Eyes

Question 1

Name topical mydriatic (dilatory) drugs which can cause drug induced angle closure (DAC):

Answer 1

Topicamide
Cylopentolate
Phenylephrine
Atropine

Question 1

Name nebulised drugs which can cause drug induced angle closure:

Answer 1

Ipatropium
Salbutamol
Ephedrine

Question 2

Name oral/ IV drugs which can cause drug induced angle closure:

Answer 2

TCA (amitriptyline etc), SSRIs (paroxetine, citalopram)
Epinephrine
Anticholinergics (e.g oxybutinin)
Atropine

Question 3

Name other drugs (very rare) which can cause drug induced angle closure:

Answer 3

Topiramate
Hydrchlorthiazide
Acetazolamide
Quinine
Tetracycline
Pilocarpine
Botox
OTC flu remedies

Question 4

What is POAG?

Answer 4

Primary open angle glaucoma- most common type of glaucoma in UK
-initially asymptomatic
-usually slowly progressive
-often presents late

Question 5

What is the value for high IOP in POAG?

Answer 5

Around more than than 30mmHg

Question 6

Name topical anti-glaucoma therapy:

Answer 6

PG analogues
BBs
Carbonic anhydrase inhibitors (CAIs)
Alpha agonists

Question 7

Name systemic SEs of PG analogues:

Answer 7

Rare:
Brittle asthma worse
Can induce possible labour

Question 8

Name ocular SEs of PG analogues:

Answer 8

Common:
Lash growth
Iris pigmentation
Periocular skin darkening
Conjunctival infection (red eye)
Orbital fat atrophy
Post op cystoid macular oedema

Question 9

Name examples of PG analogues:

Answer 9

Latanoprost 0.005%
Travoprost 0.004%
Bimatoprost 0.01%
Tafluprost 0.0015%

Question 10

How do BBs work for glaucoma?

Answer 10

Decrease aq production (BD or OD)
If OD, apply drop in morning to avoid nocturnal hypotensive dips and reduced optic disc perfusion
Generally well tolerated
Good/moderate efficacy
Can get non-selective or cardio selective
All P or PF

Question 11

What are the SEs of topical BBs?

Answer 11

Asthma/ breathlessness
Bradycardia
Tiredness
Depression
ED
Hypotension
Angina

Question 12

Name examples of topical BBs:

Answer 12

Timolol (0.1,0.25,0.5%)
Levobunolol 0.5%
Betaxolol (0.25, 0.5%)
Carteolol

Question 13

What are the CI of CAIs?

Answer 13

Sulphonamide sensitivity

Question 14

Name examples of CAIs:

Answer 14

Dorzolamide 2%
Brinzolamide 10mg/ml
Acetazolamide- not recommended for long term, not an eye drop

Question 15

Name examples of alpha agonists:

Answer 15

Brimonidine 0.2% BD
Apraclonidine 0.5, 1% BD

Question 16

What are the interactions with alpha agonists?

Answer 16

Avoid concomitant use of antidepressants (MAOIs and TCA)