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10 Cards in this Set
- Front
- Back
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what can be used to decrease aqueous humor synthesis in glaucoma?
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alpha-agonists (due to vasoconstriction)
-eipnephrine - mydriasis, stinging; do NOT used for closed-angle -brimonidine - no pupillary/vision changes beta-blockers (timolol, betaxolol, carteolol) - no pupillary/vision changes Acetazolamide - due to decreased HCO3 - no pupillary/vision changes |
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what can be used to increase outflow of aqueous humor in glaucoma?
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cholinomimetics - contracts ciliar mm which opens trabecular meshwork; can cause miosis & cyclospasm
*direct - pilocarpine, carbachol *indirect - physostigmine, echothiophate Latanoprost (PGF [2-alpha] is a prostaglandin) - darkens color of iris (browning) **give pilocarpine for emergency |
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what to give for glaucoma emergency?
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pilocarpine (cholinomimetic) - very good at opening meshwork in canal of schlemm
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what opioid effects do not develop tolerance?
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miosis & constipation
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how do opioids modulate synaptic transmission?
-channels? -change in neutotransmitters? -receptors? |
modulate synaptic transmission
-open K+ channels, close Ca2+ channels --> decreased synaptic transmission -inhibit release of: ACh, NE, 5-HT, glutamate, substance P -mu receptor = morphine; delta receptor = enkephalin; kappa receptor = dynorphin |
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clinical use or opioid analgesics?
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pain
cough suppression (dextromethorphan) diarrhea (loperamide & diphenoxylate) acute pulmonary edema maintenance programs (methadone) |
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toxicity of opioids?
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addiciton
respiratory depression constipation miosis (pinpoint pupils) additive CNS depression w/other drugs |
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what opioids can be used for cough? for diarrhea?
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cough - dextromethorphan
diarrhea - loperamide, diphenoxylate |
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what is butorphanol?
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partial agonist of mu opioid receptor
agonist at kappa receptor used for pain, less resp depression than full agonists can precipitate withdrawl if accustomed to a full agonist |
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what is tramadol?
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very weak opioid agonist
-inhibits serotonin & NE reuptake used for: chronic pain toxicity: similar to opoids; decreased SEIZURE threshold "tram it all" in - works on multiple neurotransmitters (5HT & NE reuptake inhibiton) |
