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NBEO Pharmacology Questions with Answers
(100% Correct Answers)
Mechanism and 2 indications of pilocarpine Answer: parasympathomimetic
Used for angle closure attack, dilute pilo for Adie's tonic pupil
Toxicities of pilocarpine Answer: Browaches, headaches, myopic shifts
(accommodative spasm)
Mechanism and indication of Edrophonium (Enlon) Answer: AChE inhibitior
Used for Dx of MG
Mechanism and indiction of Neostigmine (Prostigmin) Answer: AChE
inhibitior
Used for Tx of MG
Mechanism and indication of Echothiophate Answer: Irreversible AChE
inhibitior
Used for accommodative esotropia
Pyridostigmine (Mestinon) mechanism and indication Answer: AChE
inhibitior
Used for Tx of MG
Pralidoxime (Protopam) mechanism and indication Answer: Binds to
irreversible AChE inhibitors
Used to reverse effects of pesticide (organophosphate) poisoning
Atropine toxicity Answer: Dry mouth
Dry flushed skin
,2
Rapid pulse
Disorientation and fever
Caution in Down's syndrome
Treat with physostigmine.
Phenylephrine (Neo-Synephrine) MOA and indications Answer: alpha-1
adrenergic agonist
Dilation without cycloplegia, differentiate between scleritis and episcleritis,
10% used to break PS in uveitis
Contraindications of phenylephrine 10% Answer: Pts taking MAOIs, TCAs,
and atropine
Pts with Graves' disease (sympathetics already high)
Naphazoline (Naphcon) mechanism Answer: adrenergic agonists, alpha > beta
used as ocular decongestion to constrict conj vessels
Tetrahydrozoline (Visine) mechanism and indication Answer: adrenergic
agonists, alpha > beta
used as ocular decongestion to constrict conj vessels
Which glaucoma drug can cause follicular conjunctivitis? Answer: Brimonidine
(alphagan)
Brimonidine contraindications/precautions Answer: Pts taking MAOIs
Brimonidine mechanism Answer: highly selective alpha-2 agonist
decreases aqueous production AND increases uveoscleral outflow
Apraclonidine (Iopidine) mechanism and indications Answer: primarily alpha-
1 (some alpha-2) adrenergic agonist
,3
used to control acute IOP spikes before/after surgery including LPI and SLTs,
used for acute angle closure
Which IOP lowering agent can result in tachyphylaxis? Answer: Apraclonidine
(Iopidine)
What can be used to dilate a Horner's pupil? Answer: Apraclonidine
Hydroxyamphetamine will dilate normal pupil and pre-ganglionic Horner's
Contraindications of topical beta-blockers Answer: Asthma/COPD
CV disorders: bradycardia, CHF
Timolol mechanism Answer: non-selective beta-blocker acting on NPCE to
decrease aqueous production
Timolol cautions / contraindications Answer: Asthma/COPD
CV disorders / CHF
Caution in diabetics (mask sx of hypoglycemia)
Also caution in hyperthyroidism and MG
Which IOP lowering agent can result in long-term drift or short-term escape?
Answer: Timolol
What is the name of the only topical selective beta-1 drug? Answer: Betaxolol
What drugs make up Cosopt? Answer: Timolol and Dorzolamide
What drugs make up Combigan? Answer: Timolol and Brimonidine?
What combination IOP lowering agent does not contain timolol? What does it
contain? Answer: Simbrinza: Brinzolamide and Brimonidine
How do cholinergic agonists decrease IOP? Answer: increase corneoscleral
(aka trabecular) outflow
, 4
How do alpha agonists decrease IOP? Answer: decrease aqueous production
AND increase uveoscleral outflow
How do beta blockers decrease IOP? Answer: decrease aqueous production
How do CAIs decrease IOP? Answer: decrease aqueous production
How do prostaglandin analogs decrease IOP? Answer: Increase uveoscleral
outflow
Brinzolamide (Azopt) and Dorzolamide (Trusopt) mechanism Answer: CAIs
that result in decrease bicarb ions which results in decreased Cl- / Na+ influx =
decreased aqueous production
CAIs contraindications / toxicities Answer: Sulfa allergies
Anemic patients / thrombocytopenia
Liver and Renal Disease
Corneal edema / dystrophy
Metallic taste
Prostaglandin analogs mechanism Answer: act on PGF2 receptors on ciliary
muscle, increase inflammation which triggers tissue repair enzymes that
remodel the ECM --> widens the connective tissue spaces = increases
uveoslceral outflow
PGAs also relax ciliary muscles = increases outflow
PGAs contraindications Answer: Patients at risk for CME (esp cataract post-
op)
Cases of active inflammation (uveitis)
Patients with previous episodes of HSV-keratitis
NBEO Pharmacology Questions with Answers
(100% Correct Answers)
Mechanism and 2 indications of pilocarpine Answer: parasympathomimetic
Used for angle closure attack, dilute pilo for Adie's tonic pupil
Toxicities of pilocarpine Answer: Browaches, headaches, myopic shifts
(accommodative spasm)
Mechanism and indication of Edrophonium (Enlon) Answer: AChE inhibitior
Used for Dx of MG
Mechanism and indiction of Neostigmine (Prostigmin) Answer: AChE
inhibitior
Used for Tx of MG
Mechanism and indication of Echothiophate Answer: Irreversible AChE
inhibitior
Used for accommodative esotropia
Pyridostigmine (Mestinon) mechanism and indication Answer: AChE
inhibitior
Used for Tx of MG
Pralidoxime (Protopam) mechanism and indication Answer: Binds to
irreversible AChE inhibitors
Used to reverse effects of pesticide (organophosphate) poisoning
Atropine toxicity Answer: Dry mouth
Dry flushed skin
,2
Rapid pulse
Disorientation and fever
Caution in Down's syndrome
Treat with physostigmine.
