Pharm Exam #2

Front 1

ACh is the NT at which sites:

Back 1

All simp and parasymp ganglia, most parasymp postgang fibers, some simp postgang nerves, symp fibers that directly innervate the adrenal medulla and motor nerves to skeletal muscle

Front 2

NE is the NT at most....

Back 2

all sympathetic postgang nerves

Front 3

What are the two receptor types for NE?

Back 3

Alpha and Beta

Front 4

Alpha receptors for NE have ___ types.

____ receptor stimulation results in.....

____ are located at...

Back 4

2;

alpha1; increased intracellular calcium concentrations;

alpha 2; presynaptic adrenergic nerve terminals

Front 5

Beta receptors have ___ types.

Stimulation of these receptors results in....

Back 5

3;

the activation of membrane adenyl cyclase and increased formation of cAMP

Front 6

ACh has ____ receptor types and they are:

Back 6

2;

Muscarinic and Nicotinic

Front 7

The major response of the alpha 1 receptors is to cause....

stimulation of this causes baroreceptor-medaited reflex ____ in the normal subject which may be blunted in ____ states.

Back 7

vascular smooth muscle contraction (vasoconstriction);

bradycardia; hypotensive

Front 8

Alpha 2 receptors are ___synaptic and stimulation by NE has a _____ feedback effect and results in....

Back 8

pre-;

negative;

inhibition of further release of NE

Front 9

Beta 1 receptors are found in the ____ and ____

In the ___ they function to increase ____ activity (positive chonotropic effect) increasing ______. They also increase ____ (positive inotropic effect) to increase _________.

In the ___ they stimulate ___ release

Back 9

heart; kidney

heart; pacemaker; heart rate; contractility; cardiac output

kidney; renin

Front 10

Beta 2 receptors are found in the _____ and stimulation causes _______.

Beta 3 receptors are found in ______ and stimulation causes ______.

Back 10

bronchioles; bronchodilation

adipose tissue; lipolysis

Front 11

The major responses of muscarinic receptor stimulation include.... (6)

Back 11

Constriction of visceral smooth muscle;
Increased bronchial, gastric, and glandular secretions;
Miosis (pupil constriction);
Increased gastric emptying rate and intestinal motility;
Micturition due to increased detursor muscle contraction

Front 12

Stimulation of Nicotinic receptors in the _____ causes the release of ___ and ___ into circulation

Back 12

adrenal medulla;

NE and EPI

Front 13

ACh= ____= 2 receptor types ___ and ____

Back 13

cholinergic; nicotinic and muscarinic

Front 14

The major mechanism for the termination of the actions of NE is........

Back 14

the reuptake of NE into the adrenergic nerve terminal by special transport processes

Front 15

Termination of ACh action is through ......

Back 15

metabolic degradation (hydrolysis) via acetylcholinesterase

Front 16

NE has low affinity for beta ____ receptors.

Is an _____.

Back 16

2; agonist

Front 17

EPI has high affinity for....

Is an ____.

Back 17

all receptors; agonist

Front 18

Phenylephrine has a high affinity for alpha __ and a very low affinity for beta ___ and ____.

IS an ______.

Back 18

1; 1 and 2;

agonist

Front 19

Clonidine has a high affinity for alpha _____ and a very low affinity for beta ____.

Is an ____.

Back 19

2; 1;

agonist

Front 20

Isoproterenol has high affinity for beta ___ and ___.

Is an _____

Back 20

1 and 2;

agonist

Front 21

Yohomibine has a high affinity for alpha ___.

Is an ____

Back 21

2;

antagonist

Front 22

Atenolol has high affinity for beta _____ receptors (effects are ________).

Is an _____

Back 22

1;

dose-dependent;

antagonist

Front 23

Albuterol has low affinity for beta ___ and high affinity for beta ____.

Is an ______.

The preferential selectivity for beta ___ receptors diminishes as.....

Back 23

1; 2;

agonist;

2; as dose increases

Front 24

The primary action of NE is at the ____ receptors on _____ to produce_____.

