Epinephrine is an...
alpha-agonist that decreases aqueous humor synthesis via vasoconstriction. (use for open-angle glaucoma)
Side effects of Epinephrine
mydriasis (do NOT use in closed-angle glaucoma)
Brimonidine is an...
alpha2-agonist that decreased aquous humor synthesis (glaucoma)
Brimonidine side effects
-blurry vision -ocular hyperemia -foregin body sensation -ocular allergic rxn and pruritis
Timolol, betaxolol and carteolol are...
beta-blockers that decrease aqueous humor synthesis. (glaucoma)
Acetazolamide is a...
diuretic that decreases aqeous humor synthesis via inhibition of carbonic anhydrase.
Pilocarpine and Carbachol are...
direct cholinomimetics that increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork. (glaucoma)
Side effects of Pilocarpine and Carbachol
miosis and cyclospasm (contraction of ciliary muscle)
Physostigimine and Echothiophate are..
indirect cholinomimetics that can be used in emergencies and are very effective at opening meshwork into the canal of Schlemm.
Latanoprost is a...
PGF2alpha agonist that increases outflow of aqueous humor.
Latanoprost side effect
darkens color of iris
Opioid analgesics (8)
1. morphine 2. fentanyl 3. codeine 4. loperamide 5. methadone 6.meperidine 7. dextromethorphan 8. diphenoxylate
act as agonists at opioid receptors to modulate synaptic transmission (open K+ channels and close Ca2+ leading to decreased synaptic transmission); this inhibits release of ACh, NE, 5-HT, glutamate and substance P
mu = morphine delta = enkephalin kappa = dynorphin
Clinical use of opioids (5)
pain cough suppression diarrhea (loperamide and diphenoxylate) acute pulmonary edema maintenance for heroin addicts (methadone)
Toxciity of opioids
-addiction -respiratory depression -constipation -miosis -additive CNS depression
mu-opioid partial agonist and kappa-opioid agonist; produces analgesia
Use of Butorphanol
Butorphanol can cause opioid withdrawal symptoms if...
pt is also taking full opioid agonist.
weak opioid agonist; also inhibits serotonin and NE reuptake
Use of Tramadol
Toxicity of Tramadol
-similar to opioids -decreases seizure threshold -serotonin syndrome
absence seizures (first line)
MOA of Ethosuximide
blocks thalamic T-Type Calcium channels
Side effects of Ethosuxamide
EFGHIJ -fatigue -GI distress -Headache -Itching -stevens-Johnson syndrome
1. Diazepam 2. Lorazepam
Use of Diazepam and Lorazepam
MOA of Benzodiazepines
increase GABAa action (can also be used for eclampsia seizures)
SE of Benzodiazepines
sedation, tolerance, dependence, respiratory depression
Simple partial seizures complex partial seizures tonic-clonic seizures status epilepticus