Β Blockers Timolol Betaxolol Carteolol Ocular Hypotensives: List The

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1 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol 2 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol 3 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The ‘big three’ FDA-approved PGA that dominate the American market  Bimataprost  (Tafluprost) An FDA-approved PGA, much less well-known than the big three  (Latanaprostene bunod) A PGA ‘combo drug’ 4 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The ‘big three’ FDA-approved PGA that dominate the American market  Bimataprost  (Tafluprost) agonistAn FDA-approved PGA, much less well-known than the big three  (Latanaprostene bunod) A PGA ‘combo drug’ 5 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The three FDA-approved PGA that dominate the American market  Bimataprost What is the brand name of tafluprost?  (Tafluprost) agonistAn FDA-approved PGA, much less well-known than the big three Zioptan (and that’s all we’ll have to say about it)  (Latanaprostene bunod) A PGA combo drug 6 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The three FDA-approved PGA that dominate the American market  Bimataprost What is the brand name of tafluprost?  (Tafluprost) agonistAn FDA-approved PGA, much less well-known than the big three Zioptan (and that’s all we’ll have to say about it)  (Latanaprostene bunod) A PGA combo drug 7 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The three FDA-approved PGA that dominate the American market  Bimataprost What is the brand name of latanaprostene bunod?  (Tafluprost) agonist An FDA-approvedVyzulta PGA, much less well-known than the big three  (Latanaprostene bunod) A PGA combo drug (We’ll have more to say about this drug shortly) 8 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost The three FDA-approved PGA that dominate the American market  Bimataprost What is the brand name of latanaprostene bunod?  (Tafluprost) agonist An FDA-approvedVyzulta PGA, much less well-known than the big three  (Latanaprostene bunod) A PGA combo drug (We’ll have more to say about this drug later) 9 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin 10 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin 11 Ocular Hypotensives: List the common agents

  blockers  Timolol (This drove me nuts when I was a med  Betaxolol student—how could the same disease be  Carteolol treated by two different medicines with the  Prostaglandin analogues exact opposite effect? The first time I read it,  Latanaprost I assumed it was a typo.)  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin 12 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI (carbonic anhydrase inhibitors)  Dorzolamide  Brinzolamide  Acetazolamide 13 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide 14 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide There is another, less well-known CAI—what is it?  ?df 15 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide There is another, less well-known CAI—what is it?  Methazolamidedf Methazolamide 16 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine 17 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine 18 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo 19 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilocarpine (Pilo for short) 20 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor 21 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 22 Q Ocular Hypotensives: List the common agents   blockers Brand Name?  Timolol Timoptic  Betaxolol xxxxx  Carteolol xxxxx  Prostaglandin analogues  Latanaprost Xalatan  Travaprost Travatan  Bimataprost Lumigan  Nonselective agonist These meds are rarely  used anymore (except for Epinephrine xxxxx pilo in certain situations),  Dipivefrin xxxxx so we won’t bother with their brand names  CAI  Dorzolamide Trusopt  Brinzolamide Azopt  Acetazolamide Diamox  Selective  agonists  Apraclonidine Iopidine  Brimonidine Alphagan  Miotics  Pilo xxxxx  Rho kinase inhibitor  Netarsudil 23 A Ocular Hypotensives: List the common agents   blockers Brand Name?  Timolol Timoptic  Betaxolol xxxxx  Carteolol xxxxx  Prostaglandin analogues  Latanaprost Xalatan  Travaprost Travatan  Bimataprost Lumigan  Nonselective agonist  Epinephrine xxxxx  Dipivefrin xxxxx  CAI  Dorzolamide Trusopt  Brinzolamide Azopt  Acetazolamide Diamox  Selective  agonists  Apraclonidine Iopidine  Brimonidine Alphagan  Miotics  Pilo xxxxx  Rho kinase inhibitor  Netarsudil Rhopressa 24 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 25 A Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 26 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 27 A Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 28 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral writevenous it out pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facilityone word , not outflow rate  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 29 A Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 30 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide The Goldmann equation implies three means by which IOP can be lowered. What are they?  Selective  agonists --Decrease the rate of aqueous formation  Apraclonidine --Increase the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 32 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide The Goldmann equation implies three means by which IOP canby which be lowered. IOP can What be lowered. are they? What are they?  Selective  agonists --Decrease the rate of aqueous formation  Apraclonidine --Increase the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure  Miotics There is another commonly-employed means of decreasing  Pilo IOP that is not implied by the Goldmann equation. What is it?  Rho kinase inhibitor  Netarsudil 33 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide The Goldmann equation implies three means by which IOP canby which be lowered. IOP can What be lowered. are they? What are they?  Selective  agonists --Decrease the rate of aqueous formation  Apraclonidine --Increase the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure  Miotics There is another commonly-employed means of decreasing  Pilo IOP that is not implied by the Goldmann equation. What is it?  Rho kinase inhibitor Dehydration of the vitreous  Netarsudil 34 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues Where, specifically, is aqueous formed?  Latanaprost In theWhat nonpigmented is the Goldmann epithelium equation? of the pars (Meaning, plicata portion of the ciliary body  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide The Goldmann equation implies three means by which IOP canby which be lowered. IOP can What be lowered. are they? What are they?  Selective  agonists --Decrease the rate of aqueous formation  Apraclonidine --Increase the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure  Miotics There is another commonly-employed means of decreasing  Pilo IOP that is not implied by the Goldmann equation. What is it?  Rho kinase inhibitor Dehydration of the vitreous  Netarsudil 35 A Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues Where, specifically, is aqueous formed?  