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General goal of tx
decrease IOP via decreasing amount of aqueous humor (inhibit synthesis/secretion or drainage).
Epinephrine (α1 agonist)- MOA and ADE
decrease aqueous humor synthesis via vasoconstriction
Mydriasis **** do not use in closed- angle
Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritus
Mydriasis **** do not use in closed- angle
Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritus
brimonidine (α2 agonist)- MOA and ADE
decrease aqueous humor synthesis
Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritus
Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular pruritus
Timolol, betaxolol, carteolol- MOA
decrease aqueous humor synthesis
Acetazolamide- MOA and ADE
decrease aqueous humor synthesis via inhibition of
carbonic anhydrase
carbonic anhydrase
Cholinomimetics (M3)- MOA, ADE
direct: pilocarpine, carbachol
indirect: physostigmine, echothiophate
Increased outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
Miosis (contraction of pupillary sphincter muscles) and cyclospasm (contraction of ciliary muscle)
***Use pilocarpine in emergencies—very effective at opening meshwork into canal of Schlemm
indirect: physostigmine, echothiophate
Increased outflow of aqueous humor via contraction of ciliary muscle and opening of trabecular meshwork
Miosis (contraction of pupillary sphincter muscles) and cyclospasm (contraction of ciliary muscle)
***Use pilocarpine in emergencies—very effective at opening meshwork into canal of Schlemm
Bimatoprost, latanoprost (PGF2α)- MOA and ADE
increased outflow of aqueous humor via decreased resistance of flow through uveoscleral pathway
Darkens color of iris (browning), eyelash growth
Darkens color of iris (browning), eyelash growth