Glaucoma

Question 1

Development of glaucoma

Answer 1

-drainage canal blocked
-fluid build up
-inc pressure damages blood vessels and optic nerve
-pressure pushes iris against cornea

Question 2

Open-angle glaucoma

Answer 2

-lil speck on the eye

Question 3

Glaucoma risk factors

Answer 3

-age/race
-corneal thickness or injury
-use of steroids
-HTN
-near/farsighted
-diabetes
-sickle cell anemia

Question 4

Glaucoma sx

Answer 4

-none in early stage
-patchy blind spots in peripheral vision
-vision difficulty in central vision

Question 5

Diagnosis of glaucoma

Answer 5

-measuring intraocular pressure
-corneal thickness measurement
-inspection of drainage canal
-vision loss assessment
-testing optic nerve damage

Question 6

Open-angle tx goals

Answer 6

-increase outflow
-decrease humor production
-a2 agonists do both

Question 7

Rx that increase outflow

Answer 7

-prostaglandin analogs
-cholinergics
-Rho kinase inhibitors
-a2-agonists

Question 8

Rx that decrease humor production

Answer 8

-B-blockers
-carbonic anhydrase inhibitors
-a2-agonists

Question 9

Open-angle tx approach

Answer 9

1. Prostaglandin analogs
2. B-blockers
   1/2. A2 agonists
3. Carbonic anhydrase inhibitors
4. Rho Kinase inhibitors
   Last line: cholinergics

Question 10

Prostaglandin analogs

Answer 10

-1st line tx open-angle glaucoma
-inc outflow
-“prosts”
-1 drop QHS

Question 11

Prostaglandin analog drugs

Answer 11

-latanoprost
-bimatoprost
-travoprost
-taflupost
-1 drop QHS

Question 12

Prostaglandin analog cautiosn

Answer 12

-eyelashes inc length and number
-darkening of eyelid, iris, skin, eyelashes

Question 13

Prostaglandin side effects

Answer 13

-blurred vision
-stinging
-light sensitivity

Question 14

B-blockers

Answer 14

-first line for open-angle glaucoma
-reduce humor production
-1 drop Qd or BID

Question 15

B-blocker drugs

Answer 15

-betaxolol
-Timolol
-Carteolol
-Levobunolol
-1 drop qd or BID

Question 16

B-Blocker contraindications

Answer 16

-sinus bradycardia
-heart conditions
-bronchospastic disease

Question 17

B-blocker side effects

Answer 17

-blurred vision
-stinging
-bradycardia, breathing probs

Question 18

A2 AGONists

Answer 18

-inc outflow AND dec humor production
-1st/2nd line open-angle glaucoma tx
-1 drop TID

Question 19

A2 drug names

Answer 19

-Aprachlonidine (Iopidine)
-Brimonidine (Alphagan P) + Timolol (Combigan) + Brinzolamide (simbrinza)
-Briminodine (Lumify)
-1 drop TID

Question 20

A2 agonist cautions

Answer 20

-CNS depression
-burred vision
-dry eyes
-xerostomia
-sedation/confusion
-conjunctival hyperemia

Question 21

Carbonic Anhydrase inhibitors

Answer 21

-dec humor production
-2nd line for open-angle glaucoma
-1 drop TID

Question 22

Carbonic anhydrase inhibitor drugs

Answer 22

-“zolamides”
-dorzolamide + timolol
-brinzolamide brimonidine
-acetazolamide
-methazolamide
-1 drop TID

Question 23

Carbonic anhydrase inhibitor cautions

Answer 23

-sulfa allergy
-blurred vision
-burning
-blepharitis
-taste disturbances
-ataxia
-confusion
-photosensitivity
-nausea
-metabolic acidosis

Question 24

Rho kinase inhibitors

Answer 24

-open-angle glaucoma tx 3rd line
-inc outflow
-Netarsudil + latanoprost
-1 drop qPM

Question 25

Rho kinase side effects

Answer 25

-burning
-corneal disease
-conjunctival hemorrhage
-conjunctival hyperemia

Question 26

Cholinergics

Answer 26

-inc outflow
-last line for open-angle glaucoma
-1-2 drops up to TID

Question 27

Cholinergic drugs

Answer 27

-Carbachol (Milostat)
-Pilocarpine (isopto carpine) (QID)
-1-2 drops up to TID

Question 28

Cholinergics caution

Answer 28

-caution in pt w hx of retinal detachment or corneal abrasion
-corneal clouding
-pupil constriction
-hypotension
-bronchospasms
-crampin in ab/Gi distress

Question 29

Intentional safety measures for eye drops

Answer 29

-caps have dif colors
-slide 18

Question 30

Closed-angle glaucoma

Answer 30

-cloudy eye

Question 31

Closed-angle glaucoma sx

Answer 31

-severe headache or blurred vision
-severe pain or halos around light
-N/V
-redness in eye/cloudy cornea

Question 32

Closed-angle tx

Answer 32

-Hyperosmotic agents:
-Mannitol (IV)
-Glycerin (PO)
-Surgery (iridotomy

Question 33

Meds that can increase intraocular pressure

Answer 33

-anticholinergics
-chronic steroids
-decongestants
-antidepressants
-topiramate