Drugs Used in Glaucoma Flashcards
What are the topical carbonic anhydrase inhibitors used in treating glaucoma
Brinzolamide
Dorolamide
What are the systemic carbonic anhydrase inhibitors used in treating glaucoma
acetazolamide
methazolamide
What effect does B adrenergic receptor activation have on the production of humor in the eye
increase
What effect does a2 adrenergic receptor activation have on the production of humor in the eye
decrease
how does carbonic anhydrase effect the volume of humor
it increases it by transporting sodium and bicarb to increase its osmolarity
What classes of drugs reduce aqueous humor production
B-blockers
a-adrenergic agonists
Carbonic Anhydrase inhibitors
What classes of drugs increase aqueous humor outflow
Prostaglandin analogs
a2-adrenergic agonists
direct cholinergic agonists
acetylcholine esterase inhibitors
Which beta blocker is favored in the treatment of glaucoma and why?
Timolol
lacks local anesthetic effect
available generic
full antagonist
What is the favored a2-agonist in the treatment of glaucoma and what are the adverse side effects?
Brimonidine
Headache, fatigue, dry mouth
mild allergic reactions
What are the adverse effects of carbonic anhydrase
Nausea, diarrhea, weight loss
paresthesia
renal stones
decreased libido
Why are prostaglandin analogs used over B-blockers in treatment of glaucoma
1/day dosing
more efficiently reduce IOP
describe local side effects of prostaglandin analogs
Corneal erosions
conjunctival hyperemia
iris hyperpigmentation
hypertrichosis
What are the two types of Closed Angle glaucoma
With pupillary block - tight contact of iris and lense, the flow of humor into anterior chamber is blocked, iris moves forward and blocks outflow
Without pupillary block - ciliary processes are located in such a way that they push iris forward and iris blocks outflow
What is the main treatment for closed angle glaucoma
Rapid reduction of IOP
- -pilocarpine to prep for surgery
- -Agent to reduce humor production)
Surgical or laser iridectomy
what classes of drugs should be avoided in glaucoma
Glucocorticoids
a1 adrenomimetic activity
antimuscarinic drugs
