Pharm: Drugs used in Glaucoma - Konorev Flashcards
what is the favored b-blocker used for glaucoma?
- *timolol**
- lacks local anesthetic effects
- full beta-antagonist (reducing aqueous humor production)
- available as generic
- shown to be as effective as pilocarpine
what are the first line agents used to treat glaucoma?
- beta-blockers
- prostaglandin analogues (brimatoprost, latanoprost, travoprost)
- brimonidine (reduces IOP as effectively as timolol)
what are the second line therapies used to treat glaucoma?
- pilocarpine
- apraclonidine
- topical anhydrase inhibitors
what is the MOA of timolol?
reduces the production of aqueous humor by the ciliary body by blocking b-receptors
what are the adverse LOCAL effects of b-blockers on the eye?
- stinging
- dry eyes
- blurred vision
- blepharitis (inflam of eyelids)
what are the adverse SYSTEMIC effects of b-blockers on the eye?
- heart: negative inotropic effects, bradycardia
- airways: bronchospasm
- may interact w/ VERAPAMIL
what drug class more efficiently reduces IOP than b-blockers?
prostaglandin analogs
- brimatoprost, latanoprost, travoprost
MOA for which drug class?
- reduce IOP by increasing the uveoscleral and trabecular outflow of aqueous humor
prostaglandin analogs
- brimatoprost, latanoprost, travoprost
what drug class:
- given once daily, at night (1 drop)
- no significant systemic side effects
- local side effects: corneal erosions, conjunctival hyperemia, iris hyperpigmentation, hypertrichosis
prostaglandin analogs
- brimatoprost, latanoprost, travoprost
what drug MOA:
- decrease the rate of aqueous humor production
- as effective as timolol
brimonidine
what are the adverse effects of brimonidine?
- systemic: dizziness, fatigue, dry mouth, bradycardia, decreased BP
- local: allergic rxn (eyelid edema, itchingm hyperemia)
what is the first step in treating open angle glaucoma?
start with b-blocker
if intolerant of specific b-block, or contraindications, what med should you try next?
prostaglandins or brimonidine
if intolerance to all first class agents, what should you use next?
topical carbonic anhydrase inhibitors (second-line agents)
- if monotherapy fails, try combination therapy
what should you do if intolerance or inadequate response to combination therapy?
laser or surgical procedure
