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ODR
Pharmacology of the Eye
26
Pharmacology
Graduate
11/24/2010

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Cards

Term
atropine
Definition
most potent cycloplegic agent
can last up to 2 weeks
used when long term dilation is necessary (ie very bad iritis, or eveitis, post-op)
decreases intraocular inflammation
Term
mydriacyl (tropicamide)
Definition
fastest acting cycloplegic agent (30 min)
shortest duration of ation: 4-6 hrs
uses: refractions (OK in children), dilated fundus exams, used by itself or w/phenylephrine for routine dilation
Term
cyclogyl
Definition
cycloplegic agent, stronger than mydriacyl
acts in 30 min, lasts up to 24 hrs
Uses: children to determine acute refraction correction, corneal abrasion, mild conditions to keep eye relaxed for a few days or to decrease pain
Term
homatropine
Definition
cycloplegic agent
lasts 1-3 days
uses: 4x/day for corneal abrasions, chemical burns to eye, iritis, uveitis, post-op
Term
scopolamine
Definition
cycloplegic agent
lasts 2-4 days to 1 week
NOT used on a regular basis b/c of AE but used as transderm patch to prevent motion sickness (may cause unilateral pupil dilation)
AE: greater incidence of toxic rxn than any of the other drugs: psychosis, restlestness, confusion, hallucinations, vomiting, urinary incontience
Term
What cycloplegic agents can be used to increase patient comfort with corneal abrasions?
Definition
cyclogyl or homatropine
Term
used for refractions
Definition
mydriacyl or cylogyl
Term
phenylephrine
Definition
adrenergic agonist, stimulators mueller's muscles and dilator muscles
dilation seen in 45 min, recovery in 6 hours
usually added to over the counter drops, whiten the eye due to vasoconstriction
rebound effects: vasodilation, eye redeness
Term
What is the fastest acting pupil dilator?
Definition
mydriacyl
Term
What is the drug of choice for routine dilation?
Definition
mydriacyl
Term
What are the cycloplegic agents, and how do they work?
Definition
atropine, mydriacyl, cyclogyl, homatropine, scopolamine
they are cholinergic antagonists that block constriction and accomodation
Term
alpha adrenergic receptors on the eye
Definition
cause contraction of radially arranged dilator muscles in the iris--> pupil dilation
Term
cholinergic receptors on the eye
Definition
sphincter muscle in iris (constrict pupil) and ciliary muscles (near accomodation)
Term
B adrenergic receptors in eye
Definition
ciliary body: relax-> far accomodation
Term
pilocarpine
Definition
direct-acting cholinergic agonist
used to test for anisocoria
contracts and pulls iris in>stretches trabecular meshwork>^aq humor drainage>decrease intraocular pressure
Term
What drug can cause a brow ache in patients, and why?
Definition
pilocarpine
decreases amount of light into eye and ability to accommodate
Term
What are the AEs of pilocarpine?
Definition
brow ache
pupillary constriction
spasm of accomodation
Term
What is the MOA of epinephrine?
Definition
acts on receptors in trabecular meshwork to increase fluid outflow and therefore decrease intraocular pressure
Term
What are the AEs of epinephrine?
Definition
HTN crisis & tachycardia via nasal absorption
localized burning, irritation, allergic rxn, accum of melanin granules, redness of eyes, headache
Term
What is propine?
Definition
more lipophilic version of Epinephrine> increased absorption into cornea>less systemic AEs and lower concentration needed
Term
What is the drug of choice for glaucoma?
Definition
timolol
Term
timolol
Definition
non-selective beta blocker used for glaucoma
moa: decreases aqueous formation via receptors on ciliary bodies
Term
Betalol
Definition
selective B1 blocker
decreases aqueous formation
Term
alphagon
Definition
alpha-adrenergic agonist, decreases aqueous formation
Term
How do you diagnose Horner's syndrome?
Definition
block NE reuptake (ie cocaine)
(no dilation = horner's)
light reflex test (turn off light, size diff bet pupil increase = Horner's
Term
How do you test a patient to see if a 3rd order neuron defect is causing Horner's?
Definition
paredrine stimulates 3rd order neuron (no dilation = 3rd order neuron defect)
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