Ocular Drugs Flashcards
Peri-ocular injections
less common, reach behind iris-lens diaphragm, bypasses conjunctiva and corneal epithelium which is good for drugs with low lipid solubility
Intraocular injection types
intracameral or intravitreal, intravitreal anti-VEGF- macular degeneration, intrav steroid- macular edema, intrav antibiotics- endophthalmitis, intraocular acetylcholine- cataract surgery
Ophthalmic medication
Cholinergic agonists, sympathomimetics, BBs, carbonic anhydrous inhibitors, prostaglandin analogues, intraocular decongestants, anticholinergic agents, NSAIDs, corticosteroids, antihistamines, antiinfectives
Glaucoma
intraocular pressure> 30 mmHg, open is chronic and closed is severe and acute, goal is to prevent vision loss, multiple agents give at least 10 mins apart
Cholinergic agonists
pilocarpine, carbachol
Cholinergic agonist MOA
cause miosis by contraction of the iris sphincter muscle which increases aqueous humor flow through the trabecular meshwork by longitudinal cilliary muscle contraction, accommodation
Cholinergic clinical uses
miosis, glaucoma, usually second or third line
Cholinergic ADRs
HA from accomadative spasm, retinal detachment (rare), systemic cholinergic effects are rare
Anticholinergic agents
atropine, cyclopentolate, phenylephrine (Cyclomydril), Tropicamide (Midriacyl)
Anticholinergic agents MOA
causes mydriasis by paralyzing the sphincter muscle and also causes cycloplegia by paralyzing the cilliary muscle
Anticholinergic clinical uses
eye exams where dilation is needed to facilitate exam of retina, fundoscopy, cycloplegic refraction, sublingual use of atropine drops for terminal secretions
Anticholinergic agents ADRs
blurred vision, nausea, vomiting, pallor, constipation, urinary retention
Sympathomimetics
epinephrine, brimonidine (Alphagan), TID drug
Sympathomimetics MOA
a2 agonist that reduces IOP by reducing the production of aqueous humor and improving drainage
Sympathomimetics Clinical use
open angle glaucoma, ocular HTN, can be used to prevent IOP post op
Sympathomimetcs ADRs
fatigue, conjunctival blanching, mydriasis, VERY well tolerated
Beta blockers
Timolol (Timoptic), Levobunolol (Betagan), Betaxolol (Betoptic)
Beta blockers MOA
reduce intraocular pressure by blocking B2 in ciliary epithelium, reduces production of aqueous humor, given BID except Timoptic