Also acts at the ____ receptors to stimulate.......

Back 24

alpha 1; vascular smooth muscle; vasoconstriciton;

beta1; an increase in HR and contractility

Front 25

When NE causes vasoconstriction, there is a reflex response that is mediated by......

The net result is a decrease in ___ (reflex _____) if all reflex responses are in tact.

Back 25

carotid sinus baroreceptors;

HR; bradycardia

Front 26

NE is used for the treatment of _____ and ______ (as long as ____ is corrected first if present)

Back 26

cardiac arrest; profound hypotension;

hypovolemia

Front 27

EPI acts non selectively at _____ and is a physiological antagonist of ______.

Back 27

both alpha and beta receptors;

histamine

Front 28

In the Heart, EPI binds to the ___ receptor to cause an increase in ____ and ___ with a net effect to increase the ____.

Back 28

beta 1;

HR; FOC; CO

Front 29

In the lungs, EPI binds to the ____ receptors to cause _____

Back 29

Beta 2; bronchodilation

Front 30

In the eyes, EPI binds to the ____ receptors and causes __________

Back 30

alpha 2; decreased intraocular pressure

Front 31

In the Liver, EPI binds to the ____ receptors and causes.....

Back 31

beta 2; glycogenolysis

Front 32

EPI is used to treat _____ (acute _____ reaction) as well as to treat.......... (topical form)

Back 32

anaphylaxis; hypersensitivity;

mucosal congestion of hay fever, rhinitis and acute sinusitis

Front 33

Dopamine is an agonist at ___, ___ and ___ receptors.

Low doses act on the ___ receptors to cause.....

Medium doses act on the ___ Receptors to cause.....

High doses act on the ___ receptors to cause........

Back 33

alpha, beta, and dopamine (D1);

D1; dilation of renal and mesenteric vasculature to increase mesenteric blood flow and kidney perfusion (increased renal blood flow and GFR);

beta 1; increase contractility and CO;

alpha 1; increase TPR and BP

Front 34

Dopamine is use to treat......

Back 34

hemodynamic imbalances in shock syndrome

Front 35

What are the 3 endogenous, direct acting sympathomimetic drugs?

Back 35

NE, EPI, dopamine

Front 36

Isoproterenol is an ___ agonist selective for ___ receptors.

_____ receptor activation causes ______.

Need to closely monitory heart rate because it may induce _____.

Is rarely, if ever used because....

Back 36

adrenergic; beta;

beta 2; bronchodilation;

ventricular arrhythmias;

the cardiac effects are very difficult to control

Front 37

Dobutamine is relatively selective for ___ receptors.

Works by increasing the ____, improves ___ by increasing ____ usually without significantly increasing ____

Back 37

beta 1;

FOC; CO; SV; HR

Front 38

Phenylephrine acts directly at ___ Receptors to cause potent ___ and a large increase in ____

A marked reflex ___ occurs. Most vascular beds become ______.

Back 38

alpha 1;

vasoconstriction; TPR;

bradycardia; constricted

Front 39

Phenylephrine is indicated for use to treat ______ as a topical OTC agent.

Back 39

nasal decongestant

Front 40

Nasal decongestants are _____ adrenergic agonists that ____ Vascular smooth muscle in BVs throughout the body; decrease _____ of the nose, decreases the blood flow through the nasal _______, and decreases the amount of muscosal _____

Back 40

alpha 1; constrict; perfusion; sinusoidal vessels; edema

Front 41

Direct-acting nasal decongestants bind directly to ___ receptors.

Ex=________

Back 41

alpha 1; phemylephrine

Front 42

Topical nasal decong. act on ___ receptors of BVs to decrease.......

This causes... due to ______

Back 42

alpha 1; the volume of nasal mucus;

mucous membrane decongestion; vasoconstriction

Front 43

Use of topical nasal decongestants is limited to ____ Days because.............

If you suddenly d/c after long periods of use, can result in ____________. Treat this by....

