Gluacoma drug therapy Flashcards
(26 cards)
بسم الله الرحمن الرحيم وبه نستعين
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Methods of Treatment of Glaucoma ?
Drug
Laser
Surgical
Mention drugs of glacuoma
Decreas secretion BAC
BB
a2 agonis
CAI
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Increased Drainage PCE
Prostaglandins
Cholinomeimetics
Epnherine + Deivefrine
Mention onset and duration of BB and examples
Onest=30 minutes
Duration 12 -24 hours
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Timolol non selective
Betaxolol B1 selective
Mention mechanism Of BB in glaucoma
Block B2 receptors on the ciliary process causing its decreased secretion of aquous humor
Mention Advantages of BB over Cholinomimertics in glaucoma
No accommodation or pupil respnses
First Choice in CHRONIC gluacoma ?
Beta blockers
Mention side effects of BB in galucoma ?
Occular irritation
Bronchospasm CI Asthma + COPD
Hypotension - bradycardia - CHF
BB contraindicated in ?
Asthamtics
Cardicas
Explain role of a2 agonist in glaucoma
Works on alpha 2 receptors on ciliary process inhibitng secretion of aquous humor
30-60 minutes onset
side effects :
Occuler irritation
Allergy
malaise +headache
Mention types of CAI
Systemic : Acetacolamid diuretics
Topical : Dorzolamide
Mnetion mechamism and side effects of CAI
Blocks CA enzyme in ciliary epithelium decereasing aquous humor formation
adverse effects:
Transient myopia + Renal stones
NAUSE diarrhea loss of appetie and taste
Drug of Choic for EMERGENCY in Closed Angle glaucoma ?
It is Piocarpine Cholinomimetic
as repaid onset few mintures for 4-8 hours repeated
Mechanism of Pilocarpine ?
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
Mention advesres of Pilocarbine as cholinomimetics
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
Direct and indirect Cholinomimetics
Direct Pilocaprine /carbachol
Indirect: Ecothiophate
Latanoprost is ………. type ?
Mechnism of action ?
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
drug used in glaucoma causing
Increased Iris Pigmentation + Eye lashes Excessive growth
Latanoprost is
Prostaglandin like analogue
Never! never give Epinphrine in Closed Angle Glaucoma why?
becasue of it mydriatic effect closing the angle more and more preciptating Acute attack
Used somtimes in Open angle gluaucome >?
Epinephrine
Explain how epinephrine wokrs ?
-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
Less CVS side effects
Penetrate Cornea 17 times more than EP
Used in Athma , pts intolerant to miotics and pts with cataracts ?
Dipivefrine
Which drug used in
Open angle glaucoma
Clsoed angle gluaoma
Chronic gluacoma
emergency gluacoma
Open angle all 6 gropus used
Closed angle all exept epnephrina + deivefrine
Chronic glaucoma BB
ER: Pilocarpine : miosis + ciliary muscle longitudina l
Combinations
Timolo + dorzolatmde
Timolo latanoprost
Preferd in athamtics ?
not prefered?
Epinephrine
CI ? bb cholimommimetics
