Glaucoma

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Author:
alvo2234
ID:
267983
Filename:
Glaucoma
Updated:
2014-03-25 22:32:27
Tags:
PT VII
Folders:
PT VII
Description:
Exam III PT VII
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  1. pharmacotherapeutic agents that increase aqueous humor outflow
    • Prostaglandin analogs
    • Cholinergics agonists
    • Epinephrine Compounds
  2. PT agents that decrease the AH production/inflow
    • BBs
    • Alpha adrenergic agonists
    • CAIs
  3. xalatan
    latanoprost
  4. travosprost
    travatan
  5. lumigan
    bimatoprost
  6. zioptan
    tafluprost
  7. how are prostaglandin analogs given
    1 gtt into eye(s) every evening
  8. percent reduction of prostaglandin analogs
    25-33% reduction
  9. how do prostaglandin analogs work
    increases uveoscleral and/or trabecular aqueous outflow
  10. side effects of PAs
    • ocular hyperemia
    • macular edema
    • conjunctival infection
    • increased eyelash growth
    • periocular hyperpigmentation
    • iris color change
    • uveitis
    • herpes virus activation
  11. contraindication/precautions for PAs
    • Hx of macular edema
    • keratitis
    • Hx of uveitis
    • complicated cataract surgery
    • herpes simplex
  12. which PA is indicated for eyelash hypotrichosis
    bimatoprost
  13. how do BBs work in glaucoma
    reduce AH production by beta receptor blockade of ciliary bodies
  14. ocular SE's of BBs
    • irritation and dry eyes
    • uveitis
    • keratitis
    • decrease corneal sensitivity
  15. timolol
    timoptic, istalol
  16. betagan
    levobunolol
  17. betoptic
    betaxolol
  18. CIs/Precautions with BBs
    • Hx of bradycardia, HB, HF, asthma, COPD
    • narrow angle glaucoma
    • choroidal detachment
  19. how are AAA effective in treating glaucoma
    they decrease aqueous production and enhance uveoscleral outflow
  20. iodipine
    apraclonidine
  21. alphagan
    brimonidine
  22. how is AAA usually dosed
    1-2 gtts TID
  23. what is the percent reduction of AAA
    20-25%
  24. which AAA has greater A2 selectivity
    brimonidine
  25. AAA can also be used in the mgmt of what
    postop increase in IOP
  26. systemic SE of AAA
    • GI discomfort
    • taste abnormalities
    • HA
    • fatigue/drowsiness
    • dry mouth
  27. ocular SE of AAA
    • lid retraction
    • conjunctival vasoconstriction
    • allergic reaction
    • foreign body sensation
    • hyperemia
    • conjunctival follicles
  28. CI/Precautions of AAA
    use within 14 days of MAOIs
  29. CI/precautions of epinephrine cmpds
    • narrow angle glaucoma
    • aphakia
  30. how do cholinergic agonists work
    stimulates parasympathetic receptors on the ciliary body to decrease resistance and increase aqueous humor outflow
  31. miostat
    carbachol
  32. when is cholinergic agonists mostly used
    angle closure glaucoma and some secondary glaucomas
  33. systemic SEs of cholinergic agonists
    • HA
    • sweating
    • vomiting and diarrhea
    • salivation
    • bradycardia
    • arrythmia
  34. ocular SE of cholinergic agonists
    • myopia
    • miosis
    • retinal detachment
  35. trusopt
    dorzolamide
  36. azopt
    brinzolamide
  37. cosopt
    timolol-dorzolamide
  38. combigan
    timolol-brimonidine
  39. simbrinza
    brimonidine-brinzolamide
  40. what are the preferred agents for open angle
    PAs or BBs
  41. what are the preferred agents for open angle if BB and PA are contraindicated
    AAA
  42. when do you assess the pt after giving them treatment for open angle
    2-4 wks
  43. after 2-4 wks and a pt has a partial response to their tx, what is the next step
    add an alternative 1st line agent
  44. after 2-4 wks and a pt has no response to their tx, what is the next step
    switch to alternative 1st line agent
  45. the pt has been assessed after 8 wks and they have a partial response, what is the next step
    add 2nd or 3rd first line agent or topical CAI
  46. the pt has been assessed after 8 wks and they have no response, what is the next step
    switch to alternative first line
  47. after 12 weeks of assessment and the pt does not have adequate response, what is the next step
    • consider cholinergic agonist
    • consider switching from topical to PO CAI

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