Glaucoma: MOAs

Question 1

Pilocarpine

Answer 1

Direct acting cholinergic agonist
Increase aqueous outflow

Question 2

Xalatan

Answer 2

Increase uveoscleral outflow by increasing MMP and may slightly increase TM outflow
Increase aqueous outflow

Question 3

Travatan Z

Answer 3

Increase uveoscleral outflow by increasing MMP and may slightly increase TM outflow
Increase aqueous outflow

Question 4

Lumigan

Answer 4

Increase uveoscleral outflow by increasing MMP and may slightly increase TM outflow
Increase aqueous outflow

Question 5

Zioptan

Answer 5

Increase uveoscleral outflow by increasing MMP and may slightly increase TM outflow
Increase aqueous outflow

Question 6

Vyzulta

Answer 6

Increase uveoscleral outflow by increasing MMP and may slightly increase TM outflow.
Also increases TM due to nitric oxide release
Increase aqueous outflow

Question 7

Rescula

Answer 7

Prostone
Stimulate alpha-2 receptors causing a reduction in aqueous production
Increase aqueous outflow

Question 8

Rhopressa

Answer 8

Rho Kinase Inhibitors (ROCK Inhibitors)
Causes cytoskeletal/cellular reorganization
of the TM and increases trabecular outflow.
Also has some NE inhibiting effects which slightly decreases aqueous production.
Increase aqueous outflow

Question 9

Rocklatan

Answer 9

Combination (PGA + ROCK Inhibitor)
Has PGA and ROCK inhibitor effects; increases both uveoscleral outflow and TM outflow
Increase aqueous outflow

Question 10

Timolol

Answer 10

Beta-Blockers
Beta receptor antagonists
Decrease aqueous production

Question 11

Levobunolol

Answer 11

Beta-Blockers
Beta receptor antagonists
Decrease aqueous production

Question 12

Metipranolol

Answer 12

Beta-Blockers
Beta receptor antagonists
Decrease aqueous production

Question 13

Carteolol

Answer 13

Beta-Blockers
Beta receptor antagonists
Decrease aqueous production

Question 14

Apraclonidine

Answer 14

Adrenergic Agonists
Stimulate alpha receptors, with stimulation
of alpha-2 receptors causing a reduction in aqueous production
Decrease aqueous production

Question 15

Brimonidine

Answer 15

Adrenergic Agonists
Stimulate alpha receptors, with stimulation
of alpha-2 receptors causing a reduction in aqueous production
Decrease aqueous production

Question 16

Brinzolamide

Answer 16

TOPICAL Carbonic Anhydrase Inhibitors
(CAIs)
Inhibits CA II; this action decreases bicarbonate and decreases aqueous secretion
Decrease aqueous production

Question 17

Dorzolamide

Answer 17

TOPICAL Carbonic Anhydrase Inhibitors
(CAIs)
Inhibits CA II; this action decreases bicarbonate and decreases aqueous secretion
Decrease aqueous production

Question 18

Acetazolamide

Answer 18

ORAL Carbonic Anhydrase Inhibitors
(CAIs)
Inhibits CA II; this action decreases bicarbonate and decreases aqueous secretion, but oral CAIs are mainly used for their diuretic properties and for emergent IOP situations
Decrease aqueous production

Question 19

Methazolamide

Answer 19

ORAL Carbonic Anhydrase Inhibitors
(CAIs)
Inhibits CA II; this action decreases bicarbonate and decreases aqueous secretion, but oral CAIs are mainly used for their diuretic properties and for emergent IOP situations
Decrease aqueous production

Question 20

Cosopt

Answer 20

Adrenergic Agonist & CAI Combinations
(Dorzolamide/timolol)
Combined effects of different IOP-lowering drugs
Decrease aqueous production

Question 21

Combigan

Answer 21

Adrenergic Agonist & CAI Combinations
(brimonidine/timolol)
Decrease aqueous production
Combined effects of different IOP-lowering drugs

Question 22

Simbrinza

Answer 22

Adrenergic Agonist & CAI Combinations
(Brinzolamide/Brimonidine)
Decrease aqueous production
Combined effects of different IOP-lowering drugs

Question 23

Betaxolol

Answer 23

Beta-Blockers
Decrease aqueous production
Beta1 selective receptor antagonists