Drugs for Glaucoma

Question 1

What are the 5 Beta Blockers?

Answer 1

Betaxolol
Timolol
Metipranolol
Levobunolol
Carteolol

Question 2

What are the 5 Beta Blockers?

Answer 2

Betaxolol
Timolol
Metipranolol
Levobunolol
Carteolol

Question 3

What are the 2 Alpha2 Agonists?

Answer 3

Apraclonidine

Brimonidine

Question 4

What are the 2 Alpha2 Agonists?

Answer 4

Apraclonidine

Brimonidine

Question 5

What are the 3 Prostaglandin Analogs?

Answer 5

Latanoprost
Bimatoprost
Travoprost

Question 6

What are the 3 Prostaglandin Analogs?

Answer 6

Latanoprost
Bimatoprost
Travoprost

Question 7

What are the 2 Topical Carbonic Anhydrase Inhibitors?

Answer 7

Brinzolamide

Dorzolamide

Question 8

What are the 2 Topical Carbonic Anhydrase Inhibitors?

Answer 8

Brinzolamide

Dorzolamide

Question 9

What are the 2 Systemic Carbonic Anhydrase Inhibitors?

Answer 9

Acetozolamide

Methazolamide

Question 10

What are the 2 Systemic Carbonic Anhydrase Inhibitors?

Answer 10

Acetozolamide

Methazolamide

Question 11

What are the 2 Cholinergic Agonists?

Answer 11

Carbachol

Pilocarpine

Question 12

What are the 2 Cholinergic Agonists?

Answer 12

Carbachol

Pilocarpine

Question 13

What is the Cholinesterase Inhibitor?

Answer 13

Echothiophate

Question 14

What is the Cholinesterase Inhibitor?

Answer 14

Echothiophate

Question 15

What is the job of the Iris Circular muscle and through what receptor does it work?

Answer 15

(+) M3

- Miosis (pupil constriction) = improves outflow of aqueous humor

Question 16

What is the job of the Iris Radial muscle and through what receptor does it work?

Answer 16

(+) Alpha1

- Mydriasis (pupil dilation) = decreased aqueous outflow

Question 17

What is the Ciliary muscle in charge of doing and through what receptor?

Answer 17

(+) M3

Accommodation of the eye to near vision = improves aqueous outflow

Question 18

What is the job of the Ciliary Epithelium?

Answer 18

Produce Aqueous Humor

Question 19

What receptor for the Ciliary Epithelium will increase aqueous production?

Answer 19

(+) Beta

Question 20

What receptor for the Ciliary Epithelium will decrease aqueous production?

Answer 20

(+) Alpha2

Question 21

(+) the Beta receptor at the Ciliary epithelium will do what?

Answer 21

Increase aqueous production

Question 22

(+) Alpha2 receptor at the Ciliary epithelium will do what?

Answer 22

Decrease aqueous production

Question 23

What is the role of Carbonic Anhydrase?

Answer 23

• Increases Na+ and Bicarbonate in the Aqueous humor
• This will increase the osmotic pressure
• Thus, drawing in more water and increasing the volume of aqueous fluid

Question 24

What classes of drugs DECREASE aqueous humor production?

Answer 24

Beta blockers
Alpha 2 Agonists
Carbonic Anhydrase (-)s

Question 25

What classes of drugs DECREASE aqueous humor production?

Answer 25

Beta blockers Alpha2 Agonists Carbonic Anhydrase (-)'s

Question 26

What classes of drugs INCREASE aqueous humor OUTFLOW?

Answer 26

Prostaglandin Analogs Alpha2 Agonists Cholinergic Agonists Cholinesterase (-)'s

Question 27

What classes of drugs INCREASE aqueous humor OUTFLOW?

Answer 27

Prostaglandin Analogs Alpha2 Agonists Cholinergic Agonists Cholinesterase (-)'s

Question 28

What are some adverse effects of the Systemic Carbonic Anhydrase (-)'s?

Answer 28

Paresthesias Renal stones Decreased libido

Question 29

What are some adverse effects to the cornea/conjunctiva with Prostaglandin Analogs?

Answer 29

Corneal erosions | Conjunctiva hyperemia

Question 30

Prostaglandin Analogs can cause irreversible hyperpigmentation of the ____ and reversible hyperpigmentation of the _____

Answer 30

Irreversible IRIS hyperpigmentation | Reversible eyelash/eyelid hyperpigmentation

Question 31

Cholinergic Agonists and Cholinesterase (-)'s increase aqueous humor outflow by activating what receptor?

Answer 31

(+) M3 directly or indirectly

Question 32

After long term use of cholinergic agonists/cholinesterase (-)'s, what are some possible adverse effects?

Answer 32

Cataracts | Iris-lens adhesions

Question 33

Miosis (diminished night vision), myopia and eyelid twitching are adverse effects for which class of drugs?

Answer 33

Cholinergic Agonists/Cholinesterase (-)'s

Question 34

What is the best beta blocker to use and why?

Answer 34

Timolol | - lacks anesthetic effects

Question 35

Which Alpha2 Agonist is better and why?

Answer 35

Brimonidine | -- Less allergic reactions/dry mouth

Question 36

Which Prostaglandin Analog is the best at lowering IOP?

Answer 36

Bimatoprost

Question 37

For Open Angle Glaucoma (most common), what agents are first line?

Answer 37

Beta blocker or Prostaglandin Analog

Question 38

For Open Angle Glaucoma, if the first line agents cannot be used, what should be used?

Answer 38

Brimonidine or topical carbonic anhydrase (-)'s

Question 39

What is the goal of treatment for Closed Angle Glaucoma?

Answer 39

Rapid decrease of IOP

Question 40

What are 2 diuretics and 1 other drug that are used to treat Closed Angle Glaucoma?

Answer 40

1. Oral Glycerin 2. IV Mannitol Other agent = Pilocarpine