Unit 3-Ocular Pharmacology Flashcards Preview

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Flashcards in Unit 3-Ocular Pharmacology Deck (78):
1

Pilocarpine

Drug class

Direct Muscarinic agonist

2

Pilocarpine

Mechanism

Pupillary constriction, increased aqueous outflow

3

Pilocarpine

Uses

Treatment of glaucoma (both open angle and acute closed angle); cataract surgery

4

Pilocarpine

Side effects

  • Decreased vision when patient has cataracts due to miosis and headache
  • Bronchospasm, salivation, nausea, vomiting,
    diarrhea, abdominal pain, tenesmus, lacrimation, sweating
  • Used less frequently today due to side effects

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Echothiophate

Drug class

Indirect muscarinic agonist

6

Echothiophate

Mechanism

Irreversibly binds cholinesterase

7

Echothiophate

Uses

Treatment of glaucoma

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Echothiophate

Side effects

  • Bronchospasm, salivation, nausea, vomiting,
    diarrhea, abdominal pain, tenesmus, lacrimation, sweating
  • Used less frequently today due to side effects

9

Atropine

Drug class

Antimuscarinic

10

Atropine

Mechanism

Pupillary dilatation; paralysis of ciliary body

11

Atropine

Uses

Improve discomfort during active eye inflammation (uveitis)

12

Atropine

Side effects

  • Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary retention
  • Very long acting so not used unless severe inflammation

 

13

Scopalamine

Drug class

Antimuscarinic

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Scopalamine

Mechanism

Pupillary dilatation; paralysis of ciliary body

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Tropicamide

Drug class

Antimuscarinic

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Tropicamide

Mechanism

Pupillary dilatation; paralysis of ciliary body

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Tropicamide

Uses

Most commonly used cycloplegia for eye exams

(due to short half life)

18

Tropicamide

Side effects

Ataxia, nystagmus, restlessness, mental confusion, hallucination, violent and aggressive behavior, insomnia, photophobia, urinary
retention

19

Edrophonium

Drug class

Nm agonist

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Edrophonium

Mechanism

Destroys acetylcholinesterase

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Edrophonium

Uses

Diagnoses Myasthenia Gravis

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Epinephrine

Drug class

Direct adrenergic agonist

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Epinephrine

Mechanism

Dilation of episcleral vessels --> increased aqueous outflow

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Epinephrine

Side effects

Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating

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Hydroxyamphetamine

Drug class

Indirect adrenergic agonist

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Hydroxyamphetamine

Mechanism

Releases NE

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Hydroxyamphetamine

Uses

Separates 1st and 2nd from 3rd order neuron dysfunction in Horner's syndrome; positive dilation means 1st or 2nd order, an ominous sign

28

Cocaine

Drug class

Indirect adrenergic agonist

29

Cocaine

Mechanism

Prevent reuptake of NE

30

Cocaine

Uses

Use initially to confirm diagnosis of Horner's Syndrome (pupil will not dilate)

31

Phenylephrine

Drug class

Direct α1-agonist

32

Phenylephrine

Uses

Dilate pupil for eye exam and cataract surgery

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Phenylephrine

Side effects

  • Extrasystoles, palpitation, hypertension, myocardial infarction, trembling, paleness, sweating
  • Caution in elderly patients: at 10% can cause cardiac side effects

34

Brimondine tartrate

Drug class

Direct α2-agonist

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Brimondine tartrate

Mechanism

Suppresses aqueous humor production through action of cAMP in non-pigmented ciliary epithelium

36

Brimondine tartrate

Uses

Primary agent for treatment of glaucoma

37

Brimondine tartrate

Side effects

May cause follicular conjunctivitis; use with MAOi can cause fatigue/drowsiness

38

Timolol

Drug class

β-blocker

39

Timolol

Mechanism

Reduce intraocular pressure by reducing aqueous production at the ciliary process

40

Timolol

Uses

Second line treatment of glaucoma

41

Timolol

Side effects

  • Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
    fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia
  • Contraindicated in CHF, asthma;
  • bradycardia over time may produce tachyphylaxis

42

Levobunolol

Drug class

β2-blocker

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Levobunolol

Mechanism

Reduce intraocular pressure by reducing aqueous production at the ciliary process

44

Levobunolol

Uses

Second line treatment of glaucoma

45

Levobunolol

Side effects

Bradycardia, hypotension, syncope, palpitation, congestive heart failure, bronchospasm, mental confusion, depression,
fatigue, lightheadedness, hallucinations, memory impairment, sexual dysfunction, hyperkalemia

46

Betaxolol

Drug class

β1-blocker

47

Betaxolol

Mechanism

Reduce intraocular pressure by reducing aqueous production at the ciliary process

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Betaxolol

Uses

Second line treatment of glaucoma

49

Latanoprost

Drug class

Prostaglandin analog

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Latanoprost

Mechanism

Increase uveoscleral outflow

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Latanoprost

Uses

Primary agent for treatment of glaucoma

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Travoprost

Drug class

Prostaglandin analog

53

Travoprost

Mechanism

Increase uveoscleral outflow

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Travoprost

Uses

Increase uveoscleral outflow

more effective in African Americans

55

Travoprost

Side effects

Eyelash growth, change in iris color

May cause cystoid macular edema in cataract surgery;

56

Bimatoprost

Drug class

Prostaglandin analog

57

Bimatoprost

Mechanism

Increase uveoscleral outflow

58

Bimatoprost

Uses

Primary agent for treatment of glaucoma

59

Bimatoprost

Side effects

Eyelash growth, change in iris color

May cause cystoid macular edema in cataract surgery and activate herpes

60

Unoprostone isopryl

Drug class

Prostaglandin analog

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Unoprostone isopryl

Mechanism

Increase uveoscleral outflow

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Unoprostone isopryl

Uses

Glaucoma

(Least effective)

63

Unoprostone isopryl

Side effects

Eyelash growth, change in iris color

64

Nifedipine

Drug class

Ca-channel blocker

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Nifedipine

Mechanism

Increases ocular perfusion at nervehead

66

Nifedipine

Uses

Low-tension glaucoma

(not widely used)

67

Dorzolamide

Drug class

Carbonic anhydrase inhibitor

68

Dorzolamide

Mechanism

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

69

Dorzolamide

Uses

Second line glaucoma therapy

70

Dorzolamide

Side effects

Red eyes, lid allergies

Contraindicated in sulfonamide allergies

71

Acetazolamide

Drug class

Carbonic anhydrase inhibitor

72

Acetazolamide

Mechanism

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

73

Acetazolamide

Uses

Oral agent used for advanced glaucoma and with cataract surgery

Used only if other topical therapy fails.

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Acetazolamide

Side effects

Paresthesia, fatigue, drowsiness, depression, diarrhea, metaboliv acidosis, electrolyte changes

Anaphylaxis, blood dyscrasias

75

Brinzolamide

Drug class

Carbonic anhydrase inhibitor

76

Brinzolamide

Mechanism

Reduce aqueous production via interfere with the active transport of Na through Na-K-ATPase pump

77

Brinzolamide

Uses

Second line glaucoma therapy

78

Brinzolamide

Side effects

Red eyes, lid allergies