Glaucoma Flashcards
Open-angle or Closed-angle?
obstructed drainage canal
open
Open-angle or Closed-angle? pressure pushes iris against cornea
closed
Open-angle or Closed-angle?
painless, happens over time
open
Open-angle or Closed-angle?
leading cause of blindness for people 60 and up
open
T or F: high BP is a risk factor for glaucoma
T
Open-angle or Closed-angle?
patchy blind spots in peripheral vision
open
Open-angle or Closed-angle?
difficulty seeing in central vision
open
what is normal IOP?
12-20
measuring intraocular pressure:
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy
c. tonometry
Testing for optic nerve damage.
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy
a. opthalmoscopy
checking for vision loss
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy
d. perimetry
measuring corneal thickness
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy
b. pachymetry
inspecting drainage canal
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy
e. gonioscopy
what are two ways to treat open-angle?
- reduce aqueous humor production
- increase aqueous humor outflow
What two medication classes reduce aqueous humor production?
beta blockers
carbonic anhydrase inhibitors
what 3 medication classes increase aqueous humor outflow?
prostaglandin analogs
cholinergics
rho kinase inhibitors
what medication class both reduce aq humor production and increase aq humor outflow?
alpha 2 agonists
what is the first line treatment for open-angle?
prostaglandin analogs and beta blockers somehow
T or F: almost half of all glaucoma patients have a normal IOP
T
instead of memorizing all of the names for prostaglandin analogs, what do they all end with ?
-prost, and there are 5 of them
which weird ass med is indicated for eyelash hypotrichosis
bimatoprost (latisse)
by what percentage do prosta analogs reduce IOP?
a. 15
b. 30
c. 50
d. 65
b. 30
what is the dosing frequency for prosta anal
1 drop qhs
what are the important warnings for prosta anal
darkening of a lot of shit around the eye and increase in eyelash length and number
what are some side effects of prosta anal
stinging
blurry vision
foreign body sensation
more eyelashes
what is the MOA of prosta anal
increase aqueous humor outflow
what is the MOA for beta blockers
reduce aq humor production
instead of memorizing all of the names for beta blockers, what do they all end with ?
-lol, and there are 3
which beta blocker is selective
betaxolol
by what percentage do beta blockers reduce IOP
20-30%
what are some contraindications for beta-blockers?
sinus bradycardia, 2nd or 3rd degree heart block, cardiogenic shock, uncompensated cardiac failure, bronchospastic disease
they all have to do with the heart and one random one with bronchioles
side effects of beta blockers(6)
stinging
blurry vision
bradycardia (think heart CI)
breathing probs
hypotension
impotence lol
what is the common dosing frequency for beta blockers
1 drop daily or bid
what is the MOA for alpha-2 agonists
both of the other ones together im not typing that
what is the dosing frequency for alpha-2 agonists
1 drop tid
instead of memorizing all of the names for alpha-2 agonists, what do they all end with ?
-nidine
by how much do alpha 2 agonists reduce IOP?
25%
what is the one and only contraindication for alpha-2 agonists?
CNS depression
what are some side effects for alpha-2 agonists
dry eyes
xerostomia
blurry vision (no shit)
conjunctival hyperemia
sedation
confusion
what medication class is the 2nd line?
carbonic anhydrase inhibitors
what is the MOA of CAIs?
reduce aq humor prod
what is the dosing frequency for CAIs?
1 drop TID
by what percentage do CAIs reduce IOP?
15-20%
instead of memorizing all of the names for carbonic anhydrase inhibitors, what do they all end with ?
-zolamide
what is the one warning for CAIs?
sulfonamide allergy
which two CAI medications are oral?
acetazolamide and methazolamide
what are some side effects of the opthalmic CAIs?
burning
blurred vision
blepharitis (wtf)
taste disturbances
what are some side effects of oral CAIs?
ataxia
confusion
photosensitivity
nausea
metabolic acidosis
what medication class comes in 3rd in the list of lines
rho kinase inhibitors
what is the MOA of rho kinase inhibitors?
increase aqueous humor outflow
what is the dosing frequency for rho kinase inhibitors
1 drop qpm
by what percentage do rho kinase inhibitors decrease IOP?
25-30%
what is the last line for glaucoma
cholinergics
what are some side effects of rho kinase inhibitors
burning
corneal disease
conjunctival hemorrhage
conjunctival hyperemia
damn these suck
what is the moa of cholinergics
increase aq humor outflow
there are two drugs in the cholinergic class, what are they
carbachol (milostat)
pilocarpine (isopto carpine)
what is the dosing frequency for cholinergics?
1-2 drops up to TID
by what percentage do cholinergics reduce IOP/
15-25%
contraindications of cholinergics
pts with history of retinal detachment or corneal abrasion
what are some side effects of cholinergics(5)
pupil constriction
corneal clouding
hypotension
bronchospasm
abdominal cramps
treatment of closed-angle (2 options)
hyperosmotic agents and surgery
what are the two hyperosmotic agents used to treat closed-angle?
mannitol (IV)
Glycerin (PO)
what is the surgery called for treatment of closed-angle and what does it do
iridotomy, hole in iris
what are 5 medications/medication types that can increase IOP?
anticholinergics
chronic steroids
decongestants (dry you out)
topiramate
antidepressants
