Glaucoma Drugs

Question 1

Primary open-angle glaucoma

Answer 1

gradual loss of peripheral vision - usually in both eyes

Tunnel vision - in advanced stage

Question 2

Acute angle-closure glaucoma

Answer 2

Eye pain
nausea and vomiting 
sudden onset of visual disturbance 
blurred vision 
Halos around lights 
Redding of the eyes

Question 3

Intraocular pressure

Answer 3

Risk of glaucoma increases with internal eye pressure, though not every patient with ocular hypertension develops glaucoma

Question 4

What is the target for most pharmacologic intervention during management of glaucoma?

Answer 4

Intraocular pressure

Question 5

Risk factors for glaucoma

Answer 5

• IOP
• Age : the older a patient is, the higher the risk of glaucoma
• Ethnicity : African Americans, Caucasians, Asian Americans, Mexican Americans
• Genetics : Risk of glaucoma is higher if family members have glaucoma
• Drugs: corticosteriods

Question 6

Beta blockers

Answer 6

Timolol

Betaxolol

Question 7

Carbonic anhydrase inhibitors

Answer 7

Dorzolamide

Brinzolamide

Question 8

Alpha-2 agonists

Answer 8

Apraclonidine

Brimonidine

Question 9

Cholinergic agents

Answer 9

Carbachol
Pilocarpine
Echothiophate

Question 10

Prostaglandin Analogs

Answer 10

Lantanoprost

Bimatoprost

Question 11

Non-selective adrenergic agents

Answer 11

Epinephrine

Diprivefrin

Question 12

MOA of Cholinergic

Answer 12

stimulate the contraction of sphincter and ciliary muscles - mitosis and decreased intra-ocular pressure

Question 13

Tx of open-angle glaucoma

Answer 13

contract of ciliary muscles leading to increase flow through the intertribecular spaces

Question 14

Tx of close angle glaucoma

Answer 14

contraction of the sphincter muscles increases the angle sclera and iris

Question 15

Agents

Answer 15

known as mitotic agents

• direct acting: e.g. pilocarpine, carbachol
• indirect acting: e.g. physostigmine, echthiophate