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Ocular Pharmacology > Packet 2: Cholinergic Agents > Flashcards

Packet 2: Cholinergic Agents Flashcards

1
Q

ACH

A

DIRECT acting Cholinergic (Muscarinic):biotic

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2
Q

Intracameral injection of ACH

A

Miochol

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3
Q

intracameral injection of Carbachol

A

Miostat

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4
Q

Carbachol: other name

A

Carcholin

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5
Q

Carbachol

A

DIRECT acting Cholinergic Muscarinic - miotic

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6
Q

which is used intra-op or pre-op to prevent increased IOP

A

Carbachol

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7
Q

Pilocarpine:

A

DIRECT acting cholinergic muscarinic: miotic

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8
Q

Pilocarpine: treats?

A

POAG and closed angle 2%

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9
Q

should you use pilo to reverse mydriasis?

A

no, risk of pupilary block

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10
Q

what is the most popular cholingeric agonist? (miotic)

A

Pilocarpine

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11
Q

Ocular response to Pilocarpine:

A

increase accommodation, and increase aqueous outflow

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12
Q

does Pilo have pigment binding?

A

Yes, so dark irides will respond less

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13
Q

Do B-blockers have pigment binding?

A

No, they bind the same

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14
Q

Does latanoprost have pigment binding?

A

No, no effect on iris color or pigment

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15
Q

Indications for mydriasis?

A

cycloplegia, inflammation of the urea, myopia, amblyopia

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16
Q

what are contraindications for atropine?

A

glaucoma, and downs syndrome
-closed and open angle
downs syndrome is more sensitive to reactionstropine

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17
Q

physostigmine is an antidote to what?

A

atropine

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18
Q

what is atropine’s antidote?

A

physostigine

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19
Q

what does physostigmine do?

A

blocks ACH metabolism: so increase ACH (could be mitotic) and have those toxicities as well.

20
Q

cyclopentalate: other name

A

cyclogyl

21
Q

when would you not use cyclopentalate?

A

accommodative esotropia and latent hyperopia

22
Q

drug of choice for 7-8 y.o and older?

A

cyclopentalate

23
Q

max effects for cyclopentalate?

A

30-40 minutes

24
Q

duration for cyclopentalate?

A

2-4 hours

25
Q

side effects of cyclopentalate?

A

irritation and lacrimation, conj hyperemia, allergic bleph, increased IOP, drowsiness and ataxia

26
Q

paradoxical effects of cyclopentalate?

A

disorientation, incoherent speech, restlessness, visual hallucinations

27
Q

what moves into the cornea fastest?

A

nonionized.

28
Q

tropic amide: other name

A

mydriacyl

29
Q

what is the max mydriasis for tropic tropicamide:

A

20-30 minutes

30
Q

pka of tropicamide?

A

5.4 (base) so becomes non ionized when moved into the tears

31
Q

systemic effects of tropicamide:

A

there are very minimal systemic side effects with tropicamide.

32
Q

what do you want in a cyclo drop?

A

most mydriasis with least cycloplegia

33
Q

what gives us the best mydyasis and least cyclo?

A

paremyd

34
Q

what is paremyd?

A

.25% trop and 1% hydroxyamp.

35
Q

cyclomydril:

A

1% pheny & .2% cyclopentolate

36
Q

peds department cycloplegia spray concentrations:

A
  • 10 ml of 1% tropicamide
  • 5 ml of 10% phenylephrine
  • 5 ml of 2% cyclopentolate
37
Q

peds department for dilation

A

-10 ml of 1% tropicamide
-5 ml of 10% phenylephrine
5 ml of saline

38
Q

which cyclo drop last too long for normal use:

A

homatrophine and atropine

39
Q

Ecothiophate: other name

A

Phospholine 0.125% solution

40
Q

Ecothiopahte: MOA

A

INDIRECT Parasympathomimetics: inhibit AchE

-therefore increase ACH and could cause the same toxicities that direct acting choingeric agents can

41
Q

Pralidoxime: MOA

A

reactivates AchE

42
Q

Pralidoxime: other name

A

Protopam 2-PAM

43
Q

What is protopam?

A

Pralidoxime: inhibit AchE at both muscarinic and nicotinic sites

44
Q

when do we use indirect acting parasympathomimetics?

A
  1. glaucoma- no longer used because of toxicities

2. accommodative esotropia

45
Q

Major Ocular Effects of Miotics:

A
  • accommodative spasm
  • allergic bleh
  • anterior sub capsular cataract
  • pupillary block
  • band keratopath
  • miotic cysts
  • conj. injection
  • follicular conjuntivitis
  • retinal detachment
  • lid myopkmia
46
Q

what are contraindications for Miotics?

A
  • cataracts
  • under 40: because pilo can mess with accommodating
  • neovascularization
  • RD
  • Asthma: bronchoconstriction is bad for asthma
  • Phakic eyes: ONLY WITH ECHOTHIOPHATE

Ocular Pharmacology (6 decks)

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