B12 Drugs: Hypertension And Glaucoma

Question 1

What is Acetazolamide?

Answer 1

Carbonic anydrase inhibitor which prevents formation of bicarbonate ions for production of aqueous humour. Used to treat open-angle glaucoma.

NB: This leads to greater acidity and causes nephrolithiasis (kidney stones) and metabolic acidosis.

Question 2

When should acetazolamide be avoided?

Answer 2

Adrenocortical insufficiency because low aldosterone levels will worsen the levels of bicarbonate in the body. Hyponatremia and hyperkalemia due to impaired uptake with low HCO3-.

Question 3

How does Timolol work?

Answer 3

It is a non selective Beta-blocker to prevent aqueous humour formation, used to treat open-angle glaucoma and hypertension.
NB: Should be avoided in bradycardia and cardiogenic shock.

Question 4

How does Mannitol work?

Answer 4

Osmotic diuretic which increases blood osmolality for movement from fluid out of tissues and osmolality of filtrate to reduce water reabsorption in kidneys. Mannitol is used for high intracranial pressure or intraocular pressure.

Question 5

When should mannitol be avoided?

Answer 5

Severe dehydration and Anuria, because mannitol reduces water reabsorption.
Severe cardiac failure because mannitol will worsen hypotension.