Phenylephrine (Neo-Synephrine) MOA and indications Answer: alpha-1
adrenergic agonist
Dilation without cycloplegia, differentiate between scleritis and episcleritis,
10% used to break PS in uveitis
Contraindications of phenylephrine 10% Answer: Pts taking MAOIs, TCAs,
and atropine
Pts with Graves' disease (sympathetics already high)
Naphazoline (Naphcon) mechanism Answer: adrenergic agonists, alpha > beta
used as ocular decongestion to constrict conj vessels
Tetrahydrozoline (Visine) mechanism and indication Answer: adrenergic
agonists, alpha > beta
used as ocular decongestion to constrict conj vessels
Which glaucoma drug can cause follicular conjunctivitis? Answer: Brimonidine
(alphagan)
Brimonidine contraindications/precautions Answer: Pts taking MAOIs
Brimonidine mechanism Answer: highly selective alpha-2 agonist
decreases aqueous production AND increases uveoscleral outflow
Apraclonidine (Iopidine) mechanism and indications Answer: primarily alpha-
1 (some alpha-2) adrenergic agonist
,3
used to control acute IOP spikes before/after surgery including LPI and SLTs,
used for acute angle closure
Which IOP lowering agent can result in tachyphylaxis? Answer: Apraclonidine
(Iopidine)
What can be used to dilate a Horner's pupil? Answer: Apraclonidine
Hydroxyamphetamine will dilate normal pupil and pre-ganglionic Horner's
Contraindications of topical beta-blockers Answer: Asthma/COPD
CV disorders: bradycardia, CHF
Timolol mechanism Answer: non-selective beta-blocker acting on NPCE to
decrease aqueous production
Timolol cautions / contraindications Answer: Asthma/COPD
CV disorders / CHF
Caution in diabetics (mask sx of hypoglycemia)
Also caution in hyperthyroidism and MG
Which IOP lowering agent can result in long-term drift or short-term escape?
Answer: Timolol
What is the name of the only topical selective beta-1 drug? Answer: Betaxolol
What drugs make up Cosopt? Answer: Timolol and Dorzolamide
What drugs make up Combigan? Answer: Timolol and Brimonidine?
What combination IOP lowering agent does not contain timolol? What does it
contain? Answer: Simbrinza: Brinzolamide and Brimonidine
How do cholinergic agonists decrease IOP? Answer: increase corneoscleral
(aka trabecular) outflow
, 4
How do alpha agonists decrease IOP? Answer: decrease aqueous production
AND increase uveoscleral outflow
How do beta blockers decrease IOP? Answer: decrease aqueous production
How do CAIs decrease IOP? Answer: decrease aqueous production
How do prostaglandin analogs decrease IOP? Answer: Increase uveoscleral
outflow
Brinzolamide (Azopt) and Dorzolamide (Trusopt) mechanism Answer: CAIs
that result in decrease bicarb ions which results in decreased Cl- / Na+ influx =
decreased aqueous production
CAIs contraindications / toxicities Answer: Sulfa allergies
Anemic patients / thrombocytopenia
Liver and Renal Disease
Corneal edema / dystrophy
Metallic taste
Prostaglandin analogs mechanism Answer: act on PGF2 receptors on ciliary
muscle, increase inflammation which triggers tissue repair enzymes that
remodel the ECM --> widens the connective tissue spaces = increases
uveoslceral outflow
PGAs also relax ciliary muscles = increases outflow
PGAs contraindications Answer: Patients at risk for CME (esp cataract post-
op)
Cases of active inflammation (uveitis)
Patients with previous episodes of HSV-keratitis
