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GLAUCOMA TREATMENT
Glaucoma Drug Therapy
 Purpose:
- constrict the pupil
-reduce production or
increase absorption of aqueous humor
 DRUGS
 Prostaglandin agonists
 Adrenergic agonists
 Beta-adrenergic blockers
 Cholinergic agonists
 Carbonic anhydrase inhibitors
DRUGS: PROSTAGLANDIN AGONIST
HOW DO THESE TREAT GLAUCOMA?
 EXAMPLES OF DRUGS:
-Latanoprost (Xalatan)
-bimatoprost (Lumigan)
-travoprost (Travatan): not to be used with
pregnancy
DRUGS: Adrenergic Agonists
EXAMPLES:
-brimonidine tartrate ( Alphagan):
• Nursing Implications:
-cannot combine with MAOI (monoamine
oxidase inhibitor)
-Can precipitate hypertensive crisis
-Instill without contact lens in
DRUGS: BETA ADRENERGIC
BLOCKERS
EXAMPLES:
-levobunolol HCl (Betagen Liquifilm)
-betaxolol HCl (Betoptic)
-timolol (Betimol, Timoptic)
Nursing Implications
-WHAT PRECAUTIONS MUST BE USED WITH
ORAL BETA BLOCKERS AND CALCIUM
CHANNEL BLOCKERS?
Drugs: Cholinergics
 EXAMPLES
-carbochol(Carboptic, Isopto Carbachol,
Miostat)
-pilocarpine(Adsorbocarpine, Piloptic,
Pilopine)
Nursing Considerations:
-can cause increase with saliva, sweating
-pupil becomes smaller (miosis)
DRUGS: CARBONIC ANHYDRASE
INHIBITORS:
EXAMPLES:
-brinzolamide (Azopt),
-dorzolamide (Trusopt)
Nursing Implications :
-check if allergic to sulfonamide
-has a diuretic effect
-don’t use with contacts
SURGERY FOR BOTH TYPES OF
GLAUCOMA
 PURPOSE: to create a permanent way to drain fluid
 TYPES (Open Angle Glaucoma)
-Laser trabeculectomy: laser burns trabecular
meshwork
-Filtering microsurgery: creates drainage hole in
iris
If patient doesn’t respond to surgery, then a shunt or
glaucoma drainage device may be implanted
Closed Angle Glaucoma: peripheral iridectomy
Glaucoma Surgical Treatment
Glaucoma Video
 http://video.google.com/videoplay?docid=-
2504983511038511848#
POSTOP NURSING CARE
 Clinical setting: outpatient services
 Precautions: measures to prevent increased IOP
 Postop complications:
choroidal hemorrhage