Nutrition and Pharmacology Quiz

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Questions and Answers

Which of the following vitamins is primarily associated with the reduction of neural tube defects?

  • Vitamin B12 / Cyanocobalamin
  • Vitamin E
  • Niacin / Vitamin B3
  • Folic acid / Vitamin B9 (correct)

What is a primary mechanism of action of Coenzyme Q10?

  • Serving as a precursor for NAD and NADP in mitochondrial redox reactions
  • Directly lowering cholesterol levels by inhibiting HMG-CoA reductase
  • Acting as a rate-limiting cofactor in mitochondrial ATP formation (correct)
  • Enhancing the production of intrinsic factor in the stomach

A patient with hypertriglyceridemia might benefit from a supplement rich in which of the following substances?

  • Omega-3 fatty acids DHA and EPA (correct)
  • Omega-6 fatty acids
  • Omega-9 fatty acids
  • Saturated fatty acids

Which of these herbal supplements is purported to have neuroprotective properties and is considered for use in Alzheimer’s disease?

<p>Gingko biloba (A)</p> Signup and view all the answers

Which common disorder is typically treated with Vitamin D supplementation alongside Calcium?

<p>Osteoporosis (B)</p> Signup and view all the answers

A patient with macrocytic anemia might have a deficiency in which of the following?

<p>Cyanocobalamin (D)</p> Signup and view all the answers

Which supplement is primarily used to address sleep disturbances and jetlag?

<p>Melatonin (D)</p> Signup and view all the answers

Which vitamin is often used topically to minimize scar appearance?

<p>Vitamin E (D)</p> Signup and view all the answers

What is the primary purpose of Phase I trials?

<p>Determine safety, pharmacodynamics, and pharmacokinetics (B)</p> Signup and view all the answers

Which medication is NOT considered a strong inhibitor of G PACMAN?

<p>Azithromycin (A)</p> Signup and view all the answers

What does bioavailability refer to in pharmacology?

<p>The proportion of drug that reaches systemic circulation (A)</p> Signup and view all the answers

Which of the following practices is recommended to avoid medication errors?

<p>Write 0.5 mg instead of just .5 mg (D)</p> Signup and view all the answers

In Phase II trials, what is primarily being assessed in addition to safety?

<p>Efficacy and dose-response relationships (C)</p> Signup and view all the answers

A patient is prescribed an oral solution with a concentration of 25 mg/mL. The recommended dosage is 10 mg/kg/day. If the patient weighs 150 lbs, what is the maximum daily dose in mL, if the medication will be taken twice a day?

<p>10.9 mL (B)</p> Signup and view all the answers

Which of the following is the mechanism of action for prostaglandin analog medications used in glaucoma treatment?

<p>Increasing aqueous humor outflow (B)</p> Signup and view all the answers

Which medication used to treat glaucoma is contraindicated in patients with a heart block?

<p>Timolol (B)</p> Signup and view all the answers

A patient using an ophthalmic solution containing benzalkonium chloride (BAK) should be instructed to wait how long before reinserting their contact lenses?

<p>15 minutes (C)</p> Signup and view all the answers

Which of the following is an adverse effect associated with the use of cholinergic (miotic) medications for glaucoma?

<p>Poor night vision (A)</p> Signup and view all the answers

Which of the following best describes the definition of steady state in pharmacokinetics?

<p>The rate of drug intake equals the rate of drug elimination (C)</p> Signup and view all the answers

Which of the following glaucoma medications works by increasing aqueous humor outflow and reducing aqueous humor production?

<p>Brimonidine (A)</p> Signup and view all the answers

A patient is taking ibuprofen for pain. They also have a prescription for methotrexate. What is the concern of using these medications concurrently?

<p>Increased risk of GI bleeding (A)</p> Signup and view all the answers

Which of the following is a common side effect of aspirin?

<p>Bronchospasms (D)</p> Signup and view all the answers

A patient on acetaminophen is at risk of hepatotoxicity. Which of the following describes the metabolic process that creates the toxic intermediate?

<p>CYP450 metabolism (B)</p> Signup and view all the answers

What is the treatment for acetaminophen overdose?

<p>Activated charcoal or acetylcysteine (B)</p> Signup and view all the answers

Which of the following is a strong inducer of the CYP450 enzyme system?

<p>Phenytoin (D)</p> Signup and view all the answers

Which of the following should patients be counseled on when instilling ear drops?

<p>Roll the ear drops in the hand prior to use. (A)</p> Signup and view all the answers

Which of the following glaucoma drugs inhibits the enzyme carbonic anhydrase to reduce aqueous humor production?

<p>Dorzolamide (B)</p> Signup and view all the answers

Which of the following drugs inhibits both COX-1 and COX-2 enzymes?

<p>Aspirin (B)</p> Signup and view all the answers

A patient reports using kava for its calming effects. What is a potential serious adverse effect associated with kava use?

<p>Severe liver damage (D)</p> Signup and view all the answers

A patient with a history of hypertension is seeking a nasal decongestant. Which of the following would be the MOST appropriate recommendation?

<p>Oxymetazoline, for short-term use (C)</p> Signup and view all the answers

A woman in her third trimester of pregnancy complains of a headache. Which of the following over-the-counter analgesics should she absolutely avoid?

<p>Aspirin (C)</p> Signup and view all the answers

A patient with heartburn is using an antacid containing aluminum hydroxide. What is a likely side effect they may experience?

<p>Constipation (D)</p> Signup and view all the answers

Which of the following medications is associated with antiandrogenic effects such as decreased libido and gynecomastia?

<p>Cimetidine (A)</p> Signup and view all the answers

A patient taking clopidogrel is prescribed a medication for heartburn. Which of the following heartburn medications has a significant drug interaction with clopidogrel?

<p>Cimetidine (D)</p> Signup and view all the answers

A patient is using intranasal corticosteroids for allergies. Which of the following is a potential long-term side effect associated with this medication?

<p>Increased risk of fungal infections (B)</p> Signup and view all the answers

A patient is taking dextromethorphan for a cough. They also take fluoxetine for depression. What is a potential concern with this combination?

<p>Increased psychoactive effects (D)</p> Signup and view all the answers

A patient with osteoarthritis is considering using glucosamine and chondroitin. What is the primary mechanism of action of these supplements?

<p>Stimulation of chondrocytes to produce cartilage (A)</p> Signup and view all the answers

A pregnant patient with severe nasal congestion is looking for a nasal decongestant. Which option is considered the safest first-line nasal decongestant for use during pregnancy?

<p>Oxymetazoline (D)</p> Signup and view all the answers

A patient is using a combination product containing guaifenesin and pseudoephedrine. What is a potential concern, particularly with regards to the pseudoephedrine component?

<p>Risk of renal calculi (A)</p> Signup and view all the answers

What is the primary risk associated with the use of oxymetazoline (Afrin) for more than 3 consecutive days?

<p>Severe rebound congestion (A)</p> Signup and view all the answers

Which herbal supplement is primarily used for symptoms related to BPH (Benign Prostatic Hyperplasia)?

<p>Saw Palmetto (D)</p> Signup and view all the answers

What is a common side effect of cholinergic blockers, such as diphenhydramine and chlorphenamine?

<p>Dryness of the mouth and mucous membranes (B)</p> Signup and view all the answers

A patient has been using a PPI for a long time. What is a potential long-term risk associated with the use of PPIs?

<p>Increased risk of C. diff infection (A)</p> Signup and view all the answers

What is the recommended treatment for acute uncomplicated otitis media in children?

<p>Amoxicillin 90 mg/kg/day in divided doses (C)</p> Signup and view all the answers

Which of the following antibiotics must be flavored when reconstituted?

<p>Clindamycin (C)</p> Signup and view all the answers

Which antibiotic is NOT listed as requiring renal dosing adjustments?

<p>Dicloxacillin (B)</p> Signup and view all the answers

What effect does cefdinir reconstitution have on stool color?

<p>Stool turns red due to reaction with dietary iron (C)</p> Signup and view all the answers

Which of the following is a Gram-positive cocci that is catalase positive and coagulase positive?

<p>Staphylococcus Aureus (A)</p> Signup and view all the answers

Which of the following antibiotics is NOT given intravenously?

<p>Amoxicillin (B)</p> Signup and view all the answers

What is the shelf life of reconstituted medications?

