ocular pharm

Question 1

Miosis

Answer 1

activation of M3 receptor
iris circular muscle
improves humor outflow

Question 2

Mydriasis

Answer 2

A1 adrenergic receptor
iris radial muscle
decreased humor outflow

Question 3

Ciliary muscle

Answer 3

M3 receptors contract muscle

opens up trabecular meshwork

Question 4

ciliary epithelium

Answer 4

B-receptor activation increases humor production

A2 receptor activation decreases production

Question 5

First line Tx of open angle glaucoma

Answer 5

Prostaglandin analogue
Beta blocker (timolol)
Brimondine (A2 agonist)

Question 6

Second line Tx of open angle

Answer 6

Pilocarpine
alpraclonidine
Topical Carb anhydrase inhibitor

Question 7

Last line Tx of open angle

Answer 7

Carbachol (cholinergic agonist specific to eye tx)
cholinesterase inhibitor
oral carb anhydrase inhibitor

Question 8

Timolol

Answer 8

Full antagonist

reduces production humor

Question 9

Adverse effects of timolol

Answer 9

bronchospasm
negative inotropic effect, bradycardia
hypoglycemia in Diabetics

Question 10

prostaglandin analogs

Answer 10

latanoprost
brimatoprost
travoprost
more effective than beta blockers

Question 11

Brimatoprost

Answer 11

most effect prostaglandin analog

no systemic effets

Question 12

A2 agonists

Answer 12

Brimonidine (first line)
apraclonidine (allergic reactions)
both decrease rate of humor production

Question 13

adverse effects of A2 agonists

Answer 13

systemic- dizziness, fatigue, dry mouth, bradycardia, reduced BP
local- allergic reaction

Question 14

Tx of closed angle

Answer 14

Rapid reduction in IOP
Diuretics to prepare for surgery
Pilocarpine to induce miosis
agent that reduces humor production

Question 15

Drugs contraindicated in open angle

Answer 15

corticosteroids
fenoldopam
topical antimuscarinics
succinylcholine

Question 16

Drugs contraindicated in closed angle

Answer 16

antimuscarinics
sympathomimetics
tricyclic antidepressants and SSRI’s (potent antimuscarinic action)