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Pharm Unit 3 > Ocular Pharmacology > Flashcards

Ocular Pharmacology Flashcards

1
Q

What is the site of aqueous production?

A

ciliary body

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2
Q

What is the purpose of the trabecular meshwork?

A

To drain aqueous

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3
Q

What controls lens thickness?

A

muscular fibers within the ciliary body via tension on the zonules

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4
Q

What is angle closure glaucoma?

A

Flow of aqueous is prevented from draining into trabecular meshwork by bowing forward of the iris.

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5
Q

What are the three actions involved in near vision?

A

Thickening of lens
Convergence of eyes
Pupillary constriction

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6
Q

What are three syndromes that have maintained pupillary constriction with near vision but absent light reflex?

A

Parinaud’s syndrome
Argyll Robertson syndrome
Adie syndrome

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7
Q

What drug blocks muscarinic receptors?

A

Atropine

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8
Q

What drug blocks nicotinic receptors?

A

Tubocurarine

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9
Q

Where are muscarinic receptors in the eye?

A

1) Iris sphincter 2) circular fibers of ciliary muscle (constrict pupil)
3) longitudinal fibers of ciliary muscle (place tension on trabecular meshwork)

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10
Q

3 symptoms of Horner’s syndrome

A

Ptosis, Miosis, Anhidrosis

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11
Q

What drug do you use to confirm Horner’s diagnosis and how does it work?

A

Cocaine, blocks reuptake of NE. If sympathetic system intact will cause dilation of pupil.

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12
Q

What drug is used to locate lesion in Horner’s Syndrome?

A

Paredrine, if pupil dilates lesion is 1st or 2nd order neuron (pre-gang). If pupil does not dilate, lesion is in 3rd order neuron (post-gang).

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13
Q

What are three causes of pupillary dilation related to parasympathetic abnormalities?

A

Intracranial aneurysm
Aide’s Syndrome
Pharmacologic blockade

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14
Q

How do you separate Aide’s syndrome from intracranial aneurysm?

A

Give low dose pilocarpine or methacholine (direct parasympathetic agonists).

It should cause constriction due to long term disease causing hypersensitivity (increased receptors). Everyone constricts at high concentration, but Aide’s constrict at low.

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15
Q

Pt with worst headache of life with dilated pupil and limited extraocular movement. Diagnosis?

A

Intracranial aneurysm.

Parasympathetics travel on CR3 causes dilation and loss of extraocular movements

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16
Q

How would you check to make sure dilation of the eye was not due to pharmacologic blockade produced by cycloplegic?

A

Give pt 1% pilocarpine- everyones eye should dilate.

16
Q

Describe Parinaud’s syndrome

A

Most often in young children
Midbrain tumor
Extensive spread of tumor causes lid retraction, limitation of upward gaze, convergence retraction nystegmus.

17
Q

Name the characteristics of Argyll Robertson syndrome.

A

miotic irregular pupils–> do not respond to cycloplegics
pt maintains good visual acuity

CNS involvement w/ syphilis causes ataxia, difficulty walking, nerve pain

18
Q

What are B-blockers used to treat?

A

Glaucoma

19
Q

B-blocker cardiovascular side effects?

A

Bradycardia, hypotension, syncope, palpitation, CHF

20
Q

B-blocker respiratory side effects?

A

broncospasm

21
Q

B-blocker neurologic side effects?

A

confusion, depression, fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction

22
Q

Name four non-selective B-blockers used to treat glaucoma.

A

Timolol, levobunolol, metipranolol, carteolol

23
Q

Name one B1 selective B-blocker

A

Betaxolol

24
Q

What is the mechanism of B-blockers for the treatment of glaucoma?

A

Reduce intraocular pressure by reducing aqueous production at ciliary process.

25
Q

What is the mechanism of action for prostaglandin analogs in treatment of glaucoma?

A

increase uveoscleral outflow

26
Q

Side effects of prostaglandin analogs?

A

eyelash growth, change in iris color

27
Q

When is prostaglandin analog use contraindicated?

A

Cystoid macular edema and herpes

28
Q

Name four prostaglandin analogs.

A

Latanoprast, Travoprost, Bimatoprost, Unoprostone isopyl

29
Q

What are prostaglandin analogs used to treat?

A

Glaucoma

30
Q

Name a Ca channel blocker

A

Nifedipine

31
Q

How does Nifedipine work?

A

increases ocular perfusion at the nerve head

32
Q

Name three carbonic anhydrase inhibitors.

A

Dorzolamide, Acetazolamide, Brinzolamide

33
Q

Side effects of Dorzolamide and Brinzolamide

A

Red eyes, lid allergies

34
Q

How do the carbonic anhydrase inhibitors work?

A

Reduce aqueous production through interference with active transport of Na through Na/K ATPase pump.

35
Q

What are carbonic anhydrase inhibitors use to treat?

A

Glaucoma

Pharm Unit 3 (14 decks)

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