Final - Rhokinase Inhibitors and Cholinergics Flashcards
Rhokinase inhibitors
-MOA
Changes to TM-cytoskeletal modulating drugs = incr trabecular outflow
-spreads/opens TM
Netarsudil Rhopressa
- large or small
- changes it makes
Smaller molecule drug
Alters TM ells
Alters NET (norepi transporter)
-to lower aqueous production
Changes EVP
Rhopressa
- diff IOP approx __
- SE
1mmHg
Conj hyperemia, lacrimation, conj hemorrhages
Rhopressa
- shows promise as
- Roclatan
- main SE
- corneal issues
Second-line PGA drug
IOP lowering effect > Latanoprost and Rhopressa
Conj hyperemia
Erosions, endothelial changes, verticillata
Cholinergics
- main use
- drug e.g.
Angle-closure glauc with pupillary block
-1 or 2%, 2-3 times in 30 min
Pilocarpine
Cholinergics
-MOA
Contraction of ciliary muscle -> unfolding of meshwork and widening of schlemm’s canal
Cholinergics
- types of pilo
- antagonist
- preservatives
- gel
Nitrate and hydrochloride
Atropine
BAK, EDTA
Bed time
Cholinergics
-pharmacokinetics
Binds to iris pigment
Light iris = 2%
Dark iris = 6%
Cholinergics
-dose effect
Varies with strength
1%
- 10-30 min -> miosis, lasts 4-8 hrs
- max IOP reduction in 75 min, lasts 4-14 hrs
Cholinergics
-SE
Stinging, burning
Prolonged use -> risk of failure, hyphema with sx
Ciliary spasm, temporal/supraorbital HA, induced myopia
-due to induced contraction of ciliary muscle
Cholinergics
-SE
Miosis -> vision decr
Constant accomm + miosis = risk of pupillary block
Systemic toxicity
- extremely rare
- sweating, salivation, GI over-activity
Cholinergics
-long-term escape
Decr efficacy of lowering IOP with long-term use
-incr problems with draining mechanism
Cholinergics
-contraindications
Risk/hx of RD
Incraocular congestion (e.g. uveitis)
Pupil size/accomm issue
CAIs
-members of __ family
Sulfonamide
CAIs
-MOA
Carbonic anhydrase inhibitors -> reduction of bicarb ions in posterior chamber -> prevents Na+ movement = prevents water movement
