receptors

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9
Q

Ciliary muscle

A

Causes accommodation of the eye to near vision
Opens up trabecular meshwork, improves outflow of aqueous humor into the canal of s helm, decreasing intraocular pressure

M3 receptors contract the muscle

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10
Q

Ciliary epithelium

A

Produces (secretes) aqueous humor

B receptor activation increases humor production

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11
Q

Ciliary body

A

Secretes aqueous humor

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12
Q

How does aqueous humor flow

A

Into space in front of iris through trabecular meshwork and exits via canal of schlemm

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13
Q

Blocking b adrenoreceptors associated with ciliary epithelium

A

Decreases secretion. Of aqueous humor

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14
Q

Blood vessels

A

In sclera arealso under autonomic control and influence aqueous drainag

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15
Q

B receptors and aqueous humor

A

Increase

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16
Q

A2 receptors and aqueous humor

A

Decrease

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17
Q

Carbonic anhydrase

A

Aqueous humor?

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18
Q

Contraction of ciliary muscle and aqueous humor 9muscarinic)

A

Improved outflow

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19
Q

Contraction of iris circulat muscle, (muscarinic)

A

Miosis an improved outflow

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20
Q

____ improves uveoscleral, or unconventional outflow

A

Prostagladin F2a

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21
Q

Contraction of iris radial muscle (a1), mydriasis

A

Decreased outflow (conventional outflow)

22
Q

Glaucoma

A

Group of ocular disorders that lead to an optic neuropathy associated with loss of visual sensitivity and field

23
Q

Whites or African Americans get glaucoma more

A

Blacks

24
Q

Open or closed angle glaucoma more common

A

Open

25
Q

When should a patient be treated for glaucoma

A

Increased IOP and optic disc changes and/or visual field defects

26
Q

Goal of glaucoma treatment

A

Reduce IOP by 30% want is less than 21 mmHg

27
Q

If two glaucoma meds are given. How far apart should administration be

A

Ten minutes

28
Q

Does initial response to therapy dictate long term

A

No

29
Q

If agents are to be changed

A

One day overlap

30
Q

First line agents open angle glaucoma

A

Prostagladin analogues
B blockers-timolol
Brimonidine

31
Q

Second line therapy open angle glaucoma

A

Pilocarpine
Apraclonidine
Topical carbonic anhydrase inhibitors

32
Q

Last line therapy open angle glaucoma

A

Carbachol
Inhibitors of cholinesterase
Oral carbonic anhydrase

33
Q

Why are B blockers used

A

Convince of dosing few side effects

34
Q

Why is timolol the preferred beta blockers

A

Lacks local anesthetic effects (propranolol local anesthetic properties0
Generically available
Full antagonist
As effective as pilocarpine

35
Q

MOAtimolol

A

Reducing the production of aqueous humor by the ciliary body by blocking B receptors

36
Q

Adverse local effects of beta blockers

A 
Stinging
Dry eyes
Blurred vision 
Blepharitis, keratiti, conjunctivitis
-could be due to other things in the formulation and not the B blockers
37
Q

Systemic adverse effects of b blockers

A

Can get systemic absorption
Heart-negative inotropy effect, bradycardia
Airway-bronchospasm
Hyperlipidemia
Exacerbation of hypoglycemia
May interact with orally given verapamil-increase risk of cardiac depression and heart block
Use with caution in patients with bradycardia, AV block heart failure, atherosclerosis, diabetes,

38
Q

Prostagladin analogues

A

Latanoprost
Bimatoprost
Travoprost

39
Q

Which prostagladin is most effective at lower IOP

A

Bimatoprost

40
Q

Prostagladin analogues for IOP

A

More effective than B blockers
Given once daily at nighttime (1 drop)
Systemic side effects are not significant

41
Q

Local side effects prostagladin analog

A

Corneal erosions
Conjunctival hypermedia
Iris hyperpigmentation(several months of therapy and is irreversible)
Hypertrichosis, hyperpigmentation around eye lashes and eyelids are reversible upon discontinuation of therapy

42
Q

A2 agonists

A

Brimonidine-first line agent

Apraclonidine-frequent allergic reactions, development of tachyphylaxis

43
Q

MOA a2 agonists

A

Decrease the rate of aqueous humor production

44
Q

Adverse effects a2 agonists

A

Systemic-dizzy, Antigua, dry mouth, bradycardia, reduced blood pressure

45
Q

Locals adverse effect a2 agonists

A

Allergic reaction (eyelid edema, itching, hypermedia)

46
Q

How treat open angle glaucoma

A
  1. B blocker
  2. If intolerant to b blocker, use class alternative
  3. If contraindications to b blockers, switch to brimonidine or prostagladin
  4. If intolerance to prostagladin, use class alternative
  5. If contraindications to all first class agents,use topical carbonic anhydrase inhibitors (2nd line)
    - if monotherapy fails, use a combo
    - if intolerance or inadequate response to the combination therapy, use laser or a surgical procedure
47
Q

Goal of treating closed angle glaucoma

A

Rapid reduction of IOP

48
Q

Acute treat closed angle

A

Use systemic osmotic diuretics in preparation for surgery (IV mannitol)

49
Q

Pilocarpine

A

Drug of choice for closed angle before surgery. It inducedmiosis

50
Q

Surgical or laser iridectomy for closed angle

A

Produce a hole in the iris facilitating the humor outflow

51
Q

What drugs are contraindicated in open angle

A

Glucocorticoids
Fenoldopam
Topical anti muscarinic drugs

52
Q

Drugs contraindicated in closed angle (angle closure may be triggered by any drug that causes mydriasis)

A

Antimuscarinic drugs (topical, systemic)
Drugs with alpha adrenomimetics activity (topical)
Tricyclic antidepressants and serotonin-NE reuptake inhibitors (because of their potent antimuscarinic action)

Pharmacology (52 decks)

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