L9 Flashcards

1
Q

what is glaucoma eye drop

A

Most glaucoma drugs act by influencing the autonomic nervous system.

Aimed at reducing intraocular pressure (IOP)

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2
Q

what are the different categories of glaucoma eye drop

A

Cholinergics
Beta-adrenergic receptor blockers
Carbonic Anhydrase Inhibitors (CAI)
Prostaglandins
Adrenergic agonists

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3
Q

how deos miotic works and e.g of miotics

A

Effect exerted is through outflow

Contraction of the ciliary muscle pulls open the pores of the TM, thus increasing aqueous outflow.

E.g. Pilocarpine (Ocusert, Piloplex etc)

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4
Q

what is beta blocker and what is the effect of beta blocker

A

Originally developed for the treatment of cardiovascular disorders.

Beta receptors:
ß1: Mainly found in heart
ß2: Peripheral blood vessels, uterus, lungs

Function: Decreases aqueous production

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5
Q

what are the e.g of betablocker

A

Timolol (Timoptic, Betimol)
Levobunolol (Betagan)
Carteolol (Ocupress)
Betaxolol** (Betoptic)

** b1 selective, less risk to px with pulmonary disease

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6
Q

what is betaxolol

A

Better Visual Field preservation
Less systemic effects on circulation & respiratory system

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7
Q

what are the side effect of betablocker

A

Stinging sensation
Potentially reduce heart rate

Caution with patients with heart problems, lung problems, diabetes, depression due to drug interaction

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8
Q

what is carbonic anhydrase inhibitors and its e.g

A

Reduces aqueous secretion
Usually used in combination with other anti-glaucoma drugs

E.g.
Dorzolamide (Trusopt)
Acetazolamide (Diamox)
Oral

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9
Q

what is the side effect of CAI

A

Burning sensation
Bitter taste
Redness

Oral medication:
Depression
Weight loss
Kidney stones
Tingling sensation

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10
Q

what is prostalglandin and its e.g

A

increasing uveoscleral outflow
Originally discovered in the eye as chemical mediators of inflammation
However, it was later discovered that appropriate doses of PGs can lower IOP

E.g.
Latanoprost (Xalatan)
Travoprost (Travatan)
Bimatoprost (Lumigan)

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11
Q

why prostalglandin have better compliance

A

only require 1x/day instillation

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12
Q

what is uveoscleral outflow

A

Aqueous flows through the ciliary body into the suprachoroidal space (recall :space between the sclera & choroid).

There it is drained by the venous circulation of the ciliary body, choroid and sclera.

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13
Q

what are the side effect of prostalglandin

A
  • Stinging & burning sensation
  • Eye colour change due to increased iris pigmentation
  • Lengthening of eyelashes
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14
Q

what is alpha -adrenergic agonist

A

a-Receptors consist of:
a1
a2

In the eye, a2 receptors are the predominant receptor in the iris & ciliary body.
Stimulation of a2 receptors can decrease aqueous humour production.

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15
Q

e.g of alpha adrenergic

A

Apraclonidine (Iopidine)
Brimonidine (Alphagan)

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16
Q

what are the side effects of alpha adrenergic agonist

A

Blood shot eyes
Lid elevation
Dilated pupils
Itching

17
Q

what are hyperosmotic agent

A

Administered orally or intravenously

For people with severely high IOP

Useful in the mx of AACG
Osmotic gradient induced causes fluid to “move” from eye into blood vessels, thereby lowering the volume of fluid in the eye

Only a one time use

18
Q

what are the e.g of hyperosmotic agent

A

Intravenous Agents
More effective
E.g. Mannitol

Oral Agents
E.g. Glycerin (Osmoglyn)

19
Q

surgical technique for poag

A

trabeculoplaty - burn @ trabecular meshwork

trabeculectomy-a new drain is made in the eye so that fluid has a new escape route (through a scleral flap)

20
Q

surgical method for aacg

A

iridotomy: making a tiny hole in the iris with a laser so that fluid can drain freely

iridectomy: surgical removal of part of the iris

21
Q

future glaucoma therapy

A

need med that go beyond iop

  • neuroprotection
  • genetic therapy
    -neuroregenration