Latanaprost In theWhat nonpigmented is the Goldmann epithelium equation? of the pars (Meaning, plicata portion of the ciliary body  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI 1) EVP = episcleral venous pressure 2) In the interest of simplicity, I fudged a little on the denominator—  Dorzolamide technically, it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide The Goldmann equation implies three means by which IOP canby which be lowered. IOP can What be lowered. are they? What are they?  Selective  agonists --Decrease the rate of aqueous formation  Apraclonidine --Increase the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure  Miotics There is another commonly-employed means of decreasing  Pilo IOP that is not implied by the Goldmann equation. What is it?  Rho kinase inhibitor Dehydration of the vitreous  Netarsudil 36 Q Ocular Hypotensives: List the common agents   blockers  Timolol What is the name of the equation that  Betaxolol describes the factors determining IOP?  Carteolol The Goldmann equation  Prostaglandin analogues  Latanaprost What is the Goldmann equation? (Meaning,  Travaprost write it out)  Bimataprost Rate of aqueous formation  Nonselective  agonist IOP = + EVP  Epinephrine Rate of aqueous outflow

 Dipivefrin Note:  CAI What1) EVP are = the episcleral two types/pathways venous pressure of aqueous outflow? --Trabecular2) In the interest meshwork of simplicity, (TM) I fudged a little on the denominator—  Dorzolamide --Uveoscleraltechnically, (U/S) it’s outflow facility , not outflow rate  Brinzolamide  Acetazolamide OneThe ofGoldmann these is referred equation to implies as conventional three meansoutflow; by which the IOP other, unconventionalcan be lowered. .What Which are is they?which?  Selective  agonists --TM--Decrease = conventional the rate of aqueous formation  Apraclonidine --U/S--Increase = unconventional the rate of aqueous outflow  Brimonidine --Decrease episcleral venous pressure One outflow pathway is pressure dependent; the other,  Miotics pressureThere is anotherindependent commonly-em. Which isployed which? means of decreasing  Pilo --TMIOP that = conventional is not implied = pressure-dependent by the Goldmann equation. What is it?  Rho kinase inhibitor --U/SDehydration = unconventional of the vitreous = pressure-independent  Netarsudil 42 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 43 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 44 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 45 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting production of cAMP in the ciliary epithelium  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 46 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting production of cAMP in the ciliary epithelium  Dorzolamide  Brinzolamide By how much do they lower IOP?  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 47 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do  blockers lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting production of cAMP in the ciliary epithelium  Dorzolamide  Brinzolamide By how much do they lower IOP? 20-30%  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 48 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 49 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 50 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine Does it increase outflow via the conventional (TM)  Dipivefrin pathway, or the unconventional (U/S) pathway?  CAI Mainly via the U/S pathway  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 51 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine Does it increase outflow via the conventional (TM)  Dipivefrin pathway, or the unconventional (U/S) pathway?  CAI Mainly via the U/S pathway  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 52 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase U/S outflow?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 53 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase U/S outflow?  CAI It is unknown at this time  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 54 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase U/S outflow?  CAI It is unknown at this time  Dorzolamide  Brinzolamide By how much do they lower IOP?  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 55 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do PGAs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase U/S outflow?  CAI It is unknown at this time  Dorzolamide  Brinzolamide By how much do they lower IOP? 25-33%  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 56 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 57 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 58 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 59 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting the enzyme carbonic anhydrase  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 60 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting the enzyme carbonic anhydrase  Dorzolamide  Brinzolamide By how much do they lower IOP?  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 61 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do CAIs lower IOP? (Note: It could be more than  Bimataprost one)  Nonselective  agonist By decreasing the rate of aqueous formation  Epinephrine  Dipivefrin By what mechanism do they reduce aqueous formation?  CAI By inhibiting the enzyme carbonic anhydrase  Dorzolamide  Brinzolamide By how much do they lower IOP? 15-20%  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 62 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 63 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidineapra vs brimo reduces EVP.  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 64 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 65 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 66 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 67 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 68 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide --Apraclonidine increases TM outflow  Selective  agonists --Brimonidine increases U/S outflow  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 69 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide --Apraclonidine increases TM outflow  Selective  agonists --Brimonidine increases U/S outflow  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 70 Ocular Hypotensives: List the commonRate of aqueous agents formation IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide --Apraclonidine increases TM outflow  Selective  agonists --Brimonidine increases U/S outflow  Apraclonidine  Brimonidine Mnemonic for remembering their outflow pathways:  Miotics Apraclonidine: ‘ATM’  Pilo Brimonidine: ‘BUS’  Rho kinase inhibitor  Netarsudil 71 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide --Apraclonidine increases TM outflow  Selective  agonists --Brimonidine increases U/S outflow  Apraclonidine  Brimonidine By how much do they lower IOP?  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 72 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure (apra)  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do selective  agonists lower IOP? (Note: It could  Bimataprost be more than one)  Nonselective  agonist Both meds decrease aqueous formation and increase  Epinephrine outflow. Additionally, apraclonidine reduces EVP.  