Pharmacology of Glaucoma Flashcards
What two receptors are part of the two-receptor system that stimulate salivation?
a) M1 + M2
b) M2 + M3
c) M3 + M1
d) M4 + M2
e) M3 + M4
c M1 + M3
What muscarinic receptor do anti-cholinergic receptors block to affect heart?
M2
What is the function of the M2 receptor?
a) decrease heart rate
b) increase saliva
c) acid release
d) increase heart rate
a) decrease heart rate
Which one of the following is NOT a location of the M3 receptor?
a) GI smooth muscle
b) bladder smooth muscle
c) eye
d) airway smooth muscle
e) glands
f) heart
d) blood vessels
f) heart
What is the function of the M3 receptor on the eye?
constricts pupils
contracts ciliary muscle
contracts trabecular meshwork
What two muscles dilate and constrict the iris?
Radial muscle dilates
Circular muscle constricts
What receptor is involved with radial muscle dilation?
alpha 1 (a1) receptor
What receptor is involved with constriction in the circular muscle?
M3 receptor
What is the function of alpha agonists?
a) allow for constriction of eyes
b) allow for dilation of the eyes
they allow for dilation of the eyes by increasing muscle tone
What is the function of muscarinic antagonists? What is a specific function relating to the M3 contraction of the pupil?
block the function of muscarinic receptors. It will block the contraction of the circular muscle
What may be increased when using Muscaranic antagonists?
increase intraocular pressure
List one medication that is an alpha agonist
phenylephrine
List 3 common medications from muscarinic antagonists
- tropicamide
- cyclopentolate
- atropine
Side effects of eye drops (antimuscarinic drugs)
- CNS: slight drowsiness, hallucinations
- CVD: increase HR,
- Respiratory: bronchodilator
- GI: decreases secretion
- urinary: urinary retention
- glands; decreased salivationsweating
What is the main characteristic that is associated with glaucoma?
elevated intraocular pressure
Mechanical stress on the retina due to elevated intraocular pressure causes __________ blood supply to the retina (ischemia)
decreased
As people age, they lose the integrity of the ________ - ________ barrier
blood-retinal barrier
The levels of which neurotransmitter increases with neurotoxic damage?
a) acetylcholine
b) dopamine
c) noradrenaline
d) glutamate
d) glutamate
Aqueous humor fills the _______ cavity of the eye to nourish the lens, cornea, and iris
a) posterior
b) interior
c) anterior
d) exterior
c) anterior
What is the normal range of IOP?
10-21 mmHg
Which two parts of the eye secretes aqueous humor?
a) trabecular meshwork and schelmms canal
b) retina and iris
c) cornea and ciliary body
d) iris and ciliary body
d) iris and ciliary body
Which part of the eye does the aqueous humor travel through?
trabecular meshwork
what are the spaces between bundles of the ciliary muscle
uveiscleral outflow
In open-angle glaucoma what seems to be the problem?
a) the iris is blocking the flow of aqueous humor
b) the trabecular/uveoscleral outflow is impaired
c) the pressure in the anterior cavity is greater than the posterior
d) there is the resistance between the two chambers
b) the trabecular/uveoscleral outflow is impaired
signs of acute angle-closure glaucoma
pain, blurred vision, haloes around lights
If using a muscarinic agonist in glaucoma what occurs?
a) decreases outflow
b) increases outflow
c) blocks outflow
d) nothing happens
b) increases outflow (M3 receptor contracts)
What is the function of the ciliary epithelium and what does the B2 adrenergic antagonist drug do with regard to glaucoma?
ciliary epithelium produces aqueous humour and the beta-blocker will block the production of aqueous humor and the IOP will decrease
Giving an b2 agonist will _______ aqueous humor and giving a b2 antagonist will _______ aqueous humor
increase, and decrease
Pilocarpine, carbachol, physostigmine are ________ agonists and they ________ trabecular flow
muscarinic agonists, and increase trabecular flow
Side effects of muscarinic agonists
blurred/dimmed vision, ciliary muscle spasm –> headache
cataracts
Carbachol lowers intraocular pressure for open angle glaucoma patients. It activates both _______ and _______ receptors
nicotinic and muscarinic
Which of the following breakdowns acetylcholine?
a) acetylcholinesterase
b) esterlipase
c) acetylase
d) acetylcholine kinase
a) acetylcholinesterase
Which medication lowers IOP by increasing trabecular outflow and fixing xerostomia?
a) Carbochol
b) latanoprost
c) pilocarpine
d) timolol
c) pilocarpine
Which medication lowers IOP and Myasthenia Gravis
a) carbachol
b) pilocarpine
c) physostigmine
d) latanoprost
c) physostigmine
What does the B2 adrenergic receptor do with regards to ciliary epithelium?
produces aqueous humor
When using a beta-blocker, what changes occur to the heart and respiratory tract?
heart: slow down HR and slow down contraction force
Resp. tract: bronchoconstriction
What are some side effects of propranolol and what is it used for?
Use: angina, hypertension, migraine
Side effects: fatigue, dizziness, depression, bradycardia,
Is acebutolol a partial or full agonist?
parial agonist
What is acebutolol used for and what are its side effects?
hypertension and angina
fatigue, dizziness, (less bradycardia)
T or F: It is okay for someone with asthma to be using beta-blockers
False: they should not because the B2 receptor gets blocked and the lungs get constricted
What occurs if timolol gets into the systemic system?
bradycardia, fatigue, dizziness.
Why does betaxolol work to lower IOP?
off target effect. depends on concentration
Apraclonidine is a ______ agonist that lowers IOP by decreasing aqueous humor and and increasing outflow
a) B2
b) a2
c) B1
d) a1
a2
function of prostaglandins in lowering IOP for glaucoma?
alter the outflow of the aqueous humor
Side effects of prostaglandins?
no vision changes
red eyes
dark eyelashs and growth of eyelashes
The function of topical anhydrase inhibitors in lowering IOP?
blocking bicarbonate ion –> not formed in aqueous humor = less aqueous humor production and less build-up
Which of the following drugs contract with ciliary muscle?
a) pilocarpine
b) latanoprost
c) timolol
d) physostigmine
e) apraclonidine
a) pilocarpine
d) physostigmine
Which of the following drugs decrease aqueous humor production?
a) pilocarpine
b) physostigmine
c) timolol
d) apraclonidine
e) latanoprost
c) timolol
d) apraclonidine
