GLAUCOMA TREATMENT

Glaucoma Drug Therapy Purpose:

- constrict the pupil -reduce production or

increase absorption of aqueous humor

DRUGSProstaglandin agonistsAdrenergic agonistsBeta-adrenergic blockersCholinergic agonistsCarbonic anhydrase inhibitors

DRUGS: PROSTAGLANDIN AGONISTHOW DO THESE TREAT GLAUCOMA?EXAMPLES OF DRUGS:

-Latanoprost (Xalatan) -bimatoprost (Lumigan)-travoprost (Travatan): not to be used

with pregnancy

DRUGS: Adrenergic AgonistsEXAMPLES:

-brimonidine tartrate ( Alphagan): • Nursing Implications:

-cannot combine with MAOI (monoamine oxidase inhibitor)

-Can precipitate hypertensive crisis-Instill without contact lens in

DRUGS: BETA ADRENERGIC BLOCKERSEXAMPLES:

-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: CholinergicsEXAMPLES

-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 GLAUCOMAPURPOSE: to create a permanent way to drain

fluidTYPES (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 Videohttp://video.google.com/videoplay?docid=-

2504983511038511848#

POSTOP NURSING CAREClinical setting: outpatient services

Precautions: measures to prevent increased IOP

Postop complications:choroidal hemorrhage