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Therapeutics 2 > opthamology > Flashcards

opthamology Flashcards

1
Q

open angle glaucoma

A

drainage canal is obstructed

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2
Q

closed angle glaucoma

A

iris pushed against cornea by pressure

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3
Q

What drug classes reduce aqueous humor production?

A

beta blockers, carbonic anhydrase inhibitors

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4
Q

what drug classes increase aqueous humor outflow?

A

prostaglandin analogs, cholinergics, rho kinase inhibitors

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5
Q

What drug class reduces aqueous humor production and increases aqueous humor outflow???

A

alpha-2 agonists

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6
Q

what are the prostaglandin analogs?

A

bimatoprost (lumigan)(latisse), travoprost (travatan), latanoprost (xalatan), tafluprose (zioptan)

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7
Q

dosing for prostaglandin analogs

A

1 drop qhs

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8
Q

how much do prostaglandin analogs reduce IOP?

A

30%

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9
Q

warnings for prostaglandin analogs?

A

darkening of iris, eyelid, skin, and eyelashes
-increase in eyelash length and number

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10
Q

side effects of prostaglandin analogs

A

blurred vision, stinging, increases pigmentation, eyelash growth, foreign body sensation, light sensitivity

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11
Q

What are the first line treatments?

A

prostaglandin analogs, beta-blockers (kind-of alpha-2 agonists)

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12
Q

MOA beta -blockers for glaucoma

A

decrease aqueous humor production

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13
Q

MOA for prostaglandin analogs

A

increase outflow of aqueous humor

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14
Q

what are the non-selective beta blockers?

A

timolol (timoptic), carteolol, levobunolol (betagan)

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15
Q

what is the selective beta blocker

A

betaxolol (betoptic)

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16
Q

what is the dosing for the beta blockers

A

1 drop BID or daily

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17
Q

how much do beta blockers decrease IOP?

A

20-30%

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18
Q

what are the contraindications of beta-blockers

A
  • bradycardia
  • 2nd or 3rd degree heart block
  • cardiogenic shock
  • uncompensated cardiac failure
  • bronchospastic disease
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19
Q

side effects of beta blockers

A
  • stinging
  • blurred vision
  • bradycardia
  • breathing issues
  • hypotension
  • dizziness
  • fatigue
  • impotence
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20
Q

alpha-2 agonist MOA

A

increase aqueous humor outflow and reduce aqueous humor production

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21
Q

what are the alpha 2 agonists?

A

brimonidine (alphagan P (lumify)
aprachlonidine (Iopidine)

22
Q

alpha-2 agonist dosing

A

1 drop tid

23
Q

how much do alpha-2 agonists reduce intraocular pressure?

A

25%

24
Q

warnings for alpha-2`

A

cns depression

25
Q

side effects of alpha 2

A
  • dry mouth
  • dry eyes
  • blurry vision
  • conjunctival hyperemia
  • sedation
  • confusion
26
Q

carbonic anhydrase inhibitors MOA

A

reduce aqueous humor production

27
Q

what are the carbonic anhydrase inhibitors?

A
  • dorzolamide (trusopt)
  • Brinzolamide (azopt)
  • acetazolamide
  • methazolamide
28
Q

what is the dosing for ophthalmic carbonic anhydrase inhibitors?

A

1 drop tid

29
Q

what is the dosing for oral carbonic anhydrase inhibitors?

A

50 to 100mg bid to tid

29
Q

how much IOP does carbonic anhydrase inhibitors reduce?

A

15 to 20%

30
Q

contraindications for carbonic anhydrase inhibitors?

A
  • sulfonamide allergy
  • crcl <30
31
Q

carbonic anhydrase inhibitor ophthalmic SE?

A
  • burning
  • blurred vision
  • blepharitis
  • taste disturbances
32
Q

carbonic anhydrase inhibitor oral SE?

A
  • ataxia
  • confusion
  • photosensitivity
  • nausea
  • metabolic acidosis
33
Q

what is third line treatment?

A

rho kinase inhibitor

34
Q

rho kinase MOA

A

increase aqueous humor outflow

35
Q

what are the rho kinase inhibiors?

A
  • netarsudil (rhopressa)
36
Q

rho kinase dosing?

A
  • 1 drop qpm
37
Q

how much do rho kinase reduce IOP?

A

25-30%

38
Q

rho kinase SE?

A
  • burning
    -corneal disease
    conjunctival hemorrhage
  • conjunctival hyperemia
39
Q

what is the last line of treatment?

A

cholinergics

40
Q

cholinergics MOA

A

increase aqueous humor outflow

41
Q

what are the cholinergics?

A

carbachol and pilocarpine

42
Q

what is the dosing for cholinergics?

A

1-2 drops TID to QID

43
Q

contraindications for cholinergics

A
  • caution for retinal detachment an corneal abrasion
44
Q

cholinergics side effects

A
  • pupil constriction
  • corneal clouding
  • hypotension
  • bronchospasm
  • abdominal cramps
45
Q

how long should contacts stay out after applying eye drops?

A

15 minutes

46
Q

difference between open and closed angle glaucoma

A

medical emergency!!!

47
Q

signs of closed angle glaucoma?

A

severe headache, severe pain, N/V, blurred vision, halos around light, eye redness or cloudy cornea

48
Q

closed-angle glaucoma treatments

A
  • mannitol, glycerin, surgery
49
Q

mannitol (IV) dosing

A

1.5-2 g/kg/dose over 30 minutes

50
Q

glycerin (PO) dosing

A

1-2 g/kg/dose every 5 hours

51
Q

medications that increase intraocular pressure

A
  • anticholinergic medications:
  • oxybutynin, tolterodine, benztropine, scopolamine
  • chronic steroids
  • sudafed
  • topiramate
  • antidepressants

Therapeutics 2 (9 decks)

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