Glaucoma Pharmacology Flashcards
What is the purpose of glaucoma drugs?
The purpose of glaucoma drugs is to lower intraocular pressure by decreasing the amount of aqueous humor. This is done be either decreasing aqueous humor synthesis or increasing its drainage.
What classes of drugs are used for glaucoma?
- alpha agonists
- beta blockers
- diuretics
- Cholinomimetics (M3)
- Prostaglandins
What are the alpha agonists used for glaucoma treatment?
- epinephrine (alpha 1)
2. brimodine (alpha 2)
What are adverse effects of alpha agonists?
- Mydriasis - this is due to alpha 1 effects, do not use in closed angle glaucoma
- blurry vision
- ocular hyperemia
- foreign body sensation
- ocular allergic reactions
- ocular pruritis
What are the beta agonists drugs used for glaucoma treatment?
- timolol
betaxolol
carteolol
What is the mechanism of action of beta agonists in glaucoma treatment?
Beta blockers decrease aqueous humor synthesis
What are adverse effects of beta blockers for treatment of glaucoma?
There are no vision or pupillary changes associated with the use of beta blockers in glaucoma treatment; therefore, these are the best to use!
What is the mechanism of action of acetazolamide, a carbonic anhydrase inhibitor, on glaucoma treatment?
Acetazolamide works by decreasing aqueous humor synthesis via inhibition of carbonic anhydrase.
What are the adverse effects of acetazolamide?
There are no pupillary or visual changes associated with acetazolamide.
What drugs are direct cholinomimetics (M3)?
- pilocarpine
2. carbachol
What drugs are indirect cholinomimetics?
- Physostigmine
2. Echothiophate
What is the mechanism of action of cholinomimetics (M3) for glaucoma treatment?
Cholinomimetics work by increasing outflow of aqueous humor via contraction of the ciliary muscle and opening of the trabecular meshwork.
Which cholinomimetic should be used in emergency situations?
Use pilocarpine in emergencies because it is very effective at opening the meshwork into the canal of Schlemm.
What are the adverse effects of cholinomimetics?
- Miosis –> contraction of the pupillary sphincter muscles.
- Cyclospasm –> contraction of the ciliary muscles
What prostaglandin drugs are used for glaucoma treatment?
- Bimatoprost
2. Iatanoprost (PGF2 alpha)