<p>10 to 14 days (A)</p> Signup and view all the answers

Which beta-lactam antibiotic is classified as a carbapenem?

<p>Imipenem (D)</p> Signup and view all the answers

What is an important consideration for dosing pediatric medications?

<p>Always round doses to whole mL (D)</p> Signup and view all the answers

Which of these drugs has no renal dosing adjustments based on creatinine clearance?

<p>Penicillin V (B)</p> Signup and view all the answers

Flashcards

Vitamin B12 (Cyanocobalamin)

A deficiency in Vitamin B12 can cause macrocytic anemia. This can happen due to decreased intrinsic factor, which is more common in individuals over 50 or those taking metformin.

Vitamin B9 (Folic Acid)

Vitamin B9 (Folic acid) supplementation is essential for preventing neural tube defects during pregnancy.

Calcium and Vitamin D

Calcium and Vitamin D play a crucial role in maintaining strong bones and preventing osteoporosis.

Iron

Iron deficiency leads to microcytic anemia. Iron is essential for the production of red blood cells.

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Coenzyme Q10

Coenzyme Q10 (CoQ10) is an essential cofactor in mitochondrial ATP production. It is also used to reduce statin-associated adverse effects.

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Fish Oil

Fish oil contains omega-3 fatty acids (DHA and EPA) which are beneficial for lowering triglycerides and managing inflammation.

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Red Yeast Rice

Red Yeast Rice is a natural source of compounds structurally similar to statins, used to lower cholesterol levels.

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Vitamin B3 (Niacin)

Niacin (vitamin B3) acts as a precursor for NAD & NADP, which are essential for mitochondrial redox reactions. It is often used to lower cholesterol levels.

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St. John's Wort

A plant extract known for its use in treating depression, anxiety, and OCD.

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Valerian Root

A plant root traditionally used to promote relaxation and sleep, typically for insomnia and anxiety.

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Kava

A plant extract with psychoactive effects, often used for anxiety and as a ceremonial tranquilizer in the Pacific Islands. It has been known to cause severe liver damage.

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Kratom

A plant extract with both stimulant and opioid-like effects, often used for energy and pain relief, but can also cause dependence and adverse effects.

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CBD

A naturally occurring compound found in cannabis, often used for pain relief, anxiety, and sleep. It became more popular after the 2018 Farm Bill.

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Echinacea

A plant extract often used to prevent and treat colds, potentially shortening the duration of infection.

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Elderberry

A plant extract, often in berry form, used for its potential immune-boosting and antiviral properties.

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Vitamin C

A crucial nutrient for immune function, commonly found in citrus fruits and used to prevent and treat colds.

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Zinc

A mineral essential for immune function and wound healing, often used to prevent and treat colds.

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Probiotics

Live microorganisms, primarily bacteria, that have a beneficial effect on the host organism, often used to restore gut flora balance.

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Glucosamine and Chondroitin

A supplement often used to treat osteoarthritis, stimulating cartilage and synovial fluid production.

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Saw Palmetto

A plant extract often used to treat Benign Prostatic Hyperplasia (BPH), inhibiting a hormone responsible for prostate growth.

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Black Cohosh

A plant extract traditionally used to alleviate symptoms associated with premenstrual syndrome (PMS), dysmenorrhea, and menopause.

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Evening Primrose Oil

An oil extracted from a flowering plant, often used to treat PMS and menopause.

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Salicylic Acid

A medication used to treat acne and warts, but the concentration used varies significantly.

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Phase I clinical trials

Phase I trials focus on safety, pharmacodynamics (PD), and pharmacokinetics (PK) of a new drug. They are typically conducted on healthy volunteers and aim to determine the drug's safety profile, optimal dose, and how it is processed by the body.

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Phase II clinical trials

Phase II trials evaluate the safety and efficacy of a drug in a specific population with the disease of interest. They aim to determine the drug's effectiveness and identify the optimal dose range.

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Phase III clinical trials

Phase III trials, the largest clinical trials, assess the safety and efficacy of a drug in a wide range of intended populations. They aim to confirm efficacy, determine the optimal dose for different patient groups, and gather data for labeling.

