Flashcards in Pharmacology - Opthalmology Drugs Deck (20):
What drug is recommended for quick dilation of eyes - eye exam?
What are the effects of antimuscarinic agents on the eye?
Paralysis of the ciliary body
Use for eye exams
Non-specific beta blocker
What are the contraindications for Timolol?
CHF, asthma, bradycardia
What are the contraindications for Latanaprost?
Cystoid macular edema;
What are the contraindications for Brimondine?
If it's used with MAO inhibitor can cause fatigue/drowsiness
Carbonic anhydrase inhibitor
What are the contraindications for Dorzolamide?
Allergies to sulfonamides
How do you test for the type of lesion seen in Horner's syndrome (as in, pre vs. postganglionic)?
Paradrine 1% (hydroxyamphetamine) causes pupillary dilation when 3rd order neuron is intact.
If one gives Paredrine and notes pupillary dilatation, then the lesion is at the level of the 1st or 2nd order neuron, as the 3rd order neuron is intact, but not receiving a stimulus. If the pupil does not dilate with paredrine, then the 3rd order neuron is dysfunctional signifying a more benign process.
What is Adie's syndrome?
aka Tonic pupil
Adie’s syndrome is characterized by a dilated pupil with sector palsies of the pupillary sphincter. It is a benign syndrome, and thought to result from a viral infection or trauma to the ciliary ganglion.
Methacholine 2.5% or pilocarpine 1/8% are direct agonists of:
Methacholine 2.5% or pilocarpine 1/8% are direct agonists of the parasympathetic system which under normal circumstances do not produce pupillary constriction.
It is not until the pilocarpine is at 1% concentration or the methacholine at 10% that constriction takes place in the heathly individual.
In Adies syndrome, these agents will produce pupillary constriction confirming the diagnosis.
If a patient's pupil did not constrict with 1% pilocarpine, what is the likely cause?
Cycloplegics are muscarinic antagonists which combine with postsynaptic receptors to block the action of acetylcholine. Cycloplegics come in varying strengths and duration and are used commonly by ophthalmologists to facilitate eye examinations.
What are the tests for Adie's syndrome?
Pupil will constrict
What are the tests for Horner's syndrome?
Paradrine 1% - if lesion preganglionic, pupil dilates
if lesion is postganglionic, pupil does not dilate
What are the adverse effects of the cholinergics/anticholinesterases such as pilocarpine and echothiophate?
Respiratory - Bronchospasm
Gastrointestinal - Salivation, nausea, vomiting, diarrhea, abdominal pain, tenesmus
￼Miscellaneous - Lacrimation, sweating
What are the adverse effects of the anticholinergics such as atropine?
Neurologic - Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior
Miscellaneous - Insomnia, photophobia, urinary retention
What are the adverse effects of the adrenergics, such as epinephrine and phenylephrine?
Cardiovascular - Extrasystoles, palpitation, hypertension, myocardial infarction
Miscellaneous - Trembling, paleness, sweating