Glaucoma Drugs

Question 1

what are two outflows of aqueous humor?

Answer 1

trabecular and uveoscleral

Question 2

which of trabecular or uveosacral does majority of aqueous humor flow out of?

Answer 2

trabecular is 90%

Question 3

what produces the aqueous humor?

Answer 3

ciliary body

Question 4

what stimulates aqueous humor production?

Answer 4

B1/B2 receptors

Question 5

what inhibits aqueous humor production?

Answer 5

a2 receptors

Question 6

name the two types of glaucomas

Answer 6

open angle and closed angle

Question 7

describe how an open angle glaucoma occurs

Answer 7

trabecular meshwork or canal of schlemm is blocked

Question 8

describe how a closed angle glaucoma occurs

Answer 8

trabecular network obstructed by a reduced angle

Question 9

which of closed or open glaucoma is acute?

Answer 9

closed angle is acute

Question 10

name the two glaucoma drugs that both inhibit aqueous production and increase flow

Answer 10

apraclonidine and brimonidine

Question 11

what is class of apraclonidine and brimonidine?

Answer 11

a2 agonist

Question 12

what are two classes of drugs that reduce production of aqueous humor?

Answer 12

b blocker and alpha agonsit

Question 13

what are the two alpha 2 agonist for glaucoma?

Answer 13

brimonidine and apraclonidine

Question 14

what are the two b blockers for glaucoma?

Answer 14

betaxolol

timolol

Question 15

what are two tox of beta blockers in glaucoma?

Answer 15

reduced cardiac output and bronchospasm

Question 16

what is a random tox of alpha agonists for glaucoma?

Answer 16

blepharitis

Question 17

what is blepharitis?

Answer 17

inflamm of eyelids

Question 18

what is main toxicity of alpha agonist, brimonidine and apraclonidine?

Answer 18

dizziness fatigue and somnolence

Question 19

who should you be careful giving alpha agonist drugs to?

Answer 19

patinets on anti HTNs already

Question 20

what is eye toxicity with apraclonidine?

Answer 20

mydriasis and conjunctival blanching

Question 21

what is a special use for apraclonidine?

Answer 21

treatment of eyelid dropp bc it can stimulate superior tarsal muscl e

Question 22

name the two carbonic anhydrase inhibitors

Answer 22

acetazolamide

brinzolamide

Question 23

what is MoA of acetazolamide and brinzolamide?

Answer 23

CA inhibitors leda to no aqueous humor production

Question 24

how do carbonic anhydrase inhibitors limit aqueous humor production?

Answer 24

limit movement of Na and H2o into eye

Question 25

name two SEs of CA inhibitor

Answer 25

occular irritation and transient myopia

Question 26

which CA inhibitor is oral?

Answer 26

acetazolamide

Question 27

which CA inhibitor is topical?

Answer 27

brinzolamide

Question 28

what is extra SE with acetazolamide since it is oral?

Answer 28

parasthesias

Question 29

what can CA inhibitors cause with kidneys?

Answer 29

frequent urination and met acidosis

Question 30

what is molecule that stimulates flow out of uveoscleral tract?

Answer 30

PGF2a

Question 31

what are drugs named that mimic PGFa2?

Answer 31

latanoprost and bimatoprost

Question 32

what is MoA of latanoprost and bimatoprost ?

Answer 32

they mimic PGFa2 to help increase uveoscleral outflow

Question 33

what are eye toxicities of latanoprost and bimatoprost ?

Answer 33

uveitis cystoid macular edema discolored iris increased eye lash length

Question 34

what is contraindication for latanoprost and bimatoprost ? why?

Answer 34

herpetic keratosis because it reactivated ocular herpes infection

Question 35

what is parasympathetic drug class for glaucoma

Answer 35

direct and indirect M3 agonists

Question 36

what are the direct M3 agonists in glaucoma?

Answer 36

carbachol and pilocarpine

Question 37

how does carbachol and pilocarpine treat glaucoma?

Answer 37

contract the ciliary muscle which lead to opening of canal of schlem and allows aqueous to flow out

Question 38

what are the indirect M3 inhibitors used for glacucoma?

Answer 38

echothiphate and physostigmine

Question 39

what is MoA of echothiophate and physiostigmine?

Answer 39

AcH esterase inhibitor so increases AcH and allows for more ciliary contraction and canal of schlemm to be open more and allow flow of equeous out

Question 40

what are two toxicities of direct and indirect M3 agonists with the eye?

Answer 40

Miosis and loss of night vision

Question 41

name three general side effects with M3 agonists

Answer 41

decreased CO increased bronchoconstriction increased gastric acid

Question 42

what is the target of Netarusidil?

Answer 42

Rho kinase

Question 43

what is normal action of Rho kinase?

Answer 43

make trabecular meshwork less permeable

Question 44

explain MoA of netarusidil?

Answer 44

blocks rho kinase that normally makes meshworknon permeable, so now meshwork is permeable and aqueous can flow out