OPHTHALMOLOGY DRUGS
Name Class Clinical Indications Receptor Action Mechanism of Action Adverse Effects and Interactions Administration + PK
Antagonism of the 𝛽-2 receptors in the ciliary body blood vessels leads to vasoconstriction Bronchospasm
Beta Blockers Timolol Beta blocker Open angle glaucoma 𝛽-2 receptor antagonist and therefore decreased aqueous humour production and decreased intraocular pressure. Bradycardia Eye drops
Dry eyes
Adrenaline Activation of 𝜶-1 receptors leads to vasoconstriction of vessels in the ciliary body, reducing
Pain
Alpha Agonists Dipivefrine Sympathomimetic Open angle glaucoma 𝜶-1 receptor agonist blood flow and therefore aqueous humour production leading to a decrease in intraocular Eye drops
Eye redness
Brimonidine pressure.
Inhibits carbonic anhydrase in the non-pigmented epithelial cells of the ciliary body. This Eye irritation
reduced production of HCO3- which is a major component of aqueous humour. The Nausea, vomiting and diarrhoea
Oral
Carbonic Anhydrase Acetazolamide Carbonic anhydrase Open angle glaucoma Carbonic anhydrase decreased HCO3- content in the aqueous leads to an overall increase in charge of the Diuresis
Eye drops
Inhibitors Dorzolamide inhibitor Closed angle glaucoma inhibitor aqueous making it hard for Na+ to be pumped into it. Less Na+ is pumped into the aqueous
IV
meaning less water follows it, decreasing the overall production of aqueous humour and Contraindicated in hyperkalemia,
therefore intraocular pressure. hyponatremia and renal impairment
Agonises the M3 receptor in the sphincter pupillae muscle leading to constriction of the pipil. Eye irritation
Open angle glaucoma This pulls the iris backwards, opening the canal of Schlemm leading to increased outflow of Headache
Muscarinic Agonists Pilocarpine Miotic M3 receptor agonist Eye drops
Closed and glaucoma aqueous humour and therefore decreased intraocular pressure. Blurred vision
Hypersalivation
Increases uveoscleral outflow of aqueous humour from the eye leading to a decrease in Brown pigmentation of the iris
Prostaglandin Latanoprost Prostaglandin
Open angle glaucoma F2-alpha receptor agonist intraocular pressure. Eye drops
Analogues Travoprost analogue
Contraindicated in pregnancy
Activates 𝜶-1 receptors in the dilator pupillae leading to dilatation of the pupil. Does not Tachycardia
Dilatation of pupil for better
Phenylephrine Mydriatic 𝜶-1 receptor agonist cause cycloplegia as the ciliary muscles have no sympathetic innervation. Gi disturbance Eye drops
view of interior of the eye
Headaches
Mydriatics Blurred vision
+ Dry mouth
Cycloplegics Inhibits M3 receptors in the sphincter pupillae preventing the action of acetylcholine, Urinary retention
Atropine Cycloplegic + Dilatation of pupil for better Non-selective muscarinic
preventing pupil constriction. Also inhibits M3 receptors in the ciliary body leading to Constipation Eye drops
Tropicamide mydriatic view of interior of the eye AcH receptor antagonist
paralysis of the ciliary body.
Contraindicated in closed angle
glaucoma
Name Class Clinical Indications Receptor Action Mechanism of Action Adverse Effects and Interactions Administration + PK
Antagonism of the 𝛽-2 receptors in the ciliary body blood vessels leads to vasoconstriction Bronchospasm
Beta Blockers Timolol Beta blocker Open angle glaucoma 𝛽-2 receptor antagonist and therefore decreased aqueous humour production and decreased intraocular pressure. Bradycardia Eye drops
Dry eyes
Adrenaline Activation of 𝜶-1 receptors leads to vasoconstriction of vessels in the ciliary body, reducing
Pain
Alpha Agonists Dipivefrine Sympathomimetic Open angle glaucoma 𝜶-1 receptor agonist blood flow and therefore aqueous humour production leading to a decrease in intraocular Eye drops
Eye redness
Brimonidine pressure.
Inhibits carbonic anhydrase in the non-pigmented epithelial cells of the ciliary body. This Eye irritation
reduced production of HCO3- which is a major component of aqueous humour. The Nausea, vomiting and diarrhoea
Oral
Carbonic Anhydrase Acetazolamide Carbonic anhydrase Open angle glaucoma Carbonic anhydrase decreased HCO3- content in the aqueous leads to an overall increase in charge of the Diuresis
Eye drops
Inhibitors Dorzolamide inhibitor Closed angle glaucoma inhibitor aqueous making it hard for Na+ to be pumped into it. Less Na+ is pumped into the aqueous
IV
meaning less water follows it, decreasing the overall production of aqueous humour and Contraindicated in hyperkalemia,
therefore intraocular pressure. hyponatremia and renal impairment
Agonises the M3 receptor in the sphincter pupillae muscle leading to constriction of the pipil. Eye irritation
Open angle glaucoma This pulls the iris backwards, opening the canal of Schlemm leading to increased outflow of Headache
Muscarinic Agonists Pilocarpine Miotic M3 receptor agonist Eye drops
Closed and glaucoma aqueous humour and therefore decreased intraocular pressure. Blurred vision
Hypersalivation
Increases uveoscleral outflow of aqueous humour from the eye leading to a decrease in Brown pigmentation of the iris
Prostaglandin Latanoprost Prostaglandin
Open angle glaucoma F2-alpha receptor agonist intraocular pressure. Eye drops
Analogues Travoprost analogue
Contraindicated in pregnancy
Activates 𝜶-1 receptors in the dilator pupillae leading to dilatation of the pupil. Does not Tachycardia
Dilatation of pupil for better
Phenylephrine Mydriatic 𝜶-1 receptor agonist cause cycloplegia as the ciliary muscles have no sympathetic innervation. Gi disturbance Eye drops
view of interior of the eye
Headaches
Mydriatics Blurred vision
+ Dry mouth
Cycloplegics Inhibits M3 receptors in the sphincter pupillae preventing the action of acetylcholine, Urinary retention
Atropine Cycloplegic + Dilatation of pupil for better Non-selective muscarinic
preventing pupil constriction. Also inhibits M3 receptors in the ciliary body leading to Constipation Eye drops
Tropicamide mydriatic view of interior of the eye AcH receptor antagonist
paralysis of the ciliary body.
Contraindicated in closed angle
glaucoma
