Glaucoma Flashcards
Development of glaucoma
-drainage canal blocked
-fluid build up
-inc pressure damages blood vessels and optic nerve
-pressure pushes iris against cornea
Open-angle glaucoma
-lil speck on the eye
Glaucoma risk factors
-age/race
-corneal thickness or injury
-use of steroids
-HTN
-near/farsighted
-diabetes
-sickle cell anemia
Glaucoma sx
-none in early stage
-patchy blind spots in peripheral vision
-vision difficulty in central vision
Diagnosis of glaucoma
-measuring intraocular pressure
-corneal thickness measurement
-inspection of drainage canal
-vision loss assessment
-testing optic nerve damage
Open-angle tx goals
-increase outflow
-decrease humor production
-a2 agonists do both
Rx that increase outflow
-prostaglandin analogs
-cholinergics
-Rho kinase inhibitors
-a2-agonists
Rx that decrease humor production
-B-blockers
-carbonic anhydrase inhibitors
-a2-agonists
Open-angle tx approach
- Prostaglandin analogs
- B-blockers
1/2. A2 agonists - Carbonic anhydrase inhibitors
- Rho Kinase inhibitors
Last line: cholinergics
Prostaglandin analogs
-1st line tx open-angle glaucoma
-inc outflow
-“prosts”
-1 drop QHS
Prostaglandin analog drugs
-latanoprost
-bimatoprost
-travoprost
-taflupost
-1 drop QHS
Prostaglandin analog cautiosn
-eyelashes inc length and number
-darkening of eyelid, iris, skin, eyelashes
Prostaglandin side effects
-blurred vision
-stinging
-light sensitivity
B-blockers
-first line for open-angle glaucoma
-reduce humor production
-1 drop Qd or BID
B-blocker drugs
-betaxolol
-Timolol
-Carteolol
-Levobunolol
-1 drop qd or BID
B-Blocker contraindications
-sinus bradycardia
-heart conditions
-bronchospastic disease
B-blocker side effects
-blurred vision
-stinging
-bradycardia, breathing probs
A2 AGONists
-inc outflow AND dec humor production
-1st/2nd line open-angle glaucoma tx
-1 drop TID
A2 drug names
-Aprachlonidine (Iopidine)
-Brimonidine (Alphagan P) + Timolol (Combigan) + Brinzolamide (simbrinza)
-Briminodine (Lumify)
-1 drop TID
A2 agonist cautions
-CNS depression
-burred vision
-dry eyes
-xerostomia
-sedation/confusion
-conjunctival hyperemia
Carbonic Anhydrase inhibitors
-dec humor production
-2nd line for open-angle glaucoma
-1 drop TID
Carbonic anhydrase inhibitor drugs
-“zolamides”
-dorzolamide + timolol
-brinzolamide brimonidine
-acetazolamide
-methazolamide
-1 drop TID
Carbonic anhydrase inhibitor cautions
-sulfa allergy
-blurred vision
-burning
-blepharitis
-taste disturbances
-ataxia
-confusion
-photosensitivity
-nausea
-metabolic acidosis
Rho kinase inhibitors
-open-angle glaucoma tx 3rd line
-inc outflow
-Netarsudil + latanoprost
-1 drop qPM
Rho kinase side effects
-burning
-corneal disease
-conjunctival hemorrhage
-conjunctival hyperemia
Cholinergics
-inc outflow
-last line for open-angle glaucoma
-1-2 drops up to TID
Cholinergic drugs
-Carbachol (Milostat)
-Pilocarpine (isopto carpine) (QID)
-1-2 drops up to TID
Cholinergics caution
-caution in pt w hx of retinal detachment or corneal abrasion
-corneal clouding
-pupil constriction
-hypotension
-bronchospasms
-crampin in ab/Gi distress
Intentional safety measures for eye drops
-caps have dif colors
-slide 18
Closed-angle glaucoma
-cloudy eye
Closed-angle glaucoma sx
-severe headache or blurred vision
-severe pain or halos around light
-N/V
-redness in eye/cloudy cornea
Closed-angle tx
-Hyperosmotic agents:
-Mannitol (IV)
-Glycerin (PO)
-Surgery (iridotomy
Meds that can increase intraocular pressure
-anticholinergics
-chronic steroids
-decongestants
-antidepressants
-topiramate
