Ocular

Question 1

Acetylcholine

Answer 1

C: Direct muscarinic agonist
M: Pupillary constriction, increased aqueous outflow
T: Cataract surgery, treatment of glaucoma
SE: –
MISC: “Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating”

Question 2

Pilocarpine HCl (Salagen)

Answer 2

C: Direct muscarinic agonist
M: Pupillary constriction, increased aqueous outflow
T: Cataract surgery, treatment of glaucoma
SE: –
MISC: “Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating”

Question 3

Carbachol (Miostat)

Answer 3

C: Direct muscarinic agonist
M: Pupillary constriction, increased aqueous outflow
T: Cataract surgery, treatment of glaucoma
SE: –
MISC: “Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating”

Question 4

Echothiophate iodide (Phospholine)

Answer 4

C: Indirect muscarinic agonist
M: Irreversibly binds cholinesterase
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Bronchospasm, salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus, lacrimation, sweating”

Question 5

Atropine

Answer 5

C: Antimuscarinic
M: Pupillary dilatation; paralysis of ciliary body
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”

Question 6

Scopolamine

Answer 6

C: Antimuscarinic
M: Pupillary dilatation; paralysis of ciliary body
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”

Question 7

Homatropine (Equipin)

Answer 7

C: Antimuscarinic
M: Pupillary dilatation; paralysis of ciliary body
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”

Question 8

Cyclopentolate (Cyclogyl)

Answer 8

C: Antimuscarinic
M: Pupillary dilatation; paralysis of ciliary body
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”

Question 9

Tropicamide (Mydriacyl)

Answer 9

C: Antimuscarinic
M: Pupillary dilatation; paralysis of ciliary body
T: Cycloplegia for eye exams, improve discomfort during active eye inflammation (ueveitis)
SE: –
MISC: “Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention”

Question 10

Edrophonium (Enlon)

Answer 10

C: Nm agonist
M: Destroys acetylcholinesterase
T: Diagnose myasthenia gravis
SE: --
MISC: --

Question 11

Ephinephrine

Answer 11

C: Direct adrenergic agonist
M: Dilation of episcleral vessels –> increased aqueous outflow
T: Glaucoma
SE: Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating
MISC: –

Question 12

Dipivefrin HCl (Propine)

Answer 12

C: Direct adrenergic agonist
M: Prodrug of epinpehrine
T: --
SE: --
MISC: --

Question 13

Hydroxyamphetamine (Paredrine)

Answer 13

C: Indirect adrenergic agonist
M: Release NE
T: Separates 1st and 2nd from 3rd order neuron dysfunction in Horner's syndrome; positive dilation means 1st or 2nd order, an ominous sign
SE: --
MISC: --

Question 14

Cocaine

Answer 14

C: Indirect adrenergic agonist
M: Prevent reuptake of NE
T: --
SE: --
MISC: --

Question 15

Apraclonidine (Iopidine)

Answer 15

C: Direct α-agonist
M: Amino derivative of clonidine; does not cross blood-brain barrier --> minimal effect on systemic blood pressure
T: --
SE: --
MISC: --

Question 16

Phenylephrine (Neo-Synephrine)

Answer 16

C: Direct α1-agonist
M: --
T: Dilate pupil
SE: Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating
MISC: --

Question 17

Clonidine (Catapres)

Answer 17

C: Direct α2-agonist
M: Lowers intraocular pressure through central nervous system effects
T: --
SE: --
MISC: --

Question 18

Brimondine tartrate (Alphagan)

Answer 18

C: Direct α2-agonist
M: Suppresses aqueous humor production through action of cAMP in non-pigmented ciliary epithelium
T: –
SE: –
MISC: Contraindicated with follicular conjunctivitis; use with MAOi can cause fatigue/drowsiness

Question 19

Dapiprazole

Answer 19

C: α-antagonist
M: Blocks alpha-adrenergic receptors in smooth dilator muscle of iris
T: Reverses tropicamide, phenylephrine
SE: --
MISC: Not currently available

Question 20

Tamsulosin (Flomax)

Answer 20

C: α1-antagonist
M: Antagonist
T: Prostate hypertrophy
SE: --
MISC: Blocks iris dilator muscle, making cataract surgery much more difficult and with a much higher incidence of complications

Question 21

Timolol (Timoptic)

Answer 21

C: β-blocker
M: Reduce intraocular pressure by reducing aqueous production at the ciliary process
T: Glaucoma
SE: “Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
MISC: Contraindicated in CHF, asthma; bradycardia over time may produce tachyphylaxis

Question 22

Levobunolol (Betagan)

Answer 22

C: β-blocker
M: Reduce intraocular pressure by reducing aqueous production at the ciliary process
T: Glaucoma
SE: “Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
MISC: –

Question 23

Metipranolol (OptiPranolol)

Answer 23

C: β-blocker
M: Non-selective β1+2 blocker without significant intrinsic sympathomimetic activity (weak membrane stabilization, weak mycoardial depressant)
T: Glaucoma
SE: “Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
MISC: Only b-blocker that doesn’t follow the rule

Question 24

Carteolol (Ocupress)

Answer 24

C: β-blocker
M: Antagonist
T: Glaucoma
SE: “Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia”
MISC: –

Question 25

Betaxolol (Betoptic)

Answer 25

``` C: β1-blocker M: Reduce intraocular pressure by reducing aqueous production at the ciliary process T: Glaucoma SE: -- MISC: -- ```

Question 26

Latanoprast (Xalatan)

Answer 26

C: Prostaglandin analog M: Increase uveoscleral outflow T: Glaucoma SE: Eyelash growth, change in iris color, intraocular inflammation MISC: Contraindicated in cystoid macular edema and herpes

Question 27

Travoprost (Travatan)

Answer 27

``` C: Prostaglandin analog M: Increase uveoscleral outflow T: Glaucoma SE: Eyelash growth, change in iris color MISC: Contraindicated in cystoid macular edema and herpes; more effective in African Americans ```

Question 28

Bimatoprost (Lumigan)

Answer 28

``` C: Prostaglandin analog M: Increase uveoscleral outflow T: Glaucoma SE: Eyelash growth, change in iris color MISC: Contraindicated in cystoid macular edema and herpes ```

Question 29

Unoprostone isopryl (Rescula)

Answer 29

``` C: Prostaglandin analog M: Increase uveoscleral outflow T: Glaucoma SE: Eyelash growth, change in iris color MISC: Least effective overall ```

Question 30

Nifedipine (Procardia)

Answer 30

``` C: Ca-channel blocker M: Increases ocular perfusion at nervehead T: Glaucoma SE: -- MISC: -- ```

Question 31

Dorzolamide HCl (Trusopt)

Answer 31

C: Carbonic anhydrase inhibitor M: Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump T: Glaucoma SE: Red eyes, lid allergies MISC: Contraindicated in sulfonamide allergies

Question 32

Acetazolamide (Diamox)

Answer 32

``` C: Carbonic anhydrase inhibitor M: Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump T: Glaucoma SE: -- MISC: -- ```

Question 33

Brinzolamide (Azopt)

Answer 33

``` C: Carbonic anhydrase inhibitor M: Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump T: Glaucoma SE: Red eyes, lid allergies MISC: -- ```