Glaucoma latanoprost treatment

The ocular adverse effects of latanoprost include conjunctival hyperemia, iris pigmentation, periocular skin color changes, anterior uveitis, and cystoid macular edema in pseudophakic patients (77,78). H. simplex dendritic keratitis has been reported after treatment with latanoprost (79). In patients with uveitic glaucoma, latanoprost can cause increased intraocular pressure and recurrence of inflammation (80). 

Decreases intraocular pressure - latanoprost - treatment of glaucoma. 

Decreases intraocular pressure —> latanoprost —> treatment of glaucoma. 

Q84 In patients with a history of asthma, latanoprost is a preferred first-line treatment in open-angle glaucoma. Latanaprost is available as eye drops and once-daily application in the evening is recommended. 

Other forms of glaucoma There is limited experience with latanoprost in the treatment of angle closure, inflammatory or neovascular glaucoma. 

Topical PGE2 and PGF2qi significantly reduce intraocular pressure for at least 24 hours and are used in the treatment of glaucoma. Derivatives of the isopropyl ester of PGF2qi appear to be the most effective. Transient ocular adverse effects include conjunctival hyperemia, local irritation, intermittent photophobia, and pain in the eye (66-68). Newer derivatives, such as latanoprost, travoprost, and bimatoprost, appear to be better tolerated, with less severe and less frequent adverse effects (69). They reduce intraocular pressure by increasing uveoscleral outflow. 

Ekatomatis P. Herpes simplex dendritic keratitis after treatment with latanoprost for primary open angle glaucoma. Br J Ophthalmol 2001 85(8) 1008-9. 

Latanoprost is an analogue of PGF2 , used to treat glaucoma. The use of latanoprost and unoprostone in the treatment of open-angle glaucoma and ocular hypertension has been reviewed (1). More data on safety are needed to calculate its benefit-to-harm balance. 

Two patients in their seventies developed hypertension during treatment with topical latanoprost (dosage not stated) for open-angle glaucoma both were also taking tocopherol (vitamin E) supplements. Neither had a previous history of hypertension (3). The authors commented that it is likely that systemic absorption of topical latanoprost could cause hypertension. Self-medication with vitamin E has been reported to aggravate or precipitate hypertension. 

Enyedi LB, Freedman SF. Latanoprost for the treatment of pediatric glaucoma. Surv Ophthalmol 2002 47(Suppl 1) S129—32. 

Unoprostone is a synthetic prostaglandin analogue of PGF2a used in the treatment of glaucoma. Its mechanism of action is believed to be by enhancing uveoscleral outflow, like latanoprost. 

Latanoprost (Figure 3.19) is a recently introduced prostaglandin analogue which increases the outflow of aqueous humour from the eye. It is thus used to reduce intraocular pressure in the treatment of the eye disease glaucoma. 

Latanoprost is a pro drug used in the treatment of glaucoma. The 15S isomer of the acid is only about 10 % as active as the 15R isomer of the acid. Draw the structural formula of the more active epimer and determine the configuration of the remaining stereogenic units present. 

How does latanoprost work in the treatment of glaucoma Discuss the range of drugs and route of administration that can be used to treat this patient s glaucoma. 

Topical beta-blockers can precipitate asthma and therefore must not be used to treat this patient s glaucoma. Topical prostaglandin analogues (e.g. latanoprost drops) are used as first-line treatment of glaucoma together with a sympathomimetic agent, brimonidine, as an alternative to beta-blockers in asthmatic and COPD patients. 

Brimonidine s efficacy has been compared with that of prostaglandin analogues, topical CAIs, and P-blockers. Results in patients with glaucoma and ocular hypertension indicate that the peak ocnlar hypotensive effect of 0.2% brimonidine is comparable with that of 0.5% timolol (Figure 10-11). When dosed twice daily, 0.2% brimonidine is less effective than latanoprost 0.005% administered once daily. Brimonidine 0.15% with Purite is similar to dorzolamide 2% when used twice daily fc>r treatment of primary open-angle glaucoma or ocular hypertension. 

Fechtner R, McCarroU KA, Lines CR, Adamsons LA. Efficacy of the dorzolamide/timolol fixed combination versus latanoprost in the treatment of ocular hypertension or glaucoma combined analysis of pooled data from two large randomized observer... 

---