COT Ophthalmic Pharmacology 3

Question 1

Timolol maleate ophthalmic solution is contraindicated in patients with which systemic condition?

Accepted Answer

Reactive airway disease or asthma

Answer

Timolol is a non-selective beta-blocker that can cause bronchospasm by blocking beta-2 receptors in the lungs, making it contraindicated in patients with asthma or COPD.

Question 2

Which mydriatic agent provides both pupil dilation AND cycloplegia (paralysis of accommodation)?

Accepted Answer

Tropicamide

Answer

Tropicamide is an anticholinergic agent that blocks muscarinic receptors causing both mydriasis and cycloplegia, making it useful for refraction and fundus examination.

Question 3

A patient reports that their eye drops turn the iris from blue to brown over time. Which drug class is responsible for this pigmentation change?

Accepted Answer

Prostaglandin analogs

Answer

Prostaglandin analogs (e.g., latanoprost, bimatoprost) can stimulate melanogenesis in iris melanocytes, causing irreversible increased iris pigmentation over months to years.

Question 4

Which ophthalmic preservative found in many multi-dose eye drop bottles is known to be toxic to the corneal epithelium with long-term use?

Accepted Answer

Benzalkonium chloride (BAK)

Answer

Benzalkonium chloride (BAK) is a detergent-type preservative that disrupts the lipid layer of the tear film and is directly toxic to corneal epithelial cells with chronic exposure.

Question 5

Cyclopentolate is preferred over atropine for routine pediatric cycloplegic refraction primarily because:

Accepted Answer

Its effects last hours rather than days, reducing systemic toxicity risk

Answer

Cyclopentolate's effects resolve within 24 hours compared to atropine's 1–2 weeks, reducing the risk of prolonged systemic anticholinergic toxicity in children.

COT - Certified Ophthalmic Technician Practice Test

COT - Certified Ophthalmic Technician Practice Test

COT Ophthalmic Pharmacology 3