Back 43

3;

desensitization of the receptors occurs (tachyphylaxis) due to down regulation of the alpha1 receptors;

Rhinitis medicamentosa (rebound hyperemia); slowly withdrawing the decongestant and use a topical saline product to sooth irritation ( as well as a systemic decongestant if necessary)

Front 44

Long term use of topical nasal decongestants can result in...

Back 44

ischmeic changes in mucous membranes

Front 45

Systemic nasal decongestants act on the___ Receptors to cause ____ and producing mucous membrane decongestion by....

Ex:______

Back 45

alpha1; vasoconstriction; decreasing the formation of nasal mucosal discharge;

Pseudoephedrine (sudafed)

Front 46

Immediate-release pseudo ephedrine tablets may cause significant increases in ____ and ___ due to adrenergic stimulation from transiently high levels of the drug. Preferable to use _____ products which release PE at a slow enough rate to still achieve nasal decongestant action but cause relatively little CV side effects.

Back 46

BP; HR; extended release products

Front 47

Non-selective alpha adrenergic antagonists inhibit actions of circulating _____ by....

Causes ___ in vascular smooth muscles which decreases ___ and ____. This results in ______ and reflex ______ as well as nasal ____.

Also ____ GI peristalsis causing ____ and _____ ejaculation

Back 47

catecholamines;

blocking both alpha1 and 2 receptors;

vasodilation; TPR and BP;

orthostatic hypotension, tachycardia; stuffieness;

increases; diarrhea; inhibits

Front 48

Non-selective alpha blockers include ____ and _____

Back 48

phenoxybenzamine; phentolamine

Front 49

Phenoxybenzamine used in ___ and ___ management o f ______ to control ___ And ____.

Back 49

preop and surgical; pheochromocytoma;

HTN and sweating

Front 50

Phentolamine is used in the prevention or control of _______ that may occur in a pt with pheochromocytoma as a result of ___ or ___ during preop prep or surgical excision

Back 50

HTN episodes;

stress or manipulation

Front 51

Selective alpha blocking agents include ____ and ____

Back 51

tamsulosin; alfuzosin

Front 52

Tamsulosin was developed specifically for the tx of _______

Saw improvement in _____ and symptoms of ___ after 1 week of therapy

Back 52

enlarged prostate;

urine flow; BPH

Front 53

Alfuzosin was approved for signs and symptoms of _____.

Major adverse reaction :

Back 53

BPH;

prolongation of QT interval

Front 54

Beta blockers end in ____

Back 54

'olol'

Front 55

Labetalol is a _______ and works to block...

Is an competitive antagonist!
1 isomer is a _____ and 1 isomer is a ____

Back 55

combined alpha/beta blocker;

beta 1, beta 2 and alpha1;

nonselective beta blocker; alpha blocker

Front 56

Which beta blockers are nonselective for beta 1 and beta 2?

Back 56

propranolol and labetalol

Front 57

Which beta blockers are relatively selective for beta1 receptors?

Back 57

atenolol, metoprolol, nebivolol

Front 58

Beta blockers with intrinsic sympathomimetic activity extert a partial _____ activity at beta receptors while blocking the effects of ______.

Example=

Back 58

agonist; circulating catecholamies;

pindolol

Front 59

Propranolol has ____ lipid solubility. this allows for the ____ CNS penetration

Back 59

high;

best

Front 60

Nebivolol has vaso_____ Activity.

Is the most highly _______ BB

Back 60

dilatory; cardioselective

Front 61

For treatment of HTN, can use all beta blockers except ___ and ___

Back 61

esmolol and sotalol

Front 62

For treatment of angina, approved drugs include (4).......

Back 62

nadolol, propranolol, atenolol, metoprolol

Front 63

Esmolol is an _____ Acting, ____ metabolized by plasma esterase's, has a half-life of ___.

Rapidly attain steady-state by ____ and can terminate action ____.

Back 63

ultra-short; rapidly; 10 min

Infusion; rapidly

Front 64

Esmolol is used for rapid control of ____ in ___ or ___ in circumstances where short-term ventricular rate control is needed.

