What drugs are used in closed-angle glaucoma?
Primary Angle-Closure Glaucoma Medication
- Miotic agents.
- Beta-adrenergic Blocker.
- Prostaglandin, ophthalmic.
- Carbonic anhydrase inhibitor.
- Alpha2-adrenergic agonist agent, ophthalmic.
- Diuretic, Osmotic.
Which drug class is contraindicated with glaucoma?
These include selective serotonin reuptake inhibitors (SSRIs) such as Prozac (fluoxetine) and Paxil (paroxetine). Tricyclic antidepressants such as Elavil (amitriptyline) and Tofranil (imipramine) may also have some anticholinergic activity and thus should be used in caution in patients with narrow angles.
What are miotic drugs used for?
Miotics (drugs that cause the pupil to contract) improve the outflow of aqueous as part of the treatment of glaucoma and reduce the risk of a posteriorly luxated lens entering the anterior chamber.
What medications should be avoided with narrow angle glaucoma?
WHAT TO AVOID IF YOU HAVE NARROW ANGLES
- Decongestants/Cold medications.
- Allergy medications.
- Anxiety and depression medications (Do NOT stop these without discussing with your doctor as this can result in withdrawal symptoms)
- Reflux/nausea medication.
- Incontinence/Overactive bladder medication.
Why are benzodiazepines contraindicated in narrow angle glaucoma?
So, why do benzodiazepines increase the risk of narrow angle glaucoma? Benzodiazepines have muscle relaxant effects. This may affect pupillae muscle, which has been the focus of recent studies.
What is mydriatic and Miotic?
More generally, mydriasis also refers to the natural dilation of pupils, for instance in low light conditions or under sympathetic stimulation. Fixed, unilateral mydriasis could be a symptom of raised intracranial pressure. The opposite, constriction of the pupil, is referred to as miosis.
Which drug should not be given in a patient with acute angle closure glaucoma?
Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective.
Why is pilocarpine contraindicated in angle closure?
In eyes with narrow angles, pilocarpine increases the angle width as the effect of reduced iris thickness and iris root pull is greater than the forward movement of the iris-lens diaphragm due to ciliary muscle contraction.
What drugs increase intraocular pressure?
Sulfa-based agents such as topiramate, acetazolamide and hydrochlorothiazide are among the few drugs that can induce “non-pupillary block” acute angle closure glaucoma. Lee et al.,25 have reported that sulfa-based drugs can cause shallowing of the anterior chamber, choroidal effusion, increased intraocular pressure.
Which medications are used in the treatment of acute angle closure glaucoma?
Sulfa-based agents. The management of sulfa drug-induced acute angle closure glaucoma involves stopping the medication and controlling the intraocular pressure with topical or systemic steroid and cycloplegics. Topical miotics should be avoided as they have the potential of causing pupillary block.
What is acute angle closure glaucoma?
Acute angle closure glaucoma is an ophthalmic emergency and can lead to blindness if left untreated. Several types of drugs have the potential to precipitate acute angle closure glaucoma.
Do alpha-adrenergic agonists precipitate acute angle closure glaucoma?
Alpha-adrenergic agonists can precipitate acute angle closure glaucoma by pupillary block due to pupil dilatation in individuals with innately narrow iridocorneal angles.
Does hydrochlorothiazide cause angle closure glaucoma?
Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective.