Ocular pharmacology

Question 1

Drug classes that treat open-angle glaucoma

Answer 1

beta blockers: reduce AqH production

muscarinic agonists: improve AqH drainage

Question 2

Drug classes that treat closed angle glaucoma

Answer 2

cholinomimetics: decrease IOP thru CNS

carbonic anhydrase inhibitor: reduce AqH production

Question 3

Muscarinic Agonists
direct acting (3)
indirect acting (1)

Answer 3

• ACh, pilocarpine, carbachol

- echothiophate iodide

Question 4

ACh

-use

Answer 4

Muscarinic agonist

-constrict pupil during surgery

Question 5

Pilocarpine, Carbachol

• use
• side effect

Answer 5

muscarinic agonist

• constrict pupil, increase AqH outflow
• decreased vision and headache, bronchospasm, SLUDGE

Question 6

Antimuscarinics (5)
use
-side effects

Answer 6

atropine, scopolamine, homatropine, cyclopentolate, tropicamide

• dilate the pupil for eye exams and to relieve pain during inflammation
• ataxia, nystagmus, restless, confusion, aggression, insomnia, photophobia

Question 7

Which antimuscarinics are used during inflammation

Answer 7

homatropine, cyclopentolate

Question 8

When is a nicotinic agonist used in ophthalmology

Answer 8

to diagnose myesthenia gravis (edrophonium)

Question 9

Phenylephrine

• use
• side effects

Answer 9

alpha1 agonist

• dilation of the pupil for exam and surgery
• HTN, sweating, anxiety, MI

Question 10

Bromondine tartrate

-use

Answer 10

alpha2 agonist

-suppress AqH production

Question 11

Apraclonidine

-use

Answer 11

alpha agonist to treat glaucoma with minimal systemic side effects

Question 12

Clomidine

-use

Answer 12

alpha agonist to lower IOP

Question 13

cocaine

-use

Answer 13

NE reuptake inhibitor can be used to diagnose Horner’s

Question 14

hydroxyamphetamine

-use

Answer 14

releases norepi to diagnose severity of horners

Question 15

Dapiprazole

-use

Answer 15

alpha antagonist, used to reverse tropic amide and phenylephrine

Question 16

What is the second line treatment for glaucoma

Answer 16

beta-blockers and carbonic anhydrase inhibitors

Question 17

Beta blockers used to treat glaucoma (5)

Side effects?

Answer 17

timolol, betaxolol, carteolol, levobunolol, metipranolol

- bradycardia, hypotension, bronchospasm, confused, depressed, fatigued

Question 18

Which beta blocker has the least intrinsic sympathomimetic activity

Answer 18

metipranolol

Question 19

what is the first line treatment for glaucoma

Answer 19

prostaglandins

Question 20

Latanoprost, Travoprost, Bimatroprost, Unoprostone isopryl

• use
• mechanism of action
• side effect

Answer 20

prostaglandins used to treat glaucoma

• increase uveoscleral outflow
• eyelash growth, change in iris color

Question 21

Dorzolamide HCL, Acetazolamide, Brinzolamide

• use
• mechanism of action

Answer 21

carbonic anhydrase inhibitors

• treat glaucoma
• inhibit Na/K pump, reduce AqH production

Question 22

Diagnostic testing using cocaine

-what is a positive test

Answer 22

(+) for Horner’s if the pupil doesn’t dilate

Question 23

Diagnostic testing using paredine

Answer 23

If a patient has horner’s, (+) dilation indicates a preganglionic problem where as no dilation indicates a post ganglionic problem

Question 24

Diagnosing Adie’s

Answer 24

pupil constricts with the administration of pilocarpine or methancholine

Question 25

How to tell if a pupil is dilated due to pharmacologic reasons (as apposed to stroke or something)

Answer 25

give them pilocarpine, the pupil doesn’t constrict then they’ve gotten drugs.