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22 Cards in this Set

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List three classes of agents that decrease the formation of aqueous humor.
1. Carbonic Anhydrase Inhibitor
2. Osmotic Diuretics
3. Beta-Adrenergic Blocking Agents
corn C.O.B.
Classification/Effects of Carbonic Anhydrase Inhibitor
Agents that decrease the formation of aqueous humor.
Effects: Inhibits the action of carbonic anhydrase, reduces aqueous humor produced thereby reduces intraocular pressure.
Usage of Carbonic Anhydrase Inhibitor
1. open-angle glaucoma and
2. preoperative management of narrow-angle glaucoma.
Side Effects of Carbonic Anhydrase Inhibitor
1) Fluid and electrolyte imbalance, especially hypokalemia
2) Allergic reaction to sulfonamide antibiotic: fever, rash, hemolytic anemia and edema.
3) Neurological effects: "tingling" in the extremities and lips, mouth, or anus.
4) Long-term therapy may caused flaccid paralysis, convulsions, and wide variety of other symptoms.
Classification/Effects of Osmotic Diuretics
Agents that decrease the formation of aqueous humor.
Effects: withdraw fluid from the body thereby rapidly reduce the production of aqueous humor in the eye resulted in the reduction of intraocular pressure.
Usage of Osmotic Diuretics
1. acute attacks of narrow-angle glaucoma, or in
2. preparation for surgery of glaucoma.
**Not for chronic use**
Side Effects of Osmotic Diuretics
1) Use with extreme caution in clients with renal impairment.
2) May cause nausea, vomiting, plus
3) possibly phlebitis and thrombosis near the site of injection.
Classification/Effects of Beta-Adrenergic Blocking Agents
Agents that decrease the formation of aqueous humor.
Effects: when applied topically, these drugs lower intraocular pressure by reducing the formation of aqueous humor.
Usage for Beta-Adrenergic Blocking Agents
Usage: Open-angle glaucoma
Do not cause blurred vision
Side effects of Beta-Adrenergic Blocking Agents
1) Interfere with the therapy of clients with bronchial asthma and congestive heart failure.
2) Ocular irritation
3) Reduced heat rate
List two classes of Agents that Increase the Outflow of Aqueous Humor
1. Direct-Acting Miotics
2. Miotics that inhibits Cholinesterase Activity
Classifications/Effects of Direct-Acting Miotics
Agents that Increase the Outflow of Aqueous Humor.
Effects: Mimic the action of acetylcholine and act to constrict pupil (miosis) and contract ciliary muscle.
Usage for Direct-Acting Miotics
1. Narrow-angle glaucoma: miosis opens the anterior chamber angles and facilitates the out flow of aqueous humor.
2. Chronic open-angle glaucoma: contraction of ciliary muscle increases the outflow by an indirect effect on the trabecular meshwork.
Side Effects Direct-Acting Miotics
1) Reduced visual acuity
2) Systemic effects such as flushing, sweating, gastric distress, diarrhea, and headache.
3) First dose may cause stinging.
Classifications/Effects of Miotics that inhibits Cholinesterase Activity
Agents that Increase the Outflow of aqueose humor.
Effects: prevent the enzymatic destruction of actylcholine within the eye by inhibiting the enzyme cholinesterase. This results in greater acetylcholine activity, the production of miosis, and contraction of the ciliary muscles.
Usage of Miotics that inhibits Cholinesterase Activity
Usage: Open-angle glaucoma clients who failed to response to other forms of drug therapy.
Side effect of Miotics that inhibits Cholinesterase Activity
1) Systemically: precipitate salivation, urinary incontinence, sweating, diarrhea, muscle weakness, and a multitude of other adverse effects.
2) Locally: stinging, burning, lacrimation, lens opacities, and ocular inflammation.
List the two classes of agent that decrease formation and increase the outflow of aqueous humor from the eye.
1. Prostagladin-Inhibiting Agents
2. Sympathomimetic Agents
Classification/ Effects of Prostagladin-Inhibiting Agents
Agents that decrease formation and increase outflow of aqueous humor.
Effects: facilitates the outflow of aqueous humor by inhibiting protaglandin synthesis, thereby increasing vascular permeability.
side effects/cautions of Prostagladin-Inhibiting Agents
1) Change color of iris
**Take off contacts**
Classification/ Effects of Sympathomimetic Agents
Agents that decrease formation and increase outflow of aqueous humor.
side effects/cautions of Sympathomimetic Agents
1) Cautions in elderly and in clients with hypertension, diabetes mellitus, hyperthyroidism, or heart disease.
2) Persons using MAO inhibitors and/or other antidepressant drugs.
3) Should only be use for Open-angle glaucoma.