ABO Pharmacology & Ocular Therapeutics 1 — Questions and Answers
Question 1: Which drug class is typically considered first-line pharmacotherapy for primary open-angle glaucoma (POAG) in the US?
- Antihistamines
- Prostaglandin analogs (Correct answer)
- Anticholinergics
- Antifungals
Correct answer: Prostaglandin analogs
Prostaglandin analogs such as latanoprost are first-line for POAG due to their strong IOP-lowering efficacy and once-daily dosing convenience.
Question 2: Beta-adrenergic blockers (e.g., timolol) lower intraocular pressure primarily by:
- Increasing trabecular outflow
- Decreasing aqueous humor production (Correct answer)
- Constricting the pupil
- Relaxing the ciliary muscle
Correct answer: Decreasing aqueous humor production
Beta-blockers reduce IOP by blocking β-adrenergic receptors on the ciliary epithelium, decreasing aqueous humor secretion.
Question 3: Brimonidine (Alphagan) belongs to which pharmacological class?
- Beta-adrenergic blocker
- Carbonic anhydrase inhibitor
- Alpha-2 adrenergic agonist (Correct answer)
- Prostaglandin analog
Correct answer: Alpha-2 adrenergic agonist
Brimonidine is a selective alpha-2 adrenergic agonist that lowers IOP by reducing aqueous production and increasing uveoscleral outflow.
Question 4: Which topical anesthetic is most commonly used during ophthalmic procedures such as tonometry and foreign body removal?
- Injectable lidocaine
- Proparacaine (Correct answer)
- Benzocaine
- Oral tetracaine
Correct answer: Proparacaine
Proparacaine is the most widely used topical ophthalmic anesthetic, providing rapid corneal and conjunctival anesthesia without injection.
Question 5: Cyclopentolate is classified pharmacologically as a:
- Miotic agent
- Mydriatic-cycloplegic agent (Correct answer)
- Beta-adrenergic blocker
- Prostaglandin analog
Correct answer: Mydriatic-cycloplegic agent
Cyclopentolate is an anticholinergic that produces both pupil dilation (mydriasis) and paralysis of accommodation (cycloplegia) for refraction exams.
Question 6: The most clinically significant systemic side effects of topical ophthalmic beta-blockers include:
- Elevated blood pressure and tachycardia
- Bradycardia and bronchospasm (Correct answer)
- Hyperglycemia and weight gain
- Skin rash and pruritus
Correct answer: Bradycardia and bronchospasm
Systemic absorption of topical beta-blockers can cause bradycardia and bronchospasm, posing serious risk in patients with cardiac disease or asthma.
ABO Pharmacology & Ocular Therapeutics 1
Which drug class is typically considered first-line pharmacotherapy for primary open-angle glaucoma (POAG) in the US?