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OPHTHALMOLOGY > OCULAR DRUGS (Osmotic Agents, Muscarinic Agonist, Cholinergic drugs and Anticholinesterase, Sympathomimetic Agents & Muscarinic Antagonists) > Flashcards

OCULAR DRUGS (Osmotic Agents, Muscarinic Agonist, Cholinergic drugs and Anticholinesterase, Sympathomimetic Agents & Muscarinic Antagonists) Flashcards

1
Q

What is the pharmacokinetics of Mannitol?

A

IV, onset of action 30-60 minutes, duration of action 4-6 hours, distributes in extracellular fluid, t1/2 phase 0.11 ± 0.12 hrs, phase 2.2 ± 1.3 hrs, clearance 0.086 L/hr/kg.

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2
Q

What is the mechanism of action of Mannitol?

A

Osmotic diuretic that increases serum osmolality, expanding intravascular volume, reducing intraocular and intracranial pressure by drawing water out of tissues.

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3
Q

What are the clinical uses of Mannitol?

A

Acute closed-angle glaucoma, reduction of intracranial pressure.

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4
Q

What are the side effects of Mannitol?

A

Headache, nausea, vomiting, fluid overload (pulmonary edema, hypertension, water intoxication, CHF), electrolyte imbalance, dermal necrosis if solution extravasates.

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5
Q

What is the pharmacokinetics of Pilocarpine?

A

Topical drops 0.5%-6%, onset of action within minutes, peak effect 2 hrs, duration of action 8 hrs for ophthalmic solution, 24 hrs for ophthalmic gel.

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6
Q

What is the mechanism of action of Pilocarpine?

A

Direct cholinergic agonist acting at acetylcholine receptors to stimulate the ciliary muscle, causing miosis, increasing accommodation, and reducing intraocular pressure by increasing aqueous humor outflow.

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7
Q

What are the clinical uses of Pilocarpine?

A

Treatment of glaucoma, ocular hypertension.

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8
Q

What are the side effects of Pilocarpine?

A

Miosis, brow ache, induced myopia, corneal edema, retinal detachment, decreased vision, especially in patients with cataracts.

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9
Q

What is the pharmacokinetics of Acetylcholine?

A

Topical drops 1% solution.

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10
Q

What is the mechanism of action of Acetylcholine?

A

Stimulates muscarinic receptors causing miosis.

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11
Q

What are the clinical uses of Acetylcholine?

A

Induced miosis during surgery.

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12
Q

What are the side effects of Acetylcholine?

A

Corneal edema.

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13
Q

What is the pharmacokinetics of Echothiophate?

A

Topical drops 0.125% solution or gel, slow-release insert.

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14
Q

What is the mechanism of action of Echothiophate?

A

Anticholinesterase that reduces intraocular pressure by ciliary muscle contraction, opening of trabecular meshwork, increasing aqueous humor outflow.

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15
Q

What are the clinical uses of Echothiophate?

A

Treatment of glaucoma and accommodative esotropia.

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16
Q

What are the side effects of Echothiophate?

A

Muscle spasm, systemic effects, retinal detachment, miosis, cataract, pupillary block glaucoma, iris cysts, brow ache, punctal stenosis.

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17
Q

What is the pharmacokinetics of Phenylephrine?

A

Topical drops 0.12%, 0.25%, and 0.1% solution.

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18
Q

What is the mechanism of action of Phenylephrine?

A

α1-agonist that causes mydriasis and vasoconstriction, often added to OTC drops for whitening the sclera.

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19
Q

What are the clinical uses of Phenylephrine?

A

Mydriasis, vasoconstriction, scleral whitening.

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20
Q

What are the side effects of Phenylephrine?

A

Photosensitivity, hypersensitivity, rebound dilation, conjunctival hyperemia.

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21
Q

What is the pharmacokinetics of Naphazoline?

