Ophthalmic Pharmaceuticals : Cycloplegics and Mydriatics Flashcards
What is dilation of the pupil called?
Mydriasis
What is the temporary paralysis of ciliary muscle called? also the loss of accommodation
Cycloplegia
What is the use of Mydriatics and Cycloplegics?
Dilation
Cycloplegic Refraction
Amblyopic Therapy
Pain Management
Why do we use these for dilation?
For ocular health evaluation to monitor disease
ex. diabetes
Why do we use these for cycloplegic refraction?
Remove accommodation factor
What is Amblyopia?
Lazy Eye
Why do we use these for Amblyopic Therapy?
Suppression of vision in good eye forcing vision in bad eye
Why do we use these for pain management?
Uveitis
Stops spasms in the eye
What is uveitis?
Iris becomes inflamed
What are contraindications for Dilating Drops?
Allergy to preservatives
Narrow anterior chamber angle
Iris fixed for extraocular lens
Need for pupil evaluation
What are Adverse Effects for dilating drops?
Blurred vision Stinging Photophobia Glare Risk of angle closure glaucoma
Are dilating drops tend to last longer with dark colored irises or light colored irises?
Light Colored
Why do dilating drops tend to last longer on light colored irises?
They have less pigment to hold on to the drug and prevent it’s action
What is the Mechanism of Action of Cholinergic Antagonist (Anticholinergic) drugs?
Block muscarinic receptors
Inhibits pupillary sphincter : mydriasis
Inhibits ciliary body : cycloplegia
What are examples of Cholinergic Drugs?
Mydriacyl (Tropicamide)
Cyclogyl (Cyclopentolate)
Isopto Homatropine (Homatropine)
Isopto Atropine (Atropine)
What anticholinergic drug :
- Routine eye exam
- 0.5% and 0.1%
- Minimal cycloplegic effect
- Adverse effects
- Transient IOP increase
Mydriacyl (Tropicamide)
What anticholinergic drug :
- Routine cycloplegic refractions
- 0.5% and 0.1%
- Wait 45 minutes for cycloplegic effect
- Side effects : hallucinations and strange behavior
Cyclogyl (Cyclopentolate)
What anticholinergic drug :
- Manage pain associated with anterior uveitis
- Weak cycloplegic effect
Isopto Homatropine
What anticholinergic drug :
- most potent mydriatic / cycloplegic
- slows down myopia
amblyopia treatment
Isopto Atropine
What are adverse effects of Isopto Atropine?
Dry mouth and flushed skin
Rapid pulse
Disorientation
What anticholinergic drug do we have to be cautious with for elderly. young children and patients with down syndome?
Isopto Atropine
What is the Mydriasis Peak for Mydriacyl?
20-40 min
What is the Mydriasis Recovery for Mydriacyl?
6 hours
What is the Cycloplegic Peak for Mydriacyl?
20-35 min
What is the Cycloplegic Recovery for Mydriacyl?
6 hours
What is the Mydriasis Peak for Cyclogyl?
30-60 min
What is the Mydriasis Recovery for Cyclogyl?
1 day
What is the Cycloplegic Peak for Cyclogyl?
27-75 min
What is the Cycloplegic Recovery for Cyclogyl?
8 hours
What is the Mydriasis Peak for Isopto Atropine?
30-40 min
What is the Mydriasis Recovery for Isopto Atropine?
7-12 days
What is the Cycloplegic Peak for Isopto Atropine?
60-180 min
What is the Cycloplegic Recovery for Isopto Atropine?
6-12 days
What is the Mechanism of Action of Adrenergic?
“Alpha Adrenergic Agonist”
- Bind to alpha receptors
- Alpha binding = mydriasis
What are examples of Adrenergic Drugs?
Mydrifin (Phenylephrine)
What is used in combination with Mydriacyl?
Mydrifin (Phenylephrine)
What drug :
- 2% and 20% concentrations
- Adverse Effect :
- Risk of cardiovascular events
- Contraindications with numerous medications
Mydrifin
What are other delivery methods for dilating meds?
Spray bottle
Pledgets
