Glaucoma Flashcards
Pressure pushing lens against iris and closing Schlemm’s canal
intraoccqular pressure (IOP)
Only modifiable risk factor for glaucoma
IOP
90-95% of all primary glaucoma
primary open-angle (POAG)
___ is slowly progressive glaucoma.
primary open-angle (POAG)
10% of all primary glaucoma
primary angle closure
primary angle closure glaucoma is treated as an ____
emergency
MC agents that are used in glaucoma
beta adrenergic blocking agents
B blockers acts on beta 2 receptors in the ___ leading to reduction of ___
ciliary processes, aqueous humor production
systemic SE’s of beta blockers are decreased by using ___
punctual occlusion. (holding lacrimal duct for 3-5 mins)
first line agent for glaucoma unless contraindicated
beta blockers
beta blocker that does not lower IOP as much. as other products
betaxolol.
gold standard in treatment of glaucoma
timolol solution (timoptic)
timolol is ___
nono-selective
timolol is a ___ solution and is administered ___
gel-forming; once a day
adrenergic agents act on alpha receptors to:
decrease aqueous humor production
adrenergic agents act on beta receptors to::
increase in outflow
adrenergic agents
epinephrine
dipivefrin
side effects of adrenergic agents
systemic: palpitation, tachycardia, HA, anxiety, increased sweating
prodrug of epinephrine
dipivefrin
dipivefrin is shown to be effective in combo with ___
nonselective betablocker. (more pronounced IOP decrease)
purpose of selective alpha-2 agonists
decrease aqueous production
alpha2 selectivity prevents release of norepinephrine into the synapse which decreases ___ and increases ___
aqueous humor production; uveoscleral outflow
selective alpha2 agonists
apraclonidine
brimonidine
selective alpha2 agonists are used ____
in addition to other agents if used at all.
S/E of apraclonidine
tachyphylaxis develops rapidly
brimonidine can be used alone in patients who are ___
intolerant to beta blockers
purpose of cholinergics
stimulation of sphincter pupillae
causes miosis
physically pulls open meshwork
increases outflow
cholinergics
pilocarpine
Carbachol
Ocusert
Pilocarpine reduces IOP by
20-30%
Ocusert has a slow release ___
delivery system
cholinergic bind to enzyme which ___
breaks down endogenous acetylcholine. (cholinesterase inhibitor)
anticholinesterases are used only in patients _______
unresponsive or intolerant of other therapies.
carbonic anhydrase inhibitors inhibit carbonic anhydrase in ____ to decrease ___
ciliary body; aqueous formation by 40-60%
carbonic anhydrase inhibitors
dorzolamide and brinzolamide
acetazolamide
dorzolamide and brinzolamide are ___ administerd
topically
dorzolamide and brinzolamide reduce IOP by ___
15-26%
acetazolamide is administered by ___
PO
acetazolamide reduces IOP by ___
25-40%
___ has a higher incidence of S/E out of the CAIs
acetazolamide
carbonic anhydrase inhibitors are 1 of the 3 medications of choice for ___
glaucoma
medications of choice for glaucoma
beta blockers
prostaglandin F2-alpha analogues
CAIs
purpose of prostaglandin F2 alpha analogues
increased uveoscleral outflow of aqueous humor.
side effects of prostaglandin F2
iris pigmentation
eyelash thickening
prostaglandin f2 has fewer side effects than ___
timolol
prostaglandin f2 decreases IOP similar to ___
BB if not more
latanoprost solution dosage
0.005% solution Q24h
treatment of angle closure glaucoma
ER
iridectomy is definitive tx