A

Topical drops 0.012%, 0.03%, 0.1% solution.

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22
Q

What is the mechanism of action of Naphazoline?

A

Stimulates conjunctival vascular adrenergic receptors, acting as a decongestant.

23
Q

What are the clinical uses of Naphazoline?

A

Decongestant for conjunctival blood vessels.

24
Q

What are the side effects of Naphazoline?

A

Photosensitivity, conjunctival hyperemia, hypersensitivity.

25
Q

What is the pharmacokinetics of Tetrahydrozoline?

A

Topical drops 0.05% solution.

26
Q

What is the mechanism of action of Tetrahydrozoline?

A

Stimulates conjunctival vascular adrenergic receptors, acting as a decongestant.

27
Q

What are the clinical uses of Tetrahydrozoline?

A

Decongestant for conjunctival blood vessels.

28
Q

What are the side effects of Tetrahydrozoline?

A

Photosensitivity, conjunctival hyperemia, hypersensitivity.

29
Q

What is the pharmacokinetics of Atropine?

A

Topical drops 0.5%, 1%, and 2% solution; 1% ointment.

30
Q

What is the mechanism of action of Atropine?

A

Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.

31
Q

What are the clinical uses of Atropine?

A

Cycloplegic retinoscopy, dilated funduscopic exam, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.

32
Q

What are the side effects of Atropine?

A

Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.

33
Q

What is the pharmacokinetics of Scopolamine?

A

Topical drops 0.25% solution, duration of action 3-7 days.

34
Q

What is the mechanism of action of Scopolamine?

A

Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.

35
Q

What are the clinical uses of Scopolamine?

A

Cycloplegic retinoscopy, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.

36
Q

What are the side effects of Scopolamine?

A

Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.

37
Q

What is the pharmacokinetics of Homatropine?

A

Topical drops 2% and 5% solution, duration of action 1-3 days.

38
Q

What is the mechanism of action of Homatropine?

A

Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.

39
Q

What are the clinical uses of Homatropine?

A

Cycloplegic retinoscopy, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.

40
Q

What are the side effects of Homatropine?

A

Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.

41
Q

What is the pharmacokinetics of Cyclopentolate?

A

Topical drops 0.5%, 1%, and 2% solution, duration of action 1 day.

42
Q

What is the mechanism of action of Cyclopentolate?

A

Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.

43
Q

What are the clinical uses of Cyclopentolate?

A

Good for corneal abrasions, retinal examination, and conditions where cycloplegia and mydriasis are desired.

44
Q

What are the side effects of Cyclopentolate?

A

Photosensitivity, blurred vision, risk of antimuscarinic poisoning if enters systemic circulation.

45
Q

What is the pharmacokinetics of Tropicamide?

A

Topical drops 0.5% and 1% solution, duration of action 1-6 hours.

46
Q

What is the mechanism of action of Tropicamide?

A

Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.

47
Q

What are the clinical uses of Tropicamide?

A

Useful for funduscopic examination.

48
Q

What are the side effects of Tropicamide?

A

Photosensitivity, blurred vision, headache, risk of antimuscarinic poisoning if enters systemic circulation.

49
Q

What is the mydriatic effect of Tropicamide?

A

1-3 hours duration, mild mydriatic effect (++).

50
Q

What is the cycloplegic effect of Tropicamide?

A

1-3 hours duration, mild cycloplegic effect (+).

51
Q

What is the mydriatic effect of Cyclopentolate?

A

12-24 hours duration, strong mydriatic effect (+++).

52
Q

What is the cycloplegic effect of Cyclopentolate?

A

12-24 hours duration, strong cycloplegic effect (+++).

53
Q

What is the mydriatic effect of Atropine?

A

168-240 hours duration, strong mydriatic effect (+++).

54
Q

What is the cycloplegic effect of Atropine?

A

168-240 hours duration, strong cycloplegic effect (+++).

OPHTHALMOLOGY (4 decks)

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