eye: glaucoma pt 2

alpha-2 adrenergic agonist: medication

brimonidine (0.15 / 0.2%)

what is the MOA for brimonidine? (3)

1. selectively binds to alpha-2 receptors in the eye

2. initially reducing aqueous humor production

3. overtime main effect by increasing uveoscleral flow of aqueous humor

alpha-2 adrenergic agonist: common local side effects (3)

1. eye redness

2. blurred vision

3. ocular irritation

alpha-2 adrenergic agonist: common systemic side effects

feeling tired or weak

alpha-2 adrenergic agonist: drug interaction

monoamine oxidase (MAO) inhibitor

alpha-2 adrenergic agonist: storage condition ; unopened

stored below 25 degree celsius

alpha-2 adrenergic agonist: storage condition ; opened

stored at room temperature up to 25 degree celsius for 4 weeks

carbonic anhydrase inhibitors: medication

brinzolamide (0.1%)

what is the MOA of brinzolamide? (2)

1. inhibits carbonic anhydrase in the ciliary processes of the eye

2. hence decreasing aqueous humor

carbonic anhydrase inhibitors: common side effects (3)

1. burning

2. stinging

3. tearing

carbonic anhydrase inhibitors: unique side effects

bitter taste in mouth

carbonic anhydrase inhibitors: contraindication

sulphur allergy

carbonic anhydrase inhibitors: storage condition ; unopened

stored at 4 to 30 degree celsius

carbonic anhydrase inhibitors: storage conditions ; opened

stored at 4 - 30 degree celsius for 4 weeks

what is the treatment algorithm?

prostaglandin analogue has the best pressure reduction of IOP

special counselling points: contact lenses

contact lenses should be removed before instillation of the eye drops and may be reinserted after 15mins

special counselling points: number of eye drops

do not use more than 1 eye drop per eye for each dose

special counselling points: storage conditions (2)

1. eye drops should not be used after opening for 4 weeks

2. write down the date you open to know when to throw away

special counselling points: sunglasses

wear sunglasses to reduce eye discomfort due to increase sensitivity to light

special counselling points: driving

avoid driving and operating machinery if vision is blurry

when to see the doctor? (3)

1. rash around eyes

2. glaucoma deteriorates or exacerbates