Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BHS 256 - Pharmacology III > Test 1 - Glaucoma Management > Flashcards

Test 1 - Glaucoma Management Flashcards

1
Q

What are the common drug names for:

1) Acetazolamide
2) Methazolamide
3) Dorzolamide
4) Brinzolamide

Which ones are systemic and which ones are topical?

A

1) Acetazolamide - Diamox, systemic
2) Methazolamide - Neptazane, systemic
3) Dorzolamide - Trusopt, topical
4) Brinzolamide - Azopt, topical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the effect of systemic CAI agents on IOP and aqueous production? (Increase/Decrease)

The main cause of all the toxicities is metabolic _______? (alkylosis, acidosis)

A
  • decrease IOP and aqueous production

- metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is FALSE about the adverse effects of CAI?

A. Drug is tolerated well beyond 6 weeks.
B. Patients experience abnormal (metallic taste)
C. Affects GI, irritation, NVD, anorexia
D. Patients experience malaise

A

A. Drug is not well tolerated beyond 6 weeks but is better with Sequels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is TRUE about the adverse effects of CAI?

A. Patients are at risk of hypokalemia and diuresis
B. Hyperopic Shift
C. Aplastic anemia is a common adverse effect
D. 10-15% of patients experience renal stones and colic

A

A. Patients are at risk of hypokalemia and diuresis

  • Myopic shift
  • Aplastic anemia is rare
  • Only 5-10% patients experience renal stones and colic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is FALSE about methazolamide compared to acetazolamide?

A. Causes less acidosis
B. Causes less drowsiness
C. Better tolerated at low doses
D. Less risk of renal stones and colic

A

B. Causes less drowsiness is false.

Causes more drowsiness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which is NOT a contradiction of CAI?

A. sulfa allergic hypersensitivity
B. renal dysfunction
C. hyperkalemia
D. cirrhosis of liver

A

C. hyperkalemia

hypokalemia is a contradiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which is NOT a contradiction of CAI?

A. severe COPD
B. renal calculi (Kidney stones)
C. Pregnancy
D. Use in acute, short term angle closure

A

D. Use in acute, short term angle closure

Do not use in CHRONIC, non-congestive angle closure for long term (narrow angles)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is TRUE about topical CAI?

A. Plasma levels about 1/20th the amount needed for pharmacological effects
B. Concentration in the ciliary body is less compared to systemic acetazolamide
C. Topical CAI inhibit aqueous humor formation to the same degree as systemic agents.
D. Topical CAI’s reduce normal IOP and control dirunal variations better than other topical aqueous inhibitors.

A

D. Topical CAI’s reduce normal IOP and control dirunal variations better than other topical aqueous inhibitors.

  • plasma levels about 1/200th the amount needed for pharmacological events
  • concentration in ciliary body is the same compared to acetazolamide
  • topical CAI DOES NOT inhibit aqueous humor to the same degree as systemics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is FALSE about toical CAI’s?

A. Ocular allergies occur less frequently with brinzolamide
B. Patients with previous intraocular surgery can suffer corneal endothelial compromise after weeks of topical CAI use
C. The benefits of Topical CAI’s can be enhanced when used concurrently with Systemic CAI’s

A

C. The benefits of Topical CAI’s can be enhanced when used concurrently with Systemic CAI’s

DO NOT used topical CAI’s with Systemic CAI’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the common drug names for:

A) Latanoprost
B) Bimatoprost
C) Travapost
D) Tafluprost

A

A) Latanoprost - Xalatan
B) Bimatoprost - Lumigan
C) Travapost - Travatan
D) Tafluprost - Zioptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MOA for postaglandin analogs? (What receptors does it bind to, what does the receptors do?, what enzymes decrease IOP in the trabecular meshwork and how)

A
  • binds to prostanoid receptor for PGF2 alpha
  • increases outflow via uveoscleral path
  • receptors increase MMP’s
  • Increase matrix metalloproteinases (MMPs) degrade extracellular matrix proteins (collagen) in ciliary muscle and sclera
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is FALSE about properties of Latanoprost?

