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Pharmacology > Ophthalamic Drugs and Diabetes Insipidus (Ex2) > Flashcards

Ophthalamic Drugs and Diabetes Insipidus (Ex2) Flashcards

1
Q

What are the general indications of Ophthalamic drugs?

A
  • dilate or constrict the pupils
  • decrease aqueous fluid production or IOP
  • increase tear production
  • decrease inflammation
  • treat infection
  • topical anesthetics
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2
Q

What are the parasympathetic actions on the eye?

A
  • miosis: contraction of the iris sphincter muscle

- contraction of ciliary body: near vision, increases aqueous outflow

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3
Q

What are the sympathetic actions on the eye?

A
  • mydriasis: contraction of the iris dilator muscle
  • relaxation of the ciliary body: far vision
  • aqueous humor formation
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4
Q

Pilocarpine (Pilostat)

classification, uses

A
  • direct acting parasympathomimetic (miotic)
  • causes miosis lasting 2-6 hours
  • diagnosis of parasympathetic lesions
  • uncommonly used for glaucoma trtmt or KCS (keratoconjunctivitis sicca)
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5
Q

Atropine (Atrophate)

classification, uses

A
  • direct acting parasympatholytic (mydriatic)
  • causes mydriasis (onset 1 hr, dur 120+ hrs)
  • causes cycloplegia (blurred vision)
  • to reduce pain associated with uveitis
  • can break up synechiae in uveitis
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6
Q

Atropine Cautions

A
  • do not use in primary glaucoma
  • generally minimal systemic absorption
  • cycloplegia can cause horses to panic
  • very bitter taste (cats froth at mouth)
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7
Q

Tropicamide (Mydricacyl)

classification, uses

A
  • direct acting parasympatholytic
  • causes mydriasis and cycloplegia (faster onset, shorter duration than Atropine)
  • dilate pupil for exam
  • prevent adhesions after cataract surgery
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8
Q

Tropicamide Cautions

A
  • less effective pain control than atropine
  • less bitter, but still can cause cats to hypersalivate
  • avoid in glaucoma
  • may alter Shirmer’s tear test
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9
Q

Phenylephrine

classification, uses, cautions

A
  • direct acting sympathomimetic, alpha 1 agonist
  • causes mydriasis
  • perioperative use in cataract surgery
  • help in diagnosis and trtmt of Horner’s
  • cats and horses: need to combine with another agent to cause mydriasis
  • can cause cardiovascular side effects
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10
Q

What types of drugs reduce aqueous humor formation and/or improve aqueous outflow?

A
  • alpha agonists
  • beta antagonists
  • carbonic anhydrase inhibitors
  • protaglandin analogs
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11
Q

Timolol (Timoptic)

classification, uses

A
  • ophthalamic nonselective beta antagonist

- used in glaucoma management: prevent glaucoma in contralateral eye, decrease aqueous formation, may cause miosis

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12
Q

What is Cosopt?

A

Timolol + Dorzolamide

a carbonic anhydrase inhibitor

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13
Q

Dorzolamide (Trusopt)
What is it?
What is its ophthalamic use?

A
  • topical carbonic anhydrase inhibitor

- decreases aqueous humor resulting in lower IOP

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14
Q

Latanoprost (Xalatan)

classification, uses

A
  • topical prostaglandin analog
  • increases uveoscleral outflow by stimulating FP receptors in the eye
  • used topically to treat glaucoma and reduce IOP in dogs
  • not effective in cats or horses
  • often used in emergency
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15
Q

Cyclosporine (Optimmune)

classification, use

A
  • topical immunomodulator/lacrimogenic agent
  • used to treat canine KCS
  • BID topical application required
  • increases tear production and provides local immunosuppression
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16
Q

Topical Glucocorticoids
(use, administration, contraindications)
Name 2 drugs

A
  • used to manage inflammatory and immune-mediated conditions
  • some systemic absorption with local administration
  • systemic needed to treat back of the eye
  • contraindicated if corneal ulcer, infection, or diabetes
  • Dexamethasone and Prednisolone
17
Q

Topical NSAIDs
(use, contraindications)
Name 2 drugs

A
  • similar to glucocorticoids, but used when a higher local concentration and lower systemic concentration is desired
  • used in management of uveitis and some keratitis
  • used to manage inflammation associate with cataracts
  • contraindicated if corneal ulceration, glaucoma, or coagulopathies
  • Flurbiprofen and Diclofenac
18
Q

What is Gancyclovir?

A

topical antiviral agent

19
Q

What is Natamycin?

A

antifungal agent

- human labeled product

20
Q

Proparacaine (Alcaine)

classification, uses, MOA

A
  • ophthalamic topical anesthetic
  • used to decrease corneal sensation to allow diagnostic evaluation
  • blocks Na channels to prevent axonal depolarization
21
Q

Describe the stimulation of secretion of ADH

A
  • volume contraction causes increased ECF osmolality
  • this stimulates the osmoreceptors in the hypothalamus, which stimulates ADH secretion
  • Also: hypotension stimulates volume receptors, which stimulates ADH secretion
22
Q

What are the actions of ADH?

A
  • stimulates reabsorption of water in distal tubules and collecting duct
  • this results in increased water in ECF, and decreased ECF osmolality
23
Q

How is ADH used?

A

natural ADH is administered IM or IV over 1 hour in lactated ringers or 5% dextrose for diagnosis of diabetes insipidus

24
Q

What are the types of Diabetes Insipidus?

How are they caused?

A
  • Central: caused by ADH deficiency

- Nephrogenic: caused by impaired responsiveness of the kidney to ADH

25
Q

What can be used to treat central diabetes insipidus?

A

Desmopressin
Thiazide diuretics
Chlorpropamide
Restricted sodium chloride uptake

26
Q

What can be used to treat nephrogenic dibetes insipidus?

A

Thiazide diuretics are drug of choice

Restricted sodium chloride uptake

27
Q

Desmopressin

classification, actions, pharmacokinetics

A
  • a synthetic ADH analog
  • more potent and longer duration that natural ADH
  • minimal vasconstrictor action
  • parenterally and nasal drops in eye
  • drug of choice for CDI in dogs and cats
28
Q

Chlorpropamide

classification, pharmacokinetics

A
  • an oral hypoglycemic sulfonylurea durg
  • requires presence of some endogenous ADH to act
  • not very effective for trtmt of CDI in dogs and cats

Pharmacology (14 decks)

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