17 Questions
What is the primary goal of medications in the management of glaucoma?
To reduce the intraocular pressure by increasing the rate of aqueous outflow and/or reducing the production of aqueous humor
Which of the following factors is NOT considered when prescribing medications for glaucoma?
Patient's age
What is the purpose of establishing a baseline IOP value in glaucoma management?
To take into account diurnal variation in pressure
What is the target pressure reduction for patients with moderate damage to the optic nerve?
30-40%
How often should visual fields be re-checked after diagnosis and initiation of medication?
Every 6 months
What is the frequency of stereoscopic optic nerve photos after diagnosis and initiation of medication?
Yearly
What is the primary purpose of the disclaimer provided by the Institute?
To limit liability and clarify the usage of the publication
According to the disclaimer, what type of warranty does the Institute disclaim?
Warranty of merchantability and fitness for purpose
What is the implication of the Institute's statement regarding specific companies or products?
The Institute does not endorse any companies or products
Under what circumstances does the Institute exclude implied warranties?
To the extent permitted by law
What is the consequence of using the information contained in the publication?
The user assumes all liability for any loss or damage incurred
What is the primary goal of pharmacological management of glaucoma?
To increase the outflow of aqueous humor
Which of the following classes of medications is used to reduce the production of aqueous humor?
Topical beta blockers
What is the mechanism of action of prostaglandin analogs in glaucoma management?
Increasing the outflow of aqueous humor
Which of the following medications is a sympathomimetic agent used in glaucoma treatment?
Brimonidine
What is the benefit of using combination therapy in glaucoma management?
Increasing the efficacy of individual medications
Which of the following classes of medications is associated with the most significant systemic side effects?
Carbonic anhydrase inhibitors
Study Notes
Medication Management in Glaucoma
- Medication is the first choice in managing glaucoma, aiming to reduce intraocular pressure (IOP) by increasing aqueous outflow and/or reducing aqueous humor production.
- Different families of glaucoma medications have specific modes of action, side effects, and contraindications.
Prescribing Medications
- Important factors to consider when prescribing medications include:
- Potency
- Additive effects
- Interactions with other medications
- Comorbidities
- Side effects
- Method and ease of administration
- Cost
Acute Angle Closure
- Patients with acute angle closure are given medications to reduce:
- IOP
- Corneal edema
- Level of pain
- These medications prepare the patient for laser therapy or surgery.
Medical Management
- Effective management of glaucoma requires accurate and repeatable measurements of IOP.
- Establishing a baseline IOP value takes into account diurnal variation in pressure.
- Diurnal variation in IOP is determined by making multiple measurements of the pressure at various times throughout the day.
Target Pressure
- Setting a target pressure helps slow further progression of the disease.
- The target pressure is not static and must be reset if the patient continues to progress.
- The more damaged the optic nerve, the greater is the required IOP reduction.
Classification of Damage
- A classification of mild, moderate, and severe damage is used to determine target pressure reduction:
- Mild damage: 20-30% reduction
- Moderate damage: 30-40% reduction
- Severe damage: 40-50% reduction
Adherence and Compliance
- After diagnosis and initiation of medication, re-check:
- Visual Fields: 6 months, then 3-6 months for the first 18 months, then yearly
- RNFL Assessment: same as visual fields
- Stereoscopic Optic Nerve Photos: yearly
This quiz covers the disclaimer notice from a medical institution, highlighting the importance of seeking professional advice and not relying solely on the provided information. It also clarifies the Institute's stance on product endorsements. Test your understanding of medical liability and disclaimer notices.
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