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Year 2 neuro exam 1 > Pharm Ophthalmic I > Flashcards

Pharm Ophthalmic I Flashcards

1
Q

most common route administration ocular drugs

A

topical

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2
Q

locations for local injections in eye

A 
subconjunctiva;
retrobulbar
sub tenons
intracameral (ant chamber)
intravitreal
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3
Q

what barriers keep eye separated from systemic access

A

blood-retina
blood-aqueous
blood-vitreous

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4
Q

rate and extent of absorption for topical eye drugs

A

determined by time in the cul de sac and precorneal tear film
elimination by nasolacrimal drainage
drug binding to tear proteins
drug metabolis by tear and tissue protesins
diffusion across cornea and conjuctiva

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5
Q

what is reason for systemic complications of topical drugs used chronically

A

absorption from nasal mucosa avoiding first pass metabolism in liver

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6
Q

what are the desired routes for localized ocular effects

A

transcorneal and transconjunctiva/scleral absorption

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7
Q

type of drug best suited for transcorneal absorption and why

A

hydrophilic and hydrophobic

trilamellar

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8
Q

pro drug for epinephrine

A

dipivefrin hydrochloride

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9
Q

pro drug for PG F2alpha

A

latanoprost

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10
Q

what metabolizes the prod drugs given to eye

A

esterases

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11
Q

topically applied ocular drugs are eliminated how after systemic absorption

A

liver and kidney

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12
Q

what type of drug class can affect iris sphincter muscle that constricts pupils

A

PAN stimulation or inhibition

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13
Q

what is miosis

mydriasis

A

miosis is small pupils

mydriasis is large pupils

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14
Q

what type of drug class can affect the iris dilator muscle

A

sympathetic activaiton

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15
Q

what type of drug class can affect ciliary muscle

A

SAN activation
PAN activation
PAN inhibition

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16
Q

What is anisocoria

A

inequality of pupils

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17
Q

Horners syndrome

A

injury to SAN
ptosis
miosis
anhydrosis

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18
Q

third CN injury

A

ptosis

mydriasis!

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19
Q

Adies pupil

A

injury to PAN tract
mydriasis
loss of DTR
excessive sweating

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20
Q

adies pupil super sensitive to what drugs

A

muscarinic agonists like pilocarpine

21
Q

give alpha adrenergic agonist to normal eye

A

dilation! via dilator radial muscle and alpha 1 R

22
Q

five muscarinic agonist to normal eye

A

constriction! via circular sphincter m, M3 M2 R

23
Q

if give hydroxyamphetamine to someone with horners and eye dilates what does this mean

A

preganglionic horners because the pupil is still responsive to local release of NE
would be postganglionic if no dilation occured

24
Q

pilocarpine to adies pupil would cause

A

constriction

25
Q

if give opioid to nomral eye

A

pinpoint pupil

Mu R

26
Q

What type glaucoma causes progressive loss of retinal ganglion cell axons

A

open angle

cause visua lfield loss

27
Q

second leading cause of blindness in US in african americans, 3rd in caucasians and leading in hispanics

A

glaucoma

28
Q

ocular hypertensives

A

can tolerate intraocular P >21mmHg

29
Q

normal or low tension glaucoma

A

normal IOP but still have nerve damage

30
Q

roles of ciliary body

A

secretion of aqeuous humor by epithelial bilayer

accommodation by ciliary muscle

31
Q

accommodation of eye can be blocked how

A

muscarininc cholinergic antagonists

cycloplegia

32
Q

what secretes aqueous humor

A

ciliary epithelial processes

33
Q

how does aqueous humor flow

A

post chamber through pupil into ant chamber

34
Q

how do we reduce aqueous humor

A

beta blockers and carbonic anhydrase inhibitors

35
Q

how does aqueous humor leave eye

A

trabecular meshwork and canal of schlemm

36
Q

main target of cholinergic agonists in glaucoma therapy

A

canal of schlemm and trabelcular meshwork

37
Q

second pathway where aqueous humor flows out

A

uveosclera

through ciliary muscles into supreachoroidal space

38
Q

uveosclera route of aqueous flow is targeted how with drugs

A

protanoids like latanoprost

39
Q

area that determines the 2 forms of glaucoma

A

peripheral anterior chamber

40
Q

EM Tx for angle closure glaucoma

A

removal of part of iris

41
Q

drugs contraindicationed in closed angle glaucoma

A

antimuscarinics, antihistamines with antimuscarinic activity

alpha 1 agonists

42
Q

agents that reduce aqueous humor secretion

A

beta blockers
carbonic anhydrase inhibitors
alpha adrenergics (a2)

43
Q

agents that increase aqueous humor outflow

A

prostaglandin F2a analogs
alpha adrenergics
parasympathomimetics: muscarinic agonist and ACHEI

44
Q

what drug can be taken orally for open angle glaucoma

A

acetazolamide, dichlorphenamide and methazolamide

all CA Inhibitors

45
Q

preferred medication for glaucoma

A

PG F2a

latanoprost

46
Q

MOA PG F2a

A

increase outflow via uveoscleral pathway

47
Q

what beta blockers are used in galucoma

A

timolol, levobunolol, metipranolol and carteolol

48
Q

MOA beta blockers in glaucoma

A

target ciliary epithelium and blood vessels

dec aqeusou humor production reduce IOP

49
Q

adverse effects b blockers in glaucoma

A

heart and airway susceptible individuals

may interact with verapamil and increase risk heart block

Year 2 neuro exam 1 (23 decks)

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