Question
260 CHAPTER 50/ Drugs for Eye and Ear Disorders 25. Which of the following classes of drugs for eyc procedures should NOT be used foe patkents with glaucoma? a Mydriatic (sympathomimetic) drugs b. Cycloplegic (anticholinergie) drugs e, Osmoric diuretics d. Carbonic anhydrnse inhibitoes 26. When used for glaucomn, one drawbock of prostaglandin analogs is that they do which of the following? n. Change pigmentation of the eye b. Reduce blood preasure c. Increase turine outpu d. Block sympathetic impalses 27. Which of the following medicatiors is converted to epinephrine in the eye a Tafluprost (Zioptan) b. Carbachol (Miosta) c. Dipivefrin HCI (Propine d. Echochiophate iodide (Phospholine iodide) 28. Which class of drugs used for eye examinations has the potential to produce unfavorable CNS effects? a. Osmotic diuretics b. Sympathomimetic drugs c. Anticholinergie drugs d Cholinergic agonists 29. Major risk factors associated with glaucoma inclade all of the following EXCEPT a. hypertension b. migraine headaches, c, ethnic origin d. epilepsy 30. Which of the following statements regarding closed-angle (acute) glaucoma is NOT true? a. It is usually unilateral b. The iris is pushed over the area where the fluid normally drains. c. It is frequently seen in persons of Caucasian race d It constitules an emergency situation 31. Which of the following statements regarding beta blocking agents is NOT true? a They are contraindicated in persons who are allergic to sulfa b. Before the discovery of prostaglandin analogs, they were the prefenred drugs for glaucoma therapy. c. They generally produce fewer ocular adverse effects than other autonomic drugs d. They may produce systemic side effects such as bronchoconstriction, bradycardia, and hypotension Adams/Holland, Sudent Workbook and Resource Guide for Pharmacolegy for Narses 3th Edision O 2017 by Pcarson Education, Inc.
Explanation / Answer
25. a. Mydriatic (sympathomimetic) drugs
Sympathomimetics dilate the pupil vertically oval just like in an attack of acute congestive glaucoma.
26. a. Change the pigmentation of the eye
Darkening of the iris colour is a well-known side effect of both naturally occurring prostaglandins and prostaglandin analogues, such as isopropyl unoprostone and latanoprost.
27. c. Dipivefrin HCl (Propine)
Dipivefrin (Propine) is readily absorbed through the cornea and into the anterior chamber of the eye because it is a more lipophilic compound than is epinephrine. It is converted by enzyme hydrolysis to epinephrine in the eye's ocular fluid, where it serves as a direct-acting sympathomimetic to lower intraocular pressure by decreasing aqueous humour production, dilating pupils and constricting conjunctiva blood vessels, thus increasing intraocular fluid outflow.
28. c. Anticholinergic drugs
Confusion, agitation, and delirium are CNS side effects of anticholinergics that cross the blood-brain barrier. Patients at greatest risk for mental status changes are those at the extremes of age, those with preexisting abnormalities of mental status, and those taking drugs with significant anticholinergic properties (e.g., antiparkinson drugs, phenothiazines, tricyclic antidepressants, butyrophenones, antihistamines, cycloplegics, antispasmodics).
