Eye Therapeutics Flashcards
IOP drain
Trabecular
Uveoscleral flow
Risk factors for glaucoma
African American IOP >21 mmHg Diabetes Age>60 years old Hypertension Long term corticosteroid use Elderly Hispanic
Aqueous humor produced
Ciliary body
Modulate aqueous humor
Stimulate/inhibit alpha beta receptors, carbonic anhydrase, Na/K ATPase
Mechanisms of treatment
Reduce IOP
Decrease production of aqueous humor from ciliary body
Increase the rate of outflow from anterior chamber
Prostaglandin analogs
Increase uveoscleral outflow
-oprost
Can alter iris pigmentation
Tafluprost - once daily in evening
Beta blockers
Decrease aqueous humor production
Timolol non selective
Betaxolol - B1 selective (good for pulmonary disease)
Miotics
Increase trabecular outflow
Pilocarpine
Brow pain, night time vision loss
Sympathomimetics
Alpha beta activity
Increase outflow from both routes
Epinephrine
Dipivefrin - prodrug of epinephrine
Third line to beta blocker, miotics
Alpha 2 agonist
Apraclonidine
Brimonidine
Carbonic anhydrase inhibitor
Inhibitor aqueous humor production and secretion from ciliary body
1) Dorzolamide, brinzolamide- topical
2) Acetazolamide- oral
Can be used as monotherapy
Drugs that may induce glaucoma by increasing IOP
ATVS
Anticholinergic
Tricyclic antidepressant
Vasodilator
Ophthalmic steroids (decrease outflow) Even OTC nasal steroids
Topiramate
Nasolacrimal occlusion
Improves ocular bioavailability and reduced systemic absorption
1-3 minutes
Macular degeneration
Wet=worse, less common than dry
Presence of drusen
Risk factors for age-related macular degeneration
Age >60
Women
Whites
Blue eye color
Modifiable Blood pressure Exposure to sunlight Diet Smoking
