Pharmacology Flashcards
Tx for preseptal cellulitis
Oral antibiotics: augmentin 875 mg po BID
For 7-10 days
*augmentin = amoxicillin-clavulanate
Upneeq
Generic name?
MOA?
Tx?
Generic name: oxymetazoline
MOA: works on alpha-1 receptors to activate muller’s (which elevates eyelid 2-3mm)
Tx: ptosis
What is the primary mechanism of action of pilocarpine?
Pilocarpine pulls on the ciliary muscle, which opens the trabecular meshwork (TM)
This action facilitates corneoscleral outflow, accounting for 80% of the conventional route.
*direct cholinergic agonist, increases outflow via corneoscleral route
What condition can pilocarpine help treat after angle closure?
It can help make the iris tight again by inducing miosis
This is relevant for conditions like acute angle-closure glaucoma.
What are some adverse effects of pilocarpine?
Headaches, brow aches, myopic shift
Myopic shift can cause accommodation issues.
What is the effect of a 0.1% pilocarpine solution on the pupil?
It causes pupil constriction
This is a direct result of cholinergic stimulation.
What is the role of neostigmine in relation to acetylcholine?
It inhibits acetylcholinesterase (AChE)
This action increases the availability of acetylcholine at the neuromuscular junction.
Name two medications used to treat myasthenia gravis.
Neostigmine, Pyridostigmine
Both inhibit AChE to enhance neuromuscular transmission.
What is the distinguishing feature of echothiophate?
It is an irreversible inhibitor of acetylcholinesterase
This characteristic leads to prolonged effects.
What condition could beta blockers exacerbate in the context of cholinergic agonists?
Myasthenia gravis
Beta blockers can worsen symptoms by reducing cholinergic activity.
What is a common side effect of cholinergic agonists related to vision?
Diplopia
This can occur due to the effects on ciliary muscle function.
Fill in the blank: Pilocarpine is used to induce _______ in the treatment of glaucoma.
miosis
True or False: Donepezil is used to treat Alzheimer’s dementia.
True
Donepezil is a cholinesterase inhibitor that helps improve cognitive function.
What does the ciliary muscle do when stimulated by pilocarpine?
It contracts, leading to an opening of the trabecular meshwork
This mechanism is crucial for reducing intraocular pressure.
What is the effect of pilocarpine on the sphincter muscle?
It stimulates the sphincter muscle
This results in pupil constriction and is important in treating certain types of glaucoma.
MOA: inhibit acetylcholinesterase
Neosytgmine
Pyridostigmine
Edrophonium
Echothiophate
Topical ophthalmic indications of fluoroquinolones
- CL related corneal ulcers
- corneal abrasions
- bacterial conjunctivitis
Adverse effects of oral trimethoprim
Aplastic anemia
* bone marrow suppression leads to aplastic anemia
Leukopenia
Granulocytopenia
Metformin
Class?
MOA?
Tx?
Biguanide
* decrease blood glucose by inhibiting gluconeogenesis in liver and by promoting glucose reuptake by liver and muscles
Tx: diabetes
What drug based factors allow for better ability of medication to pass through plasma membranes?
- Smaller molecular structure
- Lipid-soluble
- Non-ionized
Name two examples of sedating antihistamines
Diphenhydramine (Benadryl®), chlorpheniramine (ChlorTrimeton®)
Other examples include promethazine (Phenergan®) and hydroxyzine (Atarax®)
Name four examples of non-sedating antihistamines
Fexofenadine (Allegra®), loratadine (Claritin®), desloratadine (Clarinex®), cetirizine (Zyrtec®)
Non-sedating antihistamines are designed to minimize drowsiness.
True or False: Non-sedating antihistamines cannot cause drowsiness at all.
False
While considered non-sedating, drowsiness is still possible with these medications.
What is a key reason why non-sedating antihistamines are less likely to cause drowsiness?
They don’t cross the blood-brain barrier as much as older antihistamines
This reduced penetration into the central nervous system is why they are less sedating.
What is the sedative effect of Fexofenadine at high doses?
No sedative effect
Studies have shown that Fexofenadine maintains no sedative effects even at high doses.
At what doses can loratadine and desloratadine have a low sedative effect?
Higher doses
At recommended doses, loratadine and desloratadine have no sedative effect.
Fill in the blank: Cetirizine can have a _______ sedative effect at recommended doses.
low
At higher doses, cetirizine can have a moderate sedative effect.
Fill in the blank: The sedative effect of cetirizine at higher doses is considered _______.
moderate
This indicates that cetirizine can cause more drowsiness compared to other non-sedating antihistamines at increased dosages.
What do Class I agents affect?
Sodium channels
Class I agents ultimately serve to either lengthen or shorten the duration of the action potential and help to prevent ventricular arrhythmias.
What is the primary function of Class II agents?
Decrease sympathetic activity of the heart
Class II agents block beta adrenergic receptors and aid in preventing recurrence of myocardial infarction.
How do Class III agents prevent arrhythmias?
By blocking potassium channels
Class III agents prolong repolarization.
What do Class IV agents block?
Calcium channels
Class IV agents decrease conduction through the AV node.
True or False: Class I agents help in preventing ventricular arrhythmias.
True
Fill in the blank: Class II agents aid in preventing recurrence of _______.
myocardial infarction
What is the effect of Class III agents on repolarization?
They prolong it
What is the impact of Class IV agents on the AV node?
Decreases conduction
