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Medical Pharmacology Exam 1 > Pharmacology of the eye > Flashcards

Pharmacology of the eye Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the 3 components of the uveal tract?

A

iris
ciliary body
choroid

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2
Q

What is the landmark separating the eye into anterior and posterior chambers?

A

The lens

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3
Q

What ocular reflex is a tool for assessing brain damage? What happens to the eye in low light? WHat happens in a lot of light?

A

The consensual pupil response
Mydriasis
Miosis

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4
Q

What is the mechanism by which mydriasis occurs? What is the mediating receptor?

A

Contraction of radial smooth Muscle

Alpha 1 receptors expressed on radial smooth muscle

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5
Q

What 2 drug classes can cause mydriasis?

A

Muscarinic antagonist

Alpha 1 agonist

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6
Q

What is the mechanism by which myosis occurs? What is the mediating receptor?

A

Contraction of the sphincter smooth muscle

M3 muscarinic receptors on iris

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7
Q

What are 2 drug classes that can cause myosis?

A

M3 muscarinic agonist

Opioids

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8
Q

What is the structure that governs accomodation in the eye? What structure controls it and how?

A

The lens govern accomodation

Ciliary muscle attaches to lens via suspensory ligaments

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9
Q

What happens when the ciliary muscle relaxes? Contracts?

A

Relaxes - Decreased lens radius - farsighted

Contracts - Increased lens radius - near sighted

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10
Q

What drug class will improve / increase accomodation?

A

Muscarinic agonist

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11
Q

How are the effects of adrenergic and muscarinic agents differ in the eye?

A

Adrenergic agents cause only mydriasis

Muscarinics antagonists can cause mydriasis and cycloplegia

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12
Q

What is the effect of adrenergic agonists on the ciliary muscle?

A

Nothing - no receptors expressed on them

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13
Q

Where is aqueous humor produced?

A

From blood vessels in the eye, flows into anterior chamber before draining

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14
Q

What are 2 receptors that can be activated to decrease the production of aqueous humor?

A

Alpha 1 and alpha 2, decrease blood flow and resulting aqueous humor production

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15
Q

What is a receptor that can be activated stimulated to increase production of aqueous humor?

A

Beta 1 receptors

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16
Q

What aspect of the eye can potentially bind drugs and affect their concentrations / distribution?

A

Melanin in the iris

17
Q

What can be used to detect corneal lesions or foreign bodies in the eye?

A

Fluorescent dyes

18
Q

What is the effect of muscarinic antagonists on the eye? Which Receptor subtype is targeted and where are they expressed?

A

Mydriasis

M3 on the iris and ciliary muscle

19
Q

What causes glaucoma? What are the 2 factors that determine whether it develops or not?

A

Poor drainage of aqueous humor

  • rate of aqueous humor production
  • rate of drainage
20
Q

Open angle glaucoma is a chronic / acute disease? What causes it?

A

Chronic disease

Inadequate drainage from the canal of schlemm

21
Q

Would you want to stimulate or block beta receptors to treat glaucoma? What is the effect?

A

Inhibit

Block beta 1 on the ciliary body

22
Q

Would you want to stimulate or block alpha receptors to treat glaucoma? What is the effect?

A

Stimulate

Stimulates alpha 2 on ciliary body, alpha 1 on ciliary vessels

23
Q

What is closed angle glaucoma? What causes it?

A

Rapid increase in intraoccular pressure

Iris grows towards cornea, impeding outflow

24
Q

What are 2 miotic producing drugs that can be used to treat closed angle glaucoma?

A

Pilocarpine

Carbachol

25
Q

What is the effect of mydriasis on closed angle glaucoma?

A

It worsens it

26
Q

What can be used to treat squint and blepharospasm? How does it work?

A

Botulinum toxin A

It blocks releases of neurotransmitter, causing muscle relaxation (3-6 weeks)

27
Q

Why aren’t the effects of bethanechol potentiated by an AchE inhibitor?

A

Because bethanechol isn’t a substrate for AchE in the first place

28
Q

The tracing of MAP in response to Epi or norepi is usually biphasic, a first small spike followed by a reduction and then a larger more prolonged spike. What causes these 3 things?

A

Small spike - Due to Beta 1 receptos
Reduction -due to vagal reflexes
Prolonged increase - Due to alpha 1

29
Q

The MAP tracing from Epi but not NE has an overshoot at the tail end of its effects. What mediates this?

A

Beta 2 receptors, activated by Epi but not NE

30
Q

If you wanted to block the vagal reflex that causes the initial reduction in MAP following NE or Epi infusion, what can you use?

A

A ganglionic blocker (Mecamylamine or Trimethaphan)

Medical Pharmacology Exam 1 (15 decks)

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