Pharm Ophthalmic II Flashcards
why is epinephrine poorly tolderated in glaucoma
local hyperemia and irritation
MOA dipivefrin
prodrug epi
enhance both pathways for aqueous flow
selective a2 agonist that does not readily cross BBB used in glaucoma
apraclonidine
brimonidine
selective a2 agonist that is lipophilic (corneal penetration)
how do apraclonidine and brimonidine work
decrease aqueous production and enhance uveoscleral outflow
adverse effects epinipehrine like compounds in eye
red eye from vasoconstriction-vasodilation rebound
ocular and skin allergies
CNS depression and apnea in neonates
CI in children <2 y.o !!!!
topical CA I names
MOA
dorzolamide and brinzolamide
inhibit CA II in ciliary body
side effects topical CAI
stinging, redness, dry eyes, blurred vision
what is the drug cosopt
timolol and dorzolamide
MOA topical miotic (cholintergic agonist and cholinesterase inhibitor)
lower IOP by causing contraction ciliary muscle facilitating outflow
direct muscarinic agonists
pilocarpine and carbachol
ACHEI
echthiophate
adverse effects of topical miotic agents
young patients- vusual blurring from myopia
ACHEI can cause cataracts
used cautiously in those with increased risk retinal detachment
use of oral CAI
last resort before laser or incisional surgical treatment
best tolerated oral preparation of CAI
acetazolamide in sustained release capsules
CAI systemic effects if taken orallly
malaise, fatigue, depression, paresthesias, nephrolithiasis
topical glucocorticoids used in eye
dexamethasone prednisolone fluorometholone loteprednol rimexolone difluprednate
glucocorticoids used inw hat eye conditions
ocular allergy, anterior uveitis, external eye inflammatory disease
post operative inflammation
how do glucocorticoids reduce scarring from surgical site
delay wound healing process by dec fibroblast infiltration
how are steroids given to eye
usually sub tenons capsule injection or intravitreal
toxicities from steroids in eye
posterior subcapsular cataracts, secondary infections, secondary open angle glaucoma
steroid induced IOP if + FMH glaucoma
NSAIDs used in eye topically
diclofenac flurbiprofen ketorolac bromfenac nepafenac
what is used to counter unwanted intraoperative miosis during cataract surgery
flurbiprofen
what NSAI for seasonal allergic conjunctivitis
ketorolac
