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Neuro Week 3 > Glaucoma Drugs > Flashcards

Glaucoma Drugs Flashcards

1
Q

what are two outflows of aqueous humor?

A

trabecular and uveoscleral

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2
Q

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

A

trabecular is 90%

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3
Q

what produces the aqueous humor?

A

ciliary body

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4
Q

what stimulates aqueous humor production?

A

B1/B2 receptors

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5
Q

what inhibits aqueous humor production?

A

a2 receptors

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6
Q

name the two types of glaucomas

A

open angle and closed angle

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7
Q

describe how an open angle glaucoma occurs

A

trabecular meshwork or canal of schlemm is blocked

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8
Q

describe how a closed angle glaucoma occurs

A

trabecular network obstructed by a reduced angle

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9
Q

which of closed or open glaucoma is acute?

A

closed angle is acute

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10
Q

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

A

apraclonidine and brimonidine

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11
Q

what is class of apraclonidine and brimonidine?

A

a2 agonist

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12
Q

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

A

b blocker and alpha agonsit

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13
Q

what are the two alpha 2 agonist for glaucoma?

A

brimonidine and apraclonidine

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14
Q

what are the two b blockers for glaucoma?

A

betaxolol

timolol

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15
Q

what are two tox of beta blockers in glaucoma?

A

reduced cardiac output and bronchospasm

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16
Q

what is a random tox of alpha agonists for glaucoma?

A

blepharitis

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17
Q

what is blepharitis?

A

inflamm of eyelids

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18
Q

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

A

dizziness fatigue and somnolence

19
Q

who should you be careful giving alpha agonist drugs to?

A

patinets on anti HTNs already

20
Q

what is eye toxicity with apraclonidine?

A

mydriasis and conjunctival blanching

21
Q

what is a special use for apraclonidine?

A

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

22
Q

name the two carbonic anhydrase inhibitors

A

acetazolamide

brinzolamide

23
Q

what is MoA of acetazolamide and brinzolamide?

A

CA inhibitors leda to no aqueous humor production

24
Q

how do carbonic anhydrase inhibitors limit aqueous humor production?

A

limit movement of Na and H2o into eye

25
Q

name two SEs of CA inhibitor

A

occular irritation and transient myopia

26
Q

which CA inhibitor is oral?

A

acetazolamide

27
Q

which CA inhibitor is topical?

A

brinzolamide

28
Q

what is extra SE with acetazolamide since it is oral?

A

parasthesias

29
Q

what can CA inhibitors cause with kidneys?

A

frequent urination and met acidosis

30
Q

what is molecule that stimulates flow out of uveoscleral tract?

A

PGF2a

31
Q

what are drugs named that mimic PGFa2?

A

latanoprost and bimatoprost

32
Q

what is MoA of latanoprost and bimatoprost ?

A

they mimic PGFa2 to help increase uveoscleral outflow

33
Q

what are eye toxicities of latanoprost and bimatoprost ?

A

uveitis
cystoid macular edema
discolored iris
increased eye lash length

34
Q

what is contraindication for latanoprost and bimatoprost ? why?

A

herpetic keratosis because it reactivated ocular herpes infection

35
Q

what is parasympathetic drug class for glaucoma

A

direct and indirect M3 agonists

36
Q

what are the direct M3 agonists in glaucoma?

A

carbachol and pilocarpine

37
Q

how does carbachol and pilocarpine treat glaucoma?

A

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

38
Q

what are the indirect M3 inhibitors used for glacucoma?

A

echothiphate and physostigmine

39
Q

what is MoA of echothiophate and physiostigmine?

A

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

40
Q

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

A

Miosis and loss of night vision

41
Q

name three general side effects with M3 agonists

A

decreased CO
increased bronchoconstriction
increased gastric acid

42
Q

what is the target of Netarusidil?

A

Rho kinase

43
Q

what is normal action of Rho kinase?

A

make trabecular meshwork less permeable

44
Q

explain MoA of netarusidil?

A

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

Neuro Week 3 (13 decks)

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