Eye meds

Question 1

Timolol (nonselective) and Betaxolol (cardioselective): beta adrenergic blockers

Answer 1

-primary open angle glaucoma (POAG) med
-MOA: decrease intraocular pressure (IOP) by decreasing amount of aqueous humor produced
-uses: primarily used for POAG, sometimes emergency use for PCAG (closed glaucoma)
complications: Stinging discomfort, blurred vision, conjunctivitis, photophobia, dry eyes, systemic effects if excessive dosing

-caution in chronic resp disease or heart conditions (bradycardia, heart block)
-admin: proper drop instillation, gentle pressure on lacrimal gland for 30-60 secs, monitor pulse rate/rhythm prn

Question 2

Brimonidine: alpha adrenergic agonist

Answer 2

-POAG med
-MOA: decrease production while increasing outflow of aqueous humor to lower IOP
-use: primarily for POAG, 1st line and long-term use
-complications: Stinging discomfort, pruritic, dilated pupils, blurred vision, HA, dry mouth, reddened sclera, hypotension, drowsiness

-caution in pts with soft contact lenses, admin w/out and wait 15 mins
-admin: proper instillation, monitor BP

Question 3

Latanoprost: prostaglandin analogs

Answer 3

-POAG med
-MOA: reduces IOP by increasing aqueous outflow through relaxation of ciliary muscle
-use: 1st line med for POAG and ocular HTN
-complications: Bulging of ocular blood vessels, increased pigmentation, stinging, burning, red conjunctiva, blurred vision, migraine

-admin: proper instillation, don’t rub eyes, report migraines and blurred vision

Question 4

Pilocarpine: direct acting cholinergic (muscarinic) agonist

Answer 4

-2nd line topicals for POAG
-complications: retinal detachment, parasympathetic effects, blurry vision, bronchospasm, hypotension

Question 5

Dorzolamide: carbonic anhydrase inhibitor

Answer 5

-2nd line topicals for POAG
-complications: localized allergic reactions, blurry vision, dryness, photophobia, stinging, conjunctivitis, lid reaction, bitter taste
-The systemic version is Acetazolamide and has worse systemic complications

Question 6

Mannitol: osmotic agent

Answer 6

-PCAG med
-MOA: decrease IOP by making plasma hypertonic, draws fluid in anterior chamber of eye
-use: Treat closed-angle glaucoma to prevent blindness
-complication: HA, N/V, edema, fluid/electrolyte imbalance