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HEENT > Pharmacology of Glaucoma > Flashcards

Pharmacology of Glaucoma Flashcards

1
Q

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

A

c M1 + M3

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2
Q

What muscarinic receptor do anti-cholinergic receptors block to affect heart?

A

M2

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3
Q

What is the function of the M2 receptor?

a) decrease heart rate
b) increase saliva
c) acid release
d) increase heart rate

A

a) decrease heart rate

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4
Q

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

A

f) heart

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5
Q

What is the function of the M3 receptor on the eye?

A

constricts pupils
contracts ciliary muscle
contracts trabecular meshwork

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6
Q

What two muscles dilate and constrict the iris?

A

Radial muscle dilates

Circular muscle constricts

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7
Q

What receptor is involved with radial muscle dilation?

A

alpha 1 (a1) receptor

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8
Q

What receptor is involved with constriction in the circular muscle?

A

M3 receptor

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9
Q

What is the function of alpha agonists?

a) allow for constriction of eyes
b) allow for dilation of the eyes

A

they allow for dilation of the eyes by increasing muscle tone

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10
Q

What is the function of muscarinic antagonists? What is a specific function relating to the M3 contraction of the pupil?

A

block the function of muscarinic receptors. It will block the contraction of the circular muscle

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11
Q

What may be increased when using Muscaranic antagonists?

A

increase intraocular pressure

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12
Q

List one medication that is an alpha agonist

A

phenylephrine

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13
Q

List 3 common medications from muscarinic antagonists

A
  1. tropicamide
  2. cyclopentolate
  3. atropine
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14
Q

Side effects of eye drops (antimuscarinic drugs)

A
  1. CNS: slight drowsiness, hallucinations
  2. CVD: increase HR,
  3. Respiratory: bronchodilator
  4. GI: decreases secretion
  5. urinary: urinary retention
  6. glands; decreased salivationsweating
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15
Q

What is the main characteristic that is associated with glaucoma?

A

elevated intraocular pressure

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16
Q

Mechanical stress on the retina due to elevated intraocular pressure causes __________ blood supply to the retina (ischemia)

A

decreased

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17
Q

As people age, they lose the integrity of the ________ - ________ barrier

A

blood-retinal barrier

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18
Q

The levels of which neurotransmitter increases with neurotoxic damage?

a) acetylcholine
b) dopamine
c) noradrenaline
d) glutamate

A

d) glutamate

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19
Q

Aqueous humor fills the _______ cavity of the eye to nourish the lens, cornea, and iris

a) posterior
b) interior
c) anterior
d) exterior

A

c) anterior

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20
Q

What is the normal range of IOP?

A

10-21 mmHg

21
Q

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

A

d) iris and ciliary body

22
Q

Which part of the eye does the aqueous humor travel through?

A

trabecular meshwork

23
Q

what are the spaces between bundles of the ciliary muscle

A

uveiscleral outflow

24
Q

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

A

b) the trabecular/uveoscleral outflow is impaired

25
Q

signs of acute angle-closure glaucoma

A

pain, blurred vision, haloes around lights

26
Q

If using a muscarinic agonist in glaucoma what occurs?

a) decreases outflow
b) increases outflow
c) blocks outflow
d) nothing happens

A

b) increases outflow (M3 receptor contracts)

27
Q

What is the function of the ciliary epithelium and what does the B2 adrenergic antagonist drug do with regard to glaucoma?

A

ciliary epithelium produces aqueous humour and the beta-blocker will block the production of aqueous humor and the IOP will decrease

28
Q

Giving an b2 agonist will _______ aqueous humor and giving a b2 antagonist will _______ aqueous humor

A

increase, and decrease

29
Q

Pilocarpine, carbachol, physostigmine are ________ agonists and they ________ trabecular flow

A

muscarinic agonists, and increase trabecular flow

30
Q

Side effects of muscarinic agonists

A

blurred/dimmed vision, ciliary muscle spasm –> headache

cataracts

31
Q

Carbachol lowers intraocular pressure for open angle glaucoma patients. It activates both _______ and _______ receptors

A

nicotinic and muscarinic

32
Q

Which of the following breakdowns acetylcholine?

a) acetylcholinesterase
b) esterlipase
c) acetylase
d) acetylcholine kinase

A

a) acetylcholinesterase

33
Q

Which medication lowers IOP by increasing trabecular outflow and fixing xerostomia?

a) Carbochol
b) latanoprost
c) pilocarpine
d) timolol

A

c) pilocarpine

34
Q

Which medication lowers IOP and Myasthenia Gravis

a) carbachol
b) pilocarpine
c) physostigmine
d) latanoprost

A

c) physostigmine

35
Q

What does the B2 adrenergic receptor do with regards to ciliary epithelium?

A

produces aqueous humor

36
Q

When using a beta-blocker, what changes occur to the heart and respiratory tract?

A

heart: slow down HR and slow down contraction force

Resp. tract: bronchoconstriction

37
Q

What are some side effects of propranolol and what is it used for?

A

Use: angina, hypertension, migraine

Side effects: fatigue, dizziness, depression, bradycardia,

38
Q

Is acebutolol a partial or full agonist?

A

parial agonist

39
Q

What is acebutolol used for and what are its side effects?

A

hypertension and angina

fatigue, dizziness, (less bradycardia)

40
Q

T or F: It is okay for someone with asthma to be using beta-blockers

A

False: they should not because the B2 receptor gets blocked and the lungs get constricted

41
Q

What occurs if timolol gets into the systemic system?

A

bradycardia, fatigue, dizziness.

42
Q

Why does betaxolol work to lower IOP?

A

off target effect. depends on concentration

43
Q

Apraclonidine is a ______ agonist that lowers IOP by decreasing aqueous humor and and increasing outflow

a) B2
b) a2
c) B1
d) a1

A

a2

44
Q

function of prostaglandins in lowering IOP for glaucoma?

A

alter the outflow of the aqueous humor

45
Q

Side effects of prostaglandins?

A

no vision changes
red eyes
dark eyelashs and growth of eyelashes

46
Q

The function of topical anhydrase inhibitors in lowering IOP?

A

blocking bicarbonate ion –> not formed in aqueous humor = less aqueous humor production and less build-up

47
Q

Which of the following drugs contract with ciliary muscle?

a) pilocarpine
b) latanoprost
c) timolol
d) physostigmine
e) apraclonidine

A

a) pilocarpine

d) physostigmine

48
Q

Which of the following drugs decrease aqueous humor production?

a) pilocarpine
b) physostigmine
c) timolol
d) apraclonidine
e) latanoprost

A

c) timolol

d) apraclonidine

HEENT (14 decks)

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