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Pharm2 Lect 8

Pharm2 Glaucoma

QuestionAnswer
What is the 2nd leading cause of irreversible blindness? Glaucoma.
2 types of Glaucoma 1.Open Angle (most common). 2.Narrow Angle
Aqueous humour production and movement 1.Continuously Produced in Ciliary body. 2.Secreted into eye behind lens. 3.Moves from post-Ant chambers 4.Ciliary muscles contraction, opening up the trabecular meshwork. 5.Allows Aq humour to drain out Schlem's Canal.
Which step of Aqueous humor production & movement is impaired in OPEN angle glaucoma? 1.Trabecular meshwork becomes clogged. 2.Impairs outflow of aq humour. 3.Inc amount of aq humour in eye (since it is continuously produced). 4.Inc IOP.
What drugs can be used to DECREASE aqueous humour production? Beta-Blockers: 1.Non-selective: Timolol, carteolol, levobunolol. 2.Selective B1: Betaxolol. A2 Agonist: Brimonidine, apraclonidine. **EPI & dipivefrin also activate Alpha & Beta receptors.
How can Cholinomimetics be used to treat glaucoma? 1.cause stimulation of M3 receptor. 2.Contracts ciliary muscle. 3.Allows trabecular meshwork to open. 4.Aq humour drains, Dec IOP.
What Colinomimetics are used to treat glaucoma? 1.M agonist: Pilocarpine, Carbachol. 2.Reversible AChE Inhibitors: Physostigmine. 3.irreversible AChE Inhibitors:Echothiophate.
Why do you get blurred vision when treating glaucoma with pilocarpine but not brimonidine or betaxolol B/c M agonists will Inc outflow, but also cause rounding of the lens and pupilary constriction. **Beta blockers & A2 agonist will only Dec production.
First choice treating Glaucoma? B-Blockers.
1st and Last choice cholinomimetics for treating glaucoma (after B-blockers) 1st: Pilocarpine. Last: Echothiophate.
Marijuana's affect on IOP? Dec IOP 24%. Only lasts 3-3.5hrs. **Not topical.
What causes narrow angle glaucoma A structural narrowing of the angle b/w the iris & cornea. Iris root obstructs the trabecular meshwork drainage.
When are NAG attacks worse? Pupilary Dilation. Iris root obstruction is worst.
Pressure changes during a NAG attack Go from 15mmHg to 40-60mmHg **Can cause blindness
What is used to treat NAG? Pilocarpine (M Agonist): induces miosis (constriction) which pulls iris away from trabecular meshwork and Dec IOP.
Main function of Pilocarpine in OAG? in NAG? OAG: Open up Trabecular meshwork. NAG: Move iris out of way.
Created by: WeeG
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