Topical ophthalmic drug classes (mydriatics, glaucoma agents, antibiotics) with mechanism and key side effect, tested on the NBEO.
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- What is the mechanism of action of tropicamide?
- Muscarinic (M3) receptor antagonist that blocks the iris sphincter and ciliary muscle.
- What is the typical duration of mydriasis produced by tropicamide?
- About 4 to 6 hours.
- Which cycloplegic agent is most likely to cause CNS side effects (disorientation, hallucinations) in young children?
- Cyclopentolate.
- What is the mechanism of action of phenylephrine in the eye?
- Alpha-1 adrenergic agonist that contracts the iris dilator muscle.
- Does phenylephrine produce cycloplegia along with mydriasis?
- No, it produces mydriasis without cycloplegia.
- What systemic side effect can topical phenylephrine 2.5-10% cause?
- Elevated blood pressure and tachycardia.
- Which cycloplegic/mydriatic agent has the longest duration of action (up to 1-2 weeks)?
- Atropine.
- What is atropine commonly used for besides cycloplegic refraction?
- Penalization therapy for amblyopia.
- What test uses hydroxyamphetamine (Paredrine) drops?
- A test to localize a Horner syndrome lesion as pre- or postganglionic.
- What is the mechanism of action of timolol in glaucoma treatment?
- Nonselective beta-adrenergic antagonist that decreases aqueous humor production.
- Name a systemic contraindication for topical timolol.
- Asthma or COPD, and bradycardia or heart block.
- What is the mechanism of action of latanoprost?
- Prostaglandin F2-alpha analog that increases uveoscleral outflow.
- What ocular side effect of latanoprost causes permanent iris darkening?
- Increased melanin synthesis in iris stromal melanocytes.
- Besides iris pigmentation, what cosmetic side effect is common with prostaglandin analogs?
- Increased eyelash length, thickness, and number.
- What is the mechanism of action of brimonidine?
- Alpha-2 adrenergic agonist that decreases aqueous production and increases uveoscleral outflow.