Gluacoma drug therapy

Question 1

بسم الله الرحمن الرحيم وبه نستعين
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Methods of Treatment of Glaucoma ?

Answer 1

Drug
Laser
Surgical

Question 2

Mention drugs of glacuoma

Answer 2

Decreas secretion BAC
BB
a2 agonis
CAI
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Increased Drainage PCE
Prostaglandins
Cholinomeimetics
Epnherine + Deivefrine

Question 3

Mention onset and duration of BB and examples

Answer 3

Onest=30 minutes
Duration 12 -24 hours
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Timolol non selective
Betaxolol B1 selective

Question 4

Mention mechanism Of BB in glaucoma

Answer 4

Block B2 receptors on the ciliary process causing its decreased secretion of aquous humor

Question 5

Mention Advantages of BB over Cholinomimertics in glaucoma

Answer 5

No accommodation or pupil respnses

Question 6

First Choice in CHRONIC gluacoma ?

Answer 6

Beta blockers

Question 7

Mention side effects of BB in galucoma ?

Answer 7

Occular irritation
Bronchospasm CI Asthma + COPD
Hypotension - bradycardia - CHF

Question 8

BB contraindicated in ?

Answer 8

Asthamtics
Cardicas

Question 9

Explain role of a2 agonist in glaucoma

Answer 9

Works on alpha 2 receptors on ciliary process inhibitng secretion of aquous humor
30-60 minutes onset
side effects :
Occuler irritation
Allergy
malaise +headache

Question 10

Mention types of CAI

Answer 10

Systemic : Acetacolamid diuretics
Topical : Dorzolamide

Question 11

Mnetion mechamism and side effects of CAI

Answer 11

Blocks CA enzyme in ciliary epithelium decereasing aquous humor formation
adverse effects:
Transient myopia + Renal stones
NAUSE diarrhea loss of appetie and taste

Question 12

Drug of Choic for EMERGENCY in Closed Angle glaucoma ?

Answer 12

It is Piocarpine Cholinomimetic
as repaid onset few mintures for 4-8 hours repeated

Question 13

Mechanism of Pilocarpine ?

Answer 13

Works on M3 receptor on Constricotor pupillae causing Miosis and widen the angle
Contraction Of longutidinal bundles of Ciliary muscles causing OPeninig of the trabecular meshwork causing ? increeasd drainage of Aquous humor decresing IOP

Question 14

Mention advesres of Pilocarbine as cholinomimetics

Answer 14

Loss of accommodation and miosis so better is ? bb
Increased Myopia and Vision blurring not used chronic
Eye brow pain
Cholinimimetics adverses: bradycardia- brnochospams Salivationo Abd cramps

Question 15

Direct and indirect Cholinomimetics

Answer 15

Direct Pilocaprine /carbachol
Indirect: Ecothiophate

Question 16

Latanoprost is ………. type ?
Mechnism of action ?

Answer 16

Prostaglandin like analogue
used in galucoma to increased Uvoscleral drainage by relaxation of radial fibers of ciliary muscles
No CVS or Pulmonary side effects + Once dosing

Question 17

drug used in glaucoma causing
Increased Iris Pigmentation + Eye lashes Excessive growth

Answer 17

Latanoprost is
Prostaglandin like analogue

Question 18

Never! never give Epinphrine in Closed Angle Glaucoma why?

Answer 18

becasue of it mydriatic effect closing the angle more and more preciptating Acute attack

Question 19

Used somtimes in Open angle gluaucome >?

Answer 19

Epinephrine

Question 20

Explain how epinephrine wokrs ?

Answer 20

-Working on B2 receptors on ciliary muscle realxing radial fibers causing increasing Uvosclearal tract outflow
-Working on a2 receptors decreasing secretion
working on a1 of the BVs of ciliarry bodies decreasing scetrtion

Question 21

Less CVS side effects
Penetrate Cornea 17 times more than EP
Used in Athma , pts intolerant to miotics and pts with cataracts ?

Answer 21

Dipivefrine

Question 22

Which drug used in
Open angle glaucoma
Clsoed angle gluaoma
Chronic gluacoma
emergency gluacoma

Answer 22

Open angle all 6 gropus used
Closed angle all exept epnephrina + deivefrine
Chronic glaucoma BB
ER: Pilocarpine : miosis + ciliary muscle longitudina l

Question 23

Combinations

Answer 23

Timolo + dorzolatmde
Timolo latanoprost

Question 24

Preferd in athamtics ?
not prefered?

Answer 24

Epinephrine
CI ? bb cholimommimetics

Question 25

…and… not recommedned in athamtics and cardiac patients ?

Answer 25

BB blockers and Cholinomimetics

Question 26

الحمدلله رب العالمين