Pharmacology I

Question 1

What is the general purpose of glaucoma drugs?

Answer 1

To decrease IOP via decreasing the amount of aqueous humor (p.449)

Question 2

By what two mechanisms do glaucoma drugs typically reduce IOP?

Answer 2

Inhibiting aqueous humor synthesis or by increasing aqueous humor drainage (p.449)

Question 3

Name the five drug classes used to treat glaucoma.

Answer 3

a-agonists, b-blockers, diuretics, cholinomimetics, prostaglandins (p.449)

Question 4

Which two alpha agonists are most commonly used to treat glaucoma?

Answer 4

Epinephrine, Brimonidine (a2) (p.449)

Question 5

How does epinephrine treat glaucoma?

Answer 5

By decreasing aqueous humor synthesis via vasoconstriction (p.449)

Question 6

How does brimonidine (a2) treat glaucoma?

Answer 6

By decreasing aqueous humor syntehsis (p.449)

Question 7

What are the side effects of epinephrine in glaucoma treatment?

Answer 7

Mydriasis; do not use in closed angle glaucoma (p.449)

Question 8

What are the side effects of brimonidine (a2)?

Answer 8

Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular puritis (p.449)

Question 9

What beta blockers are used to treat glaucoma?

Answer 9

Timolol, betaxolol, caretolol (p.449)

Question 10

How does beta blockers function to treat glaucoma?

Answer 10

By decreasing aqueous humor syntehsis (p.449)

Question 11

What side effects occur with use of beta blockers in treatment of glaucoma?

Answer 11

No pupillary or vision changes (p.449)

Question 12

What diuretic is used to treat glaucoma?

Answer 12

Acetazolamide (p.449)

Question 13

How does acetazolamide function to treat glaucoma?

Answer 13

By decreasing aqueous humor synthesis via inhibition of carbonic anhydrase (p.449)

Question 14

What side effects occur with use of acetazolamide in treatment of glaucoma?

Answer 14

No pupillary or vision changes (p.449)

Question 15

What subclasses of cholinomimetics are used to treat glaucoma?

Answer 15

Direct and indirect cholinomimetics (p.449)

Question 16

Which direct cholinomimetics are used to treat glaucoma?

Answer 16

Pilocarpine, carbachol (p.449)

Question 17

Which indirect cholinomimetics are used to treat glaucoma?

Answer 17

Physostigmine, echothiopate (p.449)

Question 18

How do direct and indirect cholinomimetics function to treat glaucoma?

Answer 18

By increasing outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork (p.449)

Question 19

When is pilocarpine specifically used to treat glaucoma and why?

Answer 19

In emergencies as it si very effective at opening the meshwork into the canal of Schlemm (p.449)

Question 20

What side effects occur with use of cholinomimetics in treatment of glaucoma?

Answer 20

Miosis and cyclospasm (contraction of ciliary muscle) (p.449)

Question 21

What type of prostaglandin is used to treat glaucoma?

Answer 21

Latanoprost (PGF2a) (p.449)

Question 22

What is the mechanism of action of Latanoprost (PGF2a) in treatment of glaucoma?

Answer 22

Increased outflow of aqueous humor (p.449)

Question 23

What is the mechanism of action of opiod analgesics?

Answer 23

Opiod receptor agonists to modulate synaptic transmission- open K+ channels, close Ca2+ channels, decerase synaptic transmission. Inhibit release of Ach, NE, 5-HT, glutamate, substance P (p.449)

Question 24

What is the mechanism of action of Butorphanol?

Answer 24

Mu opiod partial agonist and kappa opioid receptor agonist; produces analgesia (p.449)