Ocular Pharm

Question 0

Alpha 2 receptor

Answer 0

CB vasculature: constricts, reducing aqueous formation

Question 1

Alpha 1 receptor

Answer 1

Iris dilator

Question 2

Beta 2 receptors

Answer 2

TM: relaxation, increase outflow
CM: relaxes, opposes accommodation
NPCE: increase aqueous formation

Question 3

Beta 1 receptor

Answer 3

NPCE: increases aqueous formation

Question 4

What is the MOA of pilocarpine?

Answer 4

Stimulate longitudinal muscle of CB, which pulls posteriorly on the scleral spur and secondarily opens up trabecular spaces for increased outflow (corneoscleral)

Question 5

Neostigmine

Answer 5

Tx of myasthenia gravis and for limb strength evaluation in pts with suspected myasthenia

Question 6

Edrophonium

Answer 6

Used in dx of myasthenia (tension test), rapid onset via injection of action (30-60 secs) and short duration of action (10 mins). If ptosis improves, + test for myasthenia

Question 7

Echothiophate

Answer 7

Dx and/or tx of accommodative esotropia and rarely used for glaucoma;
Irreversible indirect cholinergic agonist

Question 8

Pyridostigmine

Answer 8

Tx of myasthenia gravis

Question 9

Isofluorophate

Answer 9

Irreversible AchE agent, not used for glaucoma bc of high incidence of SEs

Question 10

Naphazoline

Answer 10

Adrenergic agonist
Topical ocular decongestant to constrict conj BVs
Alpha>beta so can depress CNS

Question 11

Tetrahydrozoline

Answer 11

Adrenergic agonist
Topical ocular decongestant to constrict conj BVs
Alpha>beta so can depress CNS

Question 12

Brimonidine

Answer 12

Strong alpha 2 (highly selective)
Neuroprotective properties
Follicular conjunctivitis in the past
TID- short duration of action 
Miosis- used for reduce glare and halos in postrefractive pts
CI- MOAIs

Question 13

Aproclonidine

Answer 13

Alpha 2 with weak alpha 1
Control IOP spikes
Tachyphylaxis
Dx Horners

Question 14

Aproclonidine in normal vs Horners

Answer 14

Normal eye: no pupil effect

Horners: miotic pupil dilates

Question 15

Cocaine in normal eye vs Horners

Answer 15

Normal eye: always causes dilation

Horners: no effect on miotic pupil

Question 16

Hydroxyamphetamine in normal vs Horners

Answer 16

Normal eyes or pre-ganglionic damage: acts on post-ganglionic neuron to release NEpi and mydriasis occurs
Horners: no dilation in post-ganglionic neuron damage

Question 17

Phenylephrine 1% in normal and Horners eye

Answer 17

Normal eye: no full dilation

Horners: in post-ganglionic lesions, full dilation

Question 18

Which beta blocker has intrinsic sympathomimetic activity (ISA) and causes a modest reduction in cholesterol?

Answer 18

Carteolol

Question 19

Which beta blocker is beta 1 selective?

Answer 19

Betaxolol

Question 20

Acetazolamide

Answer 20

Oral CAI

Question 21

Brinzolamide

Answer 21

Topical CAI

Question 22

Dorzolamide

Answer 22

Topical CAI

Question 23

Methazolamide

Answer 23

Oral CAI

Question 24

Emedastine

Answer 24

H1 antihistamine

Question 25

Cromolyn sodium

Answer 25

Mast cell stabilizer

Question 26

Lodoxamide

Answer 26

Mast cell stabilizer

Question 27

Pemirolast

Answer 27

Mast cell stabilizer

Question 28

Nedocromil

Answer 28

Mast cell stabilizer

Question 29

Bepotastine

Answer 29

Mast cell- antihistamine combo

Question 30

Epinastine

Answer 30

Mast cell- antihistamine combo

Question 31

Ketotifen

Answer 31

Mast cell- antihistamine combo

Question 32

Olopatadine

Answer 32

Mast cell- antihistamine combo

Question 33

Azelastine

Answer 33

Mast cell- antihistamine combo

Question 34

Potent steroids (ketone-based)

Answer 34

Pred acetate Rimexolone Difluprednate Dexamethasone

Question 35

Soft steroids (ester based)

Answer 35

Fluorometholone (FML) | Loteprednol

Question 36

Diclofenac sodium

Answer 36

NSAID QID Corneal melt

Question 37

Ketorolac tromethamine

Answer 37

NSAID | QID

Question 38

Nepafenac

Answer 38

NSAID | TID

Question 39

Bromfenac

Answer 39

NSAID Ximbrom- BID Bromday- QD

Question 40

Flurbiprofen

Answer 40

NSAID

Question 41

Pegaptanib

Answer 41

Antineoplastic agent that binds and inhibits VEGF | Intravitreal

Question 42

Ranibizumab

Answer 42

``` Monoclonal antibody (Fab) from mouse antibodies that targets VEGF Intravitreal ```

Question 43

Whorl keratopathy (6)

Answer 43

``` Chloroquine Hydroxychloroquine Amiodarone Indomethacin Tamoxifen Fabry's disease ```

Question 44

SPK (2)

Answer 44

Isotrentinoin | Topical aminoglycosides

Question 45

Endo/Descemets pigmentation (2)

Answer 45

Chlorpromazine | Thioridazine

Question 46

Stromal gold deposits

Answer 46

Gold salts- posterior stroma and Descemets | = ocular chrysiasis

Question 47

Amiodarone side effects (3)

Answer 47

Whorl keratopathy Anterior subcapsular lens deposits NAION

Question 48

Anterior subcapsular effects (4)

Answer 48

Chlorpromazine Thioridazine Amiodarone (deposits) Miotics (vacuoles)

Question 49

Nystagmus (3)

Answer 49

Phenytoin Phenobarbital Salicylates

Question 50

Diplopia

Answer 50

Antidepressants Antianxiety Phenytoin

Question 51

Oculogyric crisis

Answer 51

Phenothiazines | Cetirizine

Question 52

NAION (3)

Answer 52

Sildenafil Sumatriptan Amiodarone

Question 53

Intracranial hypertension (3)

Answer 53

Tetracyclines Isotretinoin Oral contraceptives- rare

Question 54

Drugs with anticholinergic activity (decrease lacrimation, mydriasis, increased IOP)

Answer 54

Atropine & scopolamine Antihistamines Tricyclic antidepressants Antipsychotic agents