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Therapeutics 2 - Exam 5 > glaucoma > Flashcards

glaucoma Flashcards

1
Q

how does glaucoma develop?

A

obstructed drainage canal –> pushed iris against cornea –> reduces aqueous humor outflow –> increases IOP

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2
Q

what are the risk factors for glaucoma?

A

age
race (black or asian)
corneal thickness or eye injury
HTN
steroid use
nearsighted or farsighted
diabetes
sickle cell anemia

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3
Q

what are the symptoms of open-angle glaucoma?

A

asymptomatic –> progressive development of patchy blind spots in peripheral vision –> central vision difficulty

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4
Q

what are the test for diagnosing glaucoma?

A

measurement of IOP
vision loss assessment
testing for optic nerve damage
corneal thickness measurement
inspection of drainage canal

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5
Q

what are the drug classes that reduce aqueous humor production?

A

beta blockers and carbonic anhydrase inhibitors

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6
Q

what are the drugs classes that increase aqueous humor outflow?

A

prostaglandin analogs
cholinergics
rho kinase inhibitors

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7
Q

what is the drug class that increases aqueous humor outflow and decreases aqueous humor production?

A

alpha-2 agonists

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8
Q

what is the first line treatment regimen of open-angle glaucoma?

A

prostaglandin analogs
beta blockers

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9
Q

what is the first/second line treatment of open-angle glaucoma?

A

alpha-2 agonists

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10
Q

what is the second line treatment of open-angle glaucoma?

A

carbonic anhydrase inhibitors

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11
Q

what is the third line treatment of open-angle glaucoma?

A

rho kinase inhibitors

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12
Q

what is the last line treatment of open-angle glaucoma?

A

cholinergics

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13
Q

what drugs are prostaglandin analogs?

A

latanoprost (xalatan, xelpros)
bimatoprost (lumigan, latisse)
travoporst (traatan, travatan Z)
tafluprost (zioptan)

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14
Q

what is the warning of prostaglandin analogs?

A

eyelash increase in length and number
darkening of eyelids, iris, skin, and eyelashes

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15
Q

what are the SE of prostaglandins?

A

blurred vision
stinging
light sensitivity

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16
Q

what drugs are beta blockers?

A

betaxolol (betoptic S)
timolol (timoptic, istalol)
carteolol
levobunolol (betagan)

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17
Q

what is the dosing of prostaglandins?

A

1 QHS

18
Q

what is the dosing of beta blockers?

A

1QD or BID

19
Q

what are the CI of beta blockers?

A

sinus bradycardia
heart-related conditions (uncompensated cardiac failure, 2nd/3rd degree heart block, cardiogenic shock)
bronchospastic disease

20
Q

what are the SE of beta blockers?

A

blurred vision
stinging
bradycardia
breathing problems

21
Q

what drugs are alpha-2 agonists?

A

aprachlonidine (lopidine)
brimonidine (alphagan P) + timolol (combigan) + brinzolamide (simbrinza)
brimonidine (lumify)

22
Q

what is the dosing of alpha-2 agonists?

A

1 TID

23
Q

what is the warning of alpha-2 agonists?

A

CNS depression

24
Q

what are the SE of alpha-2 agonists?

A

blurred vision
dry eyes
xerostomia (dry mouth)
sedation/confusion
conjunctival hyperemia

25
Q

what drugs are carbonic anhydrase inhibitors?

A

dorzolamide (trusopt) + timolol (cosopt)
brinzolamide (azopt) + brimonidine (simbrinza)
acetazolamide (PO)
methazolamide (PO)

26
Q

what is the dosing of carbonic anhydrase inhibitors?

A

1 TID

27
Q

what is the warning of carbonic anhydrase inhibitors?

A

sulfonamide allergy

28
Q

what are the SE of eye drops carbonic anhydrase inhibitors?

A

blurred vision
burning
blepharitis
taste disturbances

29
Q

what are the SE of oral carbonic anhydrase inhibitors?

A

ataxia
confusion
photosensitivity
nausea
metabolic acidosis

30
Q

what drugs are rho kinase inhibitors?

A

netasudil (rhopressa)
latanoprost (rocklatan)

31
Q

what is the dosing of rho kinase inhibitors?

A

1 QPM

32
Q

what are the SE of rho kinase inhibitors?

A

burning
corneal disease
conjunctival hemorrhage
conjunctival hyperemia

33
Q

what are drugs are cholinergic?

A

carbachol (milostat)
pilocarpine (isopto carpine)

34
Q

what is the dosing of cholinergics?

A

1-2 drops up to TID
QID for pilocarpine

35
Q

what is the warnings of cholinergics?

A

caution in patients with a history of retinal detachment or corneal abrasion

36
Q

what are the SE of cholinergics?

A

corneal clouding
pupil constriction
hypotension
bronchospasms
abdominal cramping
GI distress

37
Q

what are the symptoms of closed-angle glaucoma?

A

severe headache
blurred vision
severe pain or halos around light
NV
redness in eye
cloudy cornea

38
Q

what is the treatment of closed-angle glaucoma?

A

hyperosmotic agents
surgery

39
Q

what are hyperosmotic agents?

A

IV mannitol
PO glycerin

40
Q

what is the surgery option?

A

iridotomy

41
Q

what medications that can increase IOP?

A

anticholinergics
topiramate
chronic steroids
decongestants
antidepressants

Therapeutics 2 - Exam 5 (14 decks)

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