Pharmacology: Cholinergic Agents Flashcards
acetylcholine 1% (Miochol), carbachol 0.01% (Miostat)
two direct muscarinic agents available for intracameral injection (give concentration and trade name)
scleral spur, peripheral retina
muscarinic agonists place tension on two sites via contraction of the longitudinal muscle of the ciliary body
seconds
onset and duration of action of Miochol
5 minutes
onset of Miostat
24 hours
duration of action of Miostat
pilocarpine 0.12%
used to confirm a diagnosis of Adie tonic pupil (drug and concentration)
acetylcholine, bethanechol, carbachol, pilocarpine
four direct-acting miotic agents
1.5, 3
two strengths of Isopto Carbachol available (in percentage)
0.25, 1, 2, 4
four strengths of Isopto Carpine available (in percentage)
4%
strength of Pilopine HS gel available
miosis, cataractogenesis, induced myopia, iris pigment epithelial cysts, retinal detachment
five side effects of topical miotics
POAG
main indication for miotic therapy
pseudophakics
group of patients who are most likely to tolerate miotic therapy
Pilopine HS gel
miotic therapy option that is most likely to be tolerated by younger phakic patients
hypersalivation, diarrhea, bronchospasm, vomiting, diaphoresis
five systemic side effects of miotic agents
qid
dosing frequency of Isopto Carpine
tid
dosing frequency of Isopto Carbachol
neostigmine, physostigmine, edrophonium
name three reversible indirect cholinergic agonists
echothiophate iodide
name the only irreversible indirect cholinergic agonist
butyrylcholinesterase, pseudocholinesterase
enzyme on which that echothiophate acts that contributes to its systemic toxicity
succinylcholine, ester anesthetics
drugs–one specific, one a class–that are largely metabolized by plasma butyrlcholinesterase (whose action is inhibited by echothiophate)
iris pigment epithelial cysts, cataractogenesis
side effects that are fairly specific to phosphorylating cholinesterase inhibitors (one in children, the other in adults)
phenylephrine
concurrent use with echothiophate iodide prevents the development of iris pigment epithelial cysts
true
TRUE or FALSE: The combination of direct-acting and indirect-acting cholinergic agents produces less effect than either agent alone
facilitate examination, aqueous misdirection syndrome, relieve ciliary spasm, prevent posterior synechiae
four uses for cycloplegic agents in ophthalmology