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Methods BLOCK 3 > Pharmacological Dilation Of The Eye > Flashcards

Pharmacological Dilation Of The Eye Flashcards

1
Q

What is the purpose of pupillary dilation?

A
  • improve visualization of the fundus

- improve visualization increases detection rate of abnormalities

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2
Q

Mydriasis

A

Dilation

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3
Q

Miosis

A

Small pupil

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4
Q

Mydriatics

A

Agent that induces dilation of the pupil

-they aid in the examination of the vitreous, the retina, and the periphery

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5
Q

What can facilitate the mydriatics effect?

A

The use of local anesthetic before instillation

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6
Q

How does the anesthetic help mydriasis?

A
  • decreases blinking and tearing and changes the permeability of the epithelium to the mydriatics agent
  • reduces any burning or stinging produced by instillation of the mydriatic
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7
Q

What color eyes dilate faster?

A

Light

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8
Q

Patients with this disease have smaller pupils and are slower to dilate than normal individuals

A

Poorly controlled diabetes

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9
Q

The older you are the more ______ your pupils are

A

The more miotic pupils

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10
Q

Increase in age does what to latency time to dilate

A

Increases

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11
Q

Side effects of dilation

A
  • blurred vision (near)
  • photophobia
  • decreased ability to recognize low-contrast hazards
  • increased glare sensitivity
  • impaired driving
  • angle closure event in pts with narrow anterior chamber depth
  • warn patients
  • document
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12
Q

What muscle does the sympathetic pathways innervate

A

Dilator

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13
Q

Parasympathetic pathway innervates what muscle?

A

Sphincter

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14
Q

Cholinergic drugs

A

Agonists

Antagonists

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15
Q

What is another name for agonists

A

Parasympathomimetics

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16
Q

What do agonists (parasympathomimetics) cause

A
  • iris sphincter contraction-miosis

- ciliary body contraction-accommodation

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17
Q

What is an example of an agonist

A

Pilocarpine

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18
Q

What is another name for antagonist

A

Anticholinergic

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19
Q

Antagonists (anticholinergics)

A
  • inhibits cholinergic receptors
  • causes pupillary sphincter inhibition-mydriasis
  • causes ciliary body inhibition-cycloplegia
20
Q

Examples of antagonists (anticholinergic)

A

Tropicamine, cyclopentolate, atropine

RED CAP

21
Q

What causes sphincter inhibition (mydriasis)

A

Antagonists

22
Q

What causes ciliary body inhibition (cycloplegia)

A

Antagonists

23
Q

What causes sphincter contraction (miosis)

A

Agonists

24
Q

What causes ciliary body contraction (accommodation)

A

Agonists

25
Q

Antagonists ST ACH

A

Scopolamine, tropicamide, atropine, cyclopentolate, homatropine

26
Q

What is the drug of choice for routine mydriasis?

A

Tropicamide

27
Q

Why is tropicamide the drug of choice for routine mydriasis?

A

Fastest onset and shortest duration of action of mydriatic effects

28
Q

What does tropicamide equivalent in mydriatic effect to?

A

0.5% and 1%, greater cycloplegia with 1%

29
Q

Side effects of tropicamide

A
  • stinging upon instillation

- transient increase IOP in POAG patients

30
Q

Contraindications and precautions of tropicamide

A

No reported adverse systemic effects

31
Q

What is the most potent mydriatic/cycloplegic currently available?

A

Atropine

32
Q

What do you use when you want completel cycloplegia

A

Atropine

33
Q

What is the drug of choice for routine cycloplegic refraction?

A

Cyclopentolate

34
Q

Weak but prolonged cycloplegic effect and strong mydriatic effect make it suitable for uveitis therapy

A

Homatropine

35
Q

What drug do you typically use if patient is allergic to the others?

A

Scopolamine

36
Q

Which one crosses blood brain barrier easier?

A

Scopolamine

37
Q

What causes stimulation of iris dilator muscle? (Mydriasis)

A

Direct alpha-adregnergic agonist like phenylephrine

38
Q

MOA for indirect alpha-adrenergic agonist

A
  • release of stored norepinephrine

- inhibits reuptake of norepinephrine

39
Q

When is phenylephrine commonly used?

A

In combination with anticholinergic to produce maximal dilation of the pupil
-2.5% commonly used in combination with tropicamide for routine dilation

40
Q

Contraindications and precautions of phenylephrine

A

-adverse cardio events with 10% that’s why you use 2.5%!

41
Q

Side effects of phenylephrine

A
  • ocular: mild stinging, pigmented aqueous floaters

- systemic: acute systemic hypertension, ventricular arrhythmia, tachycardia, subarachnoid hemorrhage

42
Q

What is used when someone has hornrs syndrome?

A

Hydroxyamphetamine

43
Q

What is the preferred method of delivery for eye drop instillation

A

Inferior fornix delivery

44
Q

Why is inferior fornix delivery preferred?

A
  • maximizes ocular contact time of drug
  • minimizes drug lose
  • increases ocular absorption
  • decreases systemic absoprtion
45
Q

Alternatives to instilling eye drops

A
  • medial canthus delivery
  • spray bottle
  • pledgets

Methods BLOCK 3 (6 decks)

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