Special considerations - drug - induced glaucomas

Question 1

Which condition is moe likely to be excerbatedby medications

Answer 1

PACG than POAG

Question 2

Medications that precipitate angle closure

Answer 2

• anticholinergic

- sympathomimetic

Question 3

Types of anticholinergic properties

Answer 3

• 1st gen antihistamines
• TAC
• antidepressants
• antipsychotics

Question 4

types of symapthiomimetic properties

Answer 4

• phenylephrine
• pseudoephrine
  = PACG patients treated with laser iridotomy use these agents without causing excerabtion

Question 5

sulpha based drugs

Answer 5

• topiramite
• acetazolamide
• HCTZ
  = swelling ciliary body
  = anterior displacement lens
  = decrease anterior chamber depth

Question 6

controlled POAG

Answer 6

rarely exerbated by anticholinergics + sympathomimetics

Question 7

uncontrolled + untreated poag

Answer 7

• risk-benefit ratio considered

Question 8

how can POAG be excerbted ?

Answer 8

adm corticosteroids

Question 9

what do corticosteroids do?

Answer 9

• increase IOP
• obstruction trabecular meshwork with extracellualr material
• topical rout increase IOP but all routes do

Question 10

what is the onset + extent IOP elevation dependent on

Answer 10

• specific corticosteroids
  dose
  route
  frequency

Question 11

Corticosteroid-induced IOP

Answer 11

• elevated

- IOP spontaenously baseline within few weeks to month upon stoppign the steroid