Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PPO > Week 1: Glaucoma > Flashcards

Week 1: Glaucoma Flashcards

1
Q

ocular HTN is defined as:

what is the goal in managing ocular HTN?

A

IOP > 21 mm Hg with healthy ONH and normal VF

Goal: Lower IOP by at least 20 %

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

For glaucoma risk calculators, what 5 factors are taken into account?

A 
age, 
IOP
CCT
PSD
Vertical C/d by contour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what do glaucoma risk calculators estimate?

A

estimated 5 y risk of developing glauc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

goal in mild glaucoma tx based on IOP:

A

Mild 20-30% lower than tmax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

goal in moderate glaucoma tx based on IOP:

A

Moderate 30-40% lower than tmax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

goal in severe glaucoma tx based on IOP:

A

Severe 40-50% lower than tmax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Consider lowering IOP an extra 10% in these situations:

A

Consider lowering extra 10% if under 50yo, African America, or sibling with glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how might you classify mild glaucoma?

A

normal VF but glaucomatous ONH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how might you classify moderate glaucoma?

A

VF abnormalities in one hemifield not w/in 5 deg of fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name 3 inflow altering glaucoma meds:

A

alpha agonists
beta blockers
carbonic anhydrase inhib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

mechanism of prostaglandins:

A

alter structure of uveoscleral pathway to increase outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

drug of choice/first line for glaucoma?

A

prostaglandins (reduce IOP by ~30%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Travatan: starts to work in _ hours, peak at _ hours

A

2 hours, peak at 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Xalatan: starts to work in _ hours, peak at _ hours

A

3-4hrs; peaks at 8-12hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lumigan: starts to work in _ hours, peak at _ hours

A

starts in 4 h max effect 8-12 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Maximum therapeutic effect for prostaglandins:

A

Maximum therapeutic effect reached in 2 to 6 weeks,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which 2 prostaglandins require refrigeration before opening:

A

Xalatan and Zioptan require refrigeration of unopened bottles, open bottles can remain at room temperature for up to 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Side effects of prostaglandins:

A
  • Ocular redness 30 mins after using, clears in one hour, common reason for d/c use.
  • FBS and SPK
  • Hyperpigmentation of skin, irides and lashes; longer lashes;
  • Anterior uveitis (rare)
  • Orbital fat atrophy in longterm use
19
Q

what % of people are prostaglandin non-responders?

A

4.1% non-responders

20
Q

Beta blocker mechanism:

A

Act on beta-adrenergic receptors in ciliary epithelium to decrease aqueous production

21
Q

Beta blockers takes effect in __ mins, peaks in __ hours, wears off in __

A

Takes effect in 30-60 mins, peaks in 2-3 hours, wears off in 24-48h (ie requires daily dosage)

22
Q

when do you give BB?

A

in am

23
Q

selective B blocker causes _% reduction in IOP?

non-selective B blocker causes _% reduction in IOP?

A

Selective: 20 % decrease

Non-selective: 25 % decrease

24
Q

what are specific 2 cons of taking B blockers long term?

A

Short term escape: less effective after one wk due to receptor saturation

Long term drift: tachyphylaxis, down regulation of receptors with constant stimulation; allow for 4 wk washout and use another brand of beta in between

25
Q

what are some contraindications to B blockers?

A
  • COPD, ANY prev or current Asthma
  • Myasthenia Gravis – can worsen symptoms
  • Bradycardia, pulse <55-60, unless on pacemaker
  • pts already on B blocker
26
Q

possible systemic side effects if beta blockers:

A
  • Systemic hypotension
  • Broncho spasm
  • CNS depression :fatigues, amnesia, depression
  • Lipid profile alteration
  • Thyroid storm: masks signs of hyperthyroidism
  • Bradycardia (unless on pacemaker)
27
Q

ocular side effects of beta blockers:

A
  • Dry eye
  • corneal anesthesia
  • allergic blephconjunctivitis
  • uveitis
28
Q

Dosing for alpha agonists? how much does it lower IOP?

A

TID;

Lowers IOP 20-25%

29
Q

For apraclonidine, IOP drop within __ hour, peaks in _ hours, wears off in _hrs

A

IOP drop within 1st hour, peaks in 3 hours, wears off in 12h

30
Q

For alphagan, IOP peaks in _ hours, wears off in _hrs

A

peaks in 2 hours, wears off in 12 hrs

31
Q

ocular side effects of alpha agonists:

A
  • Bleph
  • Dry eye, mouth and nose
  • Conj hyperemia
  • Lid retraction
  • **Allergy, follicular conjunctivitis
  • Miosis
32
Q

contraindications for alpha agonists:

A
  • monoamine oxidase inhibitors (MAO inhibitors)
  • Severe cardiovascular disease
  • Children-cyanosis
33
Q

Name 2 carbonic anhydrase inhibitors and when they peak and wear off:

A

Azopt peaks in 2 h wears off in 12h

Trusopt peaks in 2 h wears off in 12

34
Q

side effects of carbonic anhydrase inhib or contraindications?

A 
Side effects:
Metallic taste (benign, but often bothers pts so warn them)

Contraindications:

  • SULFA ALLERGIES
  • Corneal endothelial compromised patients (ex Fuch’s)
35
Q

carb anhydrase inhib reduce IOP by __%, dosage?

A

Reduces IOP 20%

TID

36
Q

miotics like pilo reduce IOP by __%?

A

Lower 15-25%

37
Q

cosopt is a combo of what drugs?

A

BB + CAI =Timolol + dorzolimide

38
Q

combigan is a combo of what drugs?

A

BB + A2 ag=Timolol + Brimonidine

39
Q

10% reduction in risk of progression with each __mmHg decrease in IOP

A

10% reduction in risk of progression with each 1mmHg decrease in IOP

40
Q

Typically, adding another drop will decrease IOP another _ mmHg

A

Typically, adding another drop will decrease IOP another 3 mmHg

41
Q

what % of people are non-responders to Beta blockers?

A

10-20%

42
Q

ocular perfusion pressure=

A

diastolic pressure-IOP

43
Q

IOP should be lowered an additional __% if progression detected on current glaucoma therapy

A

15-20%

*BUT MAKE SURE PT COMPLIANT

PPO (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions