Open Angle Glaucoma Treatment Flashcards Preview

Neuro II Final > Open Angle Glaucoma Treatment > Flashcards

Flashcards in Open Angle Glaucoma Treatment Deck (11):
1

First line agents

Prostaglandin analogues

B-blockers (timolol preferred)

Brimonidine

2

Second line therapy

Pilocarpine

Apraclonidine

Topical carbonic anhydrase inhibitors

3

Last line of therapy

Carbachol

Inhibitors of cholinesterase

Oral carbonic anhydrase inhibitors

4

Why Timolol favored?

Lacks local anesthetic effect unlike propranolol.

Available as generic, full antagonist

5

Prostaglandin analogs

Latanoprost

Bimatoprost- most effective in lowering BP

Travoprost

6

Why give prostaglandin analogs first?

More effectively reduce IOP than B-blocker

Systemic side effects not significant

7

Alpha2-Agonists

Brimodine- first line

Apraclonidine- frequent allergic rxns occur

Decrease rate aqueous humor production

8

Algorithm for pharmacotherapy of open angle glaucoma

B-blocker

Intolerance, use alternative 1st line

Contraindication to B-blocker, alternative 1st line

Contraindication to 1st line->topical carbonic anhydrase inhibitors

Mono therapy fails-> use combo

Intolerance to all-> laser/surgical procedure

9

Contraindications

Corticosteroids

Fenoldopam

Topical antimuscarinic drugs

Succinylcholine

10

Inhibitors of cholinesterase

Demecarium

Echothiophate

11

Muscarinic Agonists

Carbachol

Pilocarpine