KMK Live Ocular Pharm Session 1

Chapter 1: Introduction

  • Iris Radial Dilator:

    • Remembered as "radial" to associate with alpha-1 receptors on the radial dilator.

    • Sphincter Muscle Receptor: M3 receptors are present on the sphincter muscle.

  • Non-Pigmented Ciliary Epithelium (NPCE):

    • Dominated by Beta-2 receptors rather than Beta-1.

    • This leads to the drug Betaxelol, which selectively targets Beta-1 receptors.

    • Despite its selectivity, Betaxelol is not very effective in lowering intraocular pressure (IOP) due to the lower presence of Beta-1 receptors.

  • Impact of Iris Dilation on IOP:

    • Dilation increases the risk of elevated IOP, particularly when mid-dilated.

    • Mid-dilation brings the lens closer to the iris, potentially causing angle closure.

  • Ocular Pharmacology Chart:

    • Suggested to create a chart listing drugs and their effects on IOP.

    • For example, dilation of the iris is more likely to increase IOP.

Chapter 2: The Anticholinergic Bucket

  • Cholinergic Agonists:

    • Increase acetylcholine; stimulate the parasympathetic system.

    • Actions include "rest and digest," miosis, and SLUDGE (Salivation, Lacrimation, Urination, Diarrhea, Gastrointestinal distress, Emesis—"need to pee pee").

    • Direct Acting Agonist: Pilocarpine.

    • Indirect Agonists: Include Neostigmine, Echothiophate, Hydrophonium, Donepezil, and Pyridostigmine.

    • Common usage for these medications includes treatment of Myasthenia Gravis and Alzheimer’s disease.

  • Cholinergic Antagonists (Anticholinergics):

    • Medicines in this category reduce acetylcholine and decrease parasympathetic output.

    • Examples include Cobalamin, Tropicamide, Atropine, and Cyclopentolate.

Chapter 3: Call This Bucket

  • Anticholinergic Medications:

    • Mnemonic: "Stop ACH" indicates mechanism of decreasing acetylcholine.

    • Atropine and Scopolamine can last up to 7 days; Omatropine lasts 2 days; Cyclopentolate—1 day; Tropicamide lasts approximately 5 hours.

  • Antihistamines:

    • Target H1 receptors; divided into 1st generation (e.g., Benadryl) and 2nd generation (e.g., Claritin, Allegra).

    • 1st Generation examples include Brompheniramine, Chlorpheniramine, Diphenhydramine, and Phenergan.

    • 2nd Generation includes Allegra and Xyzal, which have fewer sedative effects compared to their predecessors.

Chapter 4: Good Mood Neurotransmitter

  • Antipsychotics:

    • Function as antidopamine drugs, decreasing dopamine production in the brain.

    • Examples include Chlorpromazine and Thioridazine, important for those exhibiting signs of excessive dopamine function.

  • Antidepressants:

    • Only two categories within this category have anticholinergic properties: TCAs (e.g., Amitriptyline) and one MAOI.

    • Other classes (SNRIs, SSRIs) do not share this property, so it’s vital to distinguish.

  • Benzodiazepines:

    • Commonly referred to as "benzos," all end with "-lam" or "-pam," and target the GABA system, assisting with anxiety.

Chapter 5: Remember The TCAs

  • TCAs:

    • Important ones include Amitriptyline and Nortriptyline.

    • Useful methods to help memorize include creating songs or rhythms around the names of these drugs.

  • Antiaging Drugs:

    • Named for their content of "toxin," including Botox alternatives that utilize Botulinum Toxin for cosmetic applications.

Chapter 6: Conclusion

  • Review of drug categories and their relevant uses is essential for understanding therapeutic applications.

  • Recognition of how various drugs influence the nervous system can greatly enhance pharmaceutical knowledge for practical examinations or real-world scenarios.