Glaucoma chronic

Eke T, Carr S, Costagliola C, Mastropasqua L, Steardo L. Acute glaucoma, chronic glaucoma, and serotoninergic drugs. Br J Ophthalmol 1998 82(8) 976-8. 

Increased intraocular pressure Acute angle-closure glaucoma Chronic glaucoma... 

Atropine is contra indicated in the following disease glaucoma, chronic lung disease, unstable cardiac rhythm, reflux esophagitis (relative). 

There are hundreds of topical steroid preparations that are available for the treatment of skin diseases. In addition to their aforementioned antiinflammatory effects, topical steroids also exert their effects by vasoconstriction of the capillaries in the superficial dermis and by reduction of cellular mitosis and cell proliferation especially in the basal cell layer of the skin. In addition to the aforementioned systemic side effects, topical steroids can have adverse local effects. Chronic treatment with topical corticosteroids may increase the risk of bacterial and fungal infections. A combination steroid and antibacterial agent can be used to combat this problem. Additional local side effects that can be caused by extended use of topical steroids are epidermal atrophy, acne, glaucoma and cataracts (thus the weakest concentrations should be used in and around the eyes), pigmentation problems, hypertrichosis, allergic contact dermatitis, perioral dermatitis, and granuloma gluteale infantum (251). 

The carbonic anhydrase inhibitors are contraindicated in patients with known hypersensitivity to the dru , electrolyte imbalances, severe kidney or liver dysfunction, or anuria, and for long-term use in chronic non-congestive angle-closure glaucoma (may mask worsening glaucoma). 

Identify risk factors for the development of chronic open-angle glaucoma and acute angle-closure glaucoma. 

Since primary open-angle glaucoma is a chronic, often asymptomatic condition, the decision of when and how to treat... 

Salmon JF, Sharma T. Chronic angle-closure glaucoma. Ophthalmology 2005 112 1844. 

All of the following drugs are used topically in the treatment of chronic wide-angle glaucoma. Which of these agents reduces intraocular pressure by decreasing the formation of the aqueous humor ... 

Carbachol is a powerful cholinic ester that stimulates both muscarinic and nicotinic receptors, as well as exhibits all of the pharmacological properties of acetylcholine while in addition resulting in vasodilation, a decrease in heart rate, an increase in tone and con-tractability of smooth muscle, stimulation of salivary, ocular, and sweat glands as well as autonomic ganglia and skeletal muscle. For this reason, use of carbachol, like acetylcholine, is limited. The exception is that it is used in ophthalmological practice and post-operational intestines and bladder atony. Upon administration in the eye, the pupil constricts and the intraocular pressure is reduced. It is used for severe chronic glaucoma. Synonyms of this drag are doryl and miostat. 

Glaucoma For adjunctive treatment of chronic simple (open-angle) glaucoma and secondary glaucoma preoperatively in acute angle-closure glaucoma when delay of surgery is desired to lower intraocular pressure (lOP). 

Hypersensitivity to these agents depressed sodium or potassium serum levels marked kidney and liver disease or dysfunction suprarenal gland failure hyperchloremic acidosis adrenocortical insufficiency severe pulmonary obstruction with inability to increase alveolar ventilation since acidosis may be increased (dichlorphenamide) cirrhosis (acetazolamide, methazolamide) long-term use in chronic noncongestive angle-closure glaucoma. 

Glaucoma Management of open-angle (chronic simple) glaucoma may be used in combination with miotics, beta blockers, hyperosmotic agents, or carbonic anhydrase inhibitors. 

Glaucoma Initial therapy or as an adjunct with other antiglaucoma agents for the control of intraocular pressure (lOP) in chronic open-angle glaucoma. 

Early chronic simple glaucoma Instill a 0.03% solution just before retiring and in the morning in cases not controlled with pilocarpine. 

Advanced chronic simple glaucoma and glaucoma secondary to cataract surgery Instill 0.03% solution twice daily, as above. 

Narrow-angle glaucoma Use with caution in patients with chronic angle-closure... 

Budesonide, Oral (Entocort EC) [Anti-inflammatory> Corticosteroid] Uses Mild-mod Crohn Dz Action Steroid, anti-inflammatory Dose Adults. Initial, 9 mg PO qAM to 8 wk max maint 6 mg PO qAM taper by 3 mo avoid grapefruit juice Contra Active TB and fungal Infxn Caution [C, /-] DM, glaucoma, cataracts, HTN, CHF Disp Caps SE HA, cough, hoarseness, Candida Infxn, epistaxis Interactions T Effects W/ erythromycin, indinavir, itraconazole, ketoconazole, ritonavir, grapefruit EMS Monitor ECG and BP for signs of electrolyte disturbances and hypovolemia OD Acute OD unlikely to cause a problem, chronic OD can reduce natural production of certain steroids symptomatic and supportive... 

Carteolol (Cartrol/ Ocupress Ophthalmic) [Beta Blocker/ Glaucoma Agent] Uses HTN, T lOP, chronic open-angle glaucoma Action Blocks [3-adrenergic receptors (p, 2)1 ISA Dose Ophth 1 gt in eye(s) bid Caution [C (1st tri) D (2nd 3rd tri), /-] Cardiac failure, asthma Contra Sinus bradycardia heart block >lst-degree bronchospasm Disp Ophth soln SE Drowsiness, sexual dysfxn, bradycardia, edema, CHF, ocular conjunctival... 

Blockers can be used topically to reduce intraocular pressure in patients with chronic open-angle glaucoma and ocular hypertension. The mechanism by which ocular pressure is reduced appears to depend on decreased production of aqueous humor. Timolol has a somewhat greater ocular hypotensive effect than do the available cholinomimetic or adrenomimetic drugs. The 3-blockers also are beneficial in the treatment of acute angle-closure glaucoma. 

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