Ocular Hypertensive Agents (F)

Question 1

What is the only universally accepted method of glaucoma treatment?

Answer 1

lower IOP

Question 2

What needs to be documented before treatment is given?

Answer 2

highest untreated IOP to determine target pressure

Question 3

What are the factors that can impair patient compliance?

Answer 3

1. lack of understanding of why they need them
2. cost/lack of access
3. ease if use/dexterity
4. side effects
5. number of drops/day, bottle confusion

Question 4

What are the drug categories that work by aqueous suppression?

Answer 4

1. B-blockers
2. alpha2-adrenergic agonists
3. carbonic anhydrase inhibitors

Question 5

What are the drug categories that work by outflow enhancement?

Answer 5

1. prostaglandin analogs
2. miotics
3. epinephrine

Question 6

What does looking at how well a patient responds to prostaglandin therapy predict about them for other care?

Answer 6

see if good candidate for SLT

Question 7

Which glaucoma agent must be refrigerated when shipped but not if the house or pharmacy is under 100degF?

Answer 7

Xalatan

Question 8

What do studies show about Xalatan compared to its generic? 1. How should this be dealt with? 2

Answer 8

1. Xalatan much better in dropping IOP

2. study in India but not a big problem here in US

Question 9

What did the XLT study show in terms of IOP effect of prostaglandins?

Answer 9

all statistically equivalent so give based on coverage or specific issue

Question 10

What is the generic and trade name for the prostaglandin agent that is given for the treatment of hypotrichosis or madar osis of the eye?

Answer 10

Latisse (0.03% bimatoprast)

Question 11

What is the miotic implant that goes into the inferior fornix and is for glaucoma?

Answer 11

Ocusert implant

Question 12

What is the term for a rapid physiological adaptation to a medicine with up-regulation of receptors, making the drug useless 2-3 months later?

Answer 12

short term escape (Tachyphylaxis)

Question 13

What is the term for a medicine the initially has response but then over a large amount of time decreases in effectiveness?

Answer 13

long term drift

Question 14

What is the amount of time to wait to judge the full effect of glaucoma meds?

Answer 14

30 days

Question 15

When is it most appropriate to use 0.25% beta blocker? 1. 0.5% beta blocker? 2

Answer 15

1. starting point

2. darkly pigmented eye, african americans

Question 16

What is the current thoughts on BID dosing for beta blockers?

Answer 16

BID only done if it is in combo drop that contains companion. Otherwise its QD

Question 17

What fails to lower IOP during the night?

Answer 17

beta blockers

Question 18

How are carbonic anhydrase inhibitors metabolized and excreted?

Answer 18

not metabolized and excreted through kidneys

Question 19

What is the problem with combo agents?

Answer 19

when compared to dosing the drugs in 2 separate bottles, combo agents produce lightly less drop in IOP

Question 20

What is the concept of putting the patient on every drop category available to control but the glaucoma is still progressing?

Answer 20

maximal medical therapy (MMT)