Ocular Pharm

Question 1

Two specialized roles of ciliary body in eye

Answer 1

Secretion of aqueous humor and accomodation

Question 2

SNS effects in the eye

Answer 2

Dilation (mydriasis), relax ciliary muscle (far sightedness), produce aqueous humor and lacrimal secretions

Question 3

PNS effects in the eye

Answer 3

Constriction (miosis), accommodation (near sightedness) and lacrimal secretions

Question 4

Pinpoint pupils means what has been taken?

Answer 4

Opiods (block inhibitory in EW nucleus)

Question 5

If a patient presents with an eye that is dilated what may have occurred?

Answer 5

Rubbing of eye with unknown exogenous anti-muscarinics or have been taken up by lacrimal gland from being put near nose or systemized

Question 6

Methods of drug route for ocular drugs

Answer 6

Topical (cornea-> aq humor), Subconjuctival, Intraocular (anterior chamber), Intravitreal (retina)

Question 7

What enzyme are useful for localized activation of pro-drugs in cornea?

Answer 7

Esterases

Question 8

ADE of anti-muscarinics

Answer 8

Anti-DUMBBELS, inc intraocular presure, stinging and burning

Question 9

Use of anti-muscarinics

Answer 9

Iritis and uveitis and eye examination (dilation)

Question 10

Contraindications of anti-muscarinics

Answer 10

Glaucoma and sulfa allergy

Question 11

Anti-muscarinics

Answer 11

atropine, Homotropine, Tropicamide, cyclopentolate, scopolamine

Question 12

Prostaglandin analogs

Answer 12

LatanoPROST, TravoPROST, BimatoPROST

Question 13

ADE of PROSTs

Answer 13

Blurred vision, burning/stinging/itching, permanent brown pigmentation of iris, increased length and thickness of eyelashes (hypertrichosis)

Question 14

MOA of beta-blockers in glaucoma

Answer 14

Decrease aq humor production (cAMP-PKA) and decrease ocular bloodflow

Question 15

Do -olols work quickly?

Answer 15

Yes

Question 16

Examples of beta-blockers used in tx of glaucoma

Answer 16

Timolol, levobunolol,metripranolol, carteolol

Question 17

ADE of beta-blockers

Answer 17

Bronchioconstriction; Decreased HR (systemic)

Question 18

MOA of carbonic anhydrase inhibtors

Answer 18

Blocks production of H2O and CO2 from carbonic acid -> decrease H2O -> decrease aq humor

Question 19

ADE of ZOLAMIDES

Answer 19

Dysguesia (bitter taste), Sulfa rxn, Burning/stinging

Question 20

Ex of carbonic anhydrase used in glaucoma

Answer 20

DorZOLAMIDE and brinZOLAMIDE

Question 21

ADE of muscarinic agonists

Answer 21

DUMBBELS, decreased night vision,

Question 22

Muscarinic agonists are contraindicated in what dx

Answer 22

Asthma, CV failure, peptic ulcer

Question 23

Ex of muscanic agonists

Answer 23

Carbachol, pilocarpine, Ach

Question 24

Additive effects of ach-inhibitors with what agricultural products

Answer 24

Carbamate and organophosphates

Question 25

Ex of ach-inhibitor

Answer 25

Echothiophate

Question 26

What advantage do ach-inhibitors have over muscarinic agonists

Answer 26

More potent and longer acting (NO IN CLOSED ANGLE GLAUCOMA)

Question 27

Sympathomimetics used in pharm work at what receptor?

Answer 27

Alpha

Question 28

MOA of sympathomimetics in glaucoma

Answer 28

Increase outflow of aq humor

Question 29

ADE of sympathomimetics

Answer 29

Photosensitivity, conjunctival hyperemia, and hypersensitivity

Question 30

Contraindications (or caution) for use of sympathomimetics

Answer 30

HTN, Hyperthyroid, DM, arteriosclerosis, asthma

Question 31

Ex of sympathomimetics used in glaucoma

Answer 31

Phenylephrine, apraclonidine, brimonidine, Naphazoline, tertrahydrozoline

Question 32

MOA of Aflibercept

Answer 32

Decoy receptor for VEGF

Question 33

MOA of Pegaptanib

Answer 33

Monoclonal antibody against VEGF

Question 34

MOA of Ranibizumab and Bevacizumab

Answer 34

Interrupt VEGF

Question 35

ADE of mabs, nibs, and cepts in macular degeneration

Answer 35

Bleeding, thrombosis, stroke, MI (CV events)

Question 36

MOA of Verteporfin

Answer 36

Systemized then hit with laser= ROS causing vascular damage

Question 37

ADE of Verteporfin

Answer 37

Headache, visual disturbances, photosensitization, and injection site rxn