Ocular Pharm Mt 1: Mydriatics + Cycloplegics

What is the drug of choice for dx mydriasis?

• Tropicamide

• Homotropine

• Atropine

• Scopolamine

Anticholinegics can cause psychotic reactions and behavioral disturbances

• True

• False

Which is the DOC for cyclo refractions due to the faster onset and shorter duration of action?

• Atropine

• Scopolamine

• Cyclopentolate

• Homotropine

Cholinergic receptors in the tissue of the iris sphincter and CB are nicotinic in type.

• True

• False

Cycloplegis are ______ which are used in the eye to inhibit ____.

• Anti-cholinergics; accommodation

• Anti-cholinergics; pupillary constriction

• Adrenergic agonists; accommodation

• Adrenergic agonists; pupillary constriction

Pheynl is rarely used alone for mydriasis.

• True

• False

What is the max concentration of cyclos that should be used in small infants?

• 0.25%

• 0.3%

• 0.5%

• 1%

Severe reactions to anti-chols is manifested by hypotension and progressive respiratory depression

• True

• False

Cyclopentolate usually has complete recovery in ___ hours

Phenylephrine (a mydriatic) acts equally on alpha1 and beta receptors, since it is a non-selective adrenegic agonist.

• True

• False

Tropicamide is the preferred drug to tx uvieitis

• True

• False

What cyclo does this describe: Greater drug diffusability compared to other anti-chols provides faster onset of action and shorter duration of action.

• Homatropine

• Cyclopentolate

• Atropine

• Tropicamide

The ophthalmic formulations for atropine come in what %?

• 0.25%

• 0.5%

• 1%

• 2.5%

In Down syndrome pts and children with brain damage, cyclos (esp atropine) may not produce enough of a pupil response

• True

• False

Synechiea between the iris and the lens is one of the most common indications for use of cyclos.

• True

• False

To break posterior synechiae and for peripheral corneal vessels vasoconstriction during LASIK, what concentration of phenyl is used?

• 0.12%

• 1%

• 2.5%

• 10%

Mydfrin is a geneic name for 10% phenyl

• True

• False

What concentrations are available for ophthalmic use of tropicamide?

• 0.25%

• 0.5%

• 1%

• 2%

Mydriatics stimulate what division of the ANS?

• Cholinergic

• Adrenergic

• Neither

• Both depending on the dosage

What is the 0.12% phenyl used for?

• Ocular decongestant

• Dx of Horner's

• For children

• More than one of the above

Strong action of 2.5% and 10% solutions on dilator muscle in older patients may result in what 30-45 minutes after use?

• Transient pigment floaters in AH

• Lens dislodgement

• Narrower angles

• Permanent mydiasis

What is the generally recommened concentration of phenyl for infants and elderly?

• 0.12%

• 1%

• 2.5%

• 10%

Which concentration of phenyl is used for Horner's syndrome?

• 0.12%

• 1%

• 2.5%

• 10%

What cyclo does this describe: non-ionized drug molecules penetrate the corneal epithelium easily, and can reach a higher concentration level at muscarinic receptor sites than other cyclos.  

• Atropine

• Homatropine

• Cyclopentolate

• Tropicamide

What is the max amount of administrations that should be used with Cyclomydril?

• 1x

• 2x

• 3x

• As often as needed to produce results

Indicate all the contraindications for cyclo use.

• Primary glc

• Hypersensitivity to belladonna alkaloids

• Adhesions between the iris and lens

What cyclo may cause CNS disturbances that may be dangerous in infants and children?

• Tropicamide

• Cyclopentolate

• Homatropine

• Atropine

• All of the above

• 2 of the above

Indicate the contraindicatesion for 10% phenyl.

• Type I diabetes

• Type II diabetes

• Orthostatic hypotension

• Advanced ASHD

• IOL

• Past refractive surgery

For what situations would be phenyl be contraindicated?

• Narrow angle glc

• Narrow angles in general

• Low birth weight infants

• Elderly with atherosclerotic CVD

• Cerebrovascular dz

• Allergies to tropicamide

• Pts with low BP

Indicate the ocular side effects of anti-chols.

• Blurry vision

• Photophobia

• Visual hallucinations

• Conjunctivitis

• Sub conj heme with over use

Cyclos are indicated in dx procedures and in chronic inflammatry conditions of the iris and uveal tract

• True

• False

Most patients in whom cyclopentolate has been administred have sufficient recovery of accomm amp to be able to read in ___-___ hours.

Choose the indications for use of cycloplegics.

• Uveitis

• Wet refractions

• DFEs

• Gonioscopy

Which drugs are used in combo to make Cyclomydril?

• 0.2% cyclopentolate HCl

• 0.5% cyclopentolate HCl

• 1% phenylephrine

• 0.5% tropicamide

Choose the indications for use of a mydriatic.

• Cycloplegia

• Pupillary dilation

• Testing for Horner's Syndrome

• Contstriction of ocular blood vessels (ocular decongestant)

What is a rare but potential systemic side effect of phenyl?

Indicate the potential systemic side effects of anti-chols.

• Dryness of mouth and skin

• Tachycardia

• Headache

• Somnolence

• Nausea and vomiting

• Facial sweating

What is the proper regiment for cycloplegic refraction in adults?