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S

SYD

Could somebody/ anybody clarify this please ??

Glaucoma MX-

Does Mydriatic( pupil dilatation) drugs make it better( curative).

I thought it was vice versa, 'cos when pupil dilates/pupillary constrictor muscle contracts there is crowding at the base making drainage of aquous fluid difficult/less..

Thanks
 
S

SYD

Its me again,

The q book answer is this-
Acute glaucoma Mx - Anti mucarinic/ Beta blockers

Don't they produce opposing effects ??

I am really confused :confused:
 

Ludy

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I think ckent is right about the anticholinesterases. The other drugs that can be used are muscarinic agonists like pilocarpine. They work for narrow-angle because they constrict the pupil and for open-angle because they increase the "tone" of the trabecular network, thereby increasing outflow of aqueous humor. As for beta-blockers, they're used because they decrease production of aqueous humor. There actually are no beta receptors on the ciliary muscles; the sympathetic receptors in the eye are alpha-1 receptors. So alpha agonists can be used to dilate the eye during eye exams.
 
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S

SYD

Thanks guys

So, we use Beta (-) to reduce Aqueous production.
( S/E pupil dilatation - not good 'cos could worsen glaucoma ??)

Pilocarpine : Cholinomimetic (muscarine +) constrict pupil, increasing outflow.

In summary When pupil constricts its good for Glaucoma- makes sense, 'cos when we dilate the eye somebody said to me ask for glaucoma , Yeap.
:)
 
S

SYD

I think I was wrong there

Rx can be

Anti ACh (-)- Physostigmine
ACh (+) Pilocarpine

Both costrict pupil- which should be good for a glaucoma eye.

Beta (-) reduce aqueous, does not dilate eye , cos ciliary muscle has no Beta, so no need to worry about S/E.

Then its only when we dilate with anti muscarinics we need to worry about making glaucome eye worse ... :D
 

BellKicker

Twisted Miler
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Don't forget alpha2-agonists (apraclonidine) and carbonic anhydrase inhibitors (acetazolamide).

And for those with waaay too much disk cortical diskspace: etacrynic acid.

Just took my pharm final yesterday. RRrrr.

Later.
 
S

SYD

Bell kicker

Acetazolamide, yes totally forgot about, now I recall..

Clonidine / Alfa 2 (+) : woouldn't it dilate the eye & make things worse ???

While your Pharm knowledge is saturating your brain I will thow in a question on PK/PD very soon, try and answer if you could..
 
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