20 - Anti - glaucoma drugs Flashcards
1
Q
what are topical classes of drugs for glaucoma
A
- prostaglandin agonists
- beta receptor antagonists
- alpha 2 receptor agonists
- carbonic anhydrase inhibtors
- cholinergic agonists
2
Q
what is the mechanism of action for these topical drugs
A
- lowering IOP (ocular hypertensive meds)
- reduce aqueous production (CAI, a2ra, beta r.a - work on ciliary epithelium)
- increase outflow through trabecular meshwork (cholinergics)
- increase uveoscleral flow (PGA, prostamide, brimonidine)
3
Q
systemic classes of glaucoma drugs (Acute angle closure)
A
- carbonic anhydrase inhibiroes (acetazolamide) - single dose/tablet
- osmotic agents (glycerol/mannitol)
4
Q
before prescribing any new eye drop for glaucoma?
A
- general medical history
- drug history
- history of topical allergy
- find out if px can use drops ; memory/dexterity/carers
5
Q
latonoprost vs timolol
A
latonoprost but not by much
6
Q
where do PGA act
A
uveo scleral pathway
7
Q
name some prostoglandin anologs
A
- latanoprost
- travuprost
-tafluprost
8
Q
side effects of PGA
A
- conjunctival hyperaemia , more pronounced in early stages of treatment
- darkening/thickening of lashes
- increased iris pigmentation
9
Q
name some Beta- antagonists
A
- timolol
-betaxolol - levobunolol Hcl
10
Q
what type of beta blocker is betaxolol
A
selective
11
Q
what type of beta blocker is timolol
A
non selective
12
Q
what are side effecs of beta antagonists
A
- bronchpconstriction: esp in px with obstructive airways disease or asthma
13
Q
If prescribing B antagonists
A
- ask about COAD inhalers
- check pulse
- check peak flow
- considering drug interactions
- recheck peak flow 1 month after starting treatment, stop if fall of 15%
14
Q
name some alpha agonists
A
- Brimonidine tartrate
- Apraclonidine
15
Q
when is Apraclonidine used and why
A
pre and post operative setting, as an effective short term IOP lowering agent
