Test 192  (Ocular pharmacology)

1. The side effects of pilocarpine include:

a. dry eye

b. increased sweating

c. bronchiolar spasm

d. increased salivation

e. constipation

 
Answera.F   b.T  c.T   d.T  e.F
Side effects of pilocarpine include:
-salivation, lacrimation, sweating
-nausea, vomiting, diarrhoea
-bronchiolar spasm and pulmonary oedema
-worsens Parkinsonism.

2. The following are true about pilocarpine:

a. it increases the concentration of acetylcholine in the 
    synaptic cleft

b. it increases trabeulcar meshwork outflow but 
    decreases uveoscleral outflow

c. patients with dark iris are more sensitive to the miotic 
    effect of pilocarpine

d. it increases the depth of focus

e. it induces myopia by increasing the axial length of the 
    lens

 

Answera.F  b.T  c.F  d.T  e.T
It is a direct acting cholinergic agonist.
A higher concentration is required in dark irides due to melanin binding of the drug. The pupil is constricted and the depth of focus is increased.

 
 

3. Pilocarpine is contraindicated in the following conditions:
 

a. malignant glaucoma

b. pseudoexfoliation glaucoma

c. hypertensive uveitis

d. aphakic glaucoma

e. subacute angle closure glaucoma

 
Answer
a.T   b.F  c.T  d.F  e.F
Malignant glaucoma resulted from aqueous direction 
and should be treated with pupil dilatation and aqueous suppression. Pilocarpine causes breakdown of the blood aqueous barrier and can increase inflammation in hypertensive uveitis.

 

. 4. With regard to the effect of atropine:

a. mydriasis is the result of paralysis of the constrictor 
    muscle of the pupil

b. mydriasis occurs more rapidly than cycloplegia

c. cycloplegia persists longer than mydriasis

d. it causes forward movement of the lens

e. it causes a breakdown in the blood aqueous barrier
 

Answer
a.T  b.T  c.F  d.F  e.F
Mydriasis from atropine tends to occur more rapidly than cycloplegia and persists longer. There is a backward movement of the lens. Atropine stabilizes the blood aqueous barrier.

5. The following are true with regard to acetazolamide: 

a. 99% of carbonic anhydrase must be inhibited before 
    there is an effect on the intraocular pressure

b. it increases rate of subretinal fluid absorption between 
    retina and retinal pigment epithelium

c. it reduces the rate of aqueous production by up to 50%

d. a solution of acetazolamide has an alkaline pH 

e. it is excreted unchanged by the kidneys

 
Answer
a.T   b.T  c.T  d.T  e.T

 

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