Ocular Drugs Flashcards
Acetylcholine (Miochol) CLass
Direct Muscarinic
Acetylcholine (Miochol) MOA
Pupillary constriction
Acetylcholine (Miochol) Therapeutics
Used in cataract surgery to constrict pupil intraoperatively
Acetylcholine (Miochol) SE
“Bronchospasm, salivation, nausea, vomiting,
diarrhea, abdominal pain, tenesmus, lacrimation, sweating”
Pilocarpine HCl (Salagen) Class
Direct Muscarinic
Pilocarpine HCl (Salagen) MOA
Pupillary constriction, increased aqueous outflow
Pilocarpine HCL (Salagen) Therapeutics
Treatment of glaucoma (both open angle and acute closed angle); used less today due to side effects
Pilocarpine HCl (Salagen) SE
- Decreased vision when patient has cataracts due to miosis and headache
- “Bronchospasm, salivation, nausea, vomiting,
diarrhea, abdominal pain, tenesmus, lacrimation, sweating”
Pilocarpine HCl (Salagen) Misc
Requires frequent dosage QID
Carbachol Class
Direct muscarinic
Carbachol MOA
Pupillary constriction, increased aqueous outflow
Carbachol Therapeutics
Treatment of glaucoma; used less today due to topical side effects
Carbachol SE
- Decreased vision due to miosis and headache
- “Bronchospasm, salivation, nausea, vomiting,
diarrhea, abdominal pain, tenesmus, lacrimation, sweating”
Atropine Class
Antimuscarinic
Atropine MOA
Pupillary dilatation; paralysis of ciliary body
Atropine Therapeutics
Improve discomfort during active eye inflammation (ueveitis)
Atropine SE
“Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”
Atropine Misc
Very long acting so not used unless severe inflammation
Scopolamine Class
Antimuscarinic
Scopolamine MOA
Pupillary dilatation; paralysis of ciliary body
Scopolamine Therapeutics
Improve discomfort during active eye inflammation (ueveitis)
Scopolamine SE
“Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”
Tropicamide (Mydriacyl) Class
Antimuscarinic
Tropicamide (Mydriacyl) MOA
Pupillary dilatation; paralysis of ciliary body
Tropicamide (Mydriacyl) Therapeutics
Most commonly used cycloplegia for eye exams
Tropicamide (Mydriacyl) SE
“Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”
Edrophonium (Enlon) Class
Nm agonist
Edrophonium (Enlon) MOA
Destroys acetylcholinesterase
Edrophonium (Enlon) Therapeutics
Diagnose myasthenia gravis
Dipivefrin HCl (Propine) Class
Direct adrenergic
Dipivefrin HCl (Propine) MOA
Prodrug of epinpehrine
Dipivefrin HCl (Propine) Therapeutics
Treatment of glaucoma
Hydroxyamphetamine (Paredrine) Class
Indirect adrenergic
Hydroxyamphetamine (Paredrine) MOA
Release NE
Hydroxyamphetamine (Paredrine) Therapeutics
Separates 1st and 2nd from 3rd order neuron dysfunction in Horner’s syndrome; positive dilation means 1st or 2nd order, an ominous sign
Cocaine Class
Indirect adrenergic
Cocaine MOA
Prevent reuptake of NE
Cocaine Therapeutics
Use initially to confirm diagnosis of Horner’s Syndrome
Apraclonidine (Iopidine) Class
Direct alpha agonist
Apraclonidine (Iopidine) MOA
Amino derivative of clonidine; does not cross blood-brain barrier –> minimal effect on systemic blood pressure
Apraclonidine (Iopidine) Therapeutics
Treatment of open angle glaucoma
Brimondine tartrate (Alphagan) Class
Direct alpha 2 agonist
Brimondine tartrate (Alphagan) MOA
Suppresses aqueous humor production through action of cAMP in non-pigmented ciliary epithelium
Brimondine tartrate (Alphagan) Therapeutics
Primary agent for treatment of glaucoma
Brimondine tartrate (Alphagen) Misc
May cause follicular conjunctivitis; use with MAOi can cause fatigue/drowsiness
Dapiprazole Class
Alpha Antagonist
Dapiprazole MOA
Blocks alpha-adrenergic receptors in smooth dilator muscle of iris
Dapiprazole Therapeutics
Reverses tropicamide, phenylephrine
Dapiprazole Misc
Not currently available
Timolol (Timoptic) Class
Beta blocker
Timolol (Timoptic) MOA
Reduce intraocular pressure by reducing aqueous production at the ciliary process
Timolol (Timoptic) Therapeutics
Second line treatment of glaucoma
Timolol (timoptic) SE
“Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
Timolol (Timoptic) Misc
Contraindicated in CHF, asthma; bradycardia over time may produce tachyphylaxis
Levobunolol (Betagan) Class
Beta blocker
Levobunolol (Betagan) MOA
Reduce intraocular pressure by reducing aqueous production at the ciliary process
Levobunolol (Betagan) Therapeutics
Second line treatment of glaucoma
Levobunolol (Betagan) SE
“Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
Latanoprast (Xalatan) Class
Prostaglandin analog
Latanoprast (Xalatan) MOA
Increase uveoscleral outflow
Latanoprast (Xalatan) Therapeutics
Primary agent for treatment of glaucoma
Latanoprast (Xalatan) SE
Eyelash growth, change in iris color, intraocular inflammation
Latanoprast (Xalatan) Misc
May cause cystoid macular edema in cataract surgery and activate herpes
Travoprost (Travatan) Class
Prostaglandin analog
Travoprost (Travatan) MOA
INcrease uveoscleral outflow
Travoprost (Travatan) Therapeutics
Second line treatment of glaucoma
Travoprost (Travatan) SE
Eyelash growth, change in iris color
Travoprost (Travatan) MIsc
May cause cystoid macular edema in cataract surgery; more effective in African Americans
Bimatoprost (Lumigan) Class
Prostaglandin Analog
Bimatoprost (Lumigan) MOA
Increase uveoscleral outflow
Bimatoprost (Lumigan) Therapeutics
Primary agent for treatment of glaucoma
Bimatoprost (Lumigan) SE
Eyelash growth, change in iris color
Bimatoprost (Lumigan) Misc
May cause cystoid macular edema in cataract surgery and activate herpes
Dorzolamide HCl (Trusopt) Class
Carbonic Anhydrase
Dorzolamide HCl (Trusopt) MOA
Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump
Dorzolamide HCl (Trusopt) Therapeutics
Second line glaucoma therapy
Dorzolamide HCl (Trusopt) SE
Red eyes, lid allergies
Dorzolamide HCl (Trusopt) MIsc
Contraindicated in sulfonamide allergies
Acetazolamide (Diamox) CLass
Carbonic anhydrase
Acetazolamide (Diamox) MOA
Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump
Acetazolamide (Diamox) Therapeutics
Oral agent used for advanced glaucoma and with cataract surgery
Brinzolamide (Azopt) Class
Carbonic Anhydrase
Brinzolamide (Azopt) MOA
Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump
Brinzolamide (Azopt) Therapeutics
Second line glaucoma therapy
Brinzolamide (Azopt) SE
Red eyes, lid allergies
Betaxolol (Betoptic) Class
Beta 1 blocker
Betaxolol (Betoptic) MOA
Reduce intraocular pressure by reducing aqueous production at the ciliary process
Betaxolol (Betoptic) Therapeutics
Reduce intraocular pressure by reducing aqueous production at the ciliary process