Drug treatment of glaucoma always start with the appointment of local medicines. These drugs are drops from glaucoma. Modern drugs for local application may well restore normal intraocular pressure (IOP) in the initial stages of the disease.
Eye drops for glaucoma - their types
All drops for glaucoma (local drugs) that reduce intraocular pressure in glaucoma, can be divided into two groups: improving the outflow of intraocular fluid and reduce its formation.
For drugs that improve the outflow of intraocular fluid include prostaglandin F-2a holinomimetiki, agonists.
For drugs that inhibits the production of intraocular fluid are selective sympathomimetic, beta-blockers (non-selective and selective) and carbonic anhydrase inhibitors.
There is also a combined glaucoma eye drops, which include several drugs - their action is often the most effective.
Preparations from glaucoma improving outflow of intraocular fluid
Prostaglandin F-2a - is latanoprost (Xalatan, 0, 005%), travoprost (Travatan, 0, 004%). They reduce IOP by improving outflow of intraocular fluid drainage outflow, so are used to treat open-angle glaucoma
Open-angle glaucoma - occurs often goes unnoticed
(in violation of the cross drainage paths). These drops instilled once a day (in the evening). Contraindicated drugs of this series during pregnancy and breastfeeding, secondary glaucoma
Secondary glaucoma - against the backdrop of another disease
amid inflammatory diseases of the eye after intraocular operations.
Holinomimetiki - a 1-2-4% pilocarpine hydrochloride and 1, 5% or 3% karbohol. Pilocarpine causes constriction of the pupil, ciliary muscle contraction, reducing the thickness of the iris, open access to the drainage area and improve the outflow of intraocular fluid. It is used in the treatment of open-angle glaucoma and closed-forms, including an acute attack of glaucoma. Pilocarpine eyedrops depot instilled twice daily.
Adrenomimetiki - 1-2% epinephrine (adrenaline hydrochloride). Helps to improve the outflow of fluid drainage system, slightly inhibits the formation of intraocular fluid. Local side effects: mydriasis, conjunctival redness and edges of the eyelids, allergic conjunctivitis, decreased blood flow in the optic disc.
Drops from glaucoma, depressing production of intraocular fluid
For drugs that inhibits the production of intraocular fluid, are selective sympathomimetic, beta-blockers (non-selective and selective) and carbonic anhydrase inhibitors.
The selective sympathomimetic - clonidine and brimonidine aproklonidin. Caused an improvement of intraocular fluid, as well as a reduction of intraocular fluid secretion. Clonidine (clonidine) causes a decrease in IOP, which starts in half an hour and lasts up to 8 hours. Recommended instilled three times a day.
The non-selective blockers. For nonselective (acting indiscriminately) in-blockers include timolol (0, 25 and 0, 5% timolol maleate). The drug is also available under the names arutimol, niolol, okumed, okupres-E, Okura, optimol, oftan-timolol, oftensin, timogeksal, timolol-PIC timoptik, timoptik depot. The mechanism of action is associated with a reduction in the formation of intraocular fluid. Lowering IOP occurs within 20 min after instillation and lasts for at least 12 hours. Recommended instilled 1-2 times a day.
In-selective blockers (acting selectively). These include betoksolol (Betoptik 0, 5%, Betoptik 0 C, 25%). Side effects - a burning sensation and pain in the eyes sometimes - decreased corneal sensitivity. The drug should be used with caution for patients with diabetes
Diabetes - threatening and incurable disease
, Hyperthyroidism, bronchial asthma
Bronchial asthma - the body's response inadequate
.
Carbonic anhydrase inhibitors cause a decrease in the formation of intraocular fluid and lowering the tone of the eyeball. Azopt 1% (1% solution brinzolamide) - IOP reduction occurs within 15-20 minutes after instillation of the drug and lasts 12 hours. Mode instillation - twice a day.
Drops for the treatment of glaucoma combined
Combination medicaments for treating glaucoma are composed of drugs with different mechanisms of action, which are mutually strengthened:
- fotil; it consists of a solution of 0, 5% solution of timolol and pilocarpine 2%; after instillation of IOP reduction begins with the second hour, the maximum effect after 3-4 hours, the duration of the therapeutic effect - 12 hours; recommended - 1-2 times a day; no side effects;
- ksalakom - combined formulation comprising a solution of 0 005% solution of latanoprost and 0, 5% timolol maleate; has a strong IOP lowering effect that persists for a day, it is recommended to dig 1 times a day (in the morning);
- normoglaukon - a combination of 2% pilocarpine solution with 0, 1% sodium metipranolol; IOP reduction begins an hour after a single instillation persists for days;
- proksofelin - combined preparation, which comprises proksodolol and clonidine, has a potentiated hypotensive effect mainly by inhibiting the production of intraocular fluid;
- proksokarpin - consists of a 1% solution proksodolola and 1% pilocarpine solution; IOP reduction begins 30-60 minutes after instillation, persists for days.
The advantages of the combined drugs are most antihypertensive efficacy, lack of addiction to the drug, reducing the number of instillation.
Eye drops for glaucoma prominent place in the treatment of this disease.
Galina Romanenko