Trachte pharmacology Flashcards

1
Q

mydriasis

A
pupillary dilator muscle contraction 
a1 receptor (Norepi)
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2
Q

sympathetic activates what muscle to hold eyelid open and through what receptors

A

superior tarsal muscle

a1 (norepi)

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3
Q

What muscles relax for distant vision and through what receptors

A

Ciliary muscle

Sympathetic –> b2 receptors (more by epinephrine - systemic, not very practical, PS more common for ciliary muscles)

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4
Q

aqueous humor formation through what receptor

A

sympathetic to B(2) receptors - block in glaucoma

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5
Q

inhibition of aqueous humor formation through what

A

sympathetic to a2 receptors

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6
Q

what focuses eye for near vision

A

parasympathetic –> muscarinic receptors –> ciliary muscle contraction

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7
Q

what constricts pupil (miosis)

A

PS –> muscarinic –> popillary sphincter contraction

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8
Q

what enhances drainage of aqueous humor

A

ps –> muscarinic –> trabecular meshwork & canal of schlemm

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9
Q

drugs promoting mydriasis

A

sympathomimetics (stimulate or mimic stimulation of symp nerves)

inhibitors of PS nervous system (atropine)

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10
Q

how does cocaine work

A

inhibit reuptake of norepi into cell

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11
Q

sympathetics overall

A

mydriasis (a1)
contract superior tarsal muscle (a1)
relax ciliary muscle (b2)
enhance AND inhibit aqueous humor formation

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12
Q

parasympathetics overall

A

focus eye for near vision - ciliary muscle
constrict pupil (miosis)
enhance drainage of aqueous humor

muscarinic receptors

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13
Q

phenylephrine

A

drug used in eye drops to dilate pupil

a1 adrenergic stimulant

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14
Q

epinephrine

A

a1 adrenergic stimulant

increases aqueous humor outflow and inhibits formation

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15
Q

cocaine will dilate eye if ___

A

sympathetics are release Norepi (issue with eye, not nerve)

If no response – horners

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16
Q

amphetamine dilates eye if _____

A

postganglionic nerve is present and contains norepi (if no response, postganglionic horners. If response, means signal not getting there from CNS but postganglionic ok)

17
Q

amphetamine mechansism

A

reverses axoplasmic pump

18
Q

response to amphetamine means

A

normal post-ganglionic nerve (issue in pre-ganglionic)

19
Q

test if eye can respond to muscarinic receptors

A

If eye responds to pilocarpine (muscarinic agonist) with miosis, then problem has to be with the nerve (third nerve palsy)
If eye does not respond to pilocarpine, then problem has to be with the eye itself (Atropinic mydriasis)

20
Q

Physostigmine (Isopto eserine), Ecothiophate (phospholine iodide), demecarium (Humorsol), isofluorophate (floropryl)

A

AchE inhibitors

21
Q

terazosin

A

a1 receptor agonist - has eye side effects

22
Q

reserpine

A

norepi depleting - side effects

23
Q

tx for glaucoma overall

A
beta blockers
muscarinic receptor agonists
AntiAchE
a2 agonists
epinephrine
latanoprost (prostaglandin)
CA inhibitors
24
Q

beta blockers and glaucoma

A

decrease aqueous humor formation (decrease sympathetic innervation to make it)

25
Q

muscarinic receptor agonists and glaucoma

A

pilocarpine

enhances aqueous humor drainage

26
Q

anticholinesterases and glaucoma

A

physostigmine, ecothiophate - enhances aqueous humor drainage

27
Q

a2 agonists and glaucoma

A

apraclonidine and brimonidine, reduce humor formation

28
Q

epinephrine and glaucoma

A

increase aqueous humor outflow but supress production

29
Q

most common tx glaucoma

A

latanoprost (prostaglandin derivative)

increase uveo-sceral outflow of aqueous humor

30
Q

CA inhibitors and glaucoma

A

acetazolamide - reserved if others dont work

31
Q

tx of muscle spasms in eyes (strabismus) and blepharospasm

A

botox - inhib. ach release from somatic nerves