Glaucoma Drugs

Question 1

Acetazolamide

Answer 1

Class: Systemic carbonic anhydrase inhibitor
Applications: orally for prophylaxis & altitude sickness. No longer primary treatment for glaucoma
Mechanism: directly inhibits CA. Reduces intraocular pressure

Question 2

Brimonidine (apraclonidine, clonidine)

Answer 2

Class: topical selective alpha2-adrenergic agonist
Applications: treat open angle glaucoma & ocular hypertension
Mechanism: selective alpha2-agonist, decreases IOP w/o causing mydriasis by reducing aq. humor production and uveoscleral aq. humor outflow
Side effects: xerostomia (dry mouth), hyperemia, ocular irritation, headache, blurred vision

Question 3

Dorzolamide

Answer 3

Class: Topical carbonic anhydrase inhibitor
Applications: glaucoma & ocular hypertension
Mechanism: specific inhibitor of CA-II, which controls aqueous production & IOP.
Side effects: none when topical

Question 4

Latanoprost

Answer 4

Class: Topical F2alpha prostaglanding agonist
Applications: used for elevated IOP
Mechanism: prodrug, administered topically. Absorbed through cornea where it is hydrolyzed into active form. Increases uveoscleral outflow
Side effects: increases iris pigmentation

Question 5

Mannitol

Answer 5

Class: parenteral osmotic diuretic
Application: reduce IOP
Mechanism: via IV. reduces IOP by elevating blood osmolality
Side effects: pulmonary congestion, electrolyte imbalance, acidosis, dry mouth, thirst, diuresis, edema, headache…

Question 6

Timolol

Answer 6

Class: topical nonselective, beta-adrenergic receptor antagonist
Applications: beta blocker, reduces IOP
Mechanism: reduces aqueous humor production or possibly outflow (beta receptor stimulation increases movement of Na into aq. humor)