Understanding Glaucoma Medications (cont.)
IN THIS ARTICLE
Hyperosmotics are sugar-based liquids meant to be taken by mouth. Hyperosmotics are used in the treatment of rapid-onset angle-closure glaucoma. The effects last only 6 to 8 hours, so they are not for long-term use. Hyperosmotics include mannitol (Osmitrol), glycerin (Osmoglyn), and isosorbide (Ismotic).
Who should not use these medications:
Use: These drugs are given orally or by injection to rapidly correct high elevations of intraocular pressure.
Drug or food interactions: Hyperosmotics may decrease lithium levels.
Side effects: Hyperosmotics should be used with caution in people who have diseases worsened by salt retention.
Many patients with glaucoma require more than one type of medication for adequate control of their glaucoma. Combined medications can offer an alternative for patients who need more than one type of medication. In addition to the convenience of using one eye drop bottle instead of two, there may also be a financial advantage, depending on the insurance plan. Cosopt is a combination of a beta blocker (timolol) and a carbonic anhydrase inhibitor (Trusopt). Combigan combines an alpha agonist (brimonidine) with a beta blocker (timolol). Combinations of prostaglandin analogs and beta adrenergic blockers are available in Europe and are awaiting FDA approval in the United States.
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While any type of glaucoma can be unilateral, primary open-angle glaucoma, primary angle-closure glaucoma, primary infantile glaucoma, juvenile-onset glaucoma, and pigmentary glaucoma are generally bilateral diseases, the severity of which may be asymmetric in the two eyes.