Back 64

ventricular rate; AFib or AFlutter;

Front 65

Esmolol and propranolol can be used to treat.....(3)....

Back 65

PAT induced by catecholamines or digoxin, supra ventricular arrhythmias due to thyrotoxicosis, AFib or Aflutter when ventricular rate is not controlled by digoxin or when digoxin is contraindicated

Front 66

Beta blockers are used as adjunct therapy to control ___ before or during surgery in pheochromocytoma its AFTER primary tx with an _______

Back 66

tachycardia;

alpha blocking agent

Front 67

Which beta blocker can be sued as prophylaxis treatment of migraine headaches?

Back 67

propranolol

Front 68

Contraindications for the use of beta blockers include: (5)

Back 68

sinus bradycardia; >1st degree heart block; cardiogenic shock; overt cardiac failure; brachial asthma or prochospasm (don't use propranolol, metoprolol appears to be less likely to cause this ADR)

Front 69

In Pheochromocytoma, do not use ___ unless alpha blockers are already in use because blocking only the peripheral vasodilatory actions of EPI (at beta 2 receptors) would result in........

Back 69

propranolol;

unopposed alpha1 receptor stimulation (vasoconstrctionn, increased BP)

Front 70

Ib diabetes, nonselective beta blockers may

___ or ___ premonitory signs and symptoms of an impending hypoglycemic event (4 sx=......)

May potentiate insulin-inudced ______ by delaying the recovery of ....

Back 70

blunt; mask;

tachycardia, palpitations, tremor, nervousness;

hypoglycemia; blood glucose to normal levels

Front 71

______ is one of the signs of impending hypoglycemia and is ____ inhibited by beta blockers. This may be the only warning sign a diabetic pt would have if on a beta blocker.

Back 71

sweating; NOT

Front 72

Methylxanthines (theophylline) are physiologic ____ of beta blockers and vice versa

Back 72

antagonists

Front 73

Will see additive or synergistic nematic inotropic and dromotropic effects with the drug _______

Back 73

verapamil

Front 74

Direct acting parasympathetic agonists mimic the effects of Parasymp stimulation by directly binding to.....

Back 74

muscarinic receptors noramlly occupied by ACh

Front 75

Bethanechol is used for treatment of postop and postpartum ________ and________

Is an example of a ________ (drug)

Back 75

nonobstructive urinary retention; neurogenic blader atony;

direct acting parasympathetic agonist

Front 76

Sialagogues include ____ and are used for the tx of...

Ex=_______

IS an example of a........

Back 76

the symptoms of xerostomia in sjogren's syndrome;

cevimeline;

direct acting parasymp agonist

Front 77

What are adverse drug reactions of direct acting parasympathetic agonists?

Back 77

facial flushing, salivation, GI hypermotility, urinary incontinence, bronchospasm, bradycardia

Front 78

Indirect acting parasympathetic agonists include _______. The actions of these may be ____ or _____

Back 78

acetylcholinesterase inhibitors;

reversible or irreversible

Front 79

AChE inhibitors can be used at the NM junction to......

Can also be sued to reverse the effects of ______ skeletal muscle relaxants

Back 79

dx and tx NM disease such as myasthenia gravis;

non-depolarizing

Front 80

Edorphonium is used to diagnose ______;

It does this by.....

Back 80

myasthenia gravis;

inhibiting acetylcholinesterase which increases the amount of ACh in the NM junction. an increased amount of ACh allows effective competition with the antibodies made to the receptor so more is able to bind and you will see a temporary, sudden increase in skeletal muscle activity

Front 81

Reversible cholinesterase inhibitors include.....

Back 81

edrophonium, neostigmine, pyridostigmines

Front 82

Edrophonium is ____ acting.

Back 82

short

Front 83

Pyridostigmine is a PO tablet used for...

Back 83

long-term management of myasthenia gravis

Front 84

Anticholinergic drugs act directly at ______ cholinergic muscarinic receptors and compete reversibly with ______ for receptor binding.

