Question

Q18. Adverse effects of adrenergic drugs (on alpha and beta receptors)/ Outcomes on CV, CNS and Misc other tissues?? Q19. Agents that influence intraocular pressure and how?? Treatment for Glaucoma??

Answer 1

18. Adrenergic drugs :-

#. Adverse Effect of Alpha 1 receptor activation

Hypertension

Necrosis

Bradycardia

#. Adverse Effect of Beta 1 :-

Adrenergic drug agonist

Altered heart rhythm

Angina

#. Adverse effects of Beta 2 :-

Adrenergic agonist

Hyperglycemia

Tremors

19. Factors that influence IOP :-

- Increased blood flow to the eye

- controlled by same elements that control cerebral blood flow (O2 tension, CO2, MAP)

- Venous return from the head

- Aqueous humor production & absorption

#. Factors Decrease IOP :-

Hyperventilation (Lower CO2 -> Decrease blood flow to the eye & brain --> Decreased IOP)

IV induction agents (except ketamine)

#. Factors increase IOP :-

Ketamine (Only IV induction agent that causes this). Also associated with nystagmus and contraction of EOM which may also contribute to increased IOP

Trendelenburg positioning/Head down position --> Venous congestion

Increase CVP ( Nml 5-10 mmHg) via increases in intrathoracic pressure i.e. Valsalva, coughing, bucking

Hypercarbia --> Increased blood flow to eye and brain

Succinylcholine (slight).

#. Treatment for Glucoma :-

Eye drops and oral medication such as adrenergic agonist , mitotics , beta blockers , alpha agonist , carbonic anhydrase inhibitor and prostaglandin.

Surgery include laser trabeculoplasty , filtering procedure , drainage implants or shunt surgery and trabectome surgery .