Treatment of Glaucoma - Chapter 18

Question 1

Glaucoma

Answer 1

A group of eye conditions that damage the optic nerve, most often due to abnormally high pressure in the eye

Question 2

Types of Glaucoma

Answer 2

• Open angle
• Angle closure
• Congenital

Question 3

Open Angle Glaucoma

Answer 3

• Most common

- Results from abnormal accumulation of aqueous humor

Question 4

Angle Closure Glaucoma

Answer 4

-When the trabecular meshwork angle is obstructed, aqueous humor drainage is impaired

Question 5

Pharmacological Treatment of Glaucoma

Answer 5

• Decrease the formation of aqueous humor

- Promote drainage of aqueous humor

Question 6

Drugs That Decrease Aqueous Humor Formation

Answer 6

• B-adrenergic antagonists
• A-adrenergic agonists
• Carbonic anhydrase inhibitors

Question 7

B-Adrenergic Antagonists

Answer 7

• Common ending: “olol”
• Decrease aqueous humor by inhibiting the action of epinephrine and norepinephrine on blood vessels in the ciliary body of the eye

Question 8

B-Adrenergic Antagonists Examples

Answer 8

• betaxolol
• levobunolol
• timolol

Question 9

Brand: Betoptic S

Answer 9

Generic: betaxolol

Question 10

Brand: Betagan

Answer 10

Generic: levobunolol

Question 11

Brand: Timoptic, Timoptic XE

Answer 11

Generic: timolol

Question 12

A-Adrenergic Agonists

Answer 12

• Reduce blood flow in the ciliary body
• Reduce formation of aqueous humor
• Increase aqueous humor outflow

Question 13

A-Adrenergic Agonists Examples

Answer 13

• brimonidine
• dipivefrin
• apraclonidine

Question 14

Brand: Alphagan, Alphagan P

Answer 14

Generic: brimonidine

Question 15

Brand: dipivefrin

Answer 15

Generic: dipivefrin

Question 16

Brand: Lopidine

Answer 16

Generic: apraclonidine

Question 17

Carbonic Anhydrase Inhibitors

Answer 17

-Common ending: “zolamide”

• Indicated for the treatment of open angle glaucoma
• Also used for short-term treatment and prevention of angle closure glaucoma

Question 18

Carbonic Anhydrase Inhibitors Examples

Answer 18

• acetazolamide
• brinzolamide
• dorzolamide
• methazolamide

Question 19

Brand: acetazolamide

Answer 19

Generic: acetazolamide

Question 20

Brand: Azopt

Answer 20

Generic: brinzolamide

Question 21

Brand: Trusopt, Trusopt PF

Answer 21

Generic: dorzolamide

Question 22

Brand: methazolamide

Answer 22

Generic: methazolamide

Question 23

Drugs That Decrease Aqueous Humor Formation Combinations Examples

Answer 23

• timolol/brimonidine
• timolol/brinzolamide
• timolol/dorzolamide
• brimonidine/brinzolamide

Question 24

Brand: Combigan

Answer 24

Generic: timolol/brimonidine

Question 25

Brand: Azarga

Answer 25

Generic: timolol/brinzolamide

Question 26

Brand: Cosopt

Answer 26

Generic: timolol/dorzolamide

Question 27

Brand: Simbrinza

Answer 27

Generic: brimonidine/brinzolamide

Question 28

Drugs That Increase Aqueous Humor Drainage

Answer 28

- A-Adrenergic agonists - Cholinergic agonists - Prostaglandin analogs

Question 29

Cholinergic Agonists

Answer 29

- Bind to receptors and mimic acetylcholine - Binding contracts the ciliary muscles and the pupil - Produce dilation of the trabecular meshwork and decrease IOP

Question 30

Cholinergic Agonists Examples

Answer 30

- carbachol | - pilocarpine

Question 31

Brand: Isopto Carbachol

Answer 31

Generic: carbachol

Question 32

Brand: Isopto Carpine

Answer 32

Generic: pilocarpine

Question 33

Prostaglandin Analogs

Answer 33

-Common ending: "prost" - Relax ciliary muscles to permit drainage of aqueous humors - ADR: permanent changes in eye colour

Question 34

Prostaglandin Analogs Examples

Answer 34

- bimatoprost - latanoprost - travoprost

Question 35

Brand: Lumigan, Lumigan RC

Answer 35

Generic: bimatoprost

Question 36

Brand: Xalatan

Answer 36

Generic: latanoprost

Question 37

Brand: Travatan

Answer 37

Generic: travoprost

Question 38

Prostaglandin Analogs Combinations Examples

Answer 38

- timolol/travoprost | - timolol latanoprost

Question 39

Brand: Xalacom

Answer 39

Generic: timolol/latanoprost

Question 40

Brand: DuoTrav

Answer 40

Generic: timolol/travoprost

Question 41

Warning Labels for Glaucoma Eye Drops

Answer 41

- FOR THE EYE - DONT D/C WITHOUT MEDICAL SUPERVISION - WASH HANDS BEFORE USE - AVOID CONTAMINATION OF TIP - DISCARD DISCOLOURED SOLUTIONS - PROTECT FROM LIGHT (SOME); SHAKE WELL (SOME) - REMOVE CONTACT LENSES BEFORE USE - REFRIGERATE (latanoprost and latanoprost combinations)