Ocular pharmacology Flashcards
Drug classes that treat open-angle glaucoma
beta blockers: reduce AqH production
muscarinic agonists: improve AqH drainage
Drug classes that treat closed angle glaucoma
cholinomimetics: decrease IOP thru CNS
carbonic anhydrase inhibitor: reduce AqH production
Muscarinic Agonists direct acting (3) indirect acting (1)
- ACh, pilocarpine, carbachol
- echothiophate iodide
ACh
-use
Muscarinic agonist
-constrict pupil during surgery
Pilocarpine, Carbachol
- use
- side effect
muscarinic agonist
- constrict pupil, increase AqH outflow
- decreased vision and headache, bronchospasm, SLUDGE
Antimuscarinics (5)
use
-side effects
atropine, scopolamine, homatropine, cyclopentolate, tropicamide
- dilate the pupil for eye exams and to relieve pain during inflammation
- ataxia, nystagmus, restless, confusion, aggression, insomnia, photophobia
Which antimuscarinics are used during inflammation
homatropine, cyclopentolate
When is a nicotinic agonist used in ophthalmology
to diagnose myesthenia gravis (edrophonium)
Phenylephrine
- use
- side effects
alpha1 agonist
- dilation of the pupil for exam and surgery
- HTN, sweating, anxiety, MI
Bromondine tartrate
-use
alpha2 agonist
-suppress AqH production
Apraclonidine
-use
alpha agonist to treat glaucoma with minimal systemic side effects
Clomidine
-use
alpha agonist to lower IOP
cocaine
-use
NE reuptake inhibitor can be used to diagnose Horner’s
hydroxyamphetamine
-use
releases norepi to diagnose severity of horners
Dapiprazole
-use
alpha antagonist, used to reverse tropic amide and phenylephrine
What is the second line treatment for glaucoma
beta-blockers and carbonic anhydrase inhibitors
Beta blockers used to treat glaucoma (5)
Side effects?
timolol, betaxolol, carteolol, levobunolol, metipranolol
- bradycardia, hypotension, bronchospasm, confused, depressed, fatigued
Which beta blocker has the least intrinsic sympathomimetic activity
metipranolol
what is the first line treatment for glaucoma
prostaglandins
Latanoprost, Travoprost, Bimatroprost, Unoprostone isopryl
- use
- mechanism of action
- side effect
prostaglandins used to treat glaucoma
- increase uveoscleral outflow
- eyelash growth, change in iris color
Dorzolamide HCL, Acetazolamide, Brinzolamide
- use
- mechanism of action
carbonic anhydrase inhibitors
- treat glaucoma
- inhibit Na/K pump, reduce AqH production
Diagnostic testing using cocaine
-what is a positive test
(+) for Horner’s if the pupil doesn’t dilate
Diagnostic testing using paredine
If a patient has horner’s, (+) dilation indicates a preganglionic problem where as no dilation indicates a post ganglionic problem
Diagnosing Adie’s
pupil constricts with the administration of pilocarpine or methancholine