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PPS 946 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

Ocular Hypertension

A

Elevated IOP without glaucomatous changes

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2
Q

Primary Open-Angle Glaucoma (POAG)

A

Normal anterior chamber angles
Glaucomatous changes of the optic disc
Peripheral visual field loss

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3
Q

Primary Angle-Closure Glaucoma (PACG)

A

Obstruciton of the anterior angle by the iris

Moderate to high elevations in IOP

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4
Q

Gonioscopy

A

Examination of the anterior chamber angle

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5
Q

Perimetry

A

Measure of the field of vision

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6
Q

Tonometry

A

Measures IOP

Does not test for glaucomatous changes.

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7
Q

Initial Target Estimate for IOP

A

20% of baseline

30-50% in Severe disease or Normal Tension Glaucoma

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8
Q

Well Tolerated Starting Pharmacotherapy Agents

A

Prostaglandins
Beta-Blockers
Brimonidine

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9
Q

When giving topical ocular solution how long must you wait to give another drug?

A

5 minutes

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10
Q

Trabeculoplasty

A

Laser Surgery

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11
Q

Trabeculoectomy

A

Surgery

Removal of trabecular meshwork

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12
Q

These two drugs are given during surgery to decrease scaring.

A

Mitomycin C

Antifibrotic agent

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13
Q

Treatment of Choice for PACG

A

Laser Iridotomy

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14
Q

Medical Therapy is used to do what in acute PACG?

A

Lower IOP
Reduce pain
Reverse corneal edema

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15
Q

Agents used to lower IOP in Acute PACG

A 
Topical Beta-Blockers
Topical Alpha-agonists
Prostaglandin F2alpha analog
Systemic Carbonic Anhydrase Inhibitors
Hyperosmotic Agents
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16
Q

In Acute PACG, once IOP is under control this medication is used to break through the pupillary block.

A

Pilocarpine

17
Q

These two drugs can induce PAOG

A

Docetaxel/Paclitaxel

Corticosteroids

18
Q

These 3 drug classes can induce PACG

A

Adrenergic Agents
Anticholinergics
Sulfa-drugs

19
Q

MOA of Prostaglandin Analogs

A

Increase uveoscleral outflow

Lower IOP 25-35%

20
Q

Contraindications for prostaglandin analogs

A

Hypersensitivity

21
Q

Rare ADR of prostaglandin analogs

A

Diplopia
Retinal detachment
Vitreous Hemorrhage

22
Q

MOA of Beta-adrenergic antagonists

A

Decrease aqueous production and IOP by 20-25%

23
Q

Contraindications of Beta-adrenergic antagonists

A

Sinus Bradycardia
Greater than first-degree AV block
Cardiogenic shock
Overt Cardiac failure

Non-selective drugs are contraindicated for bronchial asthma or severe COPD.

24
Q

MOA of Alpha2-Adrenergic Agonists

A

Decrease production of aqueous humor

Lowering IOP by 18-2&%

25
Q

Contraindications for Alpha2-Adrenergic Agonists

A

Hypersensitivity

Pt. on MAO inhibitors

26
Q

MOA of Carbonic Anhydrase Inhibitors

A

Causes a decrease in sodium and water outflow from the ciliary body, but 99% of CAs must be inhibited
IOP lowering by 15-25%

27
Q

Precautions of CAIs

A

Don’t use in renal impairment
Caution in patients with hepatic impairment
Caution in patients with sickle cell anemia.

28
Q

Contraindications for CAIs

A 
Sulfonamide allergy
Hypokalemia
Hyponatremia
Hyperchloremic acidosis
Adrenocortical insufficiency
Marked renal or hepatic impairment
Severe COPD
Long term use in PACG
29
Q

Special Instructions for CAIs

A

Monitor patient on the following:

Malaise or fatigue, Creatinine, serum potassium, serum carbon dioxide, baseline CBC and platelet count

30
Q

MOA of Cholinergics and Cholinesterase Inhibitors

A

Carbachol and pilocarpine are direct cholinergic agonists that act on ACh receptors to stimulate ciliary muscle

Cholinesterase Inhibitors act indirectly bin inhibiting AChE.

Ease the restriction of outflow of aqueous humor through the trabecular meshwork.

31
Q

Precautions for Cholinergics and cholinesterase inhibitors

A

Pregnancy and lactation
Night driving
Pts with retinal detachment, asthma, bradycardia, hypotension

32
Q

Contraindications for Cholinergics and cholinesterase inhibitors

A

Acute iritis
Uveal inflammation
Pupillary block glaucoma

PPS 946 (22 decks)

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