Ocular Pharm

Question 1

SNS to the eye

Answer 1

travels along arteries from the superior cervical ganglion. Causes mydriasis (pupil dilation via alpha 1 receptor) and ciliary relaxation for far vision (beta 2 receptor)

Question 2

PSNS to the eye

Answer 2

Cholinergic; Travel with CN III from EW nucleus. Causes Miosis (M3 receptor)

Question 3

SNS agonist on the pupils

Answer 3

dilation (mydriasis)

Question 4

PSNS agonist on pupils

Answer 4

constriction

Question 5

Opiates on pupils

Answer 5

constant constriction by blocking the inhibitory interneurons of the EW nucleus

Question 6

Muscarinic Antagonists function?

Answer 6

Well, we know that PSNS uses muscarinic (M3) receptors to cause pupillary constriction (miosis) and cilliary muscle contraction (accomodation to see close), so blocking those muscarinic receptors would cause dilation and ciliary muscle relaxation.

Used in the tx of iritis and uveitis and in eye exams

Question 7

AE of muscarinic agonists

Answer 7

stinging and increased intra-ocular pressure,

If systematized they may cause anti-sludgeBBB

Question 8

What are the two muscarinic antagonists we need to know

Answer 8

atropine and scopolamine

Question 9

What is glaucoma

Answer 9

essentially it is increased intraocular pressure from making too much aqueous humor or not draining it. Caused by lots of drugs.

Question 10

Open angle galucoma tx involves

Answer 10

lowering aqueous humor production or raising aqueous outflow.

Question 11

Latanoprost and Bimatoprost

Answer 11

Prostaglandin analogs- tx for open angle glaucoma, MOA really unknown though it may increase outflow.

PRODRUG with in situ hydrolysis

AE: blurred vision, stinging, itching
Long term may cause brown pigmentation of the iris, lid, and lashes. May also cause excessive eyelash growth hypertrichosis

Question 12

Timolol, carteolol

Answer 12

Beta Blockers- Block the ciliary body production of aqueous by lowering cAMP or lowereing ocular blood flow. Work rapidly

Question 13

Carbonic Anhydrase Inhs are

Answer 13

Dorzolamide and Brinzolamide- They block the production of water and Co2 from carbonic acid. Less water means less aqueous humor

Question 14

Two AEs to KNOW for carbonic anhydrase inhs

Answer 14

1) Taste Disturbances arise from their inhibition of CA in the oral cavity
2) These are sulfonamides and carry the risk of severe adverse outcomes

See a question with these AES think DORZOLAMIDE

Question 15

Muscarinic agonists cause what

Answer 15

Miosis and accomodation.., Also cause increased flow of aqueous humor so they used to be the drug of choice for glaucoma. No mas

Question 16

Muscarinic agonists we need to know

Answer 16

carbachol and pilocarpine

Question 17

Acetylcholinesterase inhs

Answer 17

more potent an dlonger acting than the direct muscarinic agonists

NOTE THAT YOU CAN”T USE THEM WITH CARBAMATE PHOSPHATE INSECTICIDES because they also inhibit AchE.

Also contra in closed angle glaucoma….may make it worse

Question 18

What is the Ache we need to know

Answer 18

Echothipate

Question 19

Sympathomimetics used when

Answer 19

• to increase aqueous outflow in glaucoma, to cause dilation, and as decongestants