Parasympathetic activity is ____ allowing sympathetic input to _______

Two drugs are:

Back 84

postganglionic; ACh;

inhibited; dominate;

atropine; scopolamine

Front 85

Anticholinergics have little to no affinity for ___ receptors at autonomic ganglia or the NMJ and have no detectable _______

Back 85

nicotinic; clinical effects

Front 86

Anticholinergic drugs cause (heart) _____ soon after administration because of a _____ and stimulation of _______

Back 86

tachycardia; vagal blockade; SA node

Front 87

Toxic doses of anticholinergic drugs produce CNS ________

Back 87

overstimulation

Front 88

Anticholinergics work to decrease tremor seen in parkinson's disease by.....

The tremors are caused by...

Back 88

decreasing the ability of ACh to bind to the receptors.

excess cholinergic activity in the presence of deficient dopaminergic activity

Front 89

Anticholinergics cause ___, ___ and inhibits _____ (in the eye)

Back 89

mydriasis; cytoplegia; lacrimation (dry eyes)

Front 90

Anticholinergics cause broncho______

Back 90

dilation

Front 91

Anticholinergics inhibit ___ production causing a ___ mouth.

Back 91

saliva; dry

Front 92

Anticholinergics may cause urinary ____ in prostatic hypertrophy

Back 92

retention

Front 93

Anticholinergic drug indications:

Back 93

prevention of motion sickness (scopolamine); to produce mydriasis and cycloplegia; tx GI spasm, hyper motility, diarrhea;
CV conditions with marked vagal discharge; bronchial asthma, overactive bladder, and cholinergic poisoning

Front 94

Symptoms of cholinergic poisoning include:

Back 94

N/V, diarrhea, sweating, vasodilation, reflex tachycardia; salivation, lacrimation, urination, defecation

Front 95

Cholinergic poisoning may require large, prolonged doses of _______ to reverse it.

Back 95

atropine

Front 96

Atropine is only useful for the management of ____ symptoms of cholinergic poisoning. The symptoms due to stimulation of ____ and _______ leading to respiratory paralysis are completely unaffected by atropine

Back 96

muscarinic;

autonomic ganglia; NMJ

Front 97

Atropine can be used as a preanesthetic/presurgical medication to decrease ____ and _____ as well as block anesthetic-induced ________ during surgery

Back 97

trachea; bronchial secretions;

vagal slowing

Front 98

Symptoms of Acute anticholinergic poisonings are...

Back 98

dry mouth, mydriasis, tachycardia, hot and flushed skin, agitation, delirium and fever.

Front 99

Contraindications of Anticholinergics include (3)...

Back 99

narrow angle glaucoma, prostatic hypertrophy, gastric ulcers

Front 100

Atropine is a ____, ______ medication that is used to treat _____ or ____ as well as ____

Back 100

anticholinergic; perioperative;

drug-induced bradycardia; heart block; cholinergic poisoning

Front 101

Scopolamine is an ______ Drgu and is used for the prophylactic tx of ______

Back 101

anticholinergic;

motion sickness

Front 102

Benztopine is an _______ drug and is used for the tx of.....

Back 102

anticholinergic;

parkinsons (adjunct tx)

Front 103

Atropine is a ____, ______ medication that is used to treat _____ or ____ as well as ____

Back 103

anticholinergic; perioperative;

drug-induced bradycardia; heart block; cholinergic poisoning

Front 104

Propantheline is an ____ drug and is used as an adjunct tx for ____.

Back 104

anticholinergic; duodneal ulcers

Front 105

Scopolamine is an ______ Drug and is used for the prophylactic tx of ______

Back 105

anticholinergic;

motion sickness

Front 106

Glycopyrrolate is a ____ Drug, and functions as a ______ meaning that it.....

Back 106

anticholinergic;

antisecretagogue;

reduces salivary, tracheobronchial and pharyngeal secretions

Front 107

Benztopine is an _______ drug and is used for the tx of.....

