Trachte pharmacology

Question 1

mydriasis

Answer 1

pupillary dilator muscle contraction 
a1 receptor (Norepi)

Question 2

sympathetic activates what muscle to hold eyelid open and through what receptors

Answer 2

superior tarsal muscle

a1 (norepi)

Question 3

What muscles relax for distant vision and through what receptors

Answer 3

Ciliary muscle

Sympathetic –> b2 receptors (more by epinephrine - systemic, not very practical, PS more common for ciliary muscles)

Question 4

aqueous humor formation through what receptor

Answer 4

sympathetic to B(2) receptors - block in glaucoma

Question 5

inhibition of aqueous humor formation through what

Answer 5

sympathetic to a2 receptors

Question 6

what focuses eye for near vision

Answer 6

parasympathetic –> muscarinic receptors –> ciliary muscle contraction

Question 7

what constricts pupil (miosis)

Answer 7

PS –> muscarinic –> popillary sphincter contraction

Question 8

what enhances drainage of aqueous humor

Answer 8

ps –> muscarinic –> trabecular meshwork & canal of schlemm

Question 9

drugs promoting mydriasis

Answer 9

sympathomimetics (stimulate or mimic stimulation of symp nerves)

inhibitors of PS nervous system (atropine)

Question 10

how does cocaine work

Answer 10

inhibit reuptake of norepi into cell

Question 11

sympathetics overall

Answer 11

mydriasis (a1)
contract superior tarsal muscle (a1)
relax ciliary muscle (b2)
enhance AND inhibit aqueous humor formation

Question 12

parasympathetics overall

Answer 12

focus eye for near vision - ciliary muscle
constrict pupil (miosis)
enhance drainage of aqueous humor

muscarinic receptors

Question 13

phenylephrine

Answer 13

drug used in eye drops to dilate pupil

a1 adrenergic stimulant

Question 14

epinephrine

Answer 14

a1 adrenergic stimulant

increases aqueous humor outflow and inhibits formation

Question 15

cocaine will dilate eye if ___

Answer 15

sympathetics are release Norepi (issue with eye, not nerve)

If no response – horners

Question 16

amphetamine dilates eye if _____

Answer 16

postganglionic nerve is present and contains norepi (if no response, postganglionic horners. If response, means signal not getting there from CNS but postganglionic ok)

Question 17

amphetamine mechansism

Answer 17

reverses axoplasmic pump

Question 18

response to amphetamine means

Answer 18

normal post-ganglionic nerve (issue in pre-ganglionic)

Question 19

test if eye can respond to muscarinic receptors

Answer 19

If eye responds to pilocarpine (muscarinic agonist) with miosis, then problem has to be with the nerve (third nerve palsy)
If eye does not respond to pilocarpine, then problem has to be with the eye itself (Atropinic mydriasis)

Question 20

Physostigmine (Isopto eserine), Ecothiophate (phospholine iodide), demecarium (Humorsol), isofluorophate (floropryl)

Answer 20

AchE inhibitors

Question 21

terazosin

Answer 21

a1 receptor agonist - has eye side effects

Question 22

reserpine

Answer 22

norepi depleting - side effects

Question 23

tx for glaucoma overall

Answer 23

beta blockers
muscarinic receptor agonists
AntiAchE
a2 agonists
epinephrine
latanoprost (prostaglandin)
CA inhibitors

Question 24

beta blockers and glaucoma

Answer 24

decrease aqueous humor formation (decrease sympathetic innervation to make it)

Question 25

muscarinic receptor agonists and glaucoma

Answer 25

pilocarpine | enhances aqueous humor drainage

Question 26

anticholinesterases and glaucoma

Answer 26

physostigmine, ecothiophate - enhances aqueous humor drainage

Question 27

a2 agonists and glaucoma

Answer 27

apraclonidine and brimonidine, reduce humor formation

Question 28

epinephrine and glaucoma

Answer 28

increase aqueous humor outflow but supress production

Question 29

most common tx glaucoma

Answer 29

latanoprost (prostaglandin derivative) | increase uveo-sceral outflow of aqueous humor

Question 30

CA inhibitors and glaucoma

Answer 30

acetazolamide - reserved if others dont work

Question 31

tx of muscle spasms in eyes (strabismus) and blepharospasm

Answer 31

botox - inhib. ach release from somatic nerves