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Ocular Pharmacology > Packet 3: CAI & PG analogs > Flashcards

Packet 3: CAI & PG analogs Flashcards

1
Q

Acetazolamide: other name

A

Diamox or diamox Seqels

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2
Q

Acetazolamide:

A

Systemic CAI’s

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3
Q

Methazolamide: other name

A

Neptazane

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4
Q

Methazolamide:

A

systemic CAI’s

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5
Q

Dorzolamide: other names

A

Trusopt 2%

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6
Q

Dorzolamide:

A

topically applied CAI’s

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7
Q

Brinzolamide: other names

A

Azopt 1%

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8
Q

Brinzolamide:

A

topical CAI

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9
Q

Cosopt

A

Timolol .5% & Dorzolamide (trusopt) 2%

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10
Q

Simbrinza

A

Brimonidine .2% (a2 agonist) & Brinzolamide: 1% (topical CAI)

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11
Q

Effects of systemic CAI

A

decrease IOP

  • no action in the normal eye
  • metabolic acidosis
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12
Q

What can you use in acute angle closure?

A

I.V. diamox

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13
Q

What is diamox?

A

Acetazolamide

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14
Q

what has less side effects? Acetazolamide or Methazolamide?

A

Methazolamide has less side effects

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15
Q

How common are adverse effects with systemic CAI’s?

A

very common 30-80% - therefore very high drop out rate

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16
Q

when can we see paresthesias?

A

systemic CAI

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17
Q

what are other side effects of systemic CAI;s

A

headaches, drowsy, fatigue, dizzy, GI irritations, cramping, NVD, anorexia, muscle weakness, malaise, acidosis,

  • myopia
  • aplastic anemia (RARE)
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18
Q

contraindications to systemic CAI

A

cirrhosis of liver, kidney dysfunction, SULFA, COPD, renal calculi, pregnancy, chronic non-congestive angle closure, HYPOKALEMIA

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19
Q

Dorzolamide: compared to acetazolamide?

A

we only need 1/200th the conc. of dorzolamide topically to get the same concentration in the CB as acetazolamide. therefore less toxicities but also less effective.
- might be due to isozymes

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20
Q

Dorzolamide: 2% at 3 x/day vs. 2% at 2x/ day

A

both showed about 22-24 % decrease in IOP

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21
Q

when is the max effect of dorzolamide?

A

2 hours

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22
Q

was there a decrease after 2 years with continuous use of dorzolamide?

A

yes, after 2 years there was still a 23% decrease

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23
Q

Brinzolamide 1% effective compared to dorzolamide 2%

A

show to be equally effective

-therefore less dosage but still equally effective with less systemic toxicities

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24
Q

Dorzolamide, timolol, and betaxolol, what is most effective?

A

timilol

25
Q

dorzolamide, brinzolamide, timolol: what is most effective?

A

timilol

26
Q

what is only available in suspension?

A

brinzolamide

27
Q

Toxicities with topical CAI’s

A

Brinzolamide has more blurred vision and less ocular irrigation than dorzolamide:

28
Q

what controls nocturnal IOP better? b blockers or topical CAI;s?

A

CAI’s can control nocturnal IOP better than b blockers

29
Q

Latanoprost: other name

A

Zalatan .005%

30
Q

Latanoprost:

A

PG f2a analog

-inactive prodrug (activated by the cornea)

31
Q

does latanoprost have good diurnal control?

A

yes, with bedtime administration

32
Q

what type of outflow does latanoprost effect?

A

uvealoscleral outflow

33
Q

how does latanoprost effect the outflow?

A

reduction in collagen levels in the ciliary muscle and sclera, increasing production of MMPs which will also decrease collagen levels

34
Q

what are PG derived from?

A

arachidonic acid

35
Q

toxicities of latanoprost:

A

blurred vision, burning, hyperemia, FBS, punctate keratopathy, increased iris pigmentation, increased growth and periocular pigmentation, CME (cystoid macular edema) and cataracts, aphakia
-NOT HYPERPLASIA OF MELANIN

36
Q

Brimatoprost: other name

A

Lumigan .01%

37
Q

Is Brimatropost active or inactive?

A

its the only PG that is already active

38
Q

what is the only already activated PG?

A

Brimatoprost (Lumigan)

39
Q

Latisse

A

.003% PG analog - cosmoses for eyelash hypotrichosis

40
Q

Travoprost: other name

A

Travatan 0.004% solution

41
Q

Tafluprost: other name

A

Zioptan 0.0015%

42
Q

Travaprost:

A

PG analog: inactive prodrug

43
Q

Zioptan: what is it?

A

PG analog = Tafluprost

44
Q

Unoprostone: other name

A

Rescula 0.15%

45
Q

Rescula:

A

Unoprostone

46
Q

Which PG is discontinued?

A

Unoprostone/ Rescula

47
Q

5 new approaches to treatment against neuroprotection:

A
  1. Aminogaunidine: only in animals
  2. Brimonidine: a2 agonist
  3. Memantine: NMDA blockers: decrease excitability and help prevent cell death
  4. Reseveratrol: decreases cell death: anti-oxidant/ neuroprotective
  5. Rho Kinase inhibitors: decrease tone in the contractile TM outflow and increase outflow
48
Q

inhibit NOS synthesis: =

A

neuro protection

49
Q

Mannitol: other name

A

Osmitrol I.V.

50
Q

what is an osmotic given via I.V.

A

Mannitol

51
Q

Adverse effects of Osmotic agents:

A

decrease CSF, headache, dry mouth, thirst, hyper osmotic coma (same as high glucose), CHF, pulmonary edema, muscle cramps and edema.

52
Q

maximum effect with mannitol?

A

30-60 min

53
Q

maximum effect in Glycerin:

A

about 60 minutes

54
Q

what is the safer osmotic?

A

glycerin

55
Q

glycerin: other name

A

osmoglyn

56
Q

how is osmoglyn given? I.V. or oral?

A

oral

57
Q

how do osmotic work?

A

dehydration of tissues including the vitreous and CSF

58
Q

what do effectiveness of osmotics work?

A

effect depends on the number of particles

59
Q

when do we use osmotic agents?

A

acute angle closure & pre/post surgery

Ocular Pharmacology (6 decks)

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