Pharm: Glaucoma Drugs

Question 1

Which is the only drug class that can treat closed angle glaucoma?

Answer 1

Cholinergic Agents

Question 2

Carbachol

Answer 2

Treats Open Angle Glaucoma: causes contraction of the ciliary muscles leading to increase flow through the intertrabecular spaces.

Treats Closed angle glaucoma: causes contraction of the sphincter pupillae muscle to increase the angle between the iris and sclera for aqueous drainage.

MOA: direct-acting muscarinic agonist

Side Effects: autonomic disturbances if it gets into the systemic circulation (also has nicotinic activity)

Question 3

Pilocarpine

Answer 3

Treats Open Angle Glaucoma: causes contraction of the ciliary muscles leading to increase flow through the intertrabecular spaces.

Treats Closed angle glaucoma: causes contraction of the sphincter pupillae muscle to increase the angle between the iris and sclera for aqueous drainage.

MOA: direct-acting muscarinic agonist

Side Effects: causes paradoxical hypertension and tachycardia

Question 4

Physostigmine

Answer 4

Treats Open Angle Glaucoma: causes contraction of the ciliary muscles leading to increase flow through the intertrabecular spaces.

Treats Closed angle glaucoma: causes contraction of the sphincter pupillae muscle to increase the angle between the iris and sclera for aqueous drainage.

MOA: AChase inhibitor

Side Effects: crosses BBB and cause seizures and abnormal defecation

Question 5

Ecothiphate

Answer 5

Treats Open Angle Glaucoma: causes contraction of the ciliary muscles leading to increase flow through the intertrabecular spaces.

Treats Closed angle glaucoma: causes contraction of the sphincter pupillae muscle to increase the angle between the iris and sclera for aqueous drainage.

MOA: AChase inhibitor

Side Effects: nightblindness and frontal headaches

Question 6

Betaxolol

Answer 6

Treats open angle glaucoma by inhibiting ciliary epithelium from producing aqueous humor.

Also treats ocular hypertension

MOA: SELECTIVE BETA-1 blocker (fewer side effects)

Side Effects: AV block, myocardial infarct

Question 7

Carteolol

Answer 7

Treats open angle glaucoma by inhibiting ciliary epithelium from producing aqueous humor.

Also treats ocular hypertension

MOA: non-selective Beta blocker

Side Effects: insomnia, bronchospasm

Question 8

Timolol

Answer 8

Treats open angle glaucoma by inhibiting ciliary epithelium from producing aqueous humor.

Also treats ocular hypertension

MOA: non-selective Beta blocker

SIde Effects: bradycardia, blurred vision, confusion, hallucination

Question 9

Latanoprost

Answer 9

Treats open angle glaucoma by increasing uveoscleral drainage of aqueous humor.

Treats intraocular hypertension

MOA: PGF2-alpha analog

Side Effects: Darkens the color of the iris, macular retinal edema.

Question 10

Brimatoprost

Answer 10

Treats open angle glaucoma by increasing trabecular meshwork drainage of aqueous humor.

Treats intraocular hypertension

MOA: PGF2-alpha analog

Side Effects: Darkens the color of the iris, macular retinal edema, conjunctival hyperemia

Question 11

Travoprost

Answer 11

Treats open angle glaucoma by increasing trabecular meshwork drainage of aqueous humor.

Treats intraocular hypertension

MOA: PGF2-alpha analog

Side Effects: Darkens the color of the iris, macular retinal edema, conjunctival hyperemia

Question 12

Acetazolamide

Answer 12

Treats open angle glaucoma by inhibiting production of bicarbonate ions which ultimately inhibits aqueous humor production.

Also treats intraocular hypertension.

MOA: carbonic anhydrase II inhibitor

Side Effects: Agranulocytosis, aplastic anemia, thrombocytopenia, hyperchloremic acidosis, kidney stones

Question 13

Dorzolamide

Answer 13

Treats open angle glaucoma by inhibiting production of bicarbonate ions which ultimately inhibits aqueous humor production.

Also treats intraocular hypertension.

MOA: carbonic anhydrase II inhibitor

Side Effects: immune hypersensitivity reactions, burning sensation in eye, hyperchloremic acidosis, kidney stones

Question 14

Brinzolamide

Answer 14

Treats open angle glaucoma by inhibiting production of bicarbonate ions which ultimately inhibits aqueous humor production.

Also treats intraocular hypertension.

MOA: carbonic anhydrase II inhibitor

Side Effects: hyperchloremic acidosis, kidney stones

Question 15

Apraclonidine

Answer 15

Lower ocular pressure associated with eye surgery by decreasing production of aqueous humor and increasing drainage.

MOA: Alpha-2 receptor agonist

Side Effects: depression, dizziness, chest pain

Question 16

Brimonidine

Answer 16

Treats open angle glaucoma by decreasing aqueous humor production and increasing uveoscleral drainage.

Treats ocular hypertension

MOA: Alpha-2 agonist

Side Effects: irregular heart rate, fatigue, dry, mouth, red eyes

Question 17

Dipivefrin

Answer 17

Treats open angle glaucoma by vasoconstricting blood vessels to the ciliary epithelium and preventing production of aqueous humor.

MOA: non-selective adrenergic agonist (metabolized to Epinephrine once inside the eye)

Side Effects: xerostomia, somnolence, burning eye

Question 18

Epinephrine

Answer 18

Treats open angle glaucoma by vasoconstricting blood vessels to the ciliary epithelium and preventing production of aqueous humor.

MOA: non-selective adrenergic agonist

Side Effects: xerostomia, somnolence, mydriasis