Glaucoma

Question 1

Open-angle or Closed-angle?
obstructed drainage canal

Answer 1

open

Question 2

Open-angle or Closed-angle? pressure pushes iris against cornea

Answer 2

closed

Question 3

Open-angle or Closed-angle?
painless, happens over time

Answer 3

open

Question 4

Open-angle or Closed-angle?
leading cause of blindness for people 60 and up

Answer 4

open

Question 5

T or F: high BP is a risk factor for glaucoma

Answer 5

T

Question 6

Open-angle or Closed-angle?
patchy blind spots in peripheral vision

Answer 6

open

Question 7

Open-angle or Closed-angle?
difficulty seeing in central vision

Answer 7

open

Question 8

what is normal IOP?

Answer 8

12-20

Question 9

measuring intraocular pressure:
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy

Answer 9

c. tonometry

Question 10

Testing for optic nerve damage.
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy

Answer 10

a. opthalmoscopy

Question 11

checking for vision loss
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy

Answer 11

d. perimetry

Question 12

measuring corneal thickness
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy

Answer 12

b. pachymetry

Question 13

inspecting drainage canal
a. ophthalmoscopy
b. pachymetry
c. tonometry
d. perimetry
e. gonioscopy

Answer 13

e. gonioscopy

Question 14

what are two ways to treat open-angle?

Answer 14

• reduce aqueous humor production
• increase aqueous humor outflow

Question 15

What two medication classes reduce aqueous humor production?

Answer 15

beta blockers
carbonic anhydrase inhibitors

Question 16

what 3 medication classes increase aqueous humor outflow?

Answer 16

prostaglandin analogs
cholinergics
rho kinase inhibitors

Question 17

what medication class both reduce aq humor production and increase aq humor outflow?

Answer 17

alpha 2 agonists

Question 18

what is the first line treatment for open-angle?

Answer 18

prostaglandin analogs and beta blockers somehow

Question 19

T or F: almost half of all glaucoma patients have a normal IOP

Answer 19

T

Question 20

instead of memorizing all of the names for prostaglandin analogs, what do they all end with ?

Answer 20

-prost, and there are 5 of them

Question 21

which weird ass med is indicated for eyelash hypotrichosis

Answer 21

bimatoprost (latisse)

Question 22

by what percentage do prosta analogs reduce IOP?
a. 15
b. 30
c. 50
d. 65

Answer 22

b. 30

Question 23

what is the dosing frequency for prosta anal

Answer 23

1 drop qhs

Question 24

what are the important warnings for prosta anal

Answer 24

darkening of a lot of shit around the eye and increase in eyelash length and number

Question 25

what are some side effects of prosta anal

Answer 25

stinging blurry vision foreign body sensation more eyelashes

Question 26

what is the MOA of prosta anal

Answer 26

increase aqueous humor outflow

Question 27

what is the MOA for beta blockers

Answer 27

reduce aq humor production

Question 28

instead of memorizing all of the names for beta blockers, what do they all end with ?

Answer 28

-lol, and there are 3

Question 29

which beta blocker is selective

Answer 29

betaxolol

Question 30

by what percentage do beta blockers reduce IOP

Answer 30

20-30%

Question 31

what are some contraindications for beta-blockers?

Answer 31

sinus bradycardia, 2nd or 3rd degree heart block, cardiogenic shock, uncompensated cardiac failure, bronchospastic disease they all have to do with the heart and one random one with bronchioles

Question 32

side effects of beta blockers(6)

Answer 32

stinging blurry vision bradycardia (think heart CI) breathing probs hypotension impotence lol

Question 33

what is the common dosing frequency for beta blockers

Answer 33

1 drop daily or bid

Question 34

what is the MOA for alpha-2 agonists

Answer 34

both of the other ones together im not typing that

Question 35

what is the dosing frequency for alpha-2 agonists

Answer 35

1 drop tid

Question 36

instead of memorizing all of the names for alpha-2 agonists, what do they all end with ?

Answer 36

-nidine

Question 37

by how much do alpha 2 agonists reduce IOP?

Answer 37

25%

Question 38

what is the one and only contraindication for alpha-2 agonists?

Answer 38

CNS depression

Question 39

what are some side effects for alpha-2 agonists

Answer 39

dry eyes xerostomia blurry vision (no shit) conjunctival hyperemia sedation confusion

Question 40

what medication class is the 2nd line?

Answer 40

carbonic anhydrase inhibitors

Question 41

what is the MOA of CAIs?

Answer 41

reduce aq humor prod

Question 42

what is the dosing frequency for CAIs?

Answer 42

1 drop TID

Question 43

by what percentage do CAIs reduce IOP?

Answer 43

15-20%

Question 44

instead of memorizing all of the names for carbonic anhydrase inhibitors, what do they all end with ?

Answer 44

-zolamide

Question 45

what is the one warning for CAIs?

Answer 45

sulfonamide allergy

Question 46

which two CAI medications are oral?

Answer 46

acetazolamide and methazolamide

Question 47

what are some side effects of the opthalmic CAIs?

Answer 47

burning blurred vision blepharitis (wtf) taste disturbances

Question 48

what are some side effects of oral CAIs?

Answer 48

ataxia confusion photosensitivity nausea metabolic acidosis

Question 49

what medication class comes in 3rd in the list of lines

Answer 49

rho kinase inhibitors

Question 50

what is the MOA of rho kinase inhibitors?

Answer 50

increase aqueous humor outflow

Question 51

what is the dosing frequency for rho kinase inhibitors

Answer 51

1 drop qpm

Question 52

by what percentage do rho kinase inhibitors decrease IOP?

Answer 52

25-30%

Question 53

what is the last line for glaucoma

Answer 53

cholinergics

Question 53

what are some side effects of rho kinase inhibitors

Answer 53

burning corneal disease conjunctival hemorrhage conjunctival hyperemia damn these suck

Question 54

what is the moa of cholinergics

Answer 54

increase aq humor outflow

Question 55

there are two drugs in the cholinergic class, what are they

Answer 55

carbachol (milostat) pilocarpine (isopto carpine)

Question 56

what is the dosing frequency for cholinergics?

Answer 56

1-2 drops up to TID

Question 57

by what percentage do cholinergics reduce IOP/

Answer 57

15-25%

Question 58

contraindications of cholinergics

Answer 58

pts with history of retinal detachment or corneal abrasion

Question 59

what are some side effects of cholinergics(5)

Answer 59

pupil constriction corneal clouding hypotension bronchospasm abdominal cramps

Question 60

treatment of closed-angle (2 options)

Answer 60

hyperosmotic agents and surgery

Question 61

what are the two hyperosmotic agents used to treat closed-angle?

Answer 61

mannitol (IV) Glycerin (PO)

Question 62

what is the surgery called for treatment of closed-angle and what does it do

Answer 62

iridotomy, hole in iris

Question 63

what are 5 medications/medication types that can increase IOP?

Answer 63

anticholinergics chronic steroids decongestants (dry you out) topiramate antidepressants