Term
| What are the two causes of glaucoma? |
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Definition
High Intraocular Pressure
Inadequate blood flow to the eye |
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Term
| What is the most common type of glaucoma? |
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Definition
| Primary Open Angle Glaucoma (POAG) |
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Term
| What are the two main mechanisms for decreasing IOP? |
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Definition
Decrease production rate
Increase outflow rate |
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Term
Name the 7 groups of agents used to treat glaucoma
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Definition
Epinephrine
Alpha-2 Adrenergic Agonists
Beta Blockers
Carbonic Anhydrase Inhibitors
Miotics (direct)
Miotics (indirect, ChEI)
Prostaglandins
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Term
What is the most widely used beta blocker in glaucoma treatment?
What sort of populations is this drug contraindicated for? |
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Definition
Timolol is a widely used glaucoma med.
It should not be given to patients with asthma or patients who is already on another systemic beta-blocker. |
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Term
| How do Prostaglandins affect IOP? Give an example of a Prostaglandin used to treat glaucoma. |
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Definition
Prostaglandins increase uveoscleral outflow
Latanoprost, Travoprost, Bimatoprost (Lumigan) |
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Term
| Give an example of a Carbonic Anhydrase Inhibitor and explain how it reduces IOP. |
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Definition
Acetazolamide, Dorzolamide, Brinzolamide
These drugs slow down the formation of bicarbonate ions, thus decreasing aqueous humour production-decreasing IOP
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Term
| Give an example of an alpha adrenergic agonist and explain how it reduces IOP |
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Definition
Brimonidine
Reduces IOP by decreasing aqueous production |
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Term
What 2 drugs are combined in Combigan?
Why would a patient switch to using this drug instead of solely Timolol? |
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Definition
Contains Brimonidine (alpha adrenergic agonist) & Timolol (Beta blocker).
If pt was using Timolol but their IOP was still a little bit too high, they could switch to this drug to acheive the target IOP. |
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Term
| Which two drugs are combined in Cosopt? |
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Definition
Timolol and Dorzolamide (CAI)
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Term
Describe the immediate treatment of a pt with acute angle closure glaucoma.
How would this treatment be different if the pt is known to have asthma? |
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Definition
Give pt a drop of Timolol followed by a second drop a few minutes later. Then instill a couple drops of Pilocarpine to physically open up the angle.
If the pt had asthma use Brimonidine (alpha agonist) instead of Timolol. |
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Term
| What treatment should be given for an acute angle closure pt whose pressure is above 40mg? |
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Definition
| Give them 2 250mg tablets of acetazolamide (CAI). do not use 500mg tablets since they have a slower onset. |
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Term
| Why are prostaglandins not used to treat acute angle closure glaucoma? |
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Definition
| Their onset of action is too slow. |
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Term
| How would a hyperosmotic agent like Mannitol affect IOP? |
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Definition
| It creates an osmotic gradient between plasma and ocular fluids, reducing IOP. |
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Term
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Definition
Directly acting Miotic
(cholinergic agonist) |
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Term
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Definition
Direct Miotic-increases outflow
Muscarinic agonist |
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Term
| Physostigmine and Echothiophate |
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Definition
Indirect Miotics
-Acetylcholinesterase Inhibitors |
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