Ocular and General Pharmacology

NBEO® Part 1 Full Length Test #2 - Ocular & General Pharmacology

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Optometry Board Practice Test for the NBEO^® Part 1

Test #2 – Ocular & General Pharmacology

This test is comprised of 7 items, which must be completed within 7 minutes.

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Question 1 of 13

1. Question
What part of latanoprostene bundo works exclusively on the trabecular meshwork?
- A. Prostaglandin
- B. Nitric Oxide
- C. Beta blocker
- D. CAI
Correct

B. Latanoprostene bundo is a combination drug that works on both the trabecular meshwork and the uveal scleral outflow. It is made up of prostaglandin and nitric oxide. Prostaglandin works on the uveal scleral outflow and nitric oxide works on the Trabecular meshwork.

Incorrect

B. Latanoprostene bundo is a combination drug that works on both the trabecular meshwork and the uveal scleral outflow. It is made up of prostaglandin and nitric oxide. Prostaglandin works on the uveal scleral outflow and nitric oxide works on the Trabecular meshwork.
Question 2 of 13

2. Question
Mr. Johnson visited his local optometrist for a follow up visit. He was diagnosed with uveitis, and was given a topical steroid on his first visit. The bottle containing Mr. Johnson’s medication will most likely be what color?
- A. Red
- B. Green
- C. Yellow
- D. Blue
- E. Pink
Correct

E. Pink cap indicates steroids. Red cap is mydriatic. Blue and yellow caps are glaucoma drugs.

Incorrect

E. Pink cap indicates steroids. Red cap is mydriatic. Blue and yellow caps are glaucoma drugs.
Question 3 of 13

3. Question
Which is the least likely to cause mental depression?
- A. Betaxolol
- B. Carteolol
- C. Levobunolol
- D. Timolol
Correct

B. Carteolol is a weak non-selective beta blocker. Carteolol does not cross the Blood brain barrier and thus has the lowest chance of causing anything to go on with the chemical balance of the brain.

Incorrect

B. Carteolol is a weak non-selective beta blocker. Carteolol does not cross the Blood brain barrier and thus has the lowest chance of causing anything to go on with the chemical balance of the brain.
Question 4 of 13

4. Question
A patient is currently prescribed Travatan. Which of the following below is the best topical add-on to achieve a synergistic effect?
- A. Dorzolamide
- B. Tafluprost
- C. Bimatoprost
- D. Latanoprost
Correct

A. Dorzolamide. Travatan is a prostaglandin that acts on the uveoscleral outflow mechanism. Dorzolamide is a CAI that works on the production of aqueous humor. Imagine the eye as a sink that is turned out and the drain is clogged. Prostaglandin will clean out the drain but the water is still overflowing. The only other logical thing to do is to shut off the water or reduce the amount of water coming in. This same principal can be applied to the effect of travatan on the aqueous humor mechanism.

Incorrect

A. Dorzolamide. Travatan is a prostaglandin that acts on the uveoscleral outflow mechanism. Dorzolamide is a CAI that works on the production of aqueous humor. Imagine the eye as a sink that is turned out and the drain is clogged. Prostaglandin will clean out the drain but the water is still overflowing. The only other logical thing to do is to shut off the water or reduce the amount of water coming in. This same principal can be applied to the effect of travatan on the aqueous humor mechanism.
Question 5 of 13

5. Question
What mydriatic agent is used to treat motion sickness?
- A. Homatropine
- B. Atropine
- C. Scopolamine
- D. Hydroxyamphetamine
Correct

C. scopolamine is the go to drug for motion sickness

Incorrect

C. scopolamine is the go to drug for motion sickness
Question 6 of 13

6. Question
What agent is used to treat choroidal neovascularization in ARMD?
- A. Rose bengal
- B. Lissamine green
- C. Indocyanine green
- D. Verteporfin
Correct

D. verteporfin is used for injection with diode laser to treat CNVM caused by ARMD

Incorrect

D. verteporfin is used for injection with diode laser to treat CNVM caused by ARMD
Question 7 of 13

7. Question
What tissue is the primary site for absorption of ocular pharmaceutical treatment?
- A. Cornea
- B. Conjunctiva
- C. Episclera
- D. Sclera
Correct

A. Cornea absorbs 80% of drugs in the eye. 20% or more is usually lost to the lacrimal system.

Incorrect

A. Cornea absorbs 80% of drugs in the eye. 20% or more is usually lost to the lacrimal system.
Question 8 of 13

8. Question
Which of the following factors affect drug bioavailability?
- A. Molecular solubility
- B. Molecule size
- C. pH
- D. Formulation factors
- E. All of the above
Correct

E. All of the above.

Incorrect

E. All of the above.
Question 9 of 13

9. Question
What is the mode of action of adrenergic antagonists?
- A. increase intraocular pressure (iop) by decreasing aqueous humor production
- B. decrease intraocular pressure (iop) by increasing aqueous humor production
- C. increase intraocular pressure (iop) by increasing aqueous humor production
- D. decrease intraocular pressure (iop) by decreasing aqueous humor production
Correct

D. Adrenergic antagonists are considered beta blockers. The MOA of beta blockers are to decrease the production of Aqueous Humor in the ciliary body

Incorrect

D. Adrenergic antagonists are considered beta blockers. The MOA of beta blockers are to decrease the production of Aqueous Humor in the ciliary body
Question 10 of 13

10. Question
What is the mode of action of pilocarpine?
- A. reduces intraocular pressure (iop) by constricting the iris sphincter
- B. reduces intraocular pressure (iop) by increasing aqueous humor outflow
- C. reduces intraocular pressure (iop) by decreasing aqueous humor production
- D. reduces intraocular pressure (iop) by increasing ciliary body vasodilation
Correct

B. pilocarpine causes contraction of the iris sphincter which opens up the aqueous outflow.

Incorrect

B. pilocarpine causes contraction of the iris sphincter which opens up the aqueous outflow.
Question 11 of 13

11. Question
Which of the following drugs are contraindicated in patients with extra chromosome 21?
- A. Atropine
- B. Phenylephrine
- C. Betaxolol
- D. Pilocarpine
Correct

A. Atropine is contraindicated in Down Syndrome patients. The MOA effect on down syndrome patients is unknown. Phenylephrine is contraindicated in anyone with blood pressure issues, betaxolol is contraindicated in patients with asthma. Pilocarpine is contraindicated in anyone with a retinal detachment or high hyperopes.

Incorrect

A. Atropine is contraindicated in Down Syndrome patients. The MOA effect on down syndrome patients is unknown. Phenylephrine is contraindicated in anyone with blood pressure issues, betaxolol is contraindicated in patients with asthma. Pilocarpine is contraindicated in anyone with a retinal detachment or high hyperopes.
Question 12 of 13

12. Question
Which cycloplegic drop is known to have hypersensitivity reactions in patients with allergies to sulfa?
- A. Atropine
- B. Phenylephrine
- C. Tropicamide
- D. Cyclopentolate
Correct

B. Phenylephrine.
There are no absolute contraindications to phenylephrine aside from hypersensitivity to the drug or any of its components. Phenylephrine contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms or less severe asthmatic episodes in susceptible people.

Incorrect

B. Phenylephrine.
There are no absolute contraindications to phenylephrine aside from hypersensitivity to the drug or any of its components. Phenylephrine contains sodium metabisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms or less severe asthmatic episodes in susceptible people.
Question 13 of 13

13. Question
Which drug is used to treat hyperthyroidism? (SELECT TWO)
- A. Levothyroxine
- B. Propylthiouracil
- C. Glyburide
- D. Pioglitazone
- E. Methimazole
Correct

B and E. Propylthiouracil and methimazole
→ Propylthiouracil blocks the synthesis of thyroid hormones by blocking peripheral conversion of T4 to T3 as well as blocking oxidation of iodine in the thyroid. Those with liver issues have to be careful as it carries a black box warning of hepatotoxicity.
→ Methimazole blocks the synthesis of thyroid hormones by blocking oxidation of iodine in the thyroid. Adverse effects include being teratogenic as well as agranulocytosis.
Levothyroxine, also known as Synthroid, is used for low thyroid levels (think Hashimoto’s Thyroiditis). Remember with low thyroid levels, we expect to see increased TSH and decreased T3 & T4 data in their bloodwork results.
Glyburide and Pioglitazone are both used for treatment of diabetes mellitus.
Glyburide is a sulfonylurea so careful utilizing it for patients with sensitivities to sulfa! Other sulfonylureas include chlorpropamide and glipizide and all of these block K+ channels on beta cells of the pancreas to promote insulin release.
Pioglitazone is a thiazolidinedione that acts on peroxisome proliferator activated receptors (PPAR-gamma) to increase insulin sensitivity.

Incorrect

B and E. Propylthiouracil and methimazole
→ Propylthiouracil blocks the synthesis of thyroid hormones by blocking peripheral conversion of T4 to T3 as well as blocking oxidation of iodine in the thyroid. Those with liver issues have to be careful as it carries a black box warning of hepatotoxicity.
→ Methimazole blocks the synthesis of thyroid hormones by blocking oxidation of iodine in the thyroid. Adverse effects include being teratogenic as well as agranulocytosis.
Levothyroxine, also known as Synthroid, is used for low thyroid levels (think Hashimoto’s Thyroiditis). Remember with low thyroid levels, we expect to see increased TSH and decreased T3 & T4 data in their bloodwork results.
Glyburide and Pioglitazone are both used for treatment of diabetes mellitus.
Glyburide is a sulfonylurea so careful utilizing it for patients with sensitivities to sulfa! Other sulfonylureas include chlorpropamide and glipizide and all of these block K+ channels on beta cells of the pancreas to promote insulin release.
Pioglitazone is a thiazolidinedione that acts on peroxisome proliferator activated receptors (PPAR-gamma) to increase insulin sensitivity.

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