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Pharmacology > Opthalmic drugs & systemic effects > Flashcards

Opthalmic drugs & systemic effects Flashcards

1
Q

Name the five category of drugs used to treat the eye

A 
Mydriatic agents
Cycloplegic agents
Glaucoma agents
Intraocular agents
Local anesthetic agents
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2
Q

Mydriatic agents cause

A

pupillary dilation on the dilator muscle of the iris

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3
Q

Name two mydriatic drugs

A

phenylephrine

tropicamide

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4
Q

Phenylephrine’s MOA includes

A

pupillary dilation and capillary decongestion due to alpha-1 agonism without cycloplegic effects

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5
Q

Phenylephrine’s SE includes

A

Bradycardia
Hypertension
Tremors
HA

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6
Q

Tropicamide exerts its effects as an

A

antimuscarinic

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7
Q

Cycloplegic agents are classified as ——— that exert its effects by

A

parasympatholytic compounds

temporary paralysis’ ciliary muscles and muscles of accommodation

*used frequently in phacoEmulsificaton procedures

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8
Q

Name three cycloplegic agents

A

Homoatropine
Atropine
Cyclopentolate

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9
Q

Atropine causes both

A

mydriasis and cyclopegia

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10
Q

Atropine SE include

A 
Irritability and delirium (crosses BBB)
Tachycardia
Flushing
Dry skin
Thirst
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11
Q

Atropine should be used with caution in which patient population

A

Narrow-angle glaucoma

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12
Q

Glaucoma agents are further classified as

A

cholinergic agonists (miotics)
adrenergic agents
carbonic anhydrase inhibitors
prostaglandin F2a analogues

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13
Q

cholineric agonists used to tx glaucoma are subdivided into

A

direct-acting
vs.
indirect-acting

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14
Q

Name two direct-acting cholinergic agonists

A

Pilocarpine

Carbachol

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15
Q

Name two indirect-acting cholinergic agonsists

A

physostigmine
echothiophate

*AKA anticholinesterases

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16
Q

What is the MOA of pilocarpine

A

Miosis via contraction of the iris sphincter and stimulation of ciliary muscle which opens the trabecular meshwork and facilitates the outflow of aqueous humor and decreases aqueous production…Net effect is to lower intraocular pressure.

*causes loss of accomodation

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17
Q

Does pilocarpine cross the BBB

A

Yes because it is a tertiary amine

18
Q

Carbachole is a cholinomimetic agent that

A

reduces intraocular pressure

19
Q

Physostigmine is an indirect-acting cholinergic agonist that causes

A

contraction of the sphincter muscle of the iris wihich opens the trabecular meshwork and facilitates the outflow of aqueous humor.

20
Q

Does physostigmine cross the BBB

A

Yes bc it is a tertiary amine

21
Q

Echothiophate is an indirect-acting cholinergic agent that irreversibly inhibits

A

acetylcholinesterase

*Takes 4-6 weeks required for activity to recover after stopping of echothiophate therapy

22
Q

What effect does echothiophate have after systemic absorption through the lacrimal apparatus

A

it covalently bonds with pseudocholinesterases and inhibits its activity.

*prolongs the activity of succinylcholine, mivacurium, and LA ester compounds

23
Q

What anesthetic agent should be avoided in patients taking echothiophate

A

Succinylcholine

24
Q

What effect does echothiophate have as a gluacoma drug

A

produces miosis, increased outflow of aqueous humor and decreased intraocular pressure

25
Q

The are two Major SE assocciated with echothiophate

A

BRONCHOSPASM and Paralysis r/t elevated achetylcholine levels

26
Q

Name the classification of the adrenergic AGENTS used to treat glaucoma

A

Dipiverine (epi deriviative)
B-adrenergic antagonists (timolol, betaxolol)
A-adrenergic agonists (apraclonidine, brimonidine)

27
Q

Timolol is a nonselective beta antagonist that

A

decreases the production of aqueous humor which decreases intraocular pressure

*Significant conjunctival absorpton so CAUTION in RAD, HF, hypotension

28
Q

Alpha-adrenergic agonists exerts its effect on glaucoma patients by

A

postsynaptic alpha-2 binding which decreases aqueous humor production

29
Q

Does the a-adrenergic agonist Apraclonidine cross the BBB

A

NO, highly ionized at physiologic pH

30
Q

Name four carbonic-anhydrase inhibitors

A

AcetazolAmide
MethazolAmide
DorzolAmide
BrinzolAmide

31
Q

What are carbonic-anhydrase inhibitors used for

A

glaucoma and production of mild diuretic

32
Q

What is the MOA of carbonic Anhydrase Inhibitors

A

decreases secretion of aq. humor by the ciliary body which decreases intraocular pressure

*inhibits the conversion of carbon dioxide and water to bicarbonate and hydrogen ion, and affects sodium and fluid transport

33
Q

Name the prostaglandin F2a analogues

A

IatanoPROST
TrasoPOST
BimatoPROST
UnoPROStone

34
Q

What is the MOA of the Prostaglandin F2a drugs

A

Deceases intraocular pressure by increasing uveoscleral outflow of aqueous humor

*Doesn’t have systemic effects so replaced b-adrenergic antagonists

35
Q

List three intraocular medications

A

Acetylcholine
Epinephrine
Sulfur hexafluoride/perfluorocarbons

36
Q

Acetylcholine is used for what purpose in the eye room

A

used intraocularly after LENSs extraction to produce pupillary constriction

37
Q

Epinephrine is used for what purpose in the eye room

A

placed in irrigating soln to provide continuous mydriasis

38
Q

Sulfur hexafluoride/perfluorocarbons are used for what purpose in the eye room

A

bubble of sulfar hexa…injected into posterior chamber during vitreous surgery for insufflation of vitreous cavity or tamponade of a detached retina

39
Q

15 minutes prior to intraocular gas injection what must be done

A

discontinue nitrous oxide

40
Q

Nitrous oxide must be avoided for —-days after air bubble injection

A

5

41
Q

Nitrous oxide must be avoided for —-days after sulfur hexafluride injection

A

10

42
Q

Nitrous oxide must be avoided for —-days after perfluorocarbons injection

A

30

Pharmacology (27 decks)

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