OPTHALMIC AGENTS

Used to reduce Intra-ocular Pressure

OPTHALMIC AGENTS

COMMON USES

WHAT I NEED TO KNOW AS A BRAND NEW

NURSE

Cholinergics (Miotics)

Glaucoma, ocular surgery,

and convergent strabismus

* Generally adverse effects are local and limited to the eye, these
include: blurred vision, drug induced myopia, local irritation, eye or
brow pain and accomodative spasms.

Glaucoma, ocular surgery

and the treatment of ocular
hypertension

* Generally adverse effects are local and limited to the eye, these
include: burning, eye pain, tearing, blurred vision and conjunctivitis.
* Rare systemic effects include tachycardia, hypertension, HA and
light-headedness.

Selective beta-blocker, used

for the treatment of
Glaucoma and ocular
hypertension

* Generally adverse effects are local and limited to the eye, most
commonly seen are: eye discomfort and transient burning. Other
local effects include: blurred vision, photophobia, dry eyes, and
conjunctivitis.

Common examples:
Direct-acting
Pilocarpine HCL(Pilocar),
Pilocarpine nitrate (Ocusert)
Carbachol (Miostat), Acetylcholine
(Miochol-E)
Indirect-acting (Cholinesterase
inhibitors)
Echothiophate (Phospholine Iodide)

Sympathomimetics
Common examples:
Brimonidine (Alphagan P)

Beta Adrenergic Blockers

Common examples:
Betaxolol (Betoptic), Timolol
(Timoptic, Betimol)

May be used in combination

with a Miotic for Glaucoma
and the emergency treatment
of Acute Angle Closure
Glaucoma.

Carbonic Anhydrase Inhibitors

Common examples:
Brinzolamide (Azopt), Dorzolamide
(Trusopt), Acetazolamide (Diamox)

Prostaglandin Agonists
Common examples:
Latanoprost (Xalatan),
Travoprost (Travatan)

Osmotic Diuretics
Common examples:
Glycerin (Opthalgan) Given PO 1
hour before surgery
Mannitol (Osmitrol)

Glaucoma and ocular

hypertension

*Chemically related to the sulfonamide antibiotics. These agents are

absorbed systemically and although rare, they can exert the same
adverse effects associated with the sulfonamide antibiotics. More
common adverse effects are local effects including: blurred vision,
ocular stinging, tearing, photophobia, conjunctivitis, dry eyes and lid
reactions.
*Monitor for postural hypotension, bradycardia, dyspnea and
bronchospasm
* Contraindicated with sulfa allergy

Glaucoma and ocular

hypertension

* Generally well tolerated with mild adverse effects

* Adverse effects are local and limited to the eye, most commonly
seen are: foreign body sensation, stinging, conjunctival hyperemia
(bloodshot eyes), blurred vision, itching, burning and punctuate
epithelial keratopathy (irreversible brown pigment spots)
* Glycerin generally used first followed by Mannitol if needed.

Acute glaucoma and pre and

post-op ocular surgery to
reduce intra-ocular pressure.

Considerations with Mannitol:

* Multiple adverse effects, the most commonly seen serious effects
include: fluid and electrolyte imbalance, HA, irritation and
thrombosis at the injection site, marked diuresis and dehydration.
* Observe for rebound increased intra-cranial or intra-ocular
pressure.
* May crystallize when exposed to low temperatures and should
therefore, always be administered through a filter.
*Contrandicated in severe pulmonary congestion, anuria and
dehydration