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Special Pops Exam 1 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

What is glaucoma?

A

Optic neuropathy characterized by progressive degeneration of retinal ganglion cells

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2
Q

An increase in what damages the optic nerve?

A

Increase intraocular pressure

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3
Q

Glaucoma is the leading cause of blindness for people at what age?

A

> 60 years

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4
Q

A chronic progressive optic nerve neuropathy in adults where the condition is associated with an open anterior chamber angle by gonioscopy

A

Primary open angle glaucoma

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5
Q

What are 8 risk factors of POAG?

A
  1. High IOP
  2. Older age
  3. Family history of glaucoma
  4. African race
  5. Latino/Hispanic ethnicity
  6. Thinner central cornea
  7. Myopia
  8. T2D
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6
Q

What are the 4 screenings for glaucoma?

A
  1. Goldmann applanation tonometry
  2. Gonioscopy
  3. Pachymetry
  4. Biomicroscope with ancillary lens
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7
Q

What is the normal range for IOP?

A

11-21 mmHg

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8
Q

What pressure does IOP need to be at for optic nerve damage to occur?

A

> 21 mmHg

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9
Q

How much should you lower IOP by to slow the progression of IOP?

A

25%

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10
Q

BIMATOPROST

A

LUMIGAN

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11
Q

BIMATOPROST IMPLANT

A

DURYSTA

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12
Q

LATANOPROST

A

XALATAN; XELPROS

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13
Q

TAFLUPROST

A

ZIOPTAN

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14
Q

TRAVOPROST

A

TRAVATAN

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15
Q

TRAVOPROST IMPLANT

A

iDOSE TR

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16
Q

UNOPROSTONE

A

RESCULA

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17
Q

LANTANOPROSTENE BUNOD

A

VYZULTA

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18
Q

What is the MOA of the prostaglandin analogs?

A

Increase uveoscleral outflow of aqueous humor

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19
Q

How much do the prostaglandin analogs decrease IOP?

A

By 25-30%

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20
Q

How often are the prostaglandin analogs dosed?

A

Once a day

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21
Q

What are the 6 prostaglandin analogs?

A
  1. Bimatoprost
  2. Latanoprost
  3. Travaprost
  4. Tafluprost
  5. Unoprostone
  6. Latanoprost bunod
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22
Q

What are 4 side effects of the prostaglandin analogs?

A
  1. Increased brown pigmentation of the iris
  2. Increased number, thickness, curvature, and pigmentation of eyelashes
  3. Ocular pruritis/dryness/blurring
  4. Eyelid erythema
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23
Q

Nitric oxide-donating prostaglandin analog

A

Latanoprost bunod

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24
Q

What are the 2 moieties that come from the metabolism of latanoprost bunod?

A
  1. Latanoprost acid
  2. Butanediol mononitrate
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25
Q

What prostaglandin analog can be implanted?

A

Bimatoprost implant

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26
Q

How long does bimatoprost reduce IOP?

A

15 weeks

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27
Q

What prostaglandin analog is anchored in trabecular meshwork in the sclera wall?

A

Travoprost implant

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28
Q

When is the TRAVOPROST implant replaced?

A

Every 4-5 years

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29
Q

What is the MOA of the beta blockers?

A

Decrease aqueous humor production

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30
Q

How much do the beta blockers decrease IOP by?

A

20-30%

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31
Q

Which beta blocker is the best at decreasing IOP?

A

Timolol

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32
Q

When are beta blockers best used in treatment?

A

As add on therapy for patient on a PG analog

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33
Q

How often are the beta blockers dosed?

A

Twice a day

34
Q

What are the 2 side effects seen with the beta blockers?

