Which of the following medications you would expect to increase aqueous humor production?

• A. Diazepam
• B. Albuterol
• C. Promethazine
• D. Phenelzine

Answer: (B)

The main idea is how autonomic receptor activity in the eye influences aqueous humor production. Activation of beta receptors in the ciliary body increases the production of aqueous humor, whereas blocking these receptors or activating other pathways that promote outflow tends to lower pressure.

Albuterol is a beta-2 adrenergic agonist. By stimulating beta-2 receptors in the ciliary epithelium, it increases the secretion of aqueous humor, so you would expect higher production with this drug.

The other medications act on different targets and don’t increase aqueous humor production in the same way. Diazepam works on GABA receptors and is used for sedation/anxiety. Promethazine is an antihistamine with anticholinergic effects, not a driver of aqueous humor production. Phenelzine influences monoamine levels via MAO inhibition but doesn’t specifically elevate aqueous humor production.