Eye Pharm

Front 1

cocaine

Back 1

block ne reuptake --> dilate nl eye, no effect on horner's (50% 1/2nd order, assoc pancoast) since no ne release in first place

Front 2

paredrine

Back 2

oh-amphetamine, indirect adrenergic agonist --> inc ne release --> dilates nl or 1/2nd order horner's, no effect 3rd order horner's

Front 3

dilator mm

Back 3

a-adrenergic, outside part of iris

Front 4

pupillary sphincter mm

Back 4

cholinergic, inside dilator mm

Front 5

ciliary body mm

Back 5

cholinergic contraction (accommodation), b-adrenergic relaxation (far vision)

Front 6

horner's syndr

Back 6

dec sns stim, miosis (inh dilator mm), ptosis (inh sup tarsal aka muller's m), raised brow (skeletal m compensation), color change (dec melanocyte stim, chronic/congenital)

Front 7

ant chamber angle

Back 7

cornea-iris

Front 8

anisocoria

Back 8

nl 20% pop, horner's, adie's (tonic) pupil, cniii palsy, pharm (belladonna alkaloids from jimson weed similar to atropine, scopolamine), iris dmg

Front 9

adie's pupil

Back 9

benign, 70% young f teens-30s, 50-90% dec dtr, usu unilateral, very slight reactivity to light

dmg post ganglionic psns nn from ciliary ganglion --> denervation hs (takes time to develop)

dx: .1% pilocarpine (too weak fo rnl pupil) --> contraction

Front 10

pilocarpine

Back 10

psns agonist, 1% constrict nl pupil, .1% too weak except for adie's, spasm of accommodation, red intraocular p (stretch trabecular meshwork spaces by pulling iris in), won't constrict pharm dilated pupil, inc visual acuity (dec curvature of cornea)

ae: too much --> won't dilate at night, brow ache

Front 11

cycloplegic agents

Back 11

cholinergic antagonist (mAchR), relaxes accommodation (ciliary body), relaxes pupillary constriction (sphincter)

atropine, tropicanimide, cyclopentolate, homatropine, scopolamine

Front 12

atropine

Back 12

from bella donna, most potent, up to 2 wks

use sever inflamm (uveitis w/ sarcoidosis, iritis, post-op)

Front 13

tropicanimide

Back 13

mydriacyl, shortest, onest 30 min, up to 4-6 hrs, standard, no diff .5/1% for fundus exam, determine refraction errors in children

Front 14

cyclopentolate

Back 14

cyclogyl, stronger, last 24 hrs, use corneal abrasion (ciliary spasm pain), other mild conditoins, 2ce/day

Front 15

homatropine

Back 15

longer than cyclopentolate, shorter than atropine, 1-3 days, 4x/day

use corneal abrasion, chemical burn, iritis, uveitis, post-op

Front 16

scopolamine

Back 16

2-4 days to wk

ae psychosis, restlessness, confusion, hallucination, vomiting, urinary incontinence

use motion sickness (transdermal, can cause unilateral pupil dilation)

Front 17

phenylephrine

Back 17

2.5% neosynephrine, 5-6 hr, onset 45 min, stim dilator mm (sympathetic), muller's (eye open wide), vasoconstrictor, small conc otc for redness (rebound effect)

10% sol death in few drops due to htn crisis, occipital ha, ventricular arrhythmia, tachycardia

Front 18

mydriatic agent

Back 18

dilate pupil (sns stim)

phenylephrine

Front 19

routine dilation

Back 19

combo 1% tropicanimide + 2.5% neosynephrine

.5% or 1% tropicanimide alone

REMEMBER TO DO FLASHLIGHT TEST TO CHECK FOR NARROW ANT CHAMBER ANGLES BEFORE DILATE PT'S EYES

Front 20

dapripazole

Back 20

rev-eyes, a-adrenergic reversal

Front 21

nl fluid flow

Back 21

ciliary body prod --> post chamber --> pupil --> ant chamber --> trabecular meshwork --> schlemm's canal --> episcleral v --> aq v --> blood

Front 22

dx glaucoma

Back 22

nl 15-16 mmhg

goldman applantor on anesthesized eye (old schiotz tonometer w/ weight), optometrist use non-contact air puff

check optic n cup/disc ratio, humphrey visual field perimeter

Front 23

narrow angle glaucoma

Back 23

<5% glaucoma pts, lens swells, cataracts --> push iris fwd, if dilate --> iris bunches up --> sudden absolute closure trabecular meshwork --> sudden onset inc p --> severe pain (eyes --> ha), redness of sclera, blurred vision, halos around lights, n/v, cloudy cornea, fixed/irregular/mid-dilated pupils

tx: break attack w/ drops to dec p, surgical periph iridectomy (now w/ lasers) --> equalize p ant/post chambers, lifetime cure, bilateral

Front 24

epi

Back 24

direct ns a/b-agonist, conjunctival constriction, slight mydriasis, red intraocular pressure (inc outflow), vasoconstriction

ae: if abs nasal vv --> htn crisis, tachycardia, ha, palpitation, chronic red eye, pvc, local burn/irritate, local allergic rxn, accumulate melanin granules

Front 25

dipivefrin

Back 25

propine, lipophilic ver of epi so better abs cornea --> convert to epi inside (much better ae) so .1% = 2% epi

Front 26

brimonidine

Back 26

alphagan, s a2-adrenergic, avoid b ae

Front 27

timolol

Back 27

b-block, drug of choice glaucoma, target ciliary body (dec prod)

ae: lethargy, lightheadedness, fatigue, mem loss, bradycardia, syncope, hypotension, arrythmia, wheezing, pulm edema, chf, red libido, depression, death

expensive

Front 28

levobunolol

Back 28

betagan, ns b-block

Front 29

betaxolol

Back 29

betopic, b1-block (cardioselective), not as effect but limit ae (esp pulm), use hx chf, asthma

Front 30

combigan

Back 30

alphagan + timolol, inc compliance

Front 31

pg analogue

Back 31

1st line drug, no systemic ae, iris/skin can get darker, eyelashes longer (latisse)