Treatment of Glaucoma - Chapter 18 Flashcards
Glaucoma
A group of eye conditions that damage the optic nerve, most often due to abnormally high pressure in the eye
Types of Glaucoma
- Open angle
- Angle closure
- Congenital
Open Angle Glaucoma
- Most common
- Results from abnormal accumulation of aqueous humor
Angle Closure Glaucoma
-When the trabecular meshwork angle is obstructed, aqueous humor drainage is impaired
Pharmacological Treatment of Glaucoma
- Decrease the formation of aqueous humor
- Promote drainage of aqueous humor
Drugs That Decrease Aqueous Humor Formation
- B-adrenergic antagonists
- A-adrenergic agonists
- Carbonic anhydrase inhibitors
B-Adrenergic Antagonists
- Common ending: “olol”
- Decrease aqueous humor by inhibiting the action of epinephrine and norepinephrine on blood vessels in the ciliary body of the eye
B-Adrenergic Antagonists Examples
- betaxolol
- levobunolol
- timolol
Brand: Betoptic S
Generic: betaxolol
Brand: Betagan
Generic: levobunolol
Brand: Timoptic, Timoptic XE
Generic: timolol
A-Adrenergic Agonists
- Reduce blood flow in the ciliary body
- Reduce formation of aqueous humor
- Increase aqueous humor outflow
A-Adrenergic Agonists Examples
- brimonidine
- dipivefrin
- apraclonidine
Brand: Alphagan, Alphagan P
Generic: brimonidine
Brand: dipivefrin
Generic: dipivefrin
Brand: Lopidine
Generic: apraclonidine
Carbonic Anhydrase Inhibitors
-Common ending: “zolamide”
- Indicated for the treatment of open angle glaucoma
- Also used for short-term treatment and prevention of angle closure glaucoma
Carbonic Anhydrase Inhibitors Examples
- acetazolamide
- brinzolamide
- dorzolamide
- methazolamide
Brand: acetazolamide
Generic: acetazolamide
Brand: Azopt
Generic: brinzolamide
Brand: Trusopt, Trusopt PF
Generic: dorzolamide
Brand: methazolamide
Generic: methazolamide
Drugs That Decrease Aqueous Humor Formation Combinations Examples
- timolol/brimonidine
- timolol/brinzolamide
- timolol/dorzolamide
- brimonidine/brinzolamide
Brand: Combigan
Generic: timolol/brimonidine
Brand: Azarga
Generic: timolol/brinzolamide
Brand: Cosopt
Generic: timolol/dorzolamide
Brand: Simbrinza
Generic: brimonidine/brinzolamide
Drugs That Increase Aqueous Humor Drainage
- A-Adrenergic agonists
- Cholinergic agonists
- Prostaglandin analogs
Cholinergic Agonists
- Bind to receptors and mimic acetylcholine
- Binding contracts the ciliary muscles and the pupil
- Produce dilation of the trabecular meshwork and decrease IOP
Cholinergic Agonists Examples
- carbachol
- pilocarpine
Brand: Isopto Carbachol
Generic: carbachol
Brand: Isopto Carpine
Generic: pilocarpine
Prostaglandin Analogs
-Common ending: “prost”
- Relax ciliary muscles to permit drainage of aqueous humors
- ADR: permanent changes in eye colour
Prostaglandin Analogs Examples
- bimatoprost
- latanoprost
- travoprost
Brand: Lumigan, Lumigan RC
Generic: bimatoprost
Brand: Xalatan
Generic: latanoprost
Brand: Travatan
Generic: travoprost
Prostaglandin Analogs Combinations Examples
- timolol/travoprost
- timolol latanoprost
Brand: Xalacom
Generic: timolol/latanoprost
Brand: DuoTrav
Generic: timolol/travoprost
Warning Labels for Glaucoma Eye Drops
- FOR THE EYE
- DONT D/C WITHOUT MEDICAL SUPERVISION
- WASH HANDS BEFORE USE
- AVOID CONTAMINATION OF TIP
- DISCARD DISCOLOURED SOLUTIONS
- PROTECT FROM LIGHT (SOME); SHAKE WELL (SOME)
- REMOVE CONTACT LENSES BEFORE USE
- REFRIGERATE (latanoprost and latanoprost combinations)