Neuro: Drugs for Glaucoma Flashcards
suffix of all B-blockers
-lol
Timolol
How do B-blockers work for glaucoma?
They decrease production of aqueous humor by the ciliary epithelium
Suffix for the a2 agonists?
-nidine
Bromonidie is the main
How do the a2 agonists work for glaucoma?
Decrease production of Aqueous humor
and
Increase uveoscleral outflow through relaxation of ciliary muscle
Suffix for all prostaglandin analogs?
-oprost
bimatoprost is most effective
How do the prostaglandin analogs treat glaucoma?
Improve uveosceral, or unconventional, outflow
Suffix for the carbonic anhydrase inhibitors?
-amide
Brinzolamide and Dorzolamide are long term
How do the carbonic anhydrase inhibitors treat glaucoma?
they decrease production of AQ humor
What are the cholinergic agonists used in glaucoma and how do they treat?
Carbachol and pilocarpine
contract ciliary muscle and iris circular muscle-improved conventional (trabecular) outflow
What inhibitor of cholinesterase is used for glaucoma and how does it work for treatment?
Echothiophate
contract ciliary muscle and iris circular muscle-improved conventional (trabecular) outflow
What muscle constricts the pupil to cause miosis? What ANS control is it under?
Iris circular muscle
-M3 (Gq)
What muscle dilates the pupil to cause mydraisis? What ANS control is it under?
Iris radial muscle
-a1 (Gq)
What branch of ANS contracts the ciliary muscle to cause outflow of Aqueous humor?
M3
-induces accomadation for near vision
What branch of ANS increases aqueous humor production and what branch decreases?
B2 increases
a2 decreases
What role does a1 have on the eye?
contracts radial muscle=mydriasis
What role does a2 have on the eye?
relaxes ciliary muscle=increases outflow
decreases aqueous humor production
Which drug categories reduce aqueous humor production? (3)
B blockers
a2 agonists
carbonic anhydrase inhibitors
Which drug categories increase aqueous humor outflow? (4)
Prostaglandin analogs (1st line)
a2 adrenergic agonists
M3 cholinergic agonists
Indirect inhibitors of cholinesterase
Which B-blocker is the one most chosen for glaucoma and why?
Timolol
-lacks lock anesthetic effect, has generic, and full antagonist
Adverse effects of brimodine
headache, fatigue, dry mouth, and allergic rxn
Which carbonic anhydrase inhibitors are for long term use and which are short term only?
Long term: topicals
-brinzolamide and dorzolamide
Short: systemic
-acetazolamide and methazolomide
What drugs are the most effect at treating glaucoma?
Prostaglandins
-Brimatoprost**, latanoprost, and travoprost
More expensive though
Which drugs can cause iris hyperpigmentation, hypertrichosis, and hyperpigmentation around the eyelashes?
Prostaglandin analgogs
Iris hyperpigmentation is irreversible
Adverse effects of the cholinergic agonists (both direct and indirect)
Local
-headaches, miosis, eyelid twitching, myopia
