Eye

Question 1

Apraclonidine

Brimonidine

Answer 1

Alpha2 agonists- suppresses formation and increasing outflow of aqueous humour

I- open angle glaucoma

D- 1 drop bd (or tds for apraclonidine)
M- intraocular pressure, eye irritation, compliance

AE- eye irritation, blephritis, taste disturbance

C- take every day even if you feel no different, blurred vision on instillation or make you feel drowsy- dont drive if affected, remove contacts and reinsert at 15min, discard 28 days after opening

Question 2

Betaxolol

Timolol

Answer 2

Beta-blockers (timolol- non selective, betaxolol- beta 1 selective)- reduce formation of aqueous humour

I- all types of glaucoma, ocular hypertension

D- betaxolol 1 drop bd,
timolol conventional 1 drop od or bd,
timolol XE and gel 1 drop d

M- intraocular pressure, systemic AE- bradycardia, BP, Asthma- CI but cardioselective betaxolol can be used cautiously, AE- stinging on installation, bradycardia, blurred vision, avoid with verapamil (profound bradycardia),

C- gel store up side down, use every day even if you feel no different, contact lens removal, discard after 28 days, if you notice dizziness on standing tiredness falls etc see dr (systemic AE), eye drop technique

CALs- nil

Question 3

Brinzolamide

Dorzolamide

Answer 3

Carbonic anhydrase inhibitors- reduces aqueous humour formation

I- all types of glaucoma, ocular hypertension

Brinzolamide- 1 drop bd

Dorzolamide- 1 drop tds

M- intraoccular pressure, compliance, eye irritation

AE- ocular irritation, foreign body sensation, bitter taste

C- eye may feel uncomfortable for a little while, blurred vision avoid driving until vision occurs, contact lens removal, discard 28 days after opening

Question 4

Bimatoprost

Lantanoprost

Tafluprost

Travoprost

Answer 4

Prostaglandin analogues- increases aqueous outflow

I- glaucoma, ocular hypertension

D- 1 drop d, usually nocte

M- Intraocular pressure, eye irritation (usually due to preservative- all PA have similar efficacy but different preservative)

AE- darkening of iris and eyelash growth- lashes reversible but iris may not, bitter taste, irritation, blurred vision

C- instil at night, contact lens removal, temporal blurred vision dont drive until resolves, lash and iris AE, use everyday even if feel no better, discard after 28 days