Glaucoma

Question 1

Glaucoma

Answer 1

Group of disease characterized by a decrease in peripheral vision d/t nerve damage

Question 2

Open Angle Glaucoma

Answer 2

90% of glaucoma. IOP often elevated.
Can also damage nerve with normal IOP OR IOP can be elevated without damage (ocular HTN)
Treat by reducing IOP

Question 3

Narrow Angle Glaucoma

Answer 3

Displacement of iris, covers Trabecular mesh, prevents exit of Aqueous Humor
IOP rises rapidly to dangerous levels, extremely painful
Drugs to control acute attack and corrective Sx is needed

Short acting miotics (Pilocarpine) + A2A (apradonidine) + Beta blocker (Timilol)
Medications used when surgery is over an hour from now and sometimes if its under.

Question 4

Drug classes for Glaucoma

Answer 4

Prostaglandin analogues, cholinergic drugs: Outflow blocks with IOP rise
BB, Alpha2 agonist, Carbonic anhydrase inhibitors: Production of AH increased causes IOP rise

Question 5

Timolol and Betaxolol (know the difference)

Answer 5

Beta blockers
IND: Treat elevated IOP. Ocular HTN and Open angle glaucoma. Off label: management of NAG
MOA: BB. Reduces aqueous humor production. All B1 and B2 except Betaxolol (B1 only)
BOX: NONE
CONTRA: COPD/asthma, bradycardia, overt heart failure, cardiogenic shock
ADRs: Local burning/stinging, bradycardia, bronchoconstriction
M/E:
Route: solution and gel

Question 6

Latanoprost

Answer 6

Travopost and Latanoprost
IND: Elevated IOP in pts with ocular HTN and OAG
MOA: Prostaglandin F2 Alpha analog. Increases outflow of AH
BOX: NONE
CONTRA: NONE
ADRs: Localized burning/stinging, FB sensation, hyperemia(bloodshot), increased eyelash length, discharge from eyes
M/E:

Question 7

Brimonidine

Answer 7

IND: Elevated IOP. Reduction in pts with OAG or ocular HTN
MOA: Alpha2 agonist: reduces AH formation (IOP reduction) and increases uveoscleral outflow (redness reduction)
BOX: NONE
CONTRA: Under 2 y/o or concomitant MAOIs
ADRs: Drowsy, HTN
M/E:

Question 8

Pilocarpine

Answer 8

IND: Elevated IOP. OAG or management of NAG, induction of miosis (pupil constriction), treat presbyopia
MOA: Cholinergic Agonist. Causes miosis and lowers IOP by increasing AH outflow
BOX: NONE
CONTRA: NONE
ADRs: Local irritation,
retinal detachment(rare)
M/E:

Question 9

Dorzolamide

Answer 9

IND: Treat elevated IOP. Ocular HTN and OAG
MOA: Carbonic anhydrase inhibitor in cilliary epithelium
BOX: NONE
CONTRA: NONE
ADRs: Bitter taste, local irritation, photophobia, allergic rxns
M/E: