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Therapeutics 2 > opthamology > Flashcards

opthamology Flashcards

1
Q

open angle glaucoma

A

drainage canal is obstructed

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2
Q

closed angle glaucoma

A

iris pushed against cornea by pressure

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3
Q

What drug classes reduce aqueous humor production?

A

beta blockers, carbonic anhydrase inhibitors

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4
Q

what drug classes increase aqueous humor outflow?

A

prostaglandin analogs, cholinergics, rho kinase inhibitors

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5
Q

What drug class reduces aqueous humor production and increases aqueous humor outflow???

A

alpha-2 agonists

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6
Q

what are the prostaglandin analogs?

A

bimatoprost (lumigan)(latisse), travoprost (travatan), latanoprost (xalatan), tafluprose (zioptan)

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7
Q

dosing for prostaglandin analogs

A

1 drop qhs

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8
Q

how much do prostaglandin analogs reduce IOP?

A

30%

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9
Q

warnings for prostaglandin analogs?

A

darkening of iris, eyelid, skin, and eyelashes
-increase in eyelash length and number

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10
Q

side effects of prostaglandin analogs

A

blurred vision, stinging, increases pigmentation, eyelash growth, foreign body sensation, light sensitivity

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11
Q

What are the first line treatments?

A

prostaglandin analogs, beta-blockers (kind-of alpha-2 agonists)

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12
Q

MOA beta -blockers for glaucoma

A

decrease aqueous humor production

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13
Q

MOA for prostaglandin analogs

A

increase outflow of aqueous humor

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14
Q

what are the non-selective beta blockers?

A

timolol (timoptic), carteolol, levobunolol (betagan)

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15
Q

what is the selective beta blocker

A

betaxolol (betoptic)

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16
Q

what is the dosing for the beta blockers

A

1 drop BID or daily

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17
Q

how much do beta blockers decrease IOP?

A

20-30%

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18
Q

what are the contraindications of beta-blockers

A
  • bradycardia
  • 2nd or 3rd degree heart block
  • cardiogenic shock
  • uncompensated cardiac failure
  • bronchospastic disease
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19
Q

side effects of beta blockers

A
  • stinging
  • blurred vision
  • bradycardia
  • breathing issues
  • hypotension
  • dizziness
  • fatigue
  • impotence
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20
Q

alpha-2 agonist MOA

A

increase aqueous humor outflow and reduce aqueous humor production

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21
Q

what are the alpha 2 agonists?

A

brimonidine (alphagan P (lumify)
aprachlonidine (Iopidine)

22
Q

alpha-2 agonist dosing

A

1 drop tid

23
Q

how much do alpha-2 agonists reduce intraocular pressure?

24
Q

warnings for alpha-2`

A

cns depression

25
side effects of alpha 2
- dry mouth - dry eyes - blurry vision - conjunctival hyperemia - sedation - confusion
26
carbonic anhydrase inhibitors MOA
reduce aqueous humor production
27
what are the carbonic anhydrase inhibitors?
- dorzolamide (trusopt) - Brinzolamide (azopt) - acetazolamide - methazolamide
28
what is the dosing for ophthalmic carbonic anhydrase inhibitors?
1 drop tid
29
what is the dosing for oral carbonic anhydrase inhibitors?
50 to 100mg bid to tid
29
how much IOP does carbonic anhydrase inhibitors reduce?
15 to 20%
30
contraindications for carbonic anhydrase inhibitors?
- sulfonamide allergy - crcl <30
31
carbonic anhydrase inhibitor ophthalmic SE?
- burning - blurred vision - blepharitis - taste disturbances
32
carbonic anhydrase inhibitor oral SE?
- ataxia - confusion - photosensitivity - nausea - metabolic acidosis
33
what is third line treatment?
rho kinase inhibitor
34
rho kinase MOA
increase aqueous humor outflow
35
what are the rho kinase inhibiors?
- netarsudil (rhopressa)
36
rho kinase dosing?
- 1 drop qpm
37
how much do rho kinase reduce IOP?
25-30%
38
rho kinase SE?
- burning -corneal disease conjunctival hemorrhage - conjunctival hyperemia
39
what is the last line of treatment?
cholinergics
40
cholinergics MOA
increase aqueous humor outflow
41
what are the cholinergics?
carbachol and pilocarpine
42
what is the dosing for cholinergics?
1-2 drops TID to QID
43
contraindications for cholinergics
- caution for retinal detachment an corneal abrasion
44
cholinergics side effects
- pupil constriction - corneal clouding - hypotension - bronchospasm - abdominal cramps
45
how long should contacts stay out after applying eye drops?
15 minutes
46
difference between open and closed angle glaucoma
medical emergency!!!
47
signs of closed angle glaucoma?
severe headache, severe pain, N/V, blurred vision, halos around light, eye redness or cloudy cornea
48
closed-angle glaucoma treatments
- mannitol, glycerin, surgery
49
mannitol (IV) dosing
1.5-2 g/kg/dose over 30 minutes
50
glycerin (PO) dosing
1-2 g/kg/dose every 5 hours
51
medications that increase intraocular pressure
- anticholinergic medications: - oxybutynin, tolterodine, benztropine, scopolamine - chronic steroids - sudafed - topiramate - antidepressants

Therapeutics 2 (9 decks)

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