Ocular irritation Bronchospasm Bradycardia Nightmares Exacerbation of hear

Ocular irritation bronchospasm bradycardia nightmares

This preview shows page 18 - 21 out of 23 pages.

Ocular irritation Bronchospasm Bradycardia Nightmares Exacerbation of hear failure Muscarinic (parasympath etic) simulates . Pilocarpine (also a differential for bilateral constricted pupils!) Glaucoma Increase aqueous outflow via trabecular meshwork by ciliary muscle contraction Ocular: Misosis (reduced vision in the presence of a cataract) spasm of accommodation, brow ache Systemic: Swaeting, bradycardia, GI disturbance Alpha2- stimulants Topical Brimonidine, Apraclonidine Glaucoma Reduces aqueos secretion by selective stimulation of alpha2 and adrenocrecptors in the ciliary body increase outflow by the uveoscleral route Ocular: Iris darkening, conjunctival hyperaemia, eyelash growth. Systemic: bitter taste, asthma. Carbonic Anhydrase Acetazolamide (systemic) Glaucoma Reduce aqueous secretion by the cilliary body Ocular route:
Image of page 18
Inhibitors Dorzolamide, Brinzolamide irritation and allergy Systemic route: Malaise, paraesthesia, urea and electrolye disturbance, aplastic anaemia Mydriatics and cycloplegics – ( Used for retinal examination and objective refraction (retinoscopy) Antimuscarini cs Tropicanamide, cyclopentolate, atropine. Eye dilation for exam Inhibit muscarinic receptors of parasympathetic nervous system to paralyse papillary sphincter and ciliary muscle. Ocular: Blurred vision, glare, angle closure glaucoma. Systemic: Tachycardia, dry mouth, confusion, tremor. Alpha- stimulant Phenylephrine Eye dilation for exam Stimulates dilator muscle of the pupil no cycloplegic effect. Ocular: Blurred vision, glare, angle closure, glaucoma, conjunctival blanching. Systemic hypertension Lubricants – There are a wide range Carbomers, hyrpmellose, polyvinyl alcohol, liquid paraffin Dry eye Exact mechanism depends on the agent Ocular: Allergy, blurred vision Ant-Inflammatory Agents. Most important drugs are corticosteroids, a Variety of other drugs are available including systemic immnosuppressants Corticosteroid s Prednisolone, betamethasone, dexamethasone Suppress Inflammation Suppresion of broad spectrum of inflammatory processes (see corticosteroids) Ocular: Glaucoma (especially with local administration), cataract (especially prolonged systemic use) exacerbation of some infections !!! e.g. herpes simplex. Systemic: Negligible with topical use, common and varied with systemic administration. Mast cell stabilisers Cromoglicate, nedocromil, lodoxamide. Allergy Stabilise mast cells Occular: Irritation Anti- Topical: Allergy Block histamine receptor Occular route:
Image of page 19
histamines Antazoline, azelastine, levocabastine. Systemic (chlorphenamine, terfendaine, cetirisine) Irritation Sytemic route: Drowsiness NSAIDS Topical: (ketorolac, diclofenac, fluribiprofen) Eye inflammation Modulate prostaglandin production.
Image of page 20
Image of page 21

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture