Carbonic Anhydrase Inhibitors and Cholinergic Agents Practice Flashcards

Vocabulary-style flashcards covering the pharmacology, mechanism of action, dosages, and contraindications of Carbonic Anhydrase Inhibitors and Cholinergic agents.

Carbonic Anhydrase Inhibitors (CAIs)

Systemic and topical agents used to lower intraocular pressure (IOP) in glaucoma patients by blocking carbonic anhydrase enzymes in the ciliary body.

CAI Mechanism of Action

Reduces the conversion of $CO_2$ and $H_2O$ into carbonic acid, leading to decreased $HCO_3$ production and reduced movement of $Na$ and $H_2O$.

Acetazolamide (Diamox)

A CAI available as a $250\,mg$ or $500\,mg$ tablet and a $500\,mg$ IV, which may cause nausea, vomiting, headache, and fatigue.

Dorzolamide (Trusopt)

An ophthalmic solution (Gutt $2\%\text{w/v}$) used to lower IOP; common side effects include a bitter taste, burning/stinging of the eye, and redness.

Brinzolamide

A CAI administered as Gutt $1\%$ with a standard frequency of BD; common side effects include blurred vision and eye discomfort.

Acidosis

A contraindication for CAIs where the body becomes more acidic due to the loss of bicarbonate ($HCO_3$).

Sulfa Allergy

A contraindication for CAIs because these drugs are sulfa-type and can cause serious reactions in allergic individuals.

Kidney Problem (CAI context)

A contraindication for CAIs because the drug is removed by the kidneys; poor function prevents the drug from being excreted properly.

Cholinergic Medications

Drugs that act on acetylcholine (ACh) to affect the parasympathetic nervous system, including the heart, muscles, glands, and eyes.

Acetylcholine (ACh)

The main neurotransmitter in the parasympathetic nervous system targeted by cholinergic agents.

Cholinergic Mechanism (Ocular)

Stimulates the contraction of the ciliary muscle, pulling the sclera spur to widen intertrabecular spaces and increase aqueous humor outflow.

Pilocarpine Hydrochloride

A cholinergic agent available as Gutt $1\%$, $2\%$, or $4\%$ used TDS/QID, which can cause eye pain, headache, and dimmed night vision.

Parasympathetic Nervous System Actions

Physiological responses including pupil constriction, decreased heart rate, airway constriction, and stimulation of digestive activity.

Cholinergic Ocular Contraindications

Conditions such as acute iriditis, acute uveitis, anterior uveitis, and acute inflammation of the anterior segment where these agents should not be used.