Flashcards in Ocular Pharm Deck (19)
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)
PSNS to the eye
Cholinergic; Travel with CN III from EW nucleus. Causes Miosis (M3 receptor)
SNS agonist on the pupils
PSNS agonist on pupils
Opiates on pupils
constant constriction by blocking the inhibitory interneurons of the EW nucleus
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
AE of muscarinic agonists
stinging and increased intra-ocular pressure,
If systematized they may cause anti-sludgeBBB
What are the two muscarinic antagonists we need to know
atropine and scopolamine
What is glaucoma
essentially it is increased intraocular pressure from making too much aqueous humor or not draining it. Caused by lots of drugs.
Open angle galucoma tx involves
lowering aqueous humor production or raising aqueous outflow.
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
Beta Blockers- Block the ciliary body production of aqueous by lowering cAMP or lowereing ocular blood flow. Work rapidly
Carbonic Anhydrase Inhs are
Dorzolamide and Brinzolamide- They block the production of water and Co2 from carbonic acid. Less water means less aqueous humor
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
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
Muscarinic agonists we need to know
carbachol and pilocarpine
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
What is the Ache we need to know