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
|
|
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
|
|
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
|
|
Term
what glaucoma drug is a a and B agonist |
|
Definition
|
|
Term
what glaucoma drug is a PGF2a Analog (3) |
|
Definition
latanoprost travoprost bimatroprost |
|
|
Term
|
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
|
Definition
contract ciliary muscle increasing aq humor outflow |
|
|
Term
|
Definition
prodrug of epinepherine
stimulates a and B receptrs increases uveoscleral outflow via prostaglandin pathway |
|
|
Term
|
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
|
|
Term
how often are a and b agonists used |
|
Definition
|
|
Term
how often are PGF2a analogs used |
|
Definition
|
|
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
|
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
|
|
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
|
Definition
stimulate receptors in radial muscle causing mydriasis |
|
|
Term
|
Definition
reduce occular misalignment and double vision by blocking ACh release leading to paralysis |
|
|
Term
|
Definition
weak a1 agonist causing pupil dulation in horner's syndrome
strong a2 agonist causing pupil constriction in normal eye |
|
|
Term
|
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
|
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
|
|
Term
how long does it take for a1 agonists to work, how long do they last |
|
Definition
|
|
Term
how long does it take for hydroxyampetamine to work |
|
Definition
|
|
Term
what is botulinum toxin A used or |
|
Definition
strabismus and blepharospasum |
|
|
Term
|
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 |
|
|