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Ocular Pharma #2

Auto NS and Diagnostic Agents

QuestionAnswer
Increased blood pressure and delayed onset over an hour is a sign of anaphylaxis reaction. T or F F
What are some signs of anaphylaxix reaction? Decreased blood pressure / Difficulty breathing / Rapid, weak pulse / Onset within 20-30 minutes
What drugs are used to decrease corneal edema? Mannitol, Hyperosmotics, Glycerine, 5%NaCl
What preservative is the most toxic to the cornea? BAK
What are some sympathomimetic effects? Dilated pupil, Deep, rapid breathing, Dry mouth
What is the neurotransmitter for the sympathetic nervous system? Norepinephrine
The neurotransmitter for the parasympathetic nervous system is? Acetylcholine
What does the parasympathetic nervous system do? Constriction of pupil, Lens accommodation, Flush skin
What diagnosis Myasthenia Gravis? IV Tensilon® (edrophonium), Ice to the lids, Measure Acetylcholinestrerase levels
What drops are occasionally used to reverse mydriasis in the office? Dapiprazole
What is true about Botulinum? Treatment of strabismus, Is a toxin, Blocks release of acetylcholine
What is the longest acting Cycloplegic drug? Atropine
What is the shortest Cycloplegic drug? Tropicamide (Mydriacyl®)
What is the drug of choice for routine cycloplegia in a child? Cyclopentolate
Cycloplegia is useful for what? Exposing latent hyperopia / Reducing spasm of inflammation / Preventing and treating posterior synechia / Assessing refractive error
Mydriatics paralyze accommodation as well as dilate. T or F False
Cycloplegics paralyze accommodation as well as dilate. T or F True
What is commonly used in Office practice? Topical Anesthetics
What is true of Tamsulosin (Flomax®)? May cause floppy iris syndrome in cataract surgery / Is an Alpha 1 blocker / Used to treat prostate enlargement
What are drugs that block the parasympathetic system called? Parasympatholytics / Parasympathic antagonists/ Cholinergic antagonists
What is commonly used for surgery? Carbachol (Miostat®)/ Acetyl choline (Miochol®)/ Viscoelastics
What drugs are Beta Blockers? Timolol– (Timoptic®) glaucoma drug
What are the side effects of Cycloplegics? Glare, photo sensitivity / Reduced near vision / Stinging / Reduced depth perception
What is true about Neosynephrine? Burning and Stinging / May raise the bp / Blanches superficial blood vessels / Dilates the pupil
Beta Blockers must be used with caution with what types of patients? Patients with low bp, All elderly patients
Filter paper strips are impregnated with what dyes? Lissamine Green / Fluorescein / Rose Bengal
Name the adrenergic receptors. Alpha-1, Alpha-2, Beta-1, and Beta-2
Name the cholinergic receptors. Muscarinic and nicotinic
What drugs are indirect cholinergics? Echothiophate, Edrophonium, Physostigmine
What two drugs are used in the diagnosis and treatment of myasthenia gravis? Edrophonium, Physostigmine
What is the approximate time of onset of full cycloplegic effect and its approximate duration effects for Atropine. 1 day and 1 day
What is the approximate time of onset of full cycloplegic effect and its approximate duration effects for Cyclopentolate. 40 mins/40 mins
What is the approximate time of onset of full cycloplegic effect and its approximate duration effects for Tropicamide. 25 mins/ 35 mins
Dapiprazole is effective reversing the action of what drug? Phenylephrine (neosynephrine). Less effective for Tropicamide, and not as effective against the rest.
Name the two most common ophthalmic sympathomimetic eye drops for dilating. Phenylephrine and Hydroxyamphetimine (the later only used by optometrists)
Name the main three ophthalmic parasympatholytic eye drops for cycloplegia. Atropine, Cyclopentolate, and Tropcicamide (strongest to weakest)
Topical fluorescein stains what part of the eye? Cornea only
Topical Lissamine Green and Rose Bengal stain what part of the eye? Cornea and conjunctiva
A dry spot on the cornea with fluorescein appears as what? Black (dark) unstained area
How does Indocyanine Green differ from Infracyanine Green? ICG (Indocyanine) contains Iodine. IFCG does not, and is more isotonic
Trypan Blue or methylene blue is mainly used to stain what two structures of the eye? Anterior lens capsule and epiretinal membranes to make them more visible for surgery.
What are the side effects of the indirect cholinergic agents and why are they not used today? Intense miosis (causes severe brow and headache), retinal detachments, Iris cysts (This was a board question last year).
Created by: Leequa
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