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34 Cards in this Set
- Front
- Back
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Latanoprost
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1st line for glaucoma, more effective in dark iris
MOA: facilitate aqueous flow through accessory uveoscleral outflow pathway through prostanoid FP receptor Pharmacokinetics: prodrug-->esterase to active, metabolized in liver active for 12-24 hrs and reduces IOP 6-8 mm Hg Side Effects: increased iris and eyelid pigment/ eyelashes, cross placenta, antagonistic to cholinergic |
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Travoprost
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1st line for glaucoma, more effective in dark iris
MOA: facilitate aqueous flow through accessory uveoscleral outflow pathway through prostanoid FP receptor Pharmacokinetics: prodrug-->esterase to active, metabolized in liver active for 24 hrs and reduces IOP 6-8 mm Hg Side Effects: increased iris and eyelid pigment/ eyelashes, cross placenta, antagonistic to cholinergic |
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Bimatoprost
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1st line for glaucoma, more effective in dark iris
MOA: facilitate aqueous flow through accessory uveoscleral outflow pathway through prostanoid FP receptor Pharmacokinetics: prodrug-->esterase to active, metabolized in liver active for 24 hrs and reduces IOP 6-8 mm Hg Side Effects: increased iris and eyelid pigment/ eyelashes, cross placenta, antagonistic to cholinergic |
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Unoprostone
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1st line for glaucoma, more effective in dark iris
MOA: facilitate aqueous flow through accessory uveoscleral outflow pathway through prostanoid FP receptor Pharmacokinetics: prodrug-->esterase to active, metabolized in liver active for 10-24 hrs and reduces IOP 3-4 mm Hg, 2x daily Side Effects: increased iris and eyelid pigment/ eyelashes, cross placenta, antagonistic to cholinergic |
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Timolol
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nonselective B Blocker
MOA: blocks the 75-90% B2 receptor on ciliary epithelium that facilitates secretion of aqueous humor. Reduces secretory activity, IOP, ocular blood flow Pharmacokinetics: 1x daily Side Effects: bronchoconstriction-avoid in smokers, bronchospastic, bradycardia, interaction with verapamil leads to heart block, lightheadedness, cold fingers/toes, fatigue, depression, vivid dreams, hallucinations, sexual dysfunction, hair loss no COPD, CHF |
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Betaxolol
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B1 Blocker
MOA: blocks the 75-90% B2 receptor on ciliary epithelium that facilitates secretion of aqueous humor. Reduces secretory activity, IOP, ocular blood flow Pharmacokinetics: 1x daily Side Effects: bradycardia, interaction with verapamil leads to heart block, lightheadedness, cold fingers/toes, fatigue, depression, vivid dreams, hallucinations, sexual dysfunction, hair loss no COPD, CHF |
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Carteolol
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nonselective B Blocker
MOA: blocks the 75-90% B2 receptor on ciliary epithelium that facilitates secretion of aqueous humor. Reduces secretory activity, IOP, ocular blood flow Pharmacokinetics: 1x daily Side Effects: bronchoconstriction-avoid in smokers, bronchospastic, bradycardia, interaction with verapamil leads to heart block, lightheadedness, cold fingers/toes, fatigue, depression, vivid dreams, hallucinations, sexual dysfunction, hair loss Ca channel blocking effects, neuroprotective |
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levobunolol
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nonselective B Blocker
MOA: blocks the 75-90% B2 receptor on ciliary epithelium that facilitates secretion of aqueous humor. Reduces secretory activity, IOP, ocular blood flow Pharmacokinetics: 1x daily Side Effects: bronchoconstriction-avoid in smokers, bronchospastic, bradycardia, interaction with verapamil leads to heart block, lightheadedness, cold fingers/toes, fatigue, depression, vivid dreams, hallucinations, sexual dysfunction, hair loss no COPD, CHF |
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metipranolol
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nonselective B Blocker, most potent, sympathomimetic
MOA: blocks the 75-90% B2 receptor on ciliary epithelium that facilitates secretion of aqueous humor. Reduces secretory activity, IOP, ocular blood flow Pharmacokinetics: 1x daily Side Effects: bronchoconstriction-avoid in smokers, bronchospastic, bradycardia, interaction with verapamil leads to heart block, lightheadedness, cold fingers/toes, fatigue, depression, vivid dreams, hallucinations, sexual dysfunction, hair loss no COPD, CHF |
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Acetazolamide
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systemic Sulfonamide used to treat open angle glaucoma, macular edema, macular degeneration
MOA: inhibit CA which reduces HCO3/ aqueous secretion/ IOP Pharmacokinetics: 25-40% for 8-12 hrs Side Effects: in other tissues, numbness, tingling, somnolence, metallic taste, depression, fatigue, metabolic acidosis, renal calculi contraindicated in sulfa allergy |
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Dorzolamide
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MOA: Inhibit CA (II) in ciliary body epithelium, reducing HCO3, fluid transport, IOP
Pharmacokinetics: 3x daily dose, IOP decrease by 18-22% Side Effects: burning, stinging of eye, conjunctivitis, eyelid edema |
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Brinzolamide
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MOA: Inhibit CA (II) in ciliary body epithelium, reducing HCO3, fluid transport, IOP
Pharmacokinetics: 3x daily dose, IOP decrease by 18-22% Side Effects: burning, stinging of eye, conjunctivitis, eyelid edema less complaints |
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Pilocarpine
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treat glaucoma