Dipivefrin  CAI By what mechanism do they reduce aqueous formation?  Dorzolamide This is not addressed in the BCSC book  Brinzolamide By what mechanism do they increase aqueous outflow?  Acetazolamide --Apraclonidine increases TM outflow  Selective  agonists --Brimonidine increases U/S outflow  Apraclonidine  Brimonidine By how much do they lower IOP?  Miotics 20-30%  Pilo  Rho kinase inhibitor  Netarsudil 73 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 74 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 75 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase outflow?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 76 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase outflow?  CAI They stimulate contraction of the longitudinaldirection portion  Dorzolamide of the ciliary muscle. These muscle fibers attach to the same structure  Brinzolamide scleralstructure (two spurwords) . Tension on the scleral spur produces tightness in the trabeculardifferent structure meshwork (two diff words) , thereby allowing  Acetazolamide aqueous to egress more efficiently.  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 77 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase outflow?  CAI They stimulate contraction of the longitudinal portion  Dorzolamide of the ciliary muscle. These muscle fibers attach to the  Brinzolamide scleral spur . Tension on the scleral spur produces tightness in the trabecular meshwork , thereby allowing  Acetazolamide aqueous to egress more efficiently.  Selective  agonists  Apraclonidine tl;dr They increase outflow through the TM pathway  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 78 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase outflow?  CAI They stimulate contraction of the longitudinal portion  Dorzolamide of the ciliary muscle. These muscle fibers attach to the  Brinzolamide scleral spur . Tension on the scleral spur produces tightness in the trabecular meshwork , thereby allowing  Acetazolamide aqueous to egress more efficiently.  Selective  agonists  Apraclonidine By how much do they lower IOP?  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 79 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do miotics lower IOP? (Note: It could be more  Bimataprost than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin By what mechanism do they increase outflow?  CAI They stimulate contraction of the longitudinal portion  Dorzolamide of the ciliary muscle. These muscle fibers attach to the  Brinzolamide scleral spur . Tension on the scleral spur produces tightness in the trabecular meshwork , thereby allowing  Acetazolamide aqueous to egress more efficiently.  Selective  agonists  Apraclonidine By how much do they lower IOP?  Brimonidine 15-20%  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 80 Ocular Hypotensives: List the common agents

Note: The next two meds are too new to appear in the latest (in my possession) edition of the BCSC Glaucoma book. Thus, questions about them are unlikely to appear on the OKAP or WQEs—yet. 81 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 82 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP, but these are thought to make minor  CAI contributions to their IOP-lowering effect)  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 83 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP,Does butit increase these outfloware thought via the to conventional make minor (TM) pathway, or the unconventional (U/S) pathway?  CAI contributions to their IOP-lowering effect) Mainly via the U/S pathway  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 84 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP,Does butit increase these outfloware thought via the to conventional make minor (TM) pathway, or the unconventional (U/S) pathway?  CAI contributions to their IOP-lowering effect) Mainly via the TM pathway  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 85 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP, but these are thought to make minor  CAI contributions to their IOP-lowering effect)  Dorzolamide  Brinzolamide By what mechanism do they increase TM outflow?  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 86 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP, but these are thought to make minor  CAI contributions to their IOP-lowering effect)  Dorzolamide  Brinzolamide By what mechanism do they increase TM outflow? By inducing relaxation of cytoskeletal elements found  Acetazolamide within TM cells  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 87 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP, but these are thought to make minor  CAI contributions to their IOP-lowering effect)  Dorzolamide  Brinzolamide By what mechanism do they increase TM outflow? By inducing relaxation of cytoskeletal elements found  Acetazolamide within TM cells  Selective  agonists  Apraclonidine By how much do they lower IOP?  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 88 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation?  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure?  Latanaprost Of the three means implied by the Goldmann equation,  Travaprost how do Rho kinase inhibitors lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist Primarily by increasing the rate of aqueous outflow  Epinephrine (they may also reduce aqueous formation as well as  Dipivefrin decrease EVP, but these are thought to make minor  CAI contributions to their IOP-lowering effect)  Dorzolamide  Brinzolamide By what mechanism do they increase TM outflow? By inducing relaxation of cytoskeletal elements found  Acetazolamide within TM cells  Selective  agonists  Apraclonidine By how much do they lower IOP?  Brimonidine By my reading of the research, in the 20-25% range  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 89 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 90 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 91 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway,  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 92 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway,  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 93 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one)  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway,  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 94 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost? Nitric? oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway,  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 95 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway,  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 96 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/SU/S outflowvs TM ↑ TMU/S outflow vs TM  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 97 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties work?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 98 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 99 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide  Brinzolamide How does manage to affect both outflow pathways?  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists these increase U/S and TM outflow, respectively.  