Ocular Pharm Drugs

Question 1

Timolol, Metipranolol, Carteolol, Levobunolol, Betaxolol

Answer 1

• Beta-adrenergic antagonists
  
  • Betaxolol - selective for beta-1
• Treats glaucoma via decreased aqueous humor production

Question 2

Acetazolamide

Answer 2

• Carbonic anhydrase inhibitor
• More side effects than methazolamide
• Treats glaucoma via decreased aqueous humor production
• Oral

Question 3

Methazolamide

Answer 3

• Carbonic anhydrase inhibitor
• Treatment of glaucoma via decreased aqueous humor production
• Side effects: hypokalmeia, diuresis, metabolic acidosis, compensatory respriatory alkalosis, GI upset
• Oral

Question 4

Dichlorphenamide

Answer 4

• Carbonic anhydrase inhibitor
• Topical
• Treatment of glaucoma via decreased aqueous humor production

Question 5

Pilocarpine

Answer 5

• Cholinergic agents (parasympathomimetic)
• Treatment of glaucoma via increased trabecular outflow
• Dry eye therapy via lacrimostimulation
  
  • parasympathetic innervation to lacrimal glands (stimulatory)
• Topical solution given orally - increase in parasympathetic activity

Question 6

Charbachol

Answer 6

• Cholinergic agents (parasympathomimetic)
• Treatment of glaucoma via increased trabecular outflow

Question 7

Physostigmine

Answer 7

• Cholinergic agents (parasympathomimetic)
• Treatment of glaucoma via increased trabecular outflow

Question 8

Neostigmine

Answer 8

• Cholinergic agents (parasympathomimetic)
• Treatment of glaucoma via increased trabecular outflow

Question 9

Mannitol

Answer 9

• Hyperosmotic agent/diuretic
• IV
• Use short term for emergency fluid reduction
• Treatment of glaucoma via osmotic gradient towards plasma
• Can be administered to diabetics

Question 10

Glycerin

Answer 10

• Hyper-osmotic agent/diuretic
• Oral
• Metabolized to sugars - can cause hyperglycemia and glucosuria, avoid in diabetics
• Short term use for emergency reduction in fluids
• Treats glaucoma via osmotic gradient towards plasma

Question 11

Epinephrine and Dipvefrin

Answer 11

• Adrenergic agents - sympathomimetics
• Alpha and beta agonists - vasoconstriction, hemostasis; reduces IOP; mydriasis without cyclopegia (iris dilator muslce, NOT ciliary muscle)
• Treatment of glaucoma via increased trabecular outflow (increased uveoscleral outflow)

Question 12

Apraclonidine

Answer 12

• Adrenergic agnet - alpha-2 agonist
• Treatment of glaucoma via decreased aqueous humor production

Question 13

Latanoprost

Answer 13

• Prostaglandin
• Treat glaucoma via increased uveoscleral outflow
• Causes intense miosis in the dog and cat and may increase conventional outflow of aqueous humor

Question 14

Cyclosproine A

Answer 14

• Immunosuppressive agent
• Dry eye therapy via lacrimostimulation
  
  • Inhibits T-cell activation - decrasing inflammation via decreasing IL-2 release and IL-2 receptor expression

Question 15

Tacrolimus

Answer 15

• Immunosuppresive agent
• Dry eye therapy via lacrimostimulation
• Macrolide of fungal origin - targets T-helper lymphocytes and inhibits transcription of IL-2
• T-cells dont proliferate and inhibit IFN-gamma secretion; no MHC class II antigens are induced and no further activation of macrophages occur