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41 Cards in this Set
- Front
- Back
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What are the 5 classes of glaucoma drugs?
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Prostaglandins, Beta blockers, Alpha agonists, CAI and Cholinergics
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What is the precaution with prostaglandins?
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They have a pro-inflammatory affect and caution should be exercised in the tx of pts with a history of uveitis, CME, aphakia, HSK, or a corneal graft
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What are the different prostaglandins?
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Xalatan, Travatan Z, Lumigan and Zioptan
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What is the efficacy of prostaglandins?
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25-30%
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How do prostaglandins work?
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By increasing outflow by the uveoscleral pathway
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What is the dosing of prostaglandins?
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1 gtt qhs
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What is another class of glaucoma meds that work well with prostaglandins?
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Beta blockers
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How do Beta blockers work?
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They decrease aqueous formation by blocking beta, receptors on non-pigmented ciliary epithelium
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What is the efficacy of non-selective beta blockers?
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25%
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What is the efficacy of Betopic S?
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20%
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What are the contraindications of beta blockers?
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Asthma, or COPD, significant heart disease, bradcardia, emotional depression
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What is the precaution with beta blockers?
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If the pt is taking a systemic beta blockers, the effectiveness of the topical drug may be reduced
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What is the dosing of beta blockers?
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1 gtt qd am
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What are the different types of beta blockers?
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Timoptic, Timolol, Betimol, Betagan, Optipranolol, Optipranolol, Ocupress and Betopic-S,
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What is the cardio selective beta blocker?
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Betopic-S
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What is the dosing of Betopic-S?
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1 gtt BID
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How do alpha agonists work?
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They suppress aqueous humor formation as well as increasing outflow
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What is the efficacy of alpha agonists?
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20-25%
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What are the contraindications of alpha agonists?
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Pregnancy, lactation and children
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What are some of the precautions with alpha agonists?
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They can cause fatigue, drowsiness, or decreased mental alertness
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What are the alpha agonists?
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Alphagan P and Iopidine
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What protective role has one of the alpha agonists been given?
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Alphagan P - Neuoprotective
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What are the contraindications with alpha agonists?
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MAOI's
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What is the dosing of alpha agonists?
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1 gtt BID
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What is combigan a mixture of?
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Alphagan P and timolol
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What is the drug of choice for lowering IOP immediately say in an angle closure attack?
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Iopidine
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What class of glaucoma meds can be used topically and orally?
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CAI's
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How do CAI's work?
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They inhibit bicarbonate production in the CB epithelium, reducing the formation of aqueous humor
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What is a common complaint with CAI use?
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Metallic taste
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What are the contraindications with CAI's?
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Sulfa allergy, adrenal/hepatic/respiratory or renal failure, metabolic acidosis
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What are the precautions with CAI's?
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May lead to corneal edema in an already compromised cornea or a corneal graft
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What are the topical CAI's?
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Trusopt, Azopt and Cozopt
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What is the efficacy of CAI's?
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15-20%
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What is the topical dosing of CAI's?
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1 gtt BID-TID
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What is the oral CAI?
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Diamox
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What is the dosing of diamox?
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250-mg tid
In acute angle closure 500mg |
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How do Cholinergic agonists work?
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They constrict the iris and contracts the ciliary muscle which increases outflow through the TM
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What are the contraindications with cholinergic agonists?
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Iritis/uveitis, secondary glaucomas associated with extensive outlfow obstruction and pregnancy
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What are the precautions with cholinergic agonists?
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Can potentially induce RD in pts with high myopia, aphakia, peripheral retinal degeneration, induce fluctuating blurred vision, accommodative spasms, frontal headaches
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What is the dosage of cholinergic agonists?
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1-2 gtt qid
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What are the cholinergic agonists?
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Pilocarpine and carbachol
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