Intraocular increase

G.J. (gastrointestinal). Refers to the digestive system. Glaucoma. Increased intraocular pressure. 

The miscellaneous anticonvulsants are used cautiously in patients with glaucoma or increased intraocular pressure a history of cardiac, renal or liver dysfunction and psychiatric disorders. When the miscellaneous anticonvulsants are used with other CNS depressants (eg, alcohol, narcotic analgesics, and antidepressants), an additive CNS depressant effect may occur. 

As with all antidepressants, the TCAs are used cautiously in patients witii hepatic or renal impairment. The tricyclics are used cautiously in patients witii heart disease, angina, paroxysmal tachycardia, increased intraocular pressure, prostatic hypertrophy, or a history of seizures. 

Miscellaneous—hypersensitivity reactions, hypokalemia, hypernatremia, increased susceptibility to infection, cushingoid appearance (eg, moon face, buffalo hump, hirsutism), cataracts, and increased intraocular pressure. 

Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos... 

Decongestants such as OTC pseudoephedrine are sympathomimetic agents that constrict capacitance vessels in the nasal turbinates.17 Decongestants effectively reduce nasal congestion and to some extent rhinorrhea associated with AR.8,12 The recommended dose of pseudoephedrine is 30 to 60 mg every 4 to 6 hours for a maximum daily dose of 240 mg.15 Systemic adverse effects such as irritability, dizziness, headache, tremor, tachycardia, and insomnia can occur. Additionally, use is associated with increased blood pressure and intraocular pressure and urinary obstruction.8,12... 

If mast cell stabilizers or multiple-action agents are not successful, a trial of a topical NSAID is appropriate. Ketorolac is the only approved topical agent for ocular itching. NSAIDs do not mask ocular infections, affect wound healing, increase intraocular pressure, or contribute to cataract formation like the topical corticosteroids. However, for allergic conjunctivitis, topical ketorolac is not as effective as olopatadine or emedas-tine in trials.15 Full efficacy of ketorolac takes up to 2 weeks.17... 

A 65-year-old male complains of losing his vision Retinal examination reveals optic nerve cupping. Peripheral vision loss is observed on visual field tests, and his intraocular pressure is increased. Following treatment with a drug, he has improved visual acuity and decreased intraocular pressure. 

The answer is c (HardmanT pp 695-697.) Mannitol increases serum osmolarity and therefore pulls water out of cells, cerebrospinal fluid (C5F), and aqueous humor. This effect can be useful in the treatment of elevated intraocular or intracranial pressure. However, by expanding the intravascular volume, mannitol can exacerbate CHF... 

In open-angle glaucoma, the specific cause of optic neuropathy is unknown. Increased intraocular pressure (IOP) was historically considered to be the sole cause. Additional contributing factors include increased susceptibility of the optic nerve to ischemia, reduced or dysregulated blood flow, excitotoxicity, autoimmune reactions, and other abnormal physiologic processes. 

Drugs That May Induce or Potentiate Increased Intraocular Pressure... 

Although anticholinergic (drying) effects contribute to efficacy, adverse effects such as dry mouth, difficulty in voiding urine, constipation, and potential cardiovascular effects may occur (see Table 79-1). Antihistamines should be used with caution in patients predisposed to urinary retention and in those with increased intraocular pressure, hyperthyroidism, and cardiovascular disease. 

A marked increase in intraocular pressure is known as glaucoma and results in hardness of the eye, atrophy of the retina, cupping of the optic disk and ultimate blindness. Atropine will cause a rise of intraocular pressure and D.F.P. will reduce intraocular pressure (see p. 195). 

In the early 1970s, cannabis was noted to reduce intraocular pressure in people with glaucoma (Cooler and Gregg 1977). In a controlled study, THC decreased intraocular pressure an average of 37%, with maximum decreases at 51% of baseline. Concurrent increases in heart rate were also observed. The mechanism of this effect of THC is uncertain. 

Xalatan (latanoprost) is a prostaglandin analogue, which increases the uvoscleral outflow, thereby decreasing the intraocular pressure. The drops, which are applied once daily, preferably in the evening, may cause eye discoloration especially in patients with mixed colour irides. 

Glaucoma is characterised by an increase in intraocular pressure. Clinical features of glaucoma include ocular pain, visual disturbances, headache and sometimes nausea and vomiting. 

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. 

Clinical use of reversible inhibitors is directed to eye, skeletal muscle, neuromuscular junctions, gastrointestinal tract, urinary tract, respiratory tract, and heart and used in treatment of glaucoma (an ocular disease caused by increased intraocular pressure due to inadequate drainage of aqueous humor at filtration angle), myasthenia gravis (an autoimmune disease... 

IV therapy may be used for rapid relief of increased intraocular pressure. A complementary effect occurs when used with miotics or mydriatics. 

Special risk patients Administer with caution to patients with thyroid disease, diabetes mellitus, cardiovascular disease, coronary artery disease, hypertension, peripheral vascular disease, heart disease, ischemic heart disease, increased intraocular pressure, or prostatic hypertrophy. 

Special risk patients Use antihistamines with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, symptomatic prostatic hypertrophy, bladder neck obstruction, bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, and hypertension. 

Anticholinergic effects Use with caution in patients with a history of urinary retention, urethral or ureteral spasm narrow-angle glaucoma, angle-closure glaucoma, or increased intraocular pressure. 

Anticholinergic properties Maprotiline should be administered with caution in patients with increased intraocular pressure, history of urinary retention, or history of narrow-angle glaucoma because of the drug s anticholinergic properties. 

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