COT Ophthalmic Pharmacology 2 — Questions and Answers
Question 1: Which class of drugs used in glaucoma treatment works by reducing aqueous humor production through inhibition of carbonic anhydrase?
- Prostaglandin analogs
- Beta-blockers
- Carbonic anhydrase inhibitors (Correct answer)
- Alpha-2 agonists
Correct answer: Carbonic anhydrase inhibitors
Carbonic anhydrase inhibitors such as dorzolamide and brinzolamide reduce aqueous humor production by inhibiting the enzyme carbonic anhydrase in the ciliary body.
Question 2: A patient taking pilocarpine for glaucoma reports difficulty driving at night. Which side effect best explains this complaint?
- Mydriasis causing glare
- Miosis reducing pupil size in low light (Correct answer)
- Cycloplegia impairing accommodation
- Increased lacrimation reducing vision
Correct answer: Miosis reducing pupil size in low light
Pilocarpine is a miotic agent that constricts the pupil, reducing the amount of light entering the eye and causing difficulty in dim lighting conditions.
Question 3: Which prostaglandin analog used to lower IOP is also FDA-approved for treating hypotrichosis of the eyelashes?
- Latanoprost
- Travoprost
- Bimatoprost (Correct answer)
- Tafluprost
Correct answer: Bimatoprost
Bimatoprost (Lumigan) is used topically to lower IOP in glaucoma and is also marketed as Latisse for enhancing eyelash growth.
Question 4: Topical fluorescein sodium is most commonly used in the clinical setting to:
- Dilate the pupil for fundus examination
- Stain corneal epithelial defects (Correct answer)
- Reduce intraocular pressure
- Anesthetize the ocular surface
Correct answer: Stain corneal epithelial defects
Fluorescein sodium is a yellow-green dye that stains areas of devitalized or absent corneal epithelium, making defects visible under cobalt blue light.
Question 5: Which topical anesthetic is most commonly used in the ophthalmic office for procedures such as tonometry and foreign body removal?
- Tetracaine
- Proparacaine (Correct answer)
- Lidocaine
- Bupivacaine
Correct answer: Proparacaine
Proparacaine (0.5%) is the most widely used topical ophthalmic anesthetic due to its rapid onset, minimal stinging, and short duration of action.
Question 6: A patient using brimonidine eye drops should be monitored for which systemic side effect, especially in pediatric patients?
- Hypertension and tachycardia
- CNS depression and bradycardia (Correct answer)
- Hyperglycemia and polyuria
- Bronchospasm and wheezing
Correct answer: CNS depression and bradycardia
Brimonidine, an alpha-2 agonist, can cause significant CNS depression (somnolence, apnea, bradycardia) in infants and young children and is contraindicated in children under 2.
Question 7: Rose bengal dye is used in the ophthalmic clinic primarily to stain:
- Normal healthy corneal epithelium
- Dead or devitalized epithelial cells and mucus (Correct answer)
- Corneal stromal edema
- Aqueous humor in the anterior chamber
Correct answer: Dead or devitalized epithelial cells and mucus
Rose bengal stains dead, devitalized, or poorly protected epithelial cells and mucus strands, making it useful for diagnosing dry eye and herpetic keratitis.
COT Ophthalmic Pharmacology 2
Which class of drugs used in glaucoma treatment works by reducing aqueous humor production through inhibition of carbonic anhydrase?