A) it’s a PGF2alpha analog
B) It’s peak effect is in 12 hours, peak aqueous concentration in 2 hours
C) Comparable effect to timolol
D) No tolerance development
E) Can not be used with other glaucoma drugs or as an individual agents
F) Has very few systemic toxicities

A

E) Can not be used with other glaucoma drugs or as an individual agents

Latanaprost CAN be used with other glaucoma drugs or as individual agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is NOT an expected toxicity of prostoglandin analogs?

A) Blurred Vision
B) Hyperemia (excessive blood flow)
C) Burning, sting or foreign body sensation
D) Increased Iris Pigmentation
E) Increased Eyelash Growth and Pigmentation
F) GI Upset

A

F) GI Upset

  • few systemic toxicities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which are NOT a contraindication or caution of prostoglandin analog?

A) Hypersensitivity to other PG analogs
B) History of ocular inflammation
C) Aphakia/Pseudoaphakia
D) History of cystoid macular edema
E) History of Herpes Simplex
A

E) History of Herpes Simplex

Herpes simplex may cause corneal pseudodendrites but is not a contraindication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which drug is a synthetic prostamide analog? Which drug has the highest and lowest concentration?

A) Xalatan
B) Lumigan
C) Travatan
D) Tafluprost

A

B) Lumigan

Highest concentration: Lumigan - 0.03%
Lowest concentration: Tafluprost - 0.015%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Match each drug with MOA and effect on cell

A) Neuroprotection
B) Brimonidine
C) Memantine
D) Resveratrol

1) Antioxidant, decrease cell death in vitro. Reduces ARMD
2) Alpha-2 agonist, decreases cell death in cases of retinal ischemia
3) NMDA receptor blocker, prevent cell death from excess glutamate on NMDA
4) Nitric Oxide synthesis inhibitor, decrease apoptosis and retinal cell death

A

A) Neuroprotection - Nitric Oxide synthesis inhibitor, decrease apoptosis and retinal cell death
B) Brimonidine - Alpha-2 agonist, decreases cell death in cases of retinal ischemia
C) Memantine - NMDA receptor blocker, prevent cell death from excess glutamate on NMDA
D) Resveratrol - Antioxidant, decrease cell death in vitro. Reduces ARMD

17
Q

What is TRUE about osmotic agents?

A) See decrease in plasma osmolarity
B) Dehydrates vitreous and CSF
C) Not useful for acute angle closure and pre/post surgery
D) Only comes in oral agents
E) Effect is not dependant on the number of molecules

A

B) Dehydrates vitreous and CSF

  • Increase plasma osmolarity
  • Fast acting, so useful for acute angle closure and pre/post surgery
  • comes in Oral and IV
  • Effect is dependant on number of molecules
18
Q

What is NOT an adverse effects of osmotic agents?

A) headaches
B) dry mouth, thirst
C) Nausea, Vomiting
D) Muscle cramping, weakness
E) CHF and pulmonary edema
F) hypoosmotic coma
A

F) hypoosmotic coma

Causes a hyperosmotic coma

19
Q

Describe the following for mannitol:

1) Method of administration (IV or oral)
2) Main toxicity (has to do with volume)
3) Max effect (minutes) and duration (hours)
4) Drug Name

A
  • IV
  • volume overload and pulmonary edema
  • max effect 30-60 minutes, duration 6-8 hours
  • Osmitrol
20
Q

Describe the following for glycerin:

1) Method of administration (IV or oral)
2) Caution for which population
3) Max effect (minutes) and duration (hours)
4) Drug Name

A

1) oral
2) Diabetics
3) Max effect 1 hour, duration 5 hours
4) Osmoglyn

21
Q

Describe the MOA for alcohol and marijuana

A

Alcohol - osmotic diuretic

Marijuana - prostanoid like receptor (cannabinoid) decreases BP thereby decrease IOP

BHS 256 - Pharmacology III (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions