Poda III final

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Author:
alvo2234
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189427
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Poda III final
Updated:
2012-12-13 23:53:37
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poda III final
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pharmacology of the eye
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  1. what is blepharitis
    inflammation of the eyelid (acute or chronic)
  2. what is keratoconjuctivitis Sicca (DED)
    chronic bilateral desiccation of the conjuctiva and cornea due to an inadequate tear film (either decrease tear production or increase tear evaporation)
  3. role of aqueous humor
    • 1. helps maintain intraocular pressure (IOP) and the eyes shape
    • 2. serves as refractive medium
    • 3. provides metabolic substrates to avasular substrates of the eye (lens, cornea)
    • 4. carries away metabolic wastes
    • 5. functions in distribution of some drugs
  4. what determines the balance of aqueous humor
    the balance in AH production (inflow) and drainage (outflow)
  5. cause of elevated AH
    usually due to the increase resistance to utflow (TM dysfunction)

    strong risk factor for the development of glaucoma
  6. what is glaucoma
    progressive optic nerve damage due to increased (IOP)
  7. patophysiology of cataract
    congenital or degenerative opacity of the lens
  8. pathophysiology of uveitis
    inflammation of the uveal tract which consists of the iris, ciliary, and the choroid
  9. Anterior segment structures include
    • cornea
    • limbus
    • TM
    • AC
    • PC
    • schlemms canal
    • lens
    • zonules
    • uvea
    • iris
    • ciliary body
  10. Posterior segment structures include
    • vitreous
    • optic nerves
    • retina
    • choroid
    • sclera
  11. pathophysiology of age related macular degeneration
    chronic age-related disease of the retina that destroys light-sensitive part of the retina known as the macula
  12. two types of ARMD
    • Dry (atrophic)
    • Wet (exudative or neovascular)
  13. pathophysiology of retinitis pigmentosa
    slowly progressive, bilateral degeneration of the retina and RPE caused by various genetic mutations
  14. first choice drug delivery to anterior segment
    • transcorneal
    • transconjuctival
  15. passive diffusion across corneal and conjuctical tissues are affected by
    • 1. drug concentration gradient between tear film and corneal and conjuctival epithelium
    • 2. size of the drug molecule
    • 3. chemical structure of drug molecule
    • 4. steric configuration
  16. purpose of prodrugs to treat eye disorders
    the development of prodrugs can be used to enhance corneal permeability
  17. excretion of ocular drugs
    excreted by the liver and kidney after systemic absorption

    some are washed out in tears or through nasal secretions
  18. purpose of autonomic drugs
    • used for diagnostic and surgical purposes and for the treatment of ocular disease:
    • -glaucoma
    • -uveitis
    • -strabismus
  19. stimulation of the ciliary body will cause
    increase of AH production by epithelium
  20. stimulation of the dilator muscles causes
    mydriasis (dilation of pupils)
  21. stimulation of ciliary muscle causes
    zonules to relax causing the lens to suspend and convex which facilitates near vision

    decreases IOP by pulling open TM and increasing AH outflow
  22. contraction of the sphincter causes
    miosis (pupil constriction)
  23. stimulation of dilator muscles causes
    mydriasis
  24. types of glaucoma
    • 1. primary open angle glaucoma (POAG)
    • 2. Angle closure glaucoma (acute, chronic or narrow)
    • 3. normal tension glaucoma
  25. normal tension glaucoma
    • -clinical evidence of optic nerve damage
    • -IOP within normal range (21 mmHg)
    • -treat to lower IOP- decrease risk of progression
  26. pharmacologic treatment to decrease the aqueous production
    • timoptic
    • trusopt
    • alphagan
  27. pharmacological treatment to increase TM outflow
    • lumigan
    • pilocarpine
  28. pharmacological treatment used to increase uveoscleral outflow
    • Xalatan
    • alphagan
  29. surgical options for POAG
    • laser trabeculoplasty
    • filtering surgery
    • cyclodestructive surgery
  30. surgical options for ACG
    • laser iridotomy
    • surgical iridectomy
  31. most commonly used agents for POAG
    prostaglandins and beta-blockers
  32. less frequently used medications for POAG
    • sympathomimetics
    • carbonic anhydrase inhibitors
    • cholinergics
  33. MOA of PGEs
    bind to prostanoid FP receptor on the iris and promotes uveoscleral outflow of AH
  34. Bimatoprost additional MOA
    increases the AH outflow through the conventional pathway
  35. Prostaglandin place in therapy
    1st line agent
  36. available PGE ophthalmic agens
    • bimatoprost (lumigan)
    • latanoprost (xalatan)
    • travoprost (travatan)
  37. Available Beta Blockers
    • timolol (timoptic)
    • levobunolol (betagan)
    • metipranolol (optipranolol)
    • carteolol (ocupress)
    • levobetaxalol (betaxon)
  38. selective Beta Blocker
    betaxolol (kerlone) b1 selective
  39. cholinergic agonists used
    • pilocarpine
    • carbachol
    • echothiophate iodide (indirect agonist)
  40. sympathomimetics MOA
    decreases IOP by increasing AH uveoscleral outflow
  41. sympathomimetics used
    • brimonidine
    • apraclonidine (efficacy wears off in less than a month)
  42. pharmacological options for ACG
    • osmotic agents:
    • -glycerin
    • -opthalagan
    • -mannitol
    • -osmitrol

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