Glaucoma

Question 1

2 ways to treat glaucoma

Answer 1

increase drainage (outflow)
decrease aqueous humor

Question 2

Open angle glaucoma

Answer 2

chronic
painless
decrease aq drainage

Question 3

How do you treat open angle glaucoma?

Answer 3

drugs, reducing IOP

Question 4

closed narrow angle glaucoma

Answer 4

angle between iris and cornea reduced
block outflow
acute
ocular pain

Question 5

How do you treat closed angle glaucoma?

Answer 5

surgically

Question 6

What type of glaucoma has IOP >30?

Answer 6

closed angle

Question 7

Which type of glaucoma is more common?

Answer 7

open angle

Question 8

Beta blocker role in glaucoma

Answer 8

decrease formation

Question 9

Alpha 2 agonist role in glaucoma

Answer 9

decrease formation

Question 10

prostaglandin role in glaucoma

Answer 10

increase outflow

Question 11

What is a BB used for glaucoma?

Answer 11

timolol

Question 12

What is an alpha 2 agonist used in glaucoma?

Answer 12

brimonidine

Question 13

What is a prostaglandin used in glaucoma?

Answer 13

latanoprost

Question 14

timolol MOA

Answer 14

nonselective BB
decrease IOP
unclear

Question 15

Why is a nonselective BB okay for glaucoma?

Answer 15

B2 predominate in ciliary body, so non selective is better than B1 selective

Question 16

List in order the most common used agents for glaucoma

Answer 16

1. prostaglandin
2. BB
3. alpha 2 agonist

Question 17

Timolol CI

Answer 17

asthma

cardiac insufficiency

Question 18

brimonidine MOA

Answer 18

a2 selective
decrease aq humor production
increase outflow long term
decrease IOP

Question 19

brimonidine uses

Answer 19

open angle glaucoma

ocular HTN

Question 20

t/f brimonidine is okay for long term use

Answer 20

true

Question 21

ADE brimonidine

Answer 21

dry mouth
ocular hyperemia (red eye)
foreign body sensation
local burning/stinging

Question 22

Systemic effects of brimonidine

Answer 22

hypotension
drowsiness
fatigue

Question 23

latanoprost MOA

Answer 23

increase outflow through uveoscleral pathway

bind FP receptors (relax ciliary muscle)

Question 24

latanoprost uses

Answer 24

glaucoma

increase diameter of eyelashes

Question 25

ADE latanoprost

Answer 25

well tolerated | darkening pigment of iris

Question 26

Pheochromocytoma

Answer 26

tumor of adrenal medulla that secretes catecholamines

Question 27

symptoms of pheochromocytoma

Answer 27

severe HTN HA palpitations sweating

Question 28

What are used for pheochromocytoma until surgery?

Answer 28

alpha receptor antagonists

Question 29

Phentolamine

Answer 29

competitive antagonist reversible blockade short DOA

Question 30

Phenoxybenzamine

Answer 30

covalent binding irreversible blockade long DOA

Question 31

What does phentolamine do to curve with BP and log dose NE?

Answer 31

shift curve right

Question 32

What does phenoxybenazmine do to curve with BP and log dose NE?

Answer 32

decrease max response

Question 33

Phentolamine/phenoxybenzamine effects

Answer 33

``` attenuate vasoconstriciton (decrease MAP) increase NE release ```

Question 34

phenoxybenzamine use

Answer 34

long term management (1-3 weeks) | prior to surgery for pheo-related HTN

Question 35

phentolamine use

Answer 35

rapid reverse of dental anesthesia | short term management for pheo-related HTN

Question 36

ADE of phentomlamine/phenoxybenzamie

Answer 36

- orthostatic hypotension | - reflex tachycardia

Question 37

overdose of phentolamine/phenoxybenzamine

Answer 37

treat with NE (not Epi) | **NE dose not stimulate vascular B2 receptors

Question 38

prevent orthostatic hypotension with phentolamine/phenoxybenzamine drugs

Answer 38

BB may be given, but admin alone to pheo patients

Question 39

Modafinil MOA

Answer 39

CNS psychostimulant | unclear

Question 40

How does modafinil differ from amphetamine?

Answer 40

- differ in structure, neurochemical profile, behavioral effects

Question 41

Where does modafinil bind?

Answer 41

NE and DA transporters | - block reuptake

Question 42

What can modafinil activate?

Answer 42

orexin neurons: hypocretin (promote wakefullness)

Question 43

FDA use for modafinil

Answer 43

narcolepsy shift work sleep disorder sleep apnea

Question 44

Off label use for modafinil

Answer 44

ADHD fatigue from MS and PD cognitive enhancement

Question 45

Military use for modafinil

Answer 45

alternative to amphetamine for prolonged combat missions

Question 46

T/F modafinil has same abuse potential as amphetamine

Answer 46

less

Question 47

ADE for modafinil

Answer 47

``` hypersensitivity reactions (SJS) dose reduction necessary with hepatic dysfunction ```

Question 48

What receptors do you want to block to increase outflow?

Answer 48

stimulate M3

Question 49

What receptors do you want to block to decrease aqueous humor?

Answer 49

block B2 | Stimulate a1