Glaucoma Medications
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3 options Choice for glaucoma
Medication Surgery Laser
7 types of anti glaucoma medications
ABCCHPR 1.Adrenergic 2.Beta Blocker 3.CAI 4.Cholinergic 5.Hyperosmotic 6.Prostaglandin 7.ROCK
3 Common Preservative in Glaucoma Medications
• BAK • Purite • Sofzia
Glaucoma medications contain BAK
ALTXC Alphagan Lumigan Timoptix Trusopt Xalatan Cosopt Combigan
Glaucoma med contain Purite
Alphagan P
SofZia
Travatan Z
4 Mechanism Pathway for anti glaucoma
1.Trabecular Outflow 2.Episcleral Venous Pressure 3.Uveoscleral Outflow 4.Aqueous Humor Outflow
Adrenegic Agonist Beta Blocker CAI Mechanism of Action ?
1.Aqueous Humor inflow
Example of Non selective Adrenergic Agonis ( Alpha and Beta )
Dipivefrin Epinephrine
Example of Selective Alpha 2 Agonist
Apraclonodine Brimonidine Alphagan Alphagan P
IOP Percent of Non selective Alpha Peak and washout
15-20 % peak 12-24 Washout 7-14 days
IOP Percent of Alpha 2 , Peak , and Washout
20-30 % Peak 1-2 hrs Washout 7-14 days
Side effects of Non selective Adrenergic Agonist
Adrenochrome deposit Follicular Conjunctivitis
Side effects of selective Adrenergic agonist
Follicular Conjunctivitis
Alphagan IOP Decrease Peak and Washout
20-30 % , Peak 2 hrs Washout 7-14 days
Alphagan most important systemic side effects
Depression
Different of Alphagan and Alphagan P
Less Severe side effect
Non Selective Beta Adrenergic Drug agonist example
Timolol Cartelol Levobunolol Metipranolol
Selective Beta Adrenergic Drug
Betaxolol
Non Selective Beta Adrenergic antagonist side effect both local and systemic
Local - blurred vision - Irritate - Punctate keratitis Systemic - Bronchospasm - MG exarcebation
Non Selective Beta Adrenergic antagonist IOP Decrease
20-30 % Peak 2-3 hrs Washout 1 month
Example of CAI ?
1.Brinzolamide 2.Dorzolamide
CAI IOP peak and Washout
IOP 20% Peak 2-3 hrs Washout 48 hrs
Local and Statemic side effects of CAI
Local - Induced myopia + Blurred Vision Systemic - Bitter taste