Apraclonidine  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 100 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide“By inducing relaxation of cytoskeletal elements found within TM cells”…Where have I heard  Brinzolamidethat before? (No cheating by lookingHow back) does manage to affect both outflow pathways? This phrase was used to characterize the mechanism of action of the Rho kinase inhibitors  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective Does agonists this mean NO and RhoKIs have the same mechanism of action? In one sense yes—they both interferethese with increase the Rho U/S signaling and TM cas cadeoutflow, that respectively.stiffens cytoskeletal  Apraclonidine elements. However, the two agents act at very different points in that signaling cascade.  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 101 Ocular Hypotensives: List the commonRate of aqueous agents formation Q/A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide“By inducing relaxation of cytoskeletal elements found within TM cells”…Where have I heard  Brinzolamidethat before? (No cheating by lookingHow back) does manage to affect both outflow pathways? This phrase was used to characterize the mechanism of action of the Rho kinase inhibitors  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective Does agonists this mean NO and RhoKIs have the same mechanism of action? In one sense yes—they both interferethese with increase the Rho U/S signaling and TM cas cadeoutflow, that respectively.stiffens cytoskeletal  Apraclonidine elements. However, the two agents act at very different points in that signaling cascade.  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 102 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide“By inducing relaxation of cytoskeletal elements found within TM cells”…Where have I heard  Brinzolamidethat before? (No cheating by lookingHow back) does manage to affect both outflow pathways? This phrase was used to characterize the mechanism of action of the Rho kinase inhibitors  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective Does agonists this mean NO and RhoKIs have the same mechanism of action? In one sense yes—they both interferethese with increase the Rho U/S signaling and TM cas cadeoutflow, that respectively.stiffens cytoskeletal  Apraclonidine elements. However, the two agents act at very different points in that signaling cascade.  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 103 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide“By inducing relaxation of cytoskeletal elements found within TM cells”…Where have I heard  Brinzolamidethat before? (No cheating by lookingHow back) does manage to affect both outflow pathways? This phrase was used to characterize the mechanism of action of the Rho kinase inhibitors  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective Does agonists this mean NO and RhoKIs have the same mechanism of action? In one sense yes—they both interferethese with increase the Rho U/S signaling and TM cas cadeoutflow, that respectively.stiffens cytoskeletal  Apraclonidine elements. However, the two agents act at very different points in that signaling cascade.  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 104 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide“By inducing relaxation of cytoskeletal elements found within TM cells”…Where have I heard  Brinzolamidethat before? (No cheating by lookingHow back) does manage to affect both outflow pathways? This phrase was used to characterize the mechanism of action of the Rho kinase inhibitors  Acetazolamide The latanaprostene bunod molecule is cleaved into two moieties: latanaprost and nitric oxide (NO) . In turn,  Selective Does agonists this mean NO and RhoKIs have the same mechanism of action? In one sense yes—they both interferethese with increase the Rho U/S signaling and TM cas cadeoutflow, that respectively.stiffens cytoskeletal  Apraclonidine elements. However, the two agents act at very different points in that signaling cascade.  Brimonidine How do the constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 105 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide By how much does latanaprostene bunod lower IOP?  Brinzolamide That’sHow not does the manage right question. to affect The both right outflow question pathways? is, by how  Acetazolamide muchThe more latanaprostene does it lower bunod IOP moleculecompared is to cleaved latanaprost into two alone ? ↓ IOP↓ IOP1.2 mmHg by ? vs moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists latanaprost alone OKthese then, increase by how much U/S moreand TMdoesoutflow, it lower respectively. IOP compared to  Apraclonidine latanaprost alone?  Brimonidine By Howabout do 1 themmHg constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 106 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide By how much does latanaprostene bunod lower IOP?  Brinzolamide That’sHow not does the manage right question. to affect The both right outflow question pathways? is, by how  Acetazolamide muchThe more latanaprostene does it lower bunod IOP moleculecompared is to cleaved latanaprost into two alone ? ↓ IOP↓ IOP1.2 mmHg by ? vs moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists latanaprost alone OKthese then, increase by how much U/S moreand TMdoesoutflow, it lower respectively. IOP compared to  Apraclonidine latanaprost alone?  Brimonidine By Howabout do 1 themmHg constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 107 Ocular Hypotensives: List the commonRate of aqueous agents formation Q IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide By how much does latanaprostene bunod lower IOP?  Brinzolamide That’sHow not does the manage right question. to affect The both right outflow question pathways? is, by how  Acetazolamide muchThe more latanaprostene does it lower bunod IOP moleculecompared is to cleaved latanaprost into two alone ? ↓ IOP 1.2 mmHg vs moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists latanaprost alone OKthese then, increase by how much U/S moreand TMdoesoutflow, it lower respectively. IOP compared to  Apraclonidine latanaprost alone?  Brimonidine By Howabout do 1 themmHg constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 108 Ocular Hypotensives: List the commonRate of aqueous agents formation A IOP = + EVP Rate of aqueous outflow   blockers  Timolol The Goldmann equation implies three means by which IOP can be lowered. What are they?  Betaxolol --Decrease the rate of aqueous formation  Carteolol --Increase the rate of aqueous outflow  Prostaglandin analogues --Decrease episcleral venous pressure  LatanaprosteneLatanaprost bunod Of the three means implied by the Goldmann equation,  Travaprost how does latanaprostene bunod lower IOP? (Note: It  Bimataprost could be more than one) Latanaprost Nitric oxide  Nonselective  agonist By increasing the rate of aqueous outflow  Epinephrine  Dipivefrin Does it increase outflow via the conventional (TM) pathway, ↑ U/S outflow ↑ TM outflow  CAI or the unconventional (U/S) pathway? Via both  Dorzolamide By how much does latanaprostene bunod lower IOP?  Brinzolamide That’sHow not does the manage right question. to affect The both right outflow question pathways? is, by how  Acetazolamide muchThe more latanaprostene does it lower bunod IOP moleculecompared is to cleaved latanaprost into two alone ? ↓ IOP 1.2 mmHg vs moieties: latanaprost and nitric oxide (NO) . In turn,  Selective  agonists latanaprost alone OKthese then, increase by how much U/S moreand TMdoesoutflow, it lower respectively. IOP compared to  Apraclonidine latanaprost alone?  Brimonidine ByHow about do 1 the mmHg constituent moieties accomplish their effects?  Miotics --Latanaprost: Mechanism unknown (as noted previously) --NO: By inducing relaxation of cytoskeletal elements found  Pilo within TM cells  Rho kinase inhibitor  Netarsudil 109 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1)  Bimataprost 2)  Nonselective  agonist 3)  Epinephrine 4)  Dipivefrin  CAI

