Ophthalmology pharmacology

Question 1

Give examples of beta-blockers used in ophthalmology.

Answer 1

• Timolol
• Betaxolol
• Carteolol

Question 2

What are the indications for use of beta-blocker eye drops?

Answer 2

• Glaucoma (i.e. increase in IOP)

Question 3

What is the MOA of beta blocker eye drops?

Answer 3

• Reduced the synthesis of aqueous humour

- Blockage of sympathetic nerve fibres in the ciliary epithelium

Question 4

What are the potential side effects of beta-blocker eye drops?

Answer 4

• No changes in vision or pupil

- Hypotension

Question 5

Give examples of alpha-1-agonists used in ophthalmology.

Answer 5

• Adrenaline

Question 6

What are the indications for use of alpha-1-agonists in ophthalmology?

Answer 6

• Open-angle glaucoma (raised IOP)

Question 7

What is the MOA of alpha-1-agonist eye drops?

Answer 7

• Reduce synthesis of aqueous humour
• Via decrease in cAMP
• Additional conjunctival vasoconstriction

Question 8

What are the potential side effects of alpha-1-agonist eye drops?

Answer 8

• Mydriasis
• Blurry vision
• Ocular hyperaemia
• Foreign body sensation
• Ocular allergy

Question 9

What is the main contraindication to using alpha-1-agonist eye drops?

Answer 9

Acute angle-closure glaucoma

Question 10

Give examples of alpha-2-agonists used in ophthalmology.

Answer 10

• Apraclonidine

- Brimonidine

Question 11

What are the indications for use of alpha-2-agonists in ophthalmology?

Answer 11

Glaucoma (raised IOP)

Question 12

What is the MOA of alpha-2-agonist eye drops?

Answer 12

• Reduce synthesis of aqueous humour

- Via decrease in cAMP

Question 13

What are the potential side effects of alpha-2-agonist eye drops?

Answer 13

• Mydriasis
• Blurry vision
• Ocular hyperaemia
• Foreign body sensation
• Ocular allergy

Question 14

Give examples of carbonic anhydrase inhibitors used in ophthalmology.

Answer 14

• Acetazolamide (oral)
• Methazolamide (oral)
• Brinzolamide
• Dorzolamide

Question 15

What are the indications for use of carbonic anhydrase inhibitors in ophthalmology?

Answer 15

• Raised IOP

Question 16

What is the MOA of carbonic anhydrase inhibitors?

Answer 16

• Reduce synthesis of aqueous humour

- By inhibiting the action of the carbonic anhydrase enzyme

Question 17

What are the potential side effects of carbonic anhydrase inhibitors?

Answer 17

• No changes in vision or pupil

- Non anion gap metabolic acidosis

Question 18

Give examples of prostaglandin analogues used in ophthalmology?

Answer 18

• Latanoprost
• Travaprost
• Bimatoprost

Question 19

What are the indications for use of prostaglandin analogues in ophthalmology?

Answer 19

• Raised IOP

Question 20

What is the MOA of prostaglandin analogues?

Answer 20

• Increase aqueous humour outflow

- By decreasing resistance through uveoscleral flow

Question 21

What are the potential side effects of prostaglandin analogues?

Answer 21

• Darkening of iris
• Growth of eyelashes
• Epithelial keratopathy

Question 22

Give examples of direct parasympathomimetics (M3) used in ophthalmology.

Answer 22

Direct

• Pilocarpine
• Carbachol

Indirect:

• Physostigmine
• Echothiophate

Question 23

What are the indications for use of parasympathomimetics (M3) used in ophthalmology?

Answer 23

• Pilocarpine –> specifically for AACG

- Others- raised IOP

Question 24

What is the MOA of parasympathomimetics (M3)?

Answer 24

• Increase aqueous humour outflow
• Via ciliary muscle contraction
• Via trabecular meshwork opening (into canal of Schlemm)

Question 25

What are the potential side effects of parasympathomimetics (M3)?

Answer 25

• Miosis (via contraction of pupillary sphincter)

- Cyclospasm (via contraction of ciliary muscle)