Glaucoma

Question 1

Prostaglandin analogues examples

Answer 1

latanoprost, travoprost, bimatoprost

Question 2

Prostaglandin analogues MOA

Answer 2

*Pro-drug –> activated to free acid agonist at prostaglandin F receptor
promotes uveoscleral outflow by increasing the sclera’s permeability to aqueous humour

Question 3

Prostaglandin analogues S/E and CI

Answer 3

S/E

• peri-orbital rash
• conjunctival hyperaemia
• eye irritation
• blurred vision
• iris hyperpigmentation
• eyelash changes

CI

• inflammation of the eye – iritis, uveitis, herpetic keratitis
• pregnancy

Question 4

Topical beta-blockers examples

Answer 4

timolol, cartelol, betaxolol (B1 selective)

Question 5

Topical beta-blockers MOA

Answer 5

• blocks beta-receptors in the ciliary epithelium, reducing aqueous humour production

Question 6

Topical beta-blockers S/E and CI

Answer 6

S/E
* bronchospasm
* worsening of COPD
* bradycardia
* reduced libido
* depression
* blurred vision

CI
* asthma
* severe COPD
* bradycardia
* other systemic beta-blockers

Question 7

Carbonic anhydrase inhibitor example

Answer 7

brinzolamide, dorzolamide

Question 8

Carbonic anhydrase inhibitor MOA

Answer 8

• inhibits carbonic anhydrase II, interferes with sodium pump and reduces aqueous humour production

Question 9

Carbonic anhydrase inhibitor S/E and CI

Answer 9

S/E
* ocular irritation
* blurred vision
* foreign body sensation
* bitter taste

CI
* hepatic/renal failure
* metabolic acidosis

Question 10

Alpha-2 adrenergic agonists example

Answer 10

apraclonidine, brimonidine

Question 11

Alpha-2 adrenergic agonists MOA

Answer 11

• promotes the reuptake of noradrenaline, reducing sympathetic effect
• decreases production of aqueous humour and increases uveoscleral outflow
• Note: alpha-2 receptors inhibit sympathetic activity wow

Question 12

Alpha-2 adrenergic agonists S/E and CI

Answer 12

S/E

• local allergic reactions
• lid retraction
• pupil dilation
• cardiovascular effects with brimonidine (which crosses BBB)

CI

• monoamine oxidase inhibitors
• severe cardiovascular disease