Back 107

anticholinergic;

parkinsons (adjunct tx)

Front 108

Propantheline is an ____ drug and is used as an adjunct tx for ____.

Back 108

anticholinergic; duodneal ulcers

Front 109

Glycopyrrolate is a ____ Drug, and functions as a ______ meaning that it.....

Back 109

anticholinergic;

antisecretagogue;

reduces salivary, tracheobronchial and pharyngeal secretions

Front 110

Diclyclomine is an _____ drug that acts as an _____ for the tx of ____ and _____

Back 110

anticholinergic; antispasmodic;

funcitonal GI disorders and irritable bowel syndrome

Front 111

Anticholinergics used in the treatment of overactive bladder works by....

Drugs used include:

Back 111

blocking involuntary detrusor contractions;

oxybutynin, tolterodine, trospium, antimuscarinics such as solifenacin and darifenacin

Front 112

Oxybutynin is a ____ drug that works through the ___ system.

Back 112

anticholinergic;

transdermal

Front 113

Tolterodine is an ___ drug that has greater functional selectivity for bladder _______ receptors compared to saliva gland muscarinic receptors;

Metabolized by....

Back 113

anticholinergic;

M3 muscarinic;

P450 3A4

Front 114

Trospium is an anticholinergic drug that is eliminated through ________.

Do not use in its with ______ because....

Back 114

renal excretion;

severe renal dysfunction;

it is excreted motley unchanged in the urin

Front 115

Which antimuscarinic drug used to tx an overactive bladder and has the highest selectivity for bladder M3 muscarinic receptors?

Back 115

darifenacin

Front 116

Flavoxate is a ____ drug that is used for......

Back 116

anticholinergic;

relief of dysuria, pain, urgency, and incontinence in detursor instability and hyperreflexia

Front 117

Aqueous humor is continuously formed in the......

Is secreted by the _______ which cover the secretory epithelial cells.

Back 117

posterior chamber;

ciliary proceses

Front 118

Beta-adrenergic agonists stimulate ____ Receptors on the ciliary epithelium to increase secretion of aqueous humor

Back 118

beta 2

Front 119

Beta blockers reduce ____ and decrease _______ in the eye

Back 119

secretion of aqueous humor;

intraocular pressure

Front 120

Outflow of aqueous humor occurs mostly through the _____ and some through the _____

Back 120

trabecular meshwork; uveoscleral pathway

Front 121

Ciliary muscle is presenta t the points of ____________ into the ciliary body.

Back 121

the insertion of the lens ligaments

Front 122

Contractions of the muscle fibers in the ciliary muscle causes.......

This allows the lends to ......

Back 122

relaxation of the tension exerted by the ligaments to the lens capsule;

assume a more spherical shape

Front 123

Pregang. Parasympathetic fibers originate in the ____ nucleus and pass through CN-III to the ____ Ganglion.

They then synapse with post gang neurons that send fibers through the ____ nerves into the eye.

Stimulation of the ciliary nerves causes ....(2)....

Back 123

Edinger-Westphal;

ciliary;

ciliary;

contraction of the ciliary muscle that controls the focusing of the lens; Contraction of the iris sphincter muscle that constricts the pupil

Front 124

Sympathetic Innervation of the eye is through _______ of the iris. Stimulation causes......

Back 124

radial muscle fibers;

contraction which causes phil dilation (mydriasis)

Front 125

Accomodation=

Back 125

focusing of the lens for near vision

Front 126

Contraction relaxes tension on the lens system and the lens .......