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Bioavailability

Bioavailability refers to the fraction of a drug that reaches the systemic circulation from the site of administration. It's calculated as the area under the plasma concentration-time curve (AUC).

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ISMP practices for drug dosage

The ISMP (Institute for Safe Medication Practices) emphasizes using leading zeros before the decimal point for doses less than one whole unit, and avoiding trailing zeros for whole number doses. This helps prevent medication errors.

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Gram-positive bacteria

A type of bacteria that is characterized by its ability to retain the crystal violet stain during the Gram staining process.

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Cocci

A spherical or round-shaped bacteria.

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Staphylococcus Aureus

A type of bacteria responsible for causing skin infections, such as boils, impetigo, and cellulitis.

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Vancomycin

An antibiotic that effectively treats infections caused by Staphylococcus Aureus.

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Linezolid

A type of antibiotic that is effective against a wide range of bacteria, often used to treat skin infections.

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Staphylococcus Epidermidis

A type of bacteria that is commonly found on the skin and can sometimes cause skin infections.

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Reconstitution of medication

A process of reconstituting a medication from powder form to a liquid solution for administration.

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Expiration date of reconstituted medication

The time period within which a reconstituted medication remains effective for administration.

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Acute uncomplicated otitis media

A condition characterized by an ear infection in the middle ear.

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Amoxicillin

An antibiotic commonly prescribed for ear infections in children.

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Clearance

The rate at which a drug is removed from the body's plasma over a given time. It's a measure of how efficiently the body eliminates a drug.

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Steady State

The state where the rate of drug intake is equal to the rate of drug elimination, resulting in a stable concentration of the drug in the body.

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CYP 3A4

The most prevalent CYP450 enzyme in adults, responsible for metabolizing a wide range of drugs and compounds.

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CYP450 Inducers

Drugs that enhance the activity of CYP450 enzymes, leading to faster metabolism of other drugs.

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CYP450 enzymes

A group of enzymes that play a crucial role in the metabolism of many drugs. They convert drugs into forms that can be more easily eliminated from the body.

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Acetaminophen (Tylenol) MOA

Acetaminophen's mechanism of action involves inhibiting prostaglandin synthesis in the central nervous system, thus reducing pain and fever.

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Acetaminophen Toxicity

Acetaminophen overdose can lead to liver damage. This is because acetaminophen is metabolized by CYP450 enzymes, producing a toxic intermediate that can overwhelm the liver's detoxification mechanisms.

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Acetaminophen Antidote

N-acetylcysteine is an antidote for acetaminophen overdose, it helps replenish the body's glutathione levels which are essential for detoxification.

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Ibuprofen (NSAID) MOA

Ibuprofen's mechanism of action involves inhibiting the production of prostaglandins by blocking cyclooxygenase (COX) enzymes, both centrally and peripherally. This leads to pain relief and reduction of inflammation.

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NSAID Adverse Effects

NSAIDs can cause gastrointestinal ulceration and bleeding, increase the risk of heart attacks and strokes, and may lead to kidney problems. They can also interact with other medications, potentially leading to adverse effects.

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Aspirin (Salicylates) MOA

Aspirin's mechanism of action involves inhibiting the synthesis of prostaglandins from arachidonic acid by blocking both COX-1 and COX-2 enzymes.

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Prostaglandin Analogs MOA

Prostaglandin analogs increase the outflow of aqueous humor from the eye, thus reducing intraocular pressure.

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Beta-blockers MOA

Beta-blockers reduce the production of aqueous humor in the eye, leading to a decrease in intraocular pressure.

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Cholinergic (miotics) MOA

Cholinergic drugs, also known as miotics, increase the outflow of aqueous humor by constricting the pupil, thus lowering intraocular pressure.

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Carbonic Anhydrase Inhibitors MOA

Carbonic anhydrase inhibitors reduce the production of aqueous humor in the eye by blocking the enzyme carbonic anhydrase, leading to a decrease in intraocular pressure.

