Drugs for Glaucoma Flashcards
What are the 5 Beta Blockers?
Betaxolol Timolol Metipranolol Levobunolol Carteolol
What are the 5 Beta Blockers?
Betaxolol Timolol Metipranolol Levobunolol Carteolol
What are the 2 Alpha2 Agonists?
Apraclonidine
Brimonidine
What are the 2 Alpha2 Agonists?
Apraclonidine
Brimonidine
What are the 3 Prostaglandin Analogs?
Latanoprost
Bimatoprost
Travoprost
What are the 3 Prostaglandin Analogs?
Latanoprost
Bimatoprost
Travoprost
What are the 2 Topical Carbonic Anhydrase Inhibitors?
Brinzolamide
Dorzolamide
What are the 2 Topical Carbonic Anhydrase Inhibitors?
Brinzolamide
Dorzolamide
What are the 2 Systemic Carbonic Anhydrase Inhibitors?
Acetozolamide
Methazolamide
What are the 2 Systemic Carbonic Anhydrase Inhibitors?
Acetozolamide
Methazolamide
What are the 2 Cholinergic Agonists?
Carbachol
Pilocarpine
What are the 2 Cholinergic Agonists?
Carbachol
Pilocarpine
What is the Cholinesterase Inhibitor?
Echothiophate
What is the Cholinesterase Inhibitor?
Echothiophate
What is the job of the Iris Circular muscle and through what receptor does it work?
(+) M3
- Miosis (pupil constriction) = improves outflow of aqueous humor
What is the job of the Iris Radial muscle and through what receptor does it work?
(+) Alpha1
- Mydriasis (pupil dilation) = decreased aqueous outflow
What is the Ciliary muscle in charge of doing and through what receptor?
(+) M3
Accommodation of the eye to near vision = improves aqueous outflow
What is the job of the Ciliary Epithelium?
Produce Aqueous Humor
What receptor for the Ciliary Epithelium will increase aqueous production?
(+) Beta
What receptor for the Ciliary Epithelium will decrease aqueous production?
(+) Alpha2
(+) the Beta receptor at the Ciliary epithelium will do what?
Increase aqueous production
(+) Alpha2 receptor at the Ciliary epithelium will do what?
Decrease aqueous production
What is the role of Carbonic Anhydrase?
- Increases Na+ and Bicarbonate in the Aqueous humor
- This will increase the osmotic pressure
- Thus, drawing in more water and increasing the volume of aqueous fluid
What classes of drugs DECREASE aqueous humor production?
Beta blockers
Alpha 2 Agonists
Carbonic Anhydrase (-)s
What classes of drugs DECREASE aqueous humor production?
Beta blockers
Alpha2 Agonists
Carbonic Anhydrase (-)’s
What classes of drugs INCREASE aqueous humor OUTFLOW?
Prostaglandin Analogs
Alpha2 Agonists
Cholinergic Agonists
Cholinesterase (-)’s
What classes of drugs INCREASE aqueous humor OUTFLOW?
Prostaglandin Analogs
Alpha2 Agonists
Cholinergic Agonists
Cholinesterase (-)’s
What are some adverse effects of the Systemic Carbonic Anhydrase (-)’s?
Paresthesias
Renal stones
Decreased libido
What are some adverse effects to the cornea/conjunctiva with Prostaglandin Analogs?
Corneal erosions
Conjunctiva hyperemia
Prostaglandin Analogs can cause irreversible hyperpigmentation of the ____ and reversible hyperpigmentation of the _____
Irreversible IRIS hyperpigmentation
Reversible eyelash/eyelid hyperpigmentation
Cholinergic Agonists and Cholinesterase (-)’s increase aqueous humor outflow by activating what receptor?
(+) M3 directly or indirectly
After long term use of cholinergic agonists/cholinesterase (-)’s, what are some possible adverse effects?
Cataracts
Iris-lens adhesions
Miosis (diminished night vision), myopia and eyelid twitching are adverse effects for which class of drugs?
Cholinergic Agonists/Cholinesterase (-)’s
What is the best beta blocker to use and why?
Timolol
- lacks anesthetic effects
Which Alpha2 Agonist is better and why?
Brimonidine
– Less allergic reactions/dry mouth
Which Prostaglandin Analog is the best at lowering IOP?
Bimatoprost
For Open Angle Glaucoma (most common), what agents are first line?
Beta blocker or Prostaglandin Analog
For Open Angle Glaucoma, if the first line agents cannot be used, what should be used?
Brimonidine or topical carbonic anhydrase (-)’s
What is the goal of treatment for Closed Angle Glaucoma?
Rapid decrease of IOP
What are 2 diuretics and 1 other drug that are used to treat Closed Angle Glaucoma?
- Oral Glycerin
- IV Mannitol
Other agent = Pilocarpine