Back 126

assumes a more spherical shape, allowing focusing for near vision

Front 127

Stimulation of the parasympathetic nerves causes _____ of the iris sphincter muscle resulting in _____

Back 127

contraction;

miosis (pupillary constriction)

Front 128

Stimulation of the sympathetic nerves causes _____ of the iris radial muscle fibers resulting in _______

Back 128

contraction;

mydriasis (pupilary dilation)

Front 129

Pupilary light reflex is when you shine light into the eyes which causes stimulation of ________. Impulses travel over the optic nerve into the _____ nuclei. Stimulation of the _______ nucleus results in parasymp activity over the oculomotor nerve resulting in _______

Back 129

retinal receptors;

pretectal;

edinger-westphal;

miosis

Front 130

_________ agonists cause contraction of the radial pupillary dilatory muscle (smooth muscle) resulting in _____/______

Back 130

alpha adrenergic;

mydriasis/ pupillary dilation

Front 131

_______ agonists cause contraction of the circular pupillary constrictor smooth muscles resulting in ____/______

Back 131

muscarinic;

miosis/ pupillary constriction

Front 132

Stimulation of parasymp nerves or muscarinic agonists cause ______ of the ciliary muscle.

This relaxes tension on the _______ which allows for.....

It also increases tension on the _____ which causes ____ and facilitates.....

These effects are prevented or reversed by ________ (____ of accommodation)

Back 132

contraction;

suspensory ligaments connecting to the lens; focusing of the lens for near vision (accommodation);

trabecular network; opening of the pores; outflow of aqueous humor;

anticholinergics; paralysis

Front 133

Cyclospasm is the......

Back 133

intense, powerful contraction of the ciliary muscle

Front 134

Direct acting miotics are ________ (____) drugs that exhibit the _____ actions of ____.

Cause the ____ of the iris sphincter muscle= ______

Cause ciliary muscle ____=______

Increase tension on the scleral spur which reduces ______ and increases ______

Open the _____ to allow for increased _____ to reduce ____

Back 134

parasymp (cholinergic); muscarinic; ACh;

contraction; pupillary constriction

contraction= accommodation for near vision

outflow resistance; uveoscleral outflow;

trabecular meshwork; outflow of aqueous humor; IOP

Front 135

Examples of mitotic drugs include:

Back 135

Pilocarpine (topical); Carbachol (intaocular)

Front 136

Pilocarpine is a _____ drug used to decrease ______.

Is the emergency treatment for....

Back 136

mitotic drug; elevated IOP in glaucoma;

acute angle closure glaucoma

Front 137

Carbachol is a ____ drug and induces ___ during surgery where rapid and complete ____ is desirable.

Back 137

miotic;

miosis; miosis

Front 138

Miotics may cause ____, ____ and decrased______ (ADRs)

Back 138

headache, browache, decreased night vision

Front 139

What is the action of topical adrenergic alpha-receptor agonists (mydriatics)?

Back 139

contract the iris dilator (radial) muscle to cause mydriasis

Front 140

Mydiratics have no effect on _____ (absence of ____).

Back 140

ciliary muscle; cycloplegia

Front 141

Cycloplegia is the....

Back 141

paralysis of accommodation (inability to focus the lens for near vision)

Front 142

Phenyephrine is a ____ Drug and is used for routine ______ to facilitate ophthalmic examination and for ______ without cycloplegia.

Back 142

Mydriatic; mydriasis; refraction

Front 143

Phenylephrine was originally contraindicated in....

Back 143

narrow angle or angle closure glaucoma

Front 144

Actions of topical anticholinergics include.... to allow a more accurate....

Back 144

paralysis of the ciliary muscle (cycloplegia);

refractory exam

Front 145

Cycloplegic mydriatics inhibit contraction of the ________

Back 145

iris sphincter muscle (mydriasis)

Front 146

What are two cycloplegic mydriatic drugs?

Back 146

tripicamide and atropine

Front 147

Which drug is the DOC for routine mydirasis with cycloplegia?

Back 147

tripicamide

Front 148

Atropine a the most potent ______ (can last up to ____ Days) and ____ (can last up to _____ days) available. Is not typically used for.....

Back 148

mydriatic; up to 10 day;

cycloplegic (7-12 Days);

routine cycloplegic refractions

Front 149

The use of mydriatics or cycloplegics is contraindicated in...

Back 149

narrow-angle glaucoma or those with a hx of angle closure attacks

Front 150

Ophthalmic decongestants include ______ (shortest duration) and _____ (longest duration)

Back 150

phenylephrine; tetrahydrozoline

Front 151

First line drugs for the treatment of glaucoma include ____ and _____.

