Chapter 10 Pharmacology

The names of β-adrenergic blockers usually end in?

"-olol."

Normal IOP is what to be considered normal?

10 and 22 mm Hg and pressure greater than 25 mmHg is considered abnormal

Indocyanine green is a fluorescent, sterile, water-soluble dye that once prepared it MUST be used within?

10 hours

What is defined as an opacity or clouding of the crystalline lens of the eye?

A cataract

A carbonic anhydrase inhibitor such as what will interfere with a production of carbonic anhydrase; thus it reduces production of aqueous humor and decreases IOP?

Acetazolamide (Diamox)

What is a miotic agent available in a solution of mannitol marketed as Miochol-E?

Acetylcholine chloride

What are spme examples of NSAIDs?

Acular Voltaren Nevanac Xibrom

What is a proteolytic enzyme; specifically, it dissolves the protein structure of fibrous connective tissue in the zonula?

Alpha-chymotrypsin

What are medications that interfere with normal transmission of pain impulses to the brain?

Anesthetics

What are frequently used in ophthalmology to treat external ocular infections and as prophylaxis against postoperative infections?

Antibiotics

Blocking β-adrenergic receptor sites, reduce what?

Aqueous fluid production

Common mydriatic agents are?

Atropine (Atropisol) & phenylephrine (Neo-Synephrine)

The most common ophthalmic irrigating solution is what?

Balanced salt solution (BSS)

What is used topically to reduce IOP in glaucoma, and by injection (Miostat) into the anterior chamber as needed intraoperatively?

Carbachol (Isopto Carbachol)

One of the most common eye disorders is?

Cataracts

The vascular layer of the eye is called

Choroid

The most common form of glaucoma is?

Chronic open-angle glaucoma

The anterior, and thickest, portion of choroid is the?

Ciliary body

The pupil regulates the amount of light entering the eye by?

Constricting (making an opening smaller)

Common cycloplegic agents are?

Cyclopentolate HCL (Cyclogyl) tropicamide (Mydriacyl)

What paralyze the accommodation mechanism? Which means that patients may be unable to see near objects clearly...

Cycloplegics

The pupil regulates the amount of light entering the eye by?

Dilating (making an opening larger)

What is a drug delivery vehicle that binds drug molecules in matrix that enables release of the medication in a gel-like drop?

DuraSite

What may also be used to observe the flow of aqueous humor or to demonstrate lacrimal system function?

Dyes

What are proteins that act as catalysts; that is, they speed up chemical reactions?

Enzymes

The most commonly performed surgical intervention for cataracts is?

Extracapsular extraction with phacoemulsification and intraocular lens implant.

The globe consists of three layers of tissue what are they?

Fibrous, vascular, and nervous.

Examples of dyes used in ophthalmology are?

Fluorescein Sodium Rose Bengal Lissamine Green Indocyanine Green (IC- Green)

What is a nontoxic, water-soluble dye that is applied to the cornea or conjunctiva to identify denuded areas of epithelium or foreign bodies?

Fluorescein sodium

What are some antibiotic agents?

Gentamycin (Garamycin) Neosporin Vigamox Zymar Ciloxan

If a blockage occurs in the trabecular meshwork, intraocular pressure (IOP) builds, causing?

Glaucoma

What are some examples of Viscoelastic Agents?

Healon Am-visc+ Occucoat Viscoat

What is a protein enzyme extracted from highly purified bovine (cattle) or ovine (sheep) testicular enzyme?

Hyaluronidase (Vitrase)

What is given intravenously outside the surgical setting in order to visualize the choroidal vascular network?

Indocyanine green (IC-Green)

Cataracts can be extracted by one of two methods?

Intracapsular or Extracapsular

What are used during ophthalmic procedures to cleanse the operative site and keep the cornea moist?

Irrigating solutions

To prevent corneal drying or damage and maintain integrity of the epithelial surface, a non-ionic ointment/lubricant such as what is applied to each eye and the eyelids are taped closed?

Lanolin alcohol (Lacri-Lube) Polyvinyl alcohol (Liquifilm)

What are agents in ointment form that are used to moisten and protect the eye?

Lubricants

The most common osmotic diuretic used in ophthalmic surgery is?

Mannitol (Osmitrol)

What may be injected during surgery to decrease IOP and to cause miosis if needed?

Miochol-E

Because constriction of the pupil what reduces IOP, miotics are frequently used in short-term treatment of glaucoma?

Miosis

What may be used intraoperatively when pupillary constriction is indicated, as in laser iridectomy? & what are used to maintain the position of an implanted lens after cataract extraction?

Miotics

What medications constrict the pupil by stimulating the sphincter muscle of the iris?

