- carbonic anhydrase inhibitor
- prophylaxis/treatment of altitude sickness, glaucoma
- reduction of intraocular pressure, reduction in aqueous humor production
brimonidine (apraclonidine, clonidine)
- alpha2 adregneric agonist
- open-angle glaucoma, ocular HTN
- reduces aqueous humor production and uveoscleral outflow w/o mydriasis
- SE: xerostomia (dry mouth), blurred vision, occular irritation
- carbonic anhydrase inhibitor (CA-II): selective control of aqueous humor production and IOP
- F2alpha prostagladin agonist
- treats elevated IOP
- prodrug, topical
- increased uveoscleral outflow
- SE: increases amount of brown pigment, burning/stinging, blurred vision
- parenteral osmotic diuretic, emergency reduction in IOP
- SE: pulmonary congestion, fluid/electrolyte imbalance, acidosis, dry mouth, urinary retention, edema
- nonselective beta-adrenergic antagonist
- reduces aqueous humor production by preventing Na+ from entering into aqueous humor
- SE: none?
Sympathetic innervation of eye
- dilator pupillae: mydriasis
- via superior cervical ganglion/internal carotid
- sphincter pupillae: miosis
- ciliary body: accomodation
- via oculomotor nerve/ciliary ganglion
What effect will an alpha1 agonist have on the eye?
- (no loss of accomodation/cycloplegia)
What effect will a muscarinic antagonist have on the eye?
- blocks contraction of ciliary body, preventing accomodation
- blocks contraction of the sphincter pupillae, causing mydriasis
- therefore, if loss of accomodation, mydriasis must be present!
- obstruction of aqueous drainage
- incr. of intraocular pressure can damage the optic nerve
- "cup" becomes larger
- only treatment of this is reduction of IOP
What classes of drugs increase aqueous humor outflow?
- parasympathomimetics (trabecular network)
- prostagladin agonists (uveoscleral outflow)
What classes of drugs decrease aqueous humor secretion?
- beta blockers
- alpha2 adrenergic agonists
- carbonic anhydrase inhibitors
What is the "angle"?
between iris and cornea