 Dorzolamide (Rank the topical formulations)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 110 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine 4) CAIs  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 111 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine 4) CAIs  Dipivefrin Give two reasons the PGAs beat the  blockers:  CAI 1)  Dorzolamide 2)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 112 A/Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine 4) CAIs  Dipivefrin Give two reasons the PGAs beat the  blockers:  CAI 1) Slightly better IOP reduction on average  Dorzolamide 2) Better 24o IOP control ( blocker efficacy drops  Brinzolamide during sleep)‘acxtivity’  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 113 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine 4) CAIs  Dipivefrin Give two reasons the PGAs beat the  blockers:  CAI 1) Slightly better IOP reduction on average  Dorzolamide 2) Better 24o IOP control ( blocker efficacy drops  Brinzolamide during sleep)  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 114 Ocular Hypotensives: List the common agents

  blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine 4) CAIs  Dipivefrin Give two reasons the PGAs beat the  blockers:  CAI 1) Slightly better IOP reduction on average  Dorzolamide 2) Better 24o IOP control ( blocker efficacy drops  Brinzolamide during sleep)  Acetazolamide  Selective  agonists This is why the second dose should be  Apraclonidine instilled a number of hours before bedtime!  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 115 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine OK, but why are the  blockers4) CAIs ranked ahead of the selective  agonists?  Dipivefrin As I recall, both reduceGive two IOP reasonsin the 20-30% the PGAs range. beat the  blockers:  CAI It’s true, their efficacies1) Slightly are equal—at better IOP peak reduction . However, on theaverage  blockers  Dorzolamide produce slightly better2) Better IOPs 24 at o troughIOP control , so they ( blockerwin. efficacy drops  Brinzolamide during sleep)  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 116 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine OK, but why are the  blockers4) CAIs ranked ahead of the selective  agonists?  Dipivefrin As I recall, both reduceGive two IOP reasonsin the 20-30% the PGAs range. beat the  blockers:  CAI one word It’s true, their efficacies1) Slightly are equal—at better IOP peak reduction . However, on theaverage  blockers  Dorzolamide diff word produce slightly better2) Better IOPs 24 at o troughIOP control , so they ( blockerwin. efficacy drops  Brinzolamide during sleep)  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 117 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Rank these four commonly-used drug classes  Latanaprost in terms of their IOP-lowering efficacy:  Travaprost 1) PGAs  Bimataprost 2) Beta blockers  Nonselective  agonist 3) Selective  agonists  Epinephrine OK, but why are the  blockers4) CAIs ranked ahead of the selective  agonists?  Dipivefrin As I recall, both reduceGive two IOP reasonsin the 20-30% the PGAs range. beat the  blockers:  CAI It’s true, their efficacies1) Slightly are equal—at better IOP peak reduction . However, on theaverage  blockers  Dorzolamide produce slightly better2) Better IOPs 24 at o troughIOP control , so they ( blockerwin. efficacy drops  Brinzolamide during sleep)  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 118 Ocular Hypotensives: List the common agents Q Some drugs are dispensed as fixed-combination meds.   blockers The drugs/classes involved are:  Timolol  Betaxolol  Carteolol Class?  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Drug? Drug?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Drug? Drug?  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 119 Ocular Hypotensives: List the common agents A Some drugs are dispensed as fixed-combination meds.   blockers The drugs/classes involved are:  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 120 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 121 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 122 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine What is the brand name of the  Dipivefrin Brimonidine Brimonidine/Timolol combo drop? Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 123 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine What is the brand name of the  Dipivefrin Brimonidine/Timolol combo drop? Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 124 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 125 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 126 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide What is the brand name of the Latanaprost/Netarsudil combo  Selective  agonists Latanaprost drop? Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 127 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide  Acetazolamide What is the brand name of the Latanaprost/Netarsudil combo  Selective  agonists Latanaprost drop? Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 128 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide Give five advantages combo drugs provide over simply using the same meds as separate drops.  Acetazolamide 1)  Selective  agonists Latanaprost2)) Roclatan Netarsudil  Apraclonidine 3) By halving the number of drops, the preservative-load the ocular surface must endure is halved as well, thus making  Brimonidine irritation less of an issue  Miotics 4)  Pilo 5) Eliminates washout (ie, when an impatient pt instills their  Rho kinase inhibitor second drop too soon after the first, thereby washing it out)  Netarsudil 129 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Brimonidine Combigan Timolol  CAI  Dorzolamide  Brinzolamide Give five advantages combo drugs provide over simply using the same meds as separate drops.  Acetazolamide 1) Convenience  Selective  agonists Latanaprost2) Costs less (usually) Roclatan Netarsudil  Apraclonidine 3) By halving the number of drops, the preservative-load the ocular surface must endure is halved as well, thus making  Brimonidine irritation less of an issue  Miotics 4) Improved compliance  Pilo 5) Eliminates washout (ie, when an impatient pt instills their  Rho kinase inhibitor second drop too soon after the first, thereby washing it out)  Netarsudil 130 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 131 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 132 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 133 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 134 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 135 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 136 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 137 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 138 Ocular Hypotensives: List the common agents