Miotics

What agents causes the dilation of the pupil by paralyzing the sphincter muscle of the iris?

Mydriatics

What are instilled topically to diagnose abnormalities of the cornea and conjunctival epithelium or to locate foreign bodies?

Ophthalmic dyes

What term is being used for viscoelastic agents because they are no longer considered as the only medications used to maintain space and coat ocular tissues?

Ophthalmic viscosurgical device

What are also used in cases of acute angle-closure glaucoma to facilitate the response of the iris muscle to miotics?

Osmotic diuretics

What may also be used for short-term treatment of glaucoma?

Osmotic diuretics

What injection is made in the soft tissue superior (above) and inferior (below) to the eyeball?

Peribulbar block

What increases flow of aqueous humor through the trabecular meshwork, thus it is most useful in treating open-angle glaucoma?

Pilocarpine (pilocar)

The first line of glaucoma treatment is a group of drugs known as?

Prostaglandin analogues (PGA)

What reduces IOP by increasing uveoscleral outflow, a different route than the trabecular meshwork & may be used alone or in combination with other categories of agents?

Prostaglandin analogues (PGA)

Ophthalmic procedures requiring an extensive area of anesthesia are performed under a?

Regional, retrobulbar or Peribulbar block

Images focused onto the retina trigger sensory receptors characterized as?

Rods and cones

These dyes are primarily used for demarcation of devitalized conjunctival epithelium seen in "dry eye" syndrome?

Rose Bengal

The fibrous outer coat of the eye is composed of a dense, white connective tissue, called the?

Sclera

What gives the globe its shape, provides protection, and can be seen through the conjunctiva as the "white" of the eye?

Sclera

What are used in ophthalmology to decrease ocular inflammatory response to trauma, to decrease corneal inflammation, to protect the eye from scarring, and postoperatively to decrease swelling?

Steroids

Two categories of anti-inflammatory agents are used in ophthalmology are?

Steroids and nonsteroidal anti-inflammatory drugs (NSAIDs)

Two common topical ophthalmic anesthetics are?

Tetracaine hydrochloride (Pontocaine) & Proparacaine hydrochloride (Alcaine, Ophthaine)

Deep to the limbus is a venous sinus called?

The Canal of Schlemm

What is posterior to the cornea and anterior to the iris?

The anterior chamber

What prevents effective absorption of most systemically administered medications?

The blood-eye barrier

A thin, transparent mucous membrane is called what? It lines the inside of the eyelids and the anterior surface of the eyeball (globe)?

The conjunctiva

The anterior covering of the eye is made of clear, nonvascular fibrous tissue which is called?

The cornea

What is a complex sense organ that receives visual stimuli and transmits signals via the optic nerve (cranial nerve II) to the brain for interpretation?

The eye

What is attached to the ciliary process and is positioned between the cornea and lens?

The iris

What produces, distributes, and removes tears, which keep eye surfaces moist and clean?

The lacrimal system

What is positioned just behind the iris and serves to focus images onto the retina?

The lens

Which is normally transparent, is covered by a clear fibrous capsule and held in place by suspensory ligaments called zonula?

The lens

The area where the cornea and sclera meet is called?

The limbus

What is behind the iris and anterior to the lens?

The posterior chamber

The pigmented iris consists of radial and circular muscle fibers whose function is to change the size of its opening, is called what?

The pupil

The nervous layer of the eye, is called what? & is present only posteriorly and covers the choroid?

The retina

What are the accessory structures?

They're eyebrows, eyelids, eyelashes, and the lacrimal system

What is used to treat chronic open-angle glaucoma?

Timolol (Timoptic)

Aqueous humor flows forward in the anterior cavity and drains through the?

Trabecular meshwork into the canal of Schlemm.

What agents are often injected into the anterior chamber during cataract extraction (phacoemulsification) to keep the chamber expanded, to prevent injury to surrounding tissue, and to protect the cornea?

Viscoelastic agents

What may also be used as a vitreous substitute or tamponade (compression)?

Viscoelastic agents

The posterior cavity is between the lens and retina, is filled with a thick substance called?

Vitreous humor

What gives the globe its shape, keeps the retina in position, and contributes to IOP?

Vitreous humor

The entire anterior cavity is filled with what and is secreted by the ciliary processes?

aqueous humor (fluid)

The ciliary body secretes what?

aqueous humor from structures called ciliary processes.

When mannitol is administered preoperatively, an what is usually inserted into the patient's bladder to accommodate resulting diuresis (increased excretion of urine)?

indwelling urinary catheter

In retrobulbar block, the agents are injected near the?

optic nerve

Unlike aqueous humor, WHAT is not replaced?

vitreous humor