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Systemic Pharmacology OPTM 5133 > Ocular effects of systemic medications > Flashcards

Ocular effects of systemic medications Flashcards

1
Q

What drug causes Intraoperative Floppy Iris Syndrome

A

Tamsulosin

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2
Q

Drugs that cause maculopathy

A

Hydroxychloroquine

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3
Q

Drugs that cause angle closure

A

Topiramate

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4
Q

Drugs that cause Whorl Keratopathy

A 
Chloroquine
Hydroxychloroquine
Amiodarone
Indomethacin
Tamoxifen
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5
Q

Drugs that cause mydriasis by a1 stimulation at iris dilator
(bad for narrow AC angle)

A 
Epinephrine, norepinephrine
Phenylephrine
Oxymetazoline
Pseudoephedrine
Cocaine
Methamphetamine
Methylphenidate
Bromocriptine, Amantadine (increase dopamine)
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6
Q

Drugs causing mydriasis by M3 inhibition at iris sphincter (anti-cholinergics)

A 
Atropine
Ipratropium & tiotropium
Tolterodine
Glycopyrrolate
Anti-histamines 1st gen STRONG: diphenhydramine & promethazine
Anti-depressants STRONGL amitriptyline, imipramine
Anti-anxiety & sleep aids
Anti-psychotics
Muscle relaxant STRONG: cyclobenzaprine
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7
Q

Drugs causing miosis by a1 inhibition at iris dilator

A

Tamsulosin, terazosin, doxazosin, prazosin

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8
Q

Drugs causing miosis by indirect stimulation at iris sphincter

A

Acetylcholinesterase inhibitors:

Donepezil, edrophonium, pyridostigmine, neostigmine, isofluorophate

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9
Q

Opioids causing miosis by M3 stimulation at iris sphincter

A

heroin, hydrocodone, oxycodone, buprenorphine, methadone, tramadol

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10
Q

Drug causing miosis by direct M3 stimulation

A

pilocarpine

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11
Q

Drugs causing dry eye by a1 stimulation @ lacrimal gland

A 
Epinephrine, norepinephrine
Phenylephrine
Oxymetazoline
Pseudoephedrine
Cocaine
Methamphetamine
Methylphenidate
Bromocriptine, Amantadine (increase dopamine)
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12
Q

Drugs causing dry eye by M# inhibition @ lacrimal gland

A 
Atropine
Ipratropium & tiotropium
Tolterodine
Glycopyrrolate
Anti-histamines 1st gen STRONG: diphenhydramine & promethazine
Anti-depressants STRONGL amitriptyline, imipramine
Anti-anxiety & sleep aids
Anti-psychotics
Muscle relaxant STRONG: cyclobenzaprine
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13
Q

Drugs increasing tears by a1 inhibition at lacrimal gland

A

None clinically relevant

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14
Q

Drugs increasing tears by M2, M3 stimulation (direct & indirect)

A

Direct: pilocarpine
Indirect: acetylcholinesterase inhibitors: donepezil, edrophonium, pyridostigmine, neostigmine, isofluorophate

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15
Q

Dry eye causing drugs unrelated to anti-cholinergic effects

A 
Isotretinoin (meibomian gland loss)
Cytotoxic chemotherapy drugs
dupilumab (for auto-immune atopic dermatitis, asthma & allergic rhinitis reduced mucin secretion from goblet cells
Estrogens &
Diuretics
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16
Q

Drugs that increase IOP by B2>B1 stimulation on NPCE of ciliary body (increased aq.)

A 
Epinephrine
Isoproterenol
Albuterol
Levalbuterol
Salmeterol 
Formoterol
Pseudoephedrine
Cocaine
Methylphenidate
Increase dopamine: bromocriptine and amantadine
17
Q

Drugs that increase IOP by decreasing TM outflow

A 
Prednisone
Methylprednisone
Dexamethasone
fluticasone
beclomethasone
budesonide
hydrocortisone
18
Q

Drugs that decrease IOP by a2 stimulation NPCE

A

adrenergic agonists: Epinephrine, norepinephrine, clonidine

19
Q

drugs that decrease IOP by B2>B1 inhibition at NPCE (adrenergic antagonists)

A

B1 selective: Metoprolol, atenolol

Non-selective: propranolol, labetalol, carvedilol

20
Q

drugs decrease IOP by M2, M3 stimulation ciliary muscle cholinergic agonist

A 
Direct: pilocarpine
Indirect: Acetylcholinesterase inhibitors
Donepezil
Edrophonium
Pyridostigmine, neostigmine
Isofluorophate
21
Q

What are the adverse effects of glucocorticoid drugs (steroids) on the eyes

A

PSC cataract, papilledema, TM resistance–>high IOP, glaucoma, and immunosuppression

22
Q

adverse systemic effects of glucocorticoids

A

high blood sugar, HTN, osteoporosis, striae, decreased growth in children, increased risk of infection, peptic ulcer, peripheral edema, hypokalemia, emotional disturbances

Systemic Pharmacology OPTM 5133 (8 decks)

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