Pharmacotherapy of Open angle and Angle closure glaucoma Rollno. 169-174.pptx

Pharmacotherapy of Open angle and Angle closure glaucoma Rollno. 169-174.pptx

1. Pharmacotherapy of Open angle & Angle closure glaucoma Introduction about disease Clinical features Drug therapy : Drug of choice & its Rationale Roll Number: 169-174

2. Definition and Types of Glaucoma: A group of diseases characterized by progressive optic nerve damage resulting in vision loss. Types of Glaucoma : Open-angle (chronic) Angle-closure (acute) are the two main types, each with distinct pathophysiological mechanisms and clinical presentations Importance of Optic Nerve Health in Vision : The optic nerve transmits visual information from the eye to the brain, and damage to the optic nerve leads to irreversible vision loss.

3. Open Angle Glaucoma Definition and Characteristics : Open-angle glaucoma is characterized by a gradual loss of trabecular meshwork function, leading to increased resistance to aqueous humor outflow and elevated IOP. Pharmacological Interventions : Various classes of ocular hypotensive drugs are used to lower IOP and prevent further optic nerve damage. Example Drugs : β blockers (Timolol, Betaxolol)

4. Angle closure glaucoma It occurs in individuals with a narrow iridocorneal angle and shallow anterior chamber. The IOP remains normal until an attack is precipitated, usually by mydriasis. The IOP rises rapidly to very high values (40–60 mmHg). It is an emergent condition with marked congestion of eyes and severe headache. Failure to lower IOP quickly may result in loss of sight. Drugs are used only to terminate the attack of angle closure glaucoma. Definitive treatment is surgical or laser iridotomy

5. Pathophysiology of Glaucoma Progressive Optic Nerve Damage : Elevated intraocular pressure (IOP) is a major risk factor for glaucoma, leading to compression and damage of the optic nerve fibers. Role of Intraocular Pressure (IOP) : IOP is determined by the balance between aqueous humor production and outflow. Elevated IOP increases the risk of optic nerve damage. Unknown Etiology and Risk Factors : While elevated IOP is a major risk factor, other factors such as genetics, age, race, and family history also play a role in the development of glaucoma.

6. Therapeutic Measures for Glaucoma Lowering Intraocular Pressure (IOP) : The primary goal of glaucoma treatment is to reduce IOP to prevent or slow down the progression of optic nerve damage. Aqueous Humor Secretion and Drainage : Therapeutic measures aim to either decrease the production of aqueous humor or improve its drainage to reduce IOP.

7. Pharmacological Treatment Overview Goals of Glaucoma Treatment : Pharmacological interventions aim to lower IOP and preserve vision by preventing further optic nerve damage. Importance of Lowering IOP : Lowering IOP has been shown to slow down the progression of glaucoma and preserve visual function.

8. β Adrenergic Blockers Mechanism of Action: β blockers reduce aqueous humor production by blocking β-adrenergic receptors in the ciliary epithelium, thereby decreasing the formation of aqueous humor. Examples : Timolol and Betaxolol Efficacy and Side Effects : β blockers are effective in lowering IOP but may cause ocular side effects such as burning, stinging, and systemic side effects like bradycardia and bronchospasm.

9. α Adrenergic Agonists Mechanism of Action: α agonists lower IOP by increasing uveoscleral outflow and reducing aqueous humor production. Examples : Dipivefrine, Apraclonidine, and Brimonidine Side Effects and Usage: α agonists may cause ocular side effects such as burning, stinging, and systemic side effects like dry mouth and sedation.

10. Prostaglandin Analogues Mechanism of Action: Prostaglandin analogues increase uveoscleral outflow, leading to a reduction in IOP. Examples: Latanoprost, Travoprost, and Bimatoprost Side Effects and Usage: Prostaglandin analogues may cause ocular side effects such as redness, itching, and darkening of the iris.

11. Carbonic Anhydrase Inhibitors Mechanism of Action: Carbonic anhydrase inhibitors reduce aqueous humor production by inhibiting the enzyme carbonic anhydrase. Examples: Acetazolamide, Dorzolamide, and Brinzolamide Side Effects and Usage: Carbonic anhydrase inhibitors may cause systemic side effects such as tingling in the fingers and toes, and kidney stones.

12. Miotics Role in Glaucoma Treatment: Miotics increase outflow through the trabecular meshwork by constricting the pupil. Examples: Pilocarpine Side Effects and Usage: Miotics may cause ocular side effects such as blurred vision, headache, and systemic side effects like sweating and salivation.

13. Combination Therapy Rationale for Using Multiple Drugs: Combination therapy is often used to achieve target IOP and minimize side effects. Examples of Combination Therapies: Combining drugs from different classes such as prostaglandin analogues and β blockers or α agonists and carbonic anhydrase inhibitors.

14. Conclusion Summary of Key Points: Glaucoma is a progressive optic nerve disease characterized by elevated IOP, and lowering IOP is crucial for preserving vision. Importance of Early Detection and Treatment: Regular eye exams and early intervention are essential for preventing vision loss in glaucoma.