Glaucoma Flashcards
what are the risk factors for glaucoma?
- age or race
- corneal thickness or eye injury
- use of steroids or HTN
- near or far sighted
- diabetes or sickle cell anemia
what are the symptoms of open-angle glaucoma?
- no symptoms in early stages
- patchy blind spots in peripheral vision
- vision difficulty in central vision
how do you diagnose glaucoma?
- measure intraocular pressure
- vision loss assessment
- corneal thickness measurement
- inspection of drainage canal
- testing for optic nerve damage
what is the two first line treatments for OA glaucoma?
- prostaglandins
- BBs
what is the MOA, names, dosing, warnings & SEs of prostaglandin analogs?
- MOA: inc. aqueous humor outflow
- Drug Names: “prosts”
– latanoprost (xalatan), bimatoprost (lumigan) - Dosing: 1 drop qhs
- Warnings:
- increase in both length and # of eyelashes
- darkening of eyelid, iris, skin, and eyelashes - SEs:
- blurred vision
- stinging
- light sensitivity
what is the MOA, drugs, contraindications, dosing, and SEs for Beta Blockers?
- MOA: reduce aq. humor production
- Names: “ol”
– betaxolol (betoptic), timolol, levobunolol (betagan) - Dosing: 1 qd or bid
- CIs:
- sinus bradycardia
- bronchospastic disease
- other heart related conditions - SEs: blurred vision, stinging, bradycardia/breathing problems
what classes for OA glaucoma is second line?
- a2 agonists
- carbonic anhydrase inhibtors
what is the MOA, drugs, dosing, warnings, and SEs of a2 agonists?
- MOA: increase outflow AND reduce production
- Drugs: “onidine”
– brimonidine (lumify), aprachlinidine (lopidine) - Dosing: TID
- Warnings: CNS depression
- SEs
– blurred vision
– dry eyes
– xerostomia
– sedation/confusion
– conjunctival hyperemia
what is the MOA, drugs, dosing, warnings, and SEs of carbonic anhydrase?
- MOA: reduce. humor
- Drugs: “amides”
– dorzaolamide + timolol
– acetazolamide - dosing: tid
- warnings: sulfa allergy
- SEs:
– blurred vision, burning, blepharitis, taste disturbances
– ataxia, confusion, photosensitivity, nausea, metabolic acidosis
what is the 3rd line inhibitor for OA glaucoma?
rho kinase inhibtors
what is the MOA, drugs, dosing, warnings, and SEs of rho kinase inhibitors?
- MOA: inc. outflow
- Drugs: natarsudil and latanprost
- Dosing: qpm
- SEs:
- burning
- corneal damage
- conjunctival hemorrhage
- conjunctival hyperemia
what is the last line (4th) for OA glaucoma?
cholinergic
what is the MOA, drugs, dosing, warnings, and SEs of cholinergics?
- MOA: increase outflow
- drugs: carbachol and pilocarpine
- Dosing: 1-2drops TID (QID pilocarpine)
- warnings: use in caution with history of retinal detachment or corneal abrasion
- SEs
– corneal clouding
– pupil constriction
– hypotension
– bronchospasms
- -cramping in the abdomen/GI distress
how should drops me administered in patients with contacts?
- take contacts out prior
- wait 15 min to reinsert
–> no contacts with ointments
how long should a patient wait between multiple doses of the same eyedrops?
5 minutes
