Term
| What four drugs inhibit acetylcholinesterase? |
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Definition
Neostigmine
Edrophonium
Echothiphate
Pyridostigmine |
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Term
| What drugs are used to d/dx MG? |
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Definition
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Term
| What drug is used to treat MG? |
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Definition
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Term
| What drug is used to d/dx accommodative esotropia? |
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Definition
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Term
| What drug has the fastest onset of mydriasis of the cholinergic antagonists? |
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Definition
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Term
| What drug has the fastest onset of cycloplegia of the cholinergic antagonists? |
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Definition
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Term
| In what 3 ways does homatropine treat anterior uveitis? |
|
Definition
1. Stabilize blood-aqueous barrier
2. Keep sticky iris mobile and away from iris
3. Paralyzes CB to decrease pain |
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Term
| What is the MOA and use for botox? |
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Definition
Blocks release of Ach in the NMJ
Temporary tx for blepharospasm
Permanent tx of strabismus |
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Term
| What are the MOA and effects of phenylephrine? |
|
Definition
Alpha 1 agonist
Dilation, palpebral widening due to Mullers |
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Term
| When should phenylephrine be avoided? |
|
Definition
C/I w/ MAOI and TCA use
Graves pt's due to BP spike |
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Term
| What are the 3 clinical uses of phenylephrine? |
|
Definition
d/dx episcleritis from scleritis Break posterior synechiae
Dilation |
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Term
| What are 3 ocular adrenergic agonists that constrict conj. BV's and have greater alpha then beta effects? |
|
Definition
Naphozoline Tetrahydrozoline (Visine)
Phenylephrine |
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Term
| What is the MOA, therapeutic use, and clinically relevant aspects of apraclonidine? |
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Definition
Alpha 2 agonist that decreases AH production and increases uveoscleral outlfow
BEST topical drop for IOP reduction
Tachyphylaxis after 8 days
Increased allergic response |
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Term
| What is the MOA, therapeutic use, and clinically relevant aspects of brimonidine? |
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Definition
Highly selective Alpha-2 agonist
*Neuroprotective!
Long term glaucoma tx
C/I w/ MAOI's |
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Term
| Is metipranolol still used clinically for glaucoma? |
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Definition
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Term
| Why are beta blockers C/I with DM, hyperthyroid and MG? |
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Definition
| Can mask s/sx of DM/Hyperthyroid Can worsen s/sx of MG |
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Term
| What beta blocker is less efficacious, but has fewer SE? |
|
Definition
Carteolol
Has a small bit of intrinsic sympathomimetic activity (ISA) that masks the SE |
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Term
| What beta blocker is B1 specific and gives neuroprotection? |
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Definition
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Term
| What beta blocker has the greatest IOP reduction? |
|
Definition
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|
Term
|
Definition
Brinzolamide
Dorzolamide
Acetazolamide
Methazolamide |
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Term
| What is the MOA of CAI's? |
|
Definition
| Inhibits enzyme in ciliary body epi that draws bicarbonate into the AH to create the osmolar gradient |
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Term
| What are C/I and SE of CAI's? |
|
Definition
C/I: sulfa allergy
SE: metallic taste, paresthesia of hands/feet, metabolic acidosis, bone marrow suppression, aplastic anemia |
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Term
| What is the only topical drug that can cause fatal aplastic anemia? |
|
Definition
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Term
| What is the MOA and clinical use of prostaglandins? Name the 3 on the NBEO outline. |
|
Definition
Latanoprost, Bimatoprost, Travoprost
MOA: Acts on PGF2 G-protein receptors in ciliary muscle to suppress collagen formation. Also activates phospholipase C --> hair growth, hyperpigmentation |
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Term
| What is the MOA and effects of corticosteroids? |
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Definition
| Inhibits phospholipase A2 (not C like PG's) --> arachidonic acid suppression --> anti-inflammatory and immunosuppression |
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Term
| What are the 2 potent and 2 weak corticosteroids? |
|
Definition
Potent: Rimexolone, Dexamethasone
Weak: FML, Loteprednol |
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Term
| What % of the population is a high steroid responder? |
|
Definition
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|
Term
| What % of POAG pt's are high steroid responders? |
|
Definition
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|
Term
| What is the MOA of NSAIDs? |
|
Definition
| Block action of COX --> reversible conversion of arachidonic acid into prostaglandins and thromboxanes |
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|
Term
| What are the main clinical uses and SE's of topical NSAIDs? |
|
Definition
Used s/p cataract surgery to reduce CME/general inflammation risks
SE: Burning and stinging, corneal melt!! |
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Term
| What is the MOA of anti-histamines? |
|
Definition
| Block H1 and H2 receptors = stop type 1 hypersensitivity rxn recall: type 1 = IgE antibodies + mast cells = degranulation and release of histamine = itchy, chemosis, and rubor |
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Term
| What is Emadines primary use? |
|
Definition
| tx of mild-moderate allergic conjunctivitis |
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|
Term
| Are there any topical H2 blockers? |
|
Definition
| No, they are ineffective when administered topically |
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Term
| What are the 4 mast cell stabilizers? What is their MOA/clinical use? |
|
Definition
Cromolyn, Lodaxamide, Pemirolast, Nedocromil
Inhibits degranulation of exposed mast cells upon re-exposure to antigen
NOT effective for acute allergic sx |
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|
Term
| What are the 4 mast cell/anti-histamine combos? |
|
Definition
| Azelastine, Epinastine, Ketotifen, Olopatadine |
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|
Term
| What is clinical use of mast cell/AH combos? |
|
Definition
| Dual mechanism of action allows effectiveness in long-term management of ocular itching and allergic conjunctivitis as well as for relief in acute symptoms |
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|
Term
| What is the MOA and clinical use of Trifluridine? |
|
Definition
Inhibits DNA polymerase in all cells it touches --> "Napalms the surface of the eye"
Tx for HSV Keratitis (types 1 and 2); STINGS!!! |
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|
Term
| Does Rose bengal stain epithelial defects? |
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Definition
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|
Term
| What does Rose Bengal stain? Why is this useful? What are SE? |
|
Definition
| Dead/devitalized cells; Stains borders of HSV keratitis; STINGS!!! |
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Term
| What is the MOA and clinical use of pegaptanib? |
|
Definition
| Antineoplastic agent binds and inhibits VEGF= angiogenesis |
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Term
| What is the MOA and clinical use of ranibizumab? |
|
Definition
| Monoclonal antibody (Fab portion) that targets VEGF |
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Term
| What is the BEST OVERALL IOP reducer? |
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Definition
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Term
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Definition
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Term
|
Definition
| Hyperosmotic NaCl solution for IOP reduction |
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Term
| What is the one drug that uses thimerosal as a preservative? |
|
Definition
| Trifluridine; because why not, you're already nuking the eye, may as well use a toxic mercury compound to preserve it. |
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Term
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Definition
| Preservative that reacts with light --> H2O and Na+ |
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Term
| What is sodium perborate? |
|
Definition
| Preservative that reacts with light --> H2O and O2 |
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|
Term
|
Definition
Sodium perborate; preservative that turns H20 + O2 upon when exposed to light.
Found in Genteal artificial tears |
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