OCULAR DRUGS (Osmotic Agents, Muscarinic Agonist, Cholinergic drugs and Anticholinesterase, Sympathomimetic Agents & Muscarinic Antagonists) Flashcards
What is the pharmacokinetics of Mannitol?
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.
What is the mechanism of action of Mannitol?
Osmotic diuretic that increases serum osmolality, expanding intravascular volume, reducing intraocular and intracranial pressure by drawing water out of tissues.
What are the clinical uses of Mannitol?
Acute closed-angle glaucoma, reduction of intracranial pressure.
What are the side effects of Mannitol?
Headache, nausea, vomiting, fluid overload (pulmonary edema, hypertension, water intoxication, CHF), electrolyte imbalance, dermal necrosis if solution extravasates.
What is the pharmacokinetics of Pilocarpine?
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.
What is the mechanism of action of Pilocarpine?
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.
What are the clinical uses of Pilocarpine?
Treatment of glaucoma, ocular hypertension.
What are the side effects of Pilocarpine?
Miosis, brow ache, induced myopia, corneal edema, retinal detachment, decreased vision, especially in patients with cataracts.
What is the pharmacokinetics of Acetylcholine?
Topical drops 1% solution.
What is the mechanism of action of Acetylcholine?
Stimulates muscarinic receptors causing miosis.
What are the clinical uses of Acetylcholine?
Induced miosis during surgery.
What are the side effects of Acetylcholine?
Corneal edema.
What is the pharmacokinetics of Echothiophate?
Topical drops 0.125% solution or gel, slow-release insert.
What is the mechanism of action of Echothiophate?
Anticholinesterase that reduces intraocular pressure by ciliary muscle contraction, opening of trabecular meshwork, increasing aqueous humor outflow.
What are the clinical uses of Echothiophate?
Treatment of glaucoma and accommodative esotropia.
What are the side effects of Echothiophate?
Muscle spasm, systemic effects, retinal detachment, miosis, cataract, pupillary block glaucoma, iris cysts, brow ache, punctal stenosis.
What is the pharmacokinetics of Phenylephrine?
Topical drops 0.12%, 0.25%, and 0.1% solution.
What is the mechanism of action of Phenylephrine?
α1-agonist that causes mydriasis and vasoconstriction, often added to OTC drops for whitening the sclera.
What are the clinical uses of Phenylephrine?
Mydriasis, vasoconstriction, scleral whitening.
What are the side effects of Phenylephrine?
Photosensitivity, hypersensitivity, rebound dilation, conjunctival hyperemia.
What is the pharmacokinetics of Naphazoline?
Topical drops 0.012%, 0.03%, 0.1% solution.
What is the mechanism of action of Naphazoline?
Stimulates conjunctival vascular adrenergic receptors, acting as a decongestant.
What are the clinical uses of Naphazoline?
Decongestant for conjunctival blood vessels.
What are the side effects of Naphazoline?
Photosensitivity, conjunctival hyperemia, hypersensitivity.
What is the pharmacokinetics of Tetrahydrozoline?
Topical drops 0.05% solution.
What is the mechanism of action of Tetrahydrozoline?
Stimulates conjunctival vascular adrenergic receptors, acting as a decongestant.
What are the clinical uses of Tetrahydrozoline?
Decongestant for conjunctival blood vessels.
What are the side effects of Tetrahydrozoline?
Photosensitivity, conjunctival hyperemia, hypersensitivity.
What is the pharmacokinetics of Atropine?
Topical drops 0.5%, 1%, and 2% solution; 1% ointment.
What is the mechanism of action of Atropine?
Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.
What are the clinical uses of Atropine?
Cycloplegic retinoscopy, dilated funduscopic exam, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.
What are the side effects of Atropine?
Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.
What is the pharmacokinetics of Scopolamine?
Topical drops 0.25% solution, duration of action 3-7 days.
What is the mechanism of action of Scopolamine?
Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.
What are the clinical uses of Scopolamine?
Cycloplegic retinoscopy, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.
What are the side effects of Scopolamine?
Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.
What is the pharmacokinetics of Homatropine?
Topical drops 2% and 5% solution, duration of action 1-3 days.
What is the mechanism of action of Homatropine?
Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.
What are the clinical uses of Homatropine?
Cycloplegic retinoscopy, decrease post-surgical inflammation, prevent adhesion formation in iritis, uveitis, and postoperatively.
What are the side effects of Homatropine?
Photosensitivity, blurred vision, acute glaucoma in patients with narrow anterior chamber angle, risk of antimuscarinic poisoning if enters systemic circulation.
What is the pharmacokinetics of Cyclopentolate?
Topical drops 0.5%, 1%, and 2% solution, duration of action 1 day.
What is the mechanism of action of Cyclopentolate?
Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.
What are the clinical uses of Cyclopentolate?
Good for corneal abrasions, retinal examination, and conditions where cycloplegia and mydriasis are desired.
What are the side effects of Cyclopentolate?
Photosensitivity, blurred vision, risk of antimuscarinic poisoning if enters systemic circulation.
What is the pharmacokinetics of Tropicamide?
Topical drops 0.5% and 1% solution, duration of action 1-6 hours.
What is the mechanism of action of Tropicamide?
Cholinergic antagonist at muscarinic receptors on the iris and ciliary body causing cycloplegia and mydriasis.
What are the clinical uses of Tropicamide?
Useful for funduscopic examination.
What are the side effects of Tropicamide?
Photosensitivity, blurred vision, headache, risk of antimuscarinic poisoning if enters systemic circulation.
What is the mydriatic effect of Tropicamide?
1-3 hours duration, mild mydriatic effect (++).
What is the cycloplegic effect of Tropicamide?
1-3 hours duration, mild cycloplegic effect (+).
What is the mydriatic effect of Cyclopentolate?
12-24 hours duration, strong mydriatic effect (+++).
What is the cycloplegic effect of Cyclopentolate?
12-24 hours duration, strong cycloplegic effect (+++).
What is the mydriatic effect of Atropine?
168-240 hours duration, strong mydriatic effect (+++).
What is the cycloplegic effect of Atropine?
168-240 hours duration, strong cycloplegic effect (+++).
