Paper I
2019 February (2010 Scheme) · 40 marks · 120 min

Question

Enumerate the topical group of agents used in the treatment of open angle glaucoma. Give examples and explain the mechanism of action of each group of drugs. (2+2+2)

Q16 marksEssays

Answer

Topical drug groups for open-angle glaucoma

  • Beta blockers: Timolol — reduce aqueous humour production by blocking β receptors on the ciliary epithelium
  • Prostaglandin analogues: Latanoprost — increase uveoscleral outflow of aqueous humour
  • Cholinergic agonists (miotics): Pilocarpine — contract the ciliary muscle, opening the trabecular meshwork and increasing conventional outflow
  • Carbonic anhydrase inhibitors: Dorzolamide (topical) — inhibit carbonic anhydrase in the ciliary epithelium, reducing bicarbonate-dependent aqueous humour formation
  • Alpha-2 agonists: Brimonidine — reduce aqueous production and increase uveoscleral outflow

All groups work by either reducing aqueous humour production or increasing its outflow, thereby lowering intraocular pressure.

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