Ocular Pharmacology

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  1. Pilocarpine
    • -direct-acting cholinergic receptor agonist
    • -activates parasympathetic system -> constricts iris and ciliary muscle, used for glaucoma
    • -resistant to cholinesterases
    • -Adverse effects: CNS disturbances, profuse sweating and salivation
  2. Physostigmine
    • reversible inhibitor of cholinesterases -> activates PNS
    • -bind at carbamylate active site and more resistant to hydration so longer duration (30-120mins)
    • -used to treat glaucoma, myasthenia gravis, Alzheimers
    • -adverse effects: enter CNS -> convulsions
  3. Neostigmine
    • similar to physostigmine, a carbamate ester, BUT water soluble so does NOT enter CNS
    • -reversibly inhibits cholinesterase -> mitotic agent to treat glaucoma short term (30-120 mins)
  4. Edrophonium
    • -reversible antagonist of cholinesterase
    • -class: quaternary alcohol
    • -short duration (10-20 mins) mitotic for glaucoma
  5. Isofluorophate
    • -irreversible inhibitor of cholinesterase (covalently phosphorylate cholinesterase) -> activates PNS
    • -used as intense, prolonged mitotic agents for treatment of glaucoma
  6. Epinephrine
    • -Non-selective alpha-adrenoceptor agonist -> stimulates SNS
    • -dilation of iris (small effect)
    • -increases AH outflow (major effect) and decreses AH secretion -> Tx for glaucoma
  7. Timolol
    • -Beta adrenoceptor blocker
    • -decreases AH production
    • -Tx for glaucoma
  8. Atropine
    • -Antimuscarinic (AchR antagmonist) -> Mydriasis and cycloplegia -> Measure refractive errors of young children without
    • accommodation capacity, retinal examinations
    • -long acting (7-10 days)
    • Tx: physostigmine
  9. Clinical uses of antimuscarinics
    • -Inhibits PNS (so SNS is in effect)
    • -mydriasis, decrease synechia in anterior uveitis
    • -antispasmodics (GI activity decreases)
    • -anesthetic
    • -opens bronchioles
    • -urinary incontinence
    • -increase HR
    • -antidote for cholinergic agents
Card Set:
Ocular Pharmacology

Optom 231
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