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EENT Drugs
KYCOM Block 11
49
Medical
Graduate
10/14/2013

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Cards

Term
where is aq humor secreted from what are the two pathways of flow named
Definition
ciliary processes

conventional and uveoscleral
Term
what is the conventional pathway of aq humor flow
Definition
posterior chamber
pupil
anterior chamber
canal of schlemm
Term
what drugs target the conventional pathway of aq humor flow
Definition
cholinergic
Term
what is the uveoscleral pathway of aq humor flow
Definition
ciliary muscle
supraoroidal space
Term
what drugs target the uveoscleral pathway of aq humor flow
Definition
prostaglandins
Term
what are the 3 conditions associated with glaucoma
Definition
optic nerve cupping
visual field loss
blindness
Term
what are the 5 factors that increase risk of nerve damage in glaucoma
Definition
increased IOP
family history
african american
myopic
hypertension
Term
what is the first, second, third, and fourth choice drug categories for glaucoma
Definition
1. PGF2a analog
2. B blockers
3. a and B agonist
4. CAI or muscarinic agonist
Term
what glaucoma drugs are B blockers (5)
Definition
betaxolol
carteolol
levobunolol
metipranolol
timolol
Term
what glaucoma drugs are carbonic anhydrase inhibitors (3)
Definition
acetazolamide
brinzolamide
dorzolamide
Term
what glaucoma drug is a muscarinic agonist
Definition
pilocarpine
Term
what glaucoma drug is a a and B agonist
Definition
dipiverfriin
Term
what glaucoma drug is a PGF2a Analog (3)
Definition
latanoprost
travoprost
bimatroprost
Term
glaucoma B blocker MOA
Definition
non-selective
B1 blocker blocks ciliary body epithelium
B2 blocker decreases aq humor production
Term
carbonic anhydrase inhibitor MOA
Definition
stop carbonic anhydrase (isoenzyme II) in ciliary body epithelium
reduces formation of bicarbonate and thus aq humor
Term
muscarinic agonist MOA
Definition
contract ciliary muscle increasing aq humor outflow
Term
a and B agonist MOA
Definition
prodrug of epinepherine

stimulates a and B receptrs
increases uveoscleral outflow via prostaglandin pathway
Term
PGF2a analog MOA
Definition
aq outflow through uvoscleral
binds Gq receptor on ciliary muscle
Term
glaucoma B blocker side effects
Definition
asthma attack- rare, need high systemic levels
Term
carbonic anhydrase inhibitor side effects
Definition
when oral- metabolic acidosis within 3 days leading to renal Ca stones
Term
how often are glaucoma B blockers used
Definition
twice a day initially, then once a day
Term
how often are carbonic anhydrase inhibitors used
Definition
three times a day
Term
how often are a and b agonists used
Definition
twice a day
Term
how often are PGF2a analogs used
Definition
one drop a day
Term
what activies do muscarinic receptors (muscarinic agonists) have in the eye (3)
Definition
M3 causes mitosis by contracting iris sphincter

M3 causes accomodation by contracting ciliary muscle (near vision)

M2 + M3 cause secretion by lacrimal gland
Term
what affects for adrenergic receptors (a1 agonists) have in the eye (2)
Definition
a1 causes mydriasis due to contraction of the radial muscle

a1 causes secretion form the lacrimal gland
Term
what would a muscarinic antagonist do to the eye (3)
Definition
stop M3 causing midriasis due to iris sphincter relaxation

stop M2 on cilliary muscle accomodating for far vision ot cycloplegia

stop M2 + M3 stopping secretion from the lacrimal gland
Term
define cycloplegia
Definition
paralysis of accomodation
Term
what are the two categories of drugs that cause eye dilation
Definition
muscarinic antagonists
a1 agonists
Term
what are the 5 muscarinic antagonists
Definition
atropine
scopolamine
homatropine
cycloentaolate
tropicamide
Term
what drug is a a1 agonist
Definition
phrnylephrine
Term
what are the 4 "other eye drugs"
Definition
botulinum toxin A
cocaine
apracoline
hydroxyampetamine
Term
MOA muscarinic antagonist
Definition
block M3 causing mydriasis and cycloplegia
Term
a1 antagonist MOA
Definition
stimulate receptors in radial muscle causing mydriasis
Term
botulimun toxin A MOA
Definition
reduce occular misalignment and double vision by blocking ACh release leading to paralysis
Term
cocaine MOA
Definition
weak a1 agonist causing pupil dulation in horner's syndrome

strong a2 agonist causing pupil constriction in normal eye
Term
hydroxyampetamine MOA
Definition
release of stored NE from postganglionic adrenergic nerve endings

normal pupil and first or second order horner's pupil will dilate

third order horner's pupil will not dilate as well as the normal pupil
Term
muscarinic antagonist side effects
Definition
decrease aq humor outflow increasing IOP (avoid in angle closure glaucoma)
Term
a1 agonist side effects
Definition
decrease aq humor outflow increasing IOP (avoid in angle closure glaucoma)
Term
botulinum toxin A side effects (2)
Definition
ptosis: lid droop
blurred vision
Term
how long does it take for muscarinic antagonists to work
Definition
20-60 min
Term
how long does it take for a1 agonists to work, how long do they last
Definition
15-30 min
duration 1 h
Term
how long does it take for hydroxyampetamine to work
Definition
1h
Term
what is botulinum toxin A used or
Definition
strabismus and blepharospasum
Term
what is cocaine used for
Definition
confirm diagnosis or horner syndrome
Term
what is aparcoline used for
Definition
alternative to cocaine for diagnosis of horner syndrome
Term
what is hydroxyampetamine used for
Definition
localize horner's lesions
Term
what are 4 signs of horner's syndrome
Definition
drooping of eyelid - ptosis
constricted pupil (mitosis)
decreased sweating (anhydrosis) conjunctiva redness
Term
what is the cause of horner's syndrome
Definition
sympathetic lesion in hypothalamus
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