  blockers  Timolol  Betaxolol What is the standard dosing frequency for latanaprost?  Carteolol Daily CAI (as Brinzolamide) (as Dorzolamide)  Prostaglandin analogues What is the standard dosing frequency for netarsudil?  Latanaprost Daily  Travaprost  Bimataprost What is the preferred/recommended time to take latanaprost?  Nonselective  agonist Bedtime  Epinephrine What is the preferred/recommended time to take netarsudil?  Dipivefrin BedtimeBrimonidine Combigan Timolol  CAI  Dorzolamide It all checks out….  Brinzolamide  Acetazolamide  Selective  agonists Latanaprost Rocklatan Netarsudil  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 139 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 140 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide Iopidine  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 141 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide Iopidine  Brinzolamide  Acetazolamide Iopidine works well for this indication, with one exception--in those pts  Selective  agonists already on a particular hypotensive drop for glaucoma. So if a pt is  Apraclonidine already on the drop in question, don’t bother with the pre-procedure Iopidine, as it’s not going to work. Which drop are we talking about?  Brimonidine Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 142 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide Iopidine  Brinzolamide  Acetazolamide Iopidine works well for this indication, with one exception--in those pts  Selective  agonists already on a particular hypotensive drop for glaucoma. So if a pt is  Apraclonidine already on the drop in question, don’t bother with the pre-procedure Iopidine, as it’s not going to work. Which drop are we talking about?  Brimonidine Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 143 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide Iopidine  Brinzolamide  Acetazolamide Iopidine works well for this indication, with one exception--in those pts  Selective  agonists already on a particular hypotensive drop for glaucoma. So if a pt is  Apraclonidine already on the drop in question, don’t bother with the post-procedure Iopidine, as it’s not going to work. Which drop are we talking about?  Brimonidine Brimonidine  Miotics  Pilo So if a pt is on brimonidine, what drop should you use to blunt a  Rho kinase inhibitor post-procedure IOP spike?  Netarsudil 144 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin Which is the only agent FDA-approved for  CAI prophylaxing against post-procedure IOP spikes?  Dorzolamide Iopidine  Brinzolamide  Acetazolamide Iopidine works well for this indication, with one exception--in those pts  Selective  agonists already on a particular hypotensive drop for glaucoma. So if a pt is  Apraclonidine already on the drop in question, don’t bother with the post-procedure Iopidine, as it’s not going to work. Which drop are we talking about?  Brimonidine Brimonidine  Miotics  Pilo So if a pt is on brimonidine, what drop should you use to blunt a  Rho kinase inhibitor post-procedure IOP spike? Pilo  Netarsudil 145 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1)  Dorzolamide 2)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 146 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1) Managing angle closure  Dorzolamide 2) Deepening the angle in plateau-iris syndrome  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 147 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1) Managing angle closure  Dorzolamide 2) Deepening the angle in plateau-iris syndrome  Brinzolamide  Acetazolamide What is the feared side effect of pilo?  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 148 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1) Managing angle closure  Dorzolamide 2) Deepening the angle in plateau-iris syndrome  Brinzolamide  Acetazolamide What is the feared side effect of pilo? Retinal tears  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 149 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1) Managing angle closure  Dorzolamide 2) Deepening the angle in plateau-iris syndrome  Brinzolamide  Acetazolamide What is the feared side effect of pilo? Retinal tears  Selective  agonists  Apraclonidine Because of its association with retinal tears, what  Brimonidine should be done prior to initiation of (non-emergent)  Miotics pilo therapy?  Pilo  Rho kinase inhibitor  Netarsudil 150 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine Speaking of pilo--besides prophylaxing IOP spikes in  Dipivefrin pts on brimonidine, in what other situations is it useful?  CAI 1) Managing angle closure  Dorzolamide 2) Deepening the angle in plateau-iris syndrome  Brinzolamide  Acetazolamide What is the feared side effect of pilo? Retinal tears  Selective  agonists  Apraclonidine Because of its association with retinal tears, what  Brimonidine should be done prior to initiation of (non-emergent)  Miotics pilo therapy?  Pilo A careful retina evaluation  Rho kinase inhibitor  Netarsudil 151 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 152 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 153 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called?  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 154 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 155 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to the eyes, what does activation of each subtype produce?  Travaprost 1: --Vasoconstriction  Bimataprost --Pupil mydriasisIn the present context, how many subtypes of  receptors  Nonselective  agonist --Eyelid retractionare we concerned about?  Epinephrine 2: Two  Dipivefrin --Reduced IOP and  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 156 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to the eyes, what does activation of each subtype produce?  Travaprost 1: --Vasoconstriction  Bimataprost --Pupil mydriasisoneIn word the present context, how many subtypes of  receptors  Nonselective  agonist one word --Eyelid retractionare we concerned about?  Epinephrine 2: Two  Dipivefrin --Reduced IOPacronym and  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 157 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to the eyes, what does activation of each subtype produce?  Travaprost 1: --Vasoconstriction  Bimataprost --Pupil mydriasisIn the present context, how many subtypes of  receptors  Nonselective  agonist --Eyelid retractionare we concerned about?  Epinephrine 2: Two  Dipivefrin --Reduced IOP and  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 158 Ocular Hypotensives: List the common agents

  blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Note:Latanaprost The latest (inWith my respect possession) to the eyes, BCSC what Glaucoma does activationbook of states each subtypethat produce? neuroprotectionTravaprost is1 another: ‘possible’ effect of 2 stimulation. That said, it doesn’t elaborate on this claim,--Vasoconstriction or explain what is meant by ‘neuroprotection’ (in fact, the  Bimataprost term doesn’t even--Pupil appear mydriasis in theIn the book’s present index) context, how many subtypes of  receptors  Nonselective  agonist --Eyelid retractionare we concerned about?  Epinephrine 2: Two  Dipivefrin --Reduced IOP and ‘neuroprotection’?  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 159 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide What does it mean to say the selective  agonists are  Acetazolamide selective? What are they ‘selecting’?  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 160 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide What does it mean to say the selective  agonists are  Acetazolamide selective? What are they ‘selecting’?  Selective  agonists It means they preferentially stimulate 2 receptors more than   Apraclonidine 1  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 161 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide What does it mean to say the selective  agonists are  Acetazolamide selective? What are they ‘selecting’?  Selective  agonists It means they preferentially stimulate 2 receptors more than   Apraclonidine 1  Brimonidine One agent is significantly more 2-selective than the  Miotics other (it is often described as a ‘highly selective   Pilo agonist’). Which is it?  Rho kinase inhibitor  Netarsudil 162 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost In the present context, how many subtypes of  receptors  Nonselective  agonist are we concerned about?  Epinephrine Two  Dipivefrin  CAI What are these two  receptor subtypes called? They are called  and   Dorzolamide 1 2  Brinzolamide What does it mean to say the selective  agonists are  Acetazolamide selective? What are they ‘selecting’?  Selective  agonists It means they preferentially stimulate 2 receptors more than   Apraclonidine 1  Brimonidine One agent is significantly more 2-selective than the  Miotics other (it is often described as a ‘highly selective   Pilo agonist’). Which is it? Brimonidine  Rho kinase inhibitor  Netarsudil 163 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 164 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 165 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 166 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 167 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --  CAI --  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 168 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --Contacttwo dermatitis words of the lid and periorbital skin  CAI --Folliculartype (one word) conjunctivitis  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 169 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --Contact dermatitis of the lid and periorbital skin  CAI --Follicular conjunctivitis  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 170 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --Contact dermatitis of the lid and periorbital skin  CAI --Follicular conjunctivitis  Dorzolamide  Brinzolamide When you encounter a follicular conjunctivitis, three things  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --  Brimonidine --  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 171 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --Contact dermatitis of the lid and periorbital skin  CAI --Follicular conjunctivitis  Dorzolamide  Brinzolamide When you encounter a follicular conjunctivitis, three things  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viralclass infection  Brimonidine --Chlamydiaspecific bug infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 172 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist  Epinephrine There are two classic manifestations of iopidine sensitivity— what are they?  Dipivefrin --Contact dermatitis of the lid and periorbital skin  CAI --Follicular conjunctivitis  Dorzolamide  Brinzolamide When you encounter a follicular conjunctivitis, three things  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viral infection  Brimonidine --Chlamydia infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 173 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist As if a high likelihood of topical sensitivity wasn’t enough,  Epinephrine There are two classic manifestations of iopidine sensitivity— iopidinewhat has are another they? drawback that also renders it inappropriate  Dipivefrin for long-term--Contact IOP dermatitis control. Wofhat the is lid this and second periorbital dealbreaker? skin  CAI A high-- Follicularpropensity forconjunctivitis the development of tachyphylaxis  Dorzolamide  Brinzolamide When you encounter a follicular conjunctivitis, three things  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viral infection  Brimonidine --Chlamydia infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 174 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist As if a high likelihood of topical sensitivity wasn’t enough,  Epinephrine There are two classic manifestations of iopidine sensitivity— iopidinewhat has are another they? drawback that also renders it inappropriate  Dipivefrin for long-term--Contact IOP dermatitis control. Wofhat the is lid this and second periorbital dealbreaker? skin  CAI A high-- Follicularpropensity forconjunctivitis the development of tachyphylaxis  Dorzolamide  Brinzolamide When you encounter a follicular conjunctivitis, three things  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viral infection  Brimonidine --Chlamydia infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 175 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist As if a high likelihood of topical sensitivity wasn’t enough,  Epinephrine There are two classic manifestations of iopidine sensitivity— iopidinewhat has are another they? drawback that also renders it inappropriate  Dipivefrin for long-term--Contact IOP dermatitis control. Wofhat the is lid this and second periorbital dealbreaker? skin  CAI A high-- Follicularpropensity forconjunctivitis the development of tachyphylaxis  Dorzolamide  Brinzolamide When youWhat encounter is tachyphylaxis? a follicular conjunctivitis, three things The tendency of a drug to lose effectiveness over time  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viral infection  Brimonidine --Chlamydia infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 176 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol How notorious is it, ie, what proportion of pts develop  Carteolol topical sensitivity?  Prostaglandin analogues Almost half!  Latanaprost  Travaprost Which agent is notoriously allergenic?  Bimataprost Iopidine  Nonselective  agonist As if a high likelihood of topical sensitivity wasn’t enough,  Epinephrine There are two classic manifestations of iopidine sensitivity— iopidinewhat has are another they? drawback that also renders it inappropriate  Dipivefrin for long-term--Contact IOP dermatitis control. Wofhat the is lid this and second periorbital dealbreaker? skin  CAI A high-- Follicularpropensity forconjunctivitis the development of tachyphylaxis  Dorzolamide  Brinzolamide When youWhat encounter is tachyphylaxis? a follicular conjunctivitis, three things The tendency of a drug to lose effectiveness over time  Acetazolamide (ie, causes) should come to mind. One is reaction to a ‘toxin’ such as iopidine. What are the other two?  