intraocular tension

4. Concepts
presynaptic membrane
synaptic membrane
postsynaptic membrane
oThe neuromuscular junction is a specialized synaps between a neuro and
the muscle.
oIt allows signals from the nervous system to contact muscle fibers causing
to contact.
oAcetylecholine plays an important role in neurotransmission.

5.  In MG, antibiotic are directed toward the acetylecholine
receptor at the neuromuscular junction of skeletal muscles.
Result in:
1) Destruction of about one third of receptors at all
neuromuscular junction of skeletal muscles,
2) Flattening of the postsynaptic folds,
3) Widening of the synaptic cleft.
 Aecetylcholine (Ach) is an important neurotransmitter that
stimulates tissue to contract.

6. Ach receptor
Ach
Igo
Ach-esterase
Ach has difficulty
binding due to lgG
blokage of the
binding site. Ach
rarely binds and
Ach –esterase
begins to break it
down.
Ach has no difficulty
binding and is
broken down after
binding his alredy
occurred.

7. 1) AChE inhibitors:
 Anticholinesterasse inhibit acetylcholinesterase (AchE), allowing
the some Ach molecular to interact with the available nicotinic
receptor (NRs); frequesncy of Ach –NR interaction is inceased.
 Drug:
1) pyridostigmine bromide
2) prostigmine
2) Immunouppressant medicines:
 They inhibit the immunity sytem, and limiting antibody
production.
 Drug: azothiaprine in addition to steriod medication
(prednisolone)
3) Tymectomy
 Removal of thymus gland , which is part of the immune system,
may reduces the MG symptoms.

8. 4) Plasmapheresis:
 Plasmapheresis is also known as a plasma exchange.
 This process removes harmful antibodies from the blood, which
may result impovement in muscle strength.
5) Combination of medicine:
 Steriods in assition with Immunosuppressant tends to work
better than alone.
6) Others:
 These drugs interface with neuromusclar transmission and
excerbate the symptoms of MG
 aminoglycoside antibiotics
 beta adrenoreceptor antagonists
 phenytoin
 choloroquine
 penicillamine

9.  Introduction:
 glaucoma is a disease that damages the eye’s
optic nerve.
 It ususally happens when fluid builds up in the
front part of the eye.
 That extra fluid increases the pressure in the
eye, damagigng the optic nerve.

10. Drugs used in glaucoma
1) Atropine-
 Nturally obtain from Atropine belladonn
 It is competitive antagonists of all five muscarinc
receptor
 It gives temporary relief from bradycardia
 Antidote for cholinesterase poisoning
 Poisoning from mashrum containing muscarine
2) Scopolamine-
 It is belladonna alkaloids
 Well absorb though skin
 Crosses BBB
 It prevent motion sickness and nausea associated
with the use of opiloid analgesics.

11. 3) Tropicamide-
 short acting antimuscarinic drug
 Applied as eye drops prior to retinal exam.
 They produce mydriasis by inhibiting the contraction of the
iris spincter muscles
 They are smetimes co-administered with phenylephrine.
4) Ipratropium bromide-
 It is quaternary analog of atropine
 Used to prevent bronchospasm assosiated with COPD and
asthma.
5) Glycopyrrolate-
 It is quaternary analog of atropine
Uesd as preoperative medication to reduce salivary and
respiratory secretion
In cobination with neostigmine to reseve the sffect of non-

12. Reference
• https.//www.SlideShare.net.com
• https//www.en.wiKipedia.org
• http://www.medscape.com/viewarticle/4826
• http://en.wikipedia.org/wiki/Myasthenia_gravis#cite_note-
• http://estudiantesdemedicina.wordpress.com/
• http://en.wikipedia.org/wiki/Myasthenia_gravis#cite_note
• http://estudiantesdemedicina.wordpress.com
• http://www.slideshare.net/drshama65/mysthenia-gravisppt