Lec. 8: Medical Therapy 2 (Rhokinase inhibitor & Carbonic anhydrase inhibitors)

What is the mechanism of action of rhokinase inhibitor netarsudil?

ALL

What is the on-label dose of netarsudil? 

Once daily at bed time

Compared to latanoprost how different is the IOP lowering efficacy of netarsudil?

Approx 1 mmHg

Fixed combination dose of latanoprost and netarsudil is called?

Rocklatan

What are the main side effects of netarsudil? 

1. Conjunctival hyperemia

2. Cornea verticillata

3. Conjunctival hemorrhages

4. Excessive tearing (epiphora)

Explain mechanism of action of carbonic anhydrase inhibitor?

Causes reduction of bicarbonate ions in posterior chamber which prevents Na+ and H2O from leaving 

What is the maximum allowed dose of acetazolamide per day?

250mg QID  (1000 mg)

What is the maximum allowed dose of methazolamide per day?

150 mg BID (300 mg)

Which drug is not allowed in individuals with sulfa drug allergies?

Carbonic anhydrase inhibitors 

Which drug is not allowed in individuals with low endothelial cell count?

Carbonic anhydrase inhibitors 

Name topical carbonic anhydrase inhibitors?

Dorzolamide and brinzolamide 

What is the usual dose of carbonic anhydrase inhibitors?

BID or TID

Name the fixed combination agent of carbonic anhydrase inhibitor and brimonidine?

Simbrinza

Dorzolamide and timolol combination is given how many times on label?

Cosopt → BID

Name the injectable bimatoprost slow release agent?

Durysta

What is the amount of bimatoprost that is injected with Durasta?

10 ug

How many times can you use durasta?

Once in lifetime

What is the reason Durasta is only allowed once?

Endothelial cell loss

What is not a known contraindication of carbonic anhydrase inhibitors?

PABA Allergy

What are known side effects of carbonic anhydrase inhibitors?

KNOW ALL YOU FOOL!!! 🙂