MOA: stimulate contraction of ciliary muscles which puts tension on trabecular meshwork, open pores, allow outflow into Canal of Schlemm, reduce IOP Pharmacokinetics:4-8 hr duration Side Effects: Ciliary muscle spasm with brow ache, myopia, headaches from contraction, pupil constriction, blurred vision, cataract formation, sweating, headache, tremor, excess saliva, diarrhea, abdominal cramps, nausea |
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Carbachol
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treat glaucoma/ intraocular use for miosis in surgery
MOA: stimulate contraction of ciliary muscles which puts tension on trabecular meshwork, open pores, allow outflow into Canal of Schlemm, reduce IOP Pharmacokinetics:4-8 hr duration Side Effects: Ciliary muscle spasm with brow ache, myopia, headaches from contraction, pupil constriction, blurred vision, cataract formation, sweating, headache, tremor, excess saliva, diarrhea, abdominal cramps, nausea |
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Acetylcholine
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intraocular use for miosis in surgery
MOA: stimulate contraction of ciliary muscles which puts tension on trabecular meshwork, open pores, allow outflow into Canal of Schlemm, reduce IOP Pharmacokinetics:4-8 hr duration Side Effects: Ciliary muscle spasm with brow ache, myopia, headaches from contraction, pupil constriction, blurred vision, cataract formation, sweating, headache, tremor, excess saliva, diarrhea, abdominal cramps, nausea |
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Demecarium
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glaucoma, accommodative esotropia
MOA: increase parasympathetic activity, allow for contraction of ciliary muscle, open up Canal of Sclemm Pharmacokinetics: organophosphate, long duration Side Effects: vitreous hemorrhaging, contact dermatitis, allergic conjunctivitis, GI disturbance, muscle spasm atropine/ pralidoxime if overdose |
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Echothiophate
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glaucoma, accommodative esotropia
MOA: increase parasympathetic activity, allow for contraction of ciliary muscle, open up Canal of Sclemm Pharmacokinetics: organophosphate, long duration Side Effects: vitreous hemorrhaging, contact dermatitis, allergic conjunctivitis, GI disturbance, muscle spasm most severe, photophobia of bright lights/close up work/myopic atropine/ pralidoxime if overdose |
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Physostigmine
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glaucoma, accommodative esotropia
MOA: increase parasympathetic activity, allow for contraction of ciliary muscle, open up Canal of Sclemm Pharmacokinetics: reversible, short duration Side Effects: vitreous hemorrhaging, contact dermatitis, allergic conjunctivitis, GI disturbance, muscle spasm atropine/ pralidoxime if overdose |
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Apraclonidine
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glaucoma
MOA:decreased production and increased outflow of aqueous humor Pharmacokinetics: 6-8 hr duration, overcoming the miosis by parasympathomimetics polar, A1 stimulation--> blanching, eyelid retraction, mild mydriassis |
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Clonidine
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A2 agonists stimulates feedback inhibition of norepi/ aqueous humor formation
avoids miosis, brow ache side effects: systemic hypotension, |
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Brimonidine
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A2 agonist, lipophilicity, lack A1 agonism
better penetration of the cornea MOA: A2 agonist, B blocker reduces aqueous humor flow by reducing production. increases uveoscleral outflow Side Effects: oral dryness, ocular hyperemia, ocular discomfort, headache, fatigue, allergy |
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Phenylephrine
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mydriatic agent to help examine the retina, localize Horners Syndrome lesion
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Horner's Syndrome
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Interruption of sympathetic nerves to face and unilateral
vasodilation, ptosis, miosis, loss of sweating preganglionic lesion not affect post ganglionic nerve, post ganglionic lesion = degernation of nerve endings |
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Localizing Horner's lesion
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If post ganglionic- sympathetomimitics will not causes dilation, phenylephrine will cause smooth muscle due to A receptor
preganglionic lesion- both work |
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Infection of lacrimal gland and sac
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systemic antibiotics
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Blepharitis
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Treat with Bacitracin zinc, Gentamicin sulfate, Polymyxin B, Tobramycin sulfate
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Conjunctivitis
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Sulfacetamide sodium, Levoflxacin
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Keratitis
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Chloramphenicol, Ciprofloxacin hydrochloride
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Viral Keratitis
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Trifluridine, Vidarabine
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Herpes Zoster Ophthalmicus
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valacyclovir, famciclovir, acyclovir
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Fungal infection
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Natamycin
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Acanthamoeba infection
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Neosporin, Imidazole
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Toxoplasma gondii infection
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trimehtoprimsulfamethoxazole, pyrimethamine, sulfadiazine, folinic acid
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ocular allergy, external eye inflammatory disease
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dexamethasone, prednisolone, fluorometholone- glucocorticiods
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