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IOS 9 Exam 2
Glaucoma
| Question | Answer |
|---|---|
| Ocular HTN treatment study Primary risk factors for Primary Open angle glaucoma | Age, Cup/disc ratio, elevated IOP, thin cornea |
| Primary Open angle glaucoma goals | Prevent loss of visual sensitivity and field, reduce IOP (15030%) and prevent optic disc changes |
| MOA of B-Blockers (Blue& yellow) | Decrease aqueous humor production |
| B-Blocker side effects | Buring, dry eyes, systemic effects(HR, BP, bronchospasms, drowness) USE: NLO to decrease SE |
| B-Blockers Caution In: | COPD, asthma, bradycardia, heart block, CHF, DM, and oral BB's |
| Betaxolol | B1 selective great for COPD patients but more burning and stinging |
| Timolol | Contains a gel solution and is oldest and most prescribed |
| Prostaglandin analoges | Latanoprost, Unoprostone, Travprost, Bimatoprost |
| Prostaglandin (teal) MOA | Increase uveoscleral outflow |
| Latanoprost | Only prostaglandin that is first line, must be refrigated given Qhs |
| Prostaglandin Side effects | Ocular hyperemia, buringg, dry eyes, increase in pigmentation or iris and eyelids, increase pigmentation and growth of eye lashes |
| Unoprostone dosing is exception | BID |
| Carbonic anhydrase inhibitors MOA (orange) | Decrease aqueous humor production via blocking secretion of Na/HCO3 from cilary body |
| Carbonic anhydrase inhibitors | Dorolamide or Brinzolamide |
| Carbonic Anhydrase inhibitor Side effects | Buring, corneal abrasions, allergic conjunctivitis, bitter taste with Dorzolamide (caution in sulfa allergy patients |
| Alpha 2 agonist MOA (purple) | Decrease aqueous humor production and increase uveoscleral outflow |
| Alpha 2 agonist are: | Brimonidine or Apraclonidine (BID-TID) |
| Combination treatment for glaucoma | Dorzolamide/timolol (CAI/BB) |
| Parasympathomimetics/Miotics (constriction)MOA Pilocarpine and carbachol | Cholinergics that increase aqueous outflow via aqueous humor trabecular |
| Pilopcarpine used | Acute procedures |
| Sympathomimetics MOA-epinephrine and depivefrin | Decrease Acute aqueous humor production followed by increase in outflow |
| Epinephrine side effects | Mydriasis (dialation) pigment deposition in cornea and contact lens treat (ACOG) |
| Treatment if ocular HTN and risks | Treat with target IOP (20-30%) Goal if high baseline<21-22 or Goal if low baseline <10-12mmHg |
| Start management | Initiate therapy in 1 eye to access efficacy and tolerability, BB or prostaglandin 1st line |
| Monitor-follow-up | Check IOP 2-4 weeks after starting treatment, then every 1-6 months, and visual field every 3-12 months |
| Drug induced glaucoma:drugs | All Corticosteroids (POAG), opthalamic anticholinergics (Both), Topical sumpathomimetics (ACAG), systemic anticholinergics, antidepressants, antispasmodics (ACAG) |
| Nasolacrimal occlusion | After administration close eye lid for 2-3 minutes. Seperate drugs by ate least 5-10 minutes to allow complete absorption |
Created by:
liza001
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