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Có hiệu lực (trong việc làm giảm IOP) hoạt động trên nhiều mặt trận (giảm sản xuất, tăng dòng chảy, bảo vệ thần kinh) tác dụng phụ tối thiểu thuận tiện liều lượng tương đối rẻ tiền | TOPIC 1 o MEDICAL TREATMENT OF GLAUCOMA Overall yield Clinical exam Viva Essay MCQ. s What is the ideal drug for glaucoma The ideal drug carries certain characteristics . Ideal drug 1. Effective in lowering IOP 2. Active on multiple fronts decrease production increase outflow neuroprotective 3. Minimal side effects 4. Convenient dosage 5. Relatively inexpensive ÊŨExam tips This is a good approach to most What is the ideal steroid for uveitis or What is the ideal antibiotic for endophthalmitis What are the current drugs available for treatment of glaucoma Current drugs available can be classified according to their effectiveness in lowering IOP. Effectiveness in lowering IOP Examples Class I 30 reduction in IOP Beta blockers Latanoprost Alpha 2 agonist brimonidine Unoprostone Class II 20 Pilocarpine Dorzolamide Alpha agonist apraclonidine Beta 1 blockers betoptic Class III 10 Propine Other older alpha agonists OExam tips One of the most important pharmacological questions in the examinations. Classify according to IOP effect mode of action difficult or traditional versus new drugs. 74 Section 2 Glaucoma and Glaucoma Surgery 75 s What are the traditional drugs for treatment of glaucoma 3 Exam tips The side effects of adrenaline can be remembered by A Traditional drugs Drug Pharmacodynamics Effectiveness advantages Side effects Beta blockers timolol Decrease aqueous production Twice daily dosage T1 2 12 hours Class 1 prototype 30 drop in IOP in 80-90 of patients e.g. 24 to 16mmHg Mild local side effects decrease corneal sensation allergic reaction cicatricial conjunctivitis Concentration 0.25 and 0.5 Good compliance Additive effects with pilocarpine but not with sympathetic agents Cheap Severe systemic side effects pulmonary bronchospasm bradycardia hypoglycemia Common systemic side effects lethargy decreased libido depression Miotics pilocarpine Increase aqueous drainage miosis with opening of angle and contraction of longitudinal fibers of ciliary body Four times .
