Ophthalmic Pharm Flashcards Preview

Exam 8 > Ophthalmic Pharm > Flashcards

Flashcards in Ophthalmic Pharm Deck (50):
1

Contracture of ciliary muscle, loosening of zonules, and thickening of lens in response to a near stimulus

Accomodation

2

Physiologic or cholinergic over stimulation of the ciliary muscle causing pain and blurred vision

spasm of accomodation

3

Provides nutrients to ocular tissue in form of glucose and mechanical stability (intraocular pressure)

aqueous humor

4

Damage to optic nerve due to elevated IOP
Loss of nerve fiber layer

Glaucoma

5

Too much aqueous humor produced, or not being drained fast enough

Primary open angle glaucoma
Most common*

6

Iris closes off angle
Dramatic increased IOP with pain
**Emergency

Closed (narrow) angle glaucoma

7

Progressive optic nerve damage in normal IOP
Vascular issue

Normal tension glaucoma

8

Sympathetics of eye
1st order (central). Cell bodies in ________
Axons __________ brainstem, synapse _________
Called _____________ (lateral horn gray matter)

hypothalamus
descend
C8-T2
Ciliospinal center of budge

9

Sympathetics of eye
2nd order (___________)
Axons exit ______, _______ sympathetic chain and synapse in _________

preganglionic
spinal column
ascend
superior cervical ganglion

10

Sympathetics of eye
3rd order (____________)
Axons ride along _________
Internal and external carotid arteries carry ________

postganglionic
common carotid artery
sympathetics

11

____________ artery carries sympthetics to sweat glands of the face
____________ carries sympathetics to dilator and mueller's muscle, and sweat glands of the forehead

external carotid

internal carotid

12

Parasympathetics
Edinger-Westphal nucleus (___________)
Axons emerge from ____________ of ________ along medial portion of CN ___
Follow inferior divisions of this nerve and split in orbit to synapse on ciliary ganglion

preganglionic
interpeduncular fossa
midbrain
3

13

Parasympathetics
Ciliary ganglion (_________________)
Axons enter ______ surrounding _____ as short posterior ciliary nerves
Innervate _____ and ________

postganglionic
posterior globe
optic nerve
iris sphincter and ciliary

14

________ has no clinical use in eye care

NE

15

Eye care drugs deal with _________

epinephrine

16

Iris dilator (radial muscle) has _________ receptors

alpha1

17

Mueller's muscle has

alpha 1 receptors

18

Ciliary processes has

beta 2 receptors

19

Conjunctival blood vessels have

alpha 1 receptors

20

Iris sphincter and ciliary muscles have __________ receptors

muscarinic acetylcholine

21

Phenylephrine is is used for ___________ in a ____________

mydriasis
dilated fundus exam

22

Epinephrine is used for _____

glaucoma

23

Beta blocker _____ is also used for glaucoma

timolol

24

Adrenergic agonists are also used as _______ because they vasoconstrict

decongestants

25

Epinephrine is not effective for ___ but is mildly effective for ________

mydriasis
glaucoma

26

Ocular side effects from ???
burning, irritation, pupil dilation, lid retraction (via mueller's muscle), lacrimation (watering eyes), angle closure

epinephrine

27

Epi can cause ______
Swelling of center portion of retina. will cause permanent vision loss if not detected and treated in a timely manner

cystoid macular edema

28

Almost no longer used in glaucoma

epi

29

Beta blockers, alpha 2 agonists, carbonic anhyrdase inhibitors, and prostaglandins are more effective for

glaucoma

30

Direct alpha 1 agonist.
Most common agent used in mydriasis. Used in exams and surgeries

Phenylephrine

31

Phenylephrine also acts as a ____________ by being a vasoconstrictor. Used for differentiating

decongestant
episcleritis from scleritis

32

__________ involved in breaking posterior synechia to the lens

phenylephrine (10% phenyl)

33

Inflammatory condition of the iris and ciliary body releasing WBCs and fibrin into anterior chamber.

Uveitis

34

Ocular side effects ??????
lid retraction, lacrimation, angle closure in narrow angle patients.
**Harder to reverse dilation so not used routinely

phenyleprhine

35

Can have exaggerated sympathomimetic effects with use of a MAOI

Phenylephrine

36

Doesn't allow cycloplegia, but pupil can still accomodate. Iris sphincter fns so no inhibition of parasympathetics. Need anticholinergic (parasymptholytic) to maintain dilation for eye exam

Phenylephrine

37

Direct alpa agonist, derivative of clonidine. Used for glaucoma. Reduces IOP by 20-30%, but reduction only lasts 3-5hrs.
Has significant drift (loses efficacy over time) with long term usage

apraclonidine

38

Used in office for fast reduction of significantly high IOP.
Pre and post op glaucoma and other laser tx

Apraclonidine

39

Main ocular side effect is an allergic rx

Apraclonidine

40

Highly selective alpha 2 agonist. More receptor affinity than apraclonidine and less allergic rx potential. Reduces IOP. Much less long term drift.

1st line tx in normal tension glaucoma (neuro protective by increasing blood flow to the optic nerve)

Brimonidine

41

Used for diagnosis of horner's

cocaine

42

Miosis, ptosis, anhydrosis
Causes by loss of _________ to eye

sympathetics

43

Cocaine prevents reuptake of ______
Normal eye - cause
Abnormal (horner's eye) -

NE
dilation
Nothing

44

Differentiates pre or post ganglionic horner's

hydroxyamphetamine

45

Hydroxyamphetamine causes release of ________ onto iris __________

NE
dilator

46

Hydroxyamphetamine test
Preganglionic -
Postganglionic -

Which is more serious?

Dilation
Nothing

Post ganglionic

47

Paralysis or inhibition of ciliary muscle tone reducing or eliminating accomodation

Cycloplegia

48

Used for diagnostic dilation

phenylephrine

49

Use for pre/post op laser tx

apraclonidine

50

Used for glaucoma

brimonidine