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Antiglaucoma drug

Antiglaucoma drug

Beta antagonist
Alpha agonist
Carbonic anhydrase inhibitors(CAI)
Prostaglandin derivatives
Combined fixed medication

Beta adrenergic antagonist


Beta blocker

Nonselective beta1 and beta2


antagonist
Beta1 selective antagonist

First line drug

High efficacy
minimal ocular side effect
Good compliance (bid. regimen)
Low cost

Beta adrenergic antagonist


blockade of sympathetic nerve endings in
the ciliary epithelium causing a fall in aque
ous humour production.

Beta adrenergic antagonist


Nonselective beta1 and beta2
antagonist
Timolol maleate (0.25-0.5%)
Levobunolol (0.5%)
Carteolol (1-2%)

Beta1 selective antagonist


Betaxolol (0.25-0.5%)

Timolol maleate (0.25-0.5%) bid.


Levobunolol (0.5%) od.
Non selective beta antagonist; 2 >
1
Decrease IOP 25-30% from baseline
Side effect: bronchospasm
(avoidance with asthma and COPD p
atient)

Carteolol (1-2%)
Non selective beta antagonist
Intrinsic sympathetic activity
Decrease IOP as the same Timolol
SE: mild irritation , local anesthetic
effect, bradycardia, bronchospasm, d
yslipidemia

Betaxolol (0.25-0.5%)
Selective beta1 antagonist
Decrease IOP 20% from baseline
Calcium chanel blocking like action,
benefit for glaucoma patient with circ
ulatory problem at optic nerve head

Beta adrenergic antagonist

http://www.reviewofophthalmology.com/content/d/glaucoma_management/i/1226/c/

Prostaglandin derivatives
Reducing intraocular pressure in
people who have open-angle glauco
ma.
Increasing the uveoscleral outflow
Remodel ECM of ciliary muscle and
reduce collagen which increase inter
muscular space

Prostaglandin derivatives
Compan
y
Alcon,
Inc.
Allergan
Inc.

Brand
Name
Travatan
Z
Lumigan

Merck &
Co.

ZIOPTAN

Pfizer
Inc.

Xalatan

Generic Name
Travaprost 0.004%
Bimatoprost 0.01%,
0.03%
Tafluprost
ophthalmic solution
0.0015%
Latanoprost 0.005%

Prostaglandin derivatives
Clinical efficacy

Decrease IOP 25-30% from baseline


Prostaglindin once daily more efficacy
than 0.5%timolol bid
more reduction IOP than 2 agonist , 2%
pilocaprine, dipivefrin and topical CAI

Prostaglandin derivatives

Side effect

Ocular side effect;

increase brown pigment in iris


Conjunctival hyperemia
Change in eye lash growth
Periocular hair growth
periorbital skin discoloration
Possibility of cystoid macular edema and
uveitis

systemic side effect;

Migraine headaches
Gastrointestinal effects

Combined medications
An alternative for patients who need more
than one type of medication.
In addition to the convenience of using one
eye drop bottle instead of two
Cosopt is a combination of a beta blocker
(timolol) and a carbonic anhydrase inhibitor
(Trusopt).
Combigan is new and combines an alpha
agonist (brimonidine) with a beta blocker
(timolol).

Trade name
Timpilo
Cosopt
Azarga
Xalacom
Ganfort
Duotrav
Combigan

Generic name
Timolol + Pilocapine
Timolol +
Dorsolamine
Timolol +
Brinzolamide
Timolol + Latanoprost
Timolol +
Bimatoprost
Timolol + Travoprost
Timolol +