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February 10, 2012
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Understanding Glaucoma Medications (cont.)

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Miotics

  • Generic/trade names: Carbachol (Carbastat, Carboptic, Isopto Carbachol, Miostat Intraocular), pilocarpine (Ocusert Pilo-40, Pilocar, Pilagan, Piloptic, Pilostat)

  • How miotics work: These drugs cause the pupil to become much smaller in diameter and relieve pressure by increasing outflow of aqueous humor.

  • Who should not use these medications

    • Persons allergic to pilocarpine

    • Persons with inflammation (swelling) of the eye

  • Use: Various dosage forms are available, including eyedrops, ocular inserts (inserted in the eye once a week), and ocular gel.

  • Drug or food interactions: If administered with prostaglandin eyedrops, wait at least 10 minutes—preferably, 1 hour—between applying the two drugs.

  • Side effects: Miotics should be used with caution in persons with corneal abrasion(s) and in those with a history of retinal detachment. An increase of blood in the eye may occur in individuals allergic to pilocarpine.

brimonidine (Alphagan), dipivefrin (AKPro, Propine)

  • How adrenergics work: These drugs lower intraocular pressure by reducing the amount of aqueous humor produced. They also reduce resistance to outflow of aqueous humor.

  • Who should not use these medications: These drugs should not be used by individuals allergic to adrenergic eyedrops.

  • Use: These drugs are given as eyedrops.

  • Drug or food interactions: Additive effects occur when adrenergics are used with other drugs that lower intraocular pressure.

  • Side effects: Adrenergics may cause macular edema (swelling of the macula, the center part of the retina) and eye irritation.
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