A
  1. Exacerbation of chronic obstructive airway diseases or bronchispasms
  2. Burning and stinging upon application
35
Q

BETAXOLOL

A

BETOPTIC S

36
Q

TIMOLOL

37
Q

LEVOBUNOLOL

38
Q

METIPRANOLOL

A

OPTIPRANOLOL

39
Q

CARTEOLOL

40
Q

BETAXOLOL

A

BETOPTIC S

41
Q

TIMOLOL

42
Q

LEVOBUNOLOL

43
Q

METIPRANOLOL

A

OPTIPRANOLOL

44
Q

CARTEOLOL

45
Q

What is the MOA for the PG analogs?

A

Increase uveoscleral outflow of aqueous humor

46
Q

What screening test is used to check IOP?

A

Goldmann applanation tonometry

47
Q

What are 4 ADRs of the PG analogs?

A
  1. Increased brown pigmentation of the iris
  2. Increased number, thickness, curvature, and pigmentation of eyelashes
  3. Ocular pruritis/dryness/blurring
  4. Eyelid erythema
48
Q

What are the 2 moieties of latanoprostene bunod?

A
  1. Latanoprost acid
  2. Butanediol mononitrate
49
Q

What beta blocker is cardio selective?

50
Q

What is the MOA of the alpha 2 agonists?

A
  1. Decrease aqueous humor production
  2. Increase outflow
51
Q

What is the preferred alpha 2 agonist?

A

Brimonidine

52
Q

Why is apraclonidine not used?

A

Has allergic potential

53
Q

How often are the alpha 2 agonists dosed?

A

Three times a day

54
Q

What are 5 SEs of the alpha 2 agonists?

A
  1. Tearing
  2. Foreign body sensation
  3. Ocular inflammation
  4. Dry mouth
  5. Altered taste
55
Q

What are the two topical carbonic a hydrate inhibitors?

A
  1. Brinzolamide
  2. Dorzolamide
56
Q

What are the 2 alpha 2 agonists?

A
  1. Apraclonidine
  2. Brimonidine
57
Q

APRACLONIDINE

58
Q

BRIMONIDINE

A

ALPHAGAN P

59
Q

BRINZOLAMIDE

60
Q

DORZOLAMIDE

61
Q

What are the 2 oral carbonic anhydrase inhibitors?

A
  1. Acetazolamide
  2. Methazolamide
62
Q

ACETAZOLAMIDE

63
Q

METHAZOLAMIDE

64
Q

What is the MOA of the carbonic anhydrase inhibitors?

A

Decrease the secretion of aqueous humor by inhibiting carbonic anhydrase in the colliery body

65
Q

What carbonic anhydrase formulation should be used first?

66
Q

What are the rho kinase inhibitors?

A

Netarsudil

67
Q

Netarsudil

68
Q

What are the 3 MOAs of rhopressa?

A
  1. Lowers the resistance to outflow through the trabecular meshwork
  2. Decreases production of aqueous fluid
  3. Decreases episcleral venous pressure
69
Q

How is the rho kinase inhibitor dosed?

A

One drop once daily in the evening

70
Q

What are the 3 mitotics?

A
  1. Pilocarpine
  2. Carbachol
  3. Echothiphate iodide
71
Q

PILOCARPINE

A

ISOPTO CARPINE

72
Q

CARBACHOL

73
Q

ECHOTHIOPHATE IODIDE

A

Phospholine iodide

74
Q

What is the MOA of the mitotics?

A

Increase outflow of aqueous humor through trabecular meshwork

75
Q

What can the mitotics cause?

A

Pupil constriction

76
Q

What are the 3 mitotics side effects?

A
  1. Brow ache
  2. Myopia
  3. Decreased vision in low light
77
Q

When is a tranecubectomy considered?

A

When 2 or more agents fail to control increasing IOPs

78
Q

What may develop after getting a trabeculectomy?

79
Q

What is closed angle glaucoma treatment considered as?

A

A medical emergency

80
Q

What 3 things can effect IOP?

A
  1. Anterior chamber angle
  2. Trabecular meshwork patency
  3. Cilliary body activity

Special Pops Exam 1 (5 decks)

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