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Flashcards in Ocular Pharm Deck (19):
1

SNS to the eye

travels along arteries from the superior cervical ganglion. Causes mydriasis (pupil dilation via alpha 1 receptor) and ciliary relaxation for far vision (beta 2 receptor)

2

PSNS to the eye

Cholinergic; Travel with CN III from EW nucleus. Causes Miosis (M3 receptor)

3

SNS agonist on the pupils

dilation (mydriasis)

4

PSNS agonist on pupils

constriction

5

Opiates on pupils

constant constriction by blocking the inhibitory interneurons of the EW nucleus

6

Muscarinic Antagonists function?

Well, we know that PSNS uses muscarinic (M3) receptors to cause pupillary constriction (miosis) and cilliary muscle contraction (accomodation to see close), so blocking those muscarinic receptors would cause dilation and ciliary muscle relaxation.

Used in the tx of iritis and uveitis and in eye exams

7

AE of muscarinic agonists

stinging and increased intra-ocular pressure,

If systematized they may cause anti-sludgeBBB

8

What are the two muscarinic antagonists we need to know

atropine and scopolamine

9

What is glaucoma

essentially it is increased intraocular pressure from making too much aqueous humor or not draining it. Caused by lots of drugs.

10

Open angle galucoma tx involves

lowering aqueous humor production or raising aqueous outflow.

11

Latanoprost and Bimatoprost

Prostaglandin analogs- tx for open angle glaucoma, MOA really unknown though it may increase outflow.

PRODRUG with in situ hydrolysis

AE: blurred vision, stinging, itching
Long term may cause brown pigmentation of the iris, lid, and lashes. May also cause excessive eyelash growth hypertrichosis

12

Timolol, carteolol

Beta Blockers- Block the ciliary body production of aqueous by lowering cAMP or lowereing ocular blood flow. Work rapidly

13

Carbonic Anhydrase Inhs are

Dorzolamide and Brinzolamide- They block the production of water and Co2 from carbonic acid. Less water means less aqueous humor

14

Two AEs to KNOW for carbonic anhydrase inhs

1) Taste Disturbances arise from their inhibition of CA in the oral cavity

2) These are sulfonamides and carry the risk of severe adverse outcomes

See a question with these AES think DORZOLAMIDE

15

Muscarinic agonists cause what

Miosis and accomodation.., Also cause increased flow of aqueous humor so they used to be the drug of choice for glaucoma. No mas

16

Muscarinic agonists we need to know

carbachol and pilocarpine

17

Acetylcholinesterase inhs

more potent an dlonger acting than the direct muscarinic agonists

NOTE THAT YOU CAN"T USE THEM WITH CARBAMATE PHOSPHATE INSECTICIDES because they also inhibit AchE.

Also contra in closed angle glaucoma....may make it worse

18

What is the Ache we need to know

Echothipate

19

Sympathomimetics used when

- to increase aqueous outflow in glaucoma, to cause dilation, and as decongestants