Sunday, November 14, 2010

pharmacology: opthalmic drugs

the pharm lecture for the conventional medications used to treat eye conditions. first, there are a number of medications that are used to assess in the diagnosis of various eye disorders: anesthetics such as opthane, staining agents such as flourescein dye (which is useful in diagnosing herpes keratitis), mydriatic agents such as homatropine, cycloplegics such as homeatropine, and miotic agents such as pilocarpine.

there are are several drugs available to combat the different types of conjunctivitis. tetrahydrozoline / visine is one that is focused on removing the redness from eyes and does so by a vasoconstrictive effect, combined with the astringent effect of zinc sulfate. azelastine / optivar is an H1 blocker that is used for allergic conjunctivitis. bacterial conjunctivitis can be combated with ocular polysporin-- a mix of bacitracin and polymyxin. viral conjunctivitis, specifically herpes simplex keratoconjunctivitis, can be combated with vidarabine / ara-a.

the main drug used to treat glaucoma is timolol / timoptic, which works by blocking ocular norepinephrine, which reduces the production of aqueous humor, thereby relieving the anterior chamber pressure. pilocarpine, the miotic agent mentioned above, might also be used in glaucoma for contraction of the ciliary muscles, which increases aqueous humor outflow.

questions
1. types of medications that aid in diagnoses of opthalmic conditions?
2. example of anesthetic?
3. example of staining agent?
4. example of mydriatic agent?
5. example of cycloplegic?
6. example of miotic agent?
7. [3] useful in diagnosing which condition?

tetrahydrozoline / visine...
8. indication?
9. mechanism?
10. side effects?

azelastine / optivar...
11. indication?
12. mechanism?

ketorolac / acular...
13. mechanism / class?
14. indication?
15. unlike ocular steroids...

antimicrobials...
16. which combination of antimicrobials might be given for a case of infectious conjunctivitis of bacterial origin?
17. which is specific for HSV?
18. which form of HSV is [17] specific for?

glaucoma...
19. timolol mechanism of action?
20. example of a miotic agent? mechanism?
21. mechanism of xalatan?
22. effect of cannabis on glaucoma?

answers
1. stains, mydriatics, miotics, cycloplegics, anesthetics.
2. opthane
3. flourescein dye.
4. homatropine.
5. homatropine.
6. pilocarpine.
7. dendritic figures of herpes keratitis.

8. relieve of redness.
9. vasoconstriction and astringent effects via tetrahydrozoline and zinc sulfate.
10. local irritation, rebound vasodilation.

11. allergic conjunctivitis.
12. blocks H1 receptor sites.

13. cyclooxygenase inhibitor.
14. ocular discomfort from swelling.
15. ketorolac does not increase risk for cataracts or glaucoma.

16. polysporin-- polymyxin and bacitracin.
17. vidarabine / ara-a
18. herpes simplex keratoconjunctivitis, not zoster.

19. blocks ocular norepinephrine release, which reduces production of aqueous humor.
20. pilocarpine. increased outflow of the aqueous humor by ciliary contraction.
21. prostaglandin receptor agonist that increases uveoscleral outflow, improving outflow of aqueous humor and reducing intraocular pressure.
22. relaxes trabecular network and increases flow, reducing intraocular pressure.

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