Neuro - Pharmacology (Glaucoma drugs)

Question 1

In general, what is the goal of Glaucoma drugs, and how is it accomplished?

Answer 1

Decrease IOP via decreasing amount of aqueous humor (inhibit synthesis/secretion or increase drainage)

Question 2

Name 2 Glaucoma drugs that act as alpha-agonists.

Answer 2

Alpha-agonists: (1) Epinephrine (2) Brimonidine (alpha2)

Question 3

Name 3 Glaucoma drugs that act as Beta-blockers.

Answer 3

Beta-blockers: (1) Timolol (2) Betaxolol (3) Carteolol

Question 4

Name a Glaucoma drug that acts as a diuretic.

Answer 4

Diuretics: Acetazolamide

Question 5

What are the categories of Glaucoma drugs that act as Cholinomimetics? Give 2 examples in each category.

Answer 5

DIRECT (pilocarpine, carbachol); INDIRECT (physostigmine, echotiophate)

Question 6

Name a Glaucoma drug that acts as a prostaglandin. What kind of analog is it?

Answer 6

Latanoprost (PGF2alpha)

Question 7

What kind of drug is Epinephrine, and what is its mechanism as a Glaucoma drug?

Answer 7

Alpha-agonist; Decrease aqueous humor synthesis via vasoconstriction

Question 8

What is a side effect of using Epinephrine as a Glaucoma drug? In what context should it not be used?

Answer 8

Mydriasis; Do not use in closed-angle glaucoma

Question 9

What kind of drug is Brimonidine, and what is its mechanism as a Glaucoma drug?

Answer 9

Alpha2-agonist; Decrease aqueous humor synthesis

Question 10

What are 5 side effects of using Brimonidine as a Glaucoma drug?

Answer 10

(1) Blurry vision, (2) ocular hyperemia, (3) foreign body sensation, (4) ocular allergic reactions, (5) ocular pruritus

Question 11

Again, what are 3 Beta-blockers that can be used as Glaucoma drugs? What is their mechanism?

Answer 11

(1) Timolol (2) Betaxolol (3) Carteolol; Decrease aqueous humor synthesis

Question 12

What side effects are associated with Beta-Blockers used as Glaucoma drugs (i.e., Timolol, Betaxolol, Carteolol)?

Answer 12

No pupillary or vision changes

Question 13

Again, what is a diuretic that can be used as a Glaucoma drug? What is its mechanism?

Answer 13

Acetazolamide; Decreases aqueous humor synthesis via inhibition of carbonic anhydrase

Question 14

What side effects are associated with Acetazolamide used as Glaucoma drugs?

Answer 14

No pupillary or vision changes

Question 15

What are 2 examples of direct cholinomimetics used as Glaucoma drugs? What is their mechanism?

Answer 15

Pilocarpine, Carachol; Increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

Question 16

What 2 side effects are associated with direct cholinomimetics used as Glaucoma drugs (i.e., pilocarpine, carbachol)?

Answer 16

Miosis and cycloplasm (contraction of ciliary muscle)

Question 17

What are 2 examples of indirect cholinomimetics used as Glaucoma drugs? What is their mechanism?

Answer 17

Physostigmine, Echothiopate; Increase outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork

Question 18

Which cholinomimetic is used as Glaucoma drug in emergencies, and why?

Answer 18

Use pilocarpine in emergencies - very effective at opening meshwork into canal of Schlemm

Question 19

What is the prostaglandin used as a Glaucoma drug? What is its mechanism?

Answer 19

Latanoprost (PGF2alpha); Increase outflow of aqueous humor

Question 20

What is the side effect of Latanoprost (PGFalpha2) when used as a Glaucoma drug?

Answer 20

Darkens color of iris (browning)