Back 151

topical beta blockers and topical prostaglandin analogs

Front 152

Topical beta blockers for the eye work to decrease.......

Back 152

aqueous humor formation and secretion

Front 153

Nonselective topical beta blockers for glaucoma=

ADRs common:

Back 153

timolol

exacerbate or precipitate asthma attack, bradycardia, aggravated heart failure, avoid in asthma or COPD

Front 154

Beta1 selective beta blocker for treatment of glaucoma=

Works to.....

______X less potent that timolol and has fewer _____ ADRs

Back 154

betaxolol;

reduce activity at beta2 receptors;

100; pulmonary

Front 155

Topical prostaglandin analogs work to reduce_________ with a net effect to increase........

Includes=

ADRs (2)=

Back 155

outflow resistance; increase uveoscleral outflow

iatanoprost;

increase/darkening of iris pigmentation (may be reversible), eyelash hypertrichosis

Front 156

Second line drugs for the treatment of glaucoma include _______ and ________

Back 156

topical alpha2 agonists and topical carbonic anhydrase inhibitors

Front 157

Topical alpha2 agonists increase _______________.

Stimulation of the alpha2 receptors decreases ____ release which results in decrease stimulation of ____ receptors with a net effect to decrease ________

Back 157

uveoscleral outflow of aqueous humor;

NE release;

beta2 receptors; aqueous humor secretion

Front 158

What are two topical alpha2 agonist drugs used to tx glaucoma?

Back 158

apraclonidine, brimonidine

Front 159

Apraclonidine ADRs include.....thought to be due to an .......

Back 159

severe itching and inflammation;

immune response

Front 160

Brimonidine penetrates ____ with increased incidence of ___________

Back 160

BBB;


systemic ADR (mild hypotension)

Front 161

Topical carbonic anhydrase inhibitors decrease........

Hav ea possible allergic crossreactivity to _____ and other _____ drugs.

Back 161

aqeuous humor production and secretion;

sulfonamides; sulfa drugs

Front 162

Third line agents for the treatment of glaucoma include _____ and ________

Back 162

pilocarpine; topical sympathomimiets

Front 163

Pilocarpine works to open ______, decrease________, and increase ________.

Causes ___ and decreased _____. ADR may include.....

Back 163

trabecular meshwork; outflow resistance; outflow of aqueous humor;

miosis; night vision;

browache, headache, blurred vision, retinal tear/detachment;

Front 164

Contraindications of miotics/pilocarpine=

Back 164

presence of cataract, <40 years old, asthma or hx of asthma

Front 165

Topical sympathomimetics have a net increase in ______ by stimulating ____ and ____receptors in the trabecular meshwork, both of which increase........

Also causes a decreased ______

Drugs include=

Back 165

outflow; beta2 and alpha2 receptors; uveoscleral outflow;

production of aqueous humor;

Dipivefrin

Front 166

Dipivefrin is a prodrug of _____ with increased ____ and better corneal _____. Is rarely used due to _______.

Back 166

EPI;

lipophilicity; penetration;

corneal hyperemia

Front 167

Topical sympathomimetics have the highest incidence of _____ including ____ and ____

Back 167

ADR; rebound hyperemia, pigmented corneal deposits

Front 168

Drugs that induce or potentiate open angle glaucoma (highest risk agents)=

Back 168

ophthalmic steroids

Front 169

Drugs that induce or potentiate narrow-angle glaucoma include ______ (highest risk) and _____ (2nd highest risk)

Back 169

topical anticholinergics; topical sympathomimetics

Front 170

Drugs used for the management of acute-angle closure glaucoma include ____ eye drops to increase the ........., IV ________ which is an _______ and decreases the .........., as well as IV ______ which acts as an .........

Back 170

Pilocarpine; outflow of aqueous humor;

acetazolamide; carbonic anhydrase inhibitor; secretion of aqueous humor;

mannitol; osmotic diuretic