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Study Notes

Indications, Classifications, and Mechanisms of Action (MOAs) for Vitamins, Minerals, Herbs

  • Vitamin B12 (cyanocobalamin): Used to treat macrocytic anemia. Decreased intrinsic factor (common in people over 50 or those taking metformin) can be a cause.
  • Vitamin B9 (folic acid): Reduces neural tube defects.
  • Calcium and Vitamin D: Used for osteoporosis treatment. Ergocalciferol (D2) is a prescription drug and cholecalciferol (D3) is an over-the-counter supplement.
  • Iron: Used in treating microcytic anemia.
  • Vitamin E: Used for topical scar minimization.
  • Coenzyme Q10: A rate-limiting cofactor in mitochondrial adenosine triphosphate (ATP) formation. Can reduce the negative effects of statins.
  • Fish Oil: Used in treating hypertriglyceridemia and inflammatory conditions. Contains omega-3 fatty acids DHA and EPA. Similar to statins in molecular structure.
  • **Vitamin B3 (niacin):**Used for treating hypercholesteremia.
  • Ginkgo biloba: Used for treating Alzheimer's disease, vascular dementia, attention deficit/hyperactivity disorder (ADHD), tardive dyskinesia, intermittent claudication, tinnitus, and acute mountain sickness.
  • Melatonin: A hormone and potent antioxidant produced by the pineal gland. Used for treating insomnia and jet lag; depression, anxiety, and OCD.
  • St. John's Wort (Hypericum perforatum): Used to treat depression, anxiety, and OCD.
  • Valerian root: Used for treating insomnia and anxiety.
  • Kava (Piper methysticum): A ceremonial tranquilizer for Pacific Islanders. May cause severe liver damage.
  • Kratom (Mitragyna speciosa): Psychoactive with stimulant and opioid-like effects.

Medication Information

  • Antacids: Magnesium hydroxide causes diarrhea; aluminum hydroxide causes constipation; calcium carbonate can cause renal calculi if there is pre-existing renal impairment; sodium bicarbonate can cause alkalosis if there is preexisting renal impairment.
  • Histamine Type 2 Receptor Antagonists: Cimetidine causes antiandrogenic effects, potentially leading to a decreased libido, impotence, and gynecomastia in men.
  • Protein Pump Inhibitors (PPIs): C.diff infections, spontaneous bacterial peritonitis, and risk of increased osteoporosis are adverse effects. Omeprazole inhibits CYP 2C19 (a significant drug interaction variable).

Additional Information

  • Pregnancy and Lactation: NSAIDs are contraindicated during the third trimester of pregnancy. Aspirin and ibuprofen are good choices during breastfeeding.
  • Various Medications: A large number of drugs, many of which interact in various ways, have been covered in the document and are related to symptoms and conditions.

CBD and Other Compounds

  • Cannabinoids (CBD): Used to prevent and treat colds. May decrease infection duration.
  • Echinacea: Used to prevent and treat colds.
  • Sambucus nigra (elderberry): Contains vitamin C.
  • Zinc (ascorbic acid): Included in Sambucus nigra (elderberry).
  • Probiotics: Used for GI flora restoration.
  • Glucosamine and chondroitin: Used for osteoarthritis.
  • Saw palmetto: Used for benign prostatic hyperplasia (BPH).
  • Black cohosh: Used for premenstrual syndrome (PMS), dysmenorrhea, and menopause.
  • Evening primrose: Used for PMS and menopause.

Salicylic Acid Concentrations

  • Acne: 0.5%-2%
  • Warts: 17%-40%

Glaucoma Drug Information

  • Prostaglandin Analogs: Increase aqueous humor outflow (treat glaucoma). Examples: Bimatoprost, Latanoprost, Tafluprost, and Travoprost. Adverse effects include darkening of iris and eyelashes.
  • Beta-Blockers: Reduce aqueous humor production (treat glaucoma). Examples: Timolol and Betaxolol. Adverse effects include increased light sensitivity and reduced heart rate and blood pressure.
  • Cholinergic Miotics: Increase aqueous humor outflow (treat glaucoma). Example: Pilocarpine. Adverse effects include poor night vision and GI distress.
  • Carbonic Anhydrase Inhibitors: Reduce aqueous humor production (treat glaucoma). Examples: Dorzolamide . Adverse reactions include sulfonamide allergies.
  • Adrenergic Alpha-2 Agonists: Increase aqueous humor outflow (treat glaucoma). Example: Brimonidine. Adverse effects include central nervous system (CNS) depression and anticholinergic effects.

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