Selective agonists  --Toxin  Apraclonidine --Viral infection  Brimonidine --Chlamydia infection  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 177 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 178 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 179 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  LatanaprostIopidine sensitivity:  Travaprost--Contact dermatitis of the lid and periorbital skin  Bimataprost--Follicular conjunctivitis ?  Nonselective  agonist  Epinephrine Are the manifestations of brimonidine sensitivity the same as those to iopidine?  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 180 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  LatanaprostIopidine sensitivity:  Travaprost--Contact dermatitis of the lid and periorbital skin  Bimataprost--Follicular conjunctivitis Yes  Nonselective  agonist  Epinephrine Are the manifestations of brimonidine sensitivity the same as those to iopidine?  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 181 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists Almost half of iopidine pts develop sensitivity to it. In this regard, how notorious is brimonidine?  Apraclonidine Much less so, although still significant—between  Brimonidine 10 and 15%  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 182 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists Almost half of iopidine pts develop sensitivity to it. In this regard, how notorious is brimonidine?  Apraclonidine Much less so, although still significant—between  Brimonidine 10 and 15%  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 183 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists Almost half of iopidine pts develop sensitivity to it. In this regard, how notorious is brimonidine?  Apraclonidine Much less so, although still significant—between  Brimonidine 10 andIf a pt15% is known to be allergic to iopidine, is it a given  Miotics that s/he will be allergic to brimonidine?  Pilo Surprisingly no--the cross-sensitivity between these  Rho kinase inhibitor meds is minimal  Netarsudil 184 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin As mentioned above, iopidine is not in common usage as  CAI a long-term IOP med. Of the meds that are commonly  Dorzolamide used long-term, which is most notoriously allergenic?  Brinzolamide Brimonidine  Acetazolamide  Selective  agonists Almost half of iopidine pts develop sensitivity to it. In this regard, how notorious is brimonidine?  Apraclonidine Much less so, although still significant—between  Brimonidine 10 andIf a pt15% is known to be allergic to iopidine, is it a given  Miotics that s/he will be allergic to brimonidine?  Pilo Surprisingly no--the cross-sensitivity between these  Rho kinase inhibitor meds is minimal  Netarsudil 185 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 186 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide (and methazolamide)  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 187 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide --Hematologic issues:  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’) taste  Brimonidine --Nephrolithiasis  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 188 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide --Hematologic issues:  Acetazolamide --Aplastictwo specific anemia issues  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’)classic descriptor taste  Brimonidine --Nephrolithiasis  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 189 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide --Hematologic issues:  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’) taste  Brimonidine --Nephrolithiasis  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 190 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide How do the--Hematologic parasthesias typically issues: manifest?  Acetazolamide As tingling of fingers, toes--Aplastic and perioral anemia area  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’) taste  Brimonidine --Nephrolithiasis  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 191 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide How do the--Hematologic parasthesias typically issues: manifest?  Acetazolamide As tingling of fingers, toes--Aplastic and perioral anemia area  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’) taste  Brimonidine --Nephrolithiasis  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 192 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression?  Dorzolamide --Paresthesias?  Brinzolamide --Hematologic issues:  Acetazolamide --Aplastic anemia?  Selective  agonists --Thrombocytopenia?  Apraclonidine --Bitter (‘metallic’) taste?  Brimonidine --Nephrolithiasis?  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 193 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide --Paresthesias  Brinzolamide --Hematologic issues:  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia  Apraclonidine --Bitter (‘metallic’) taste  Brimonidine --Nephrolithiasis  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 194 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—what--Hematologic is it? issues: It stings  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The solution --Bitterhas to be (‘metallic’) somewhat tasteacidic to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 195 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—what--Hematologic is it? issues: It stings  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The solution --Bitterhas to be (‘metallic’) somewhat tasteacidic to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 196 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—what--Hematologic is it? issues: It stings  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The solution --Bitterhas to be (‘metallic’) somewhat tasteacidic to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 197 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—what--Hematologic is it? issues: It stings  Acetazolamide --Aplastic anemia  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The vehicle has--Bitter to be (‘metallic’) somewhat acidictaste to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 198 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—whatIf--Hematologic a pt balks is at it? making issues: their eye sting 3x/d, what can It stings you do to ease their suffering (other than d/c’ing it)?  Acetazolamide --Aplastic anemia Dose it bid (it is nearly as efficacious bid as it is tid)  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The vehicle has--Bitter to be (‘metallic’) somewhat acidictaste to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 199 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which of these is available PO?  Bimataprost Acetazolamide and methazolamide  Nonselective  agonist  Epinephrine What are the common systemic side effects of  Dipivefrin PO CAIs?  CAI --Malaise/fatigue/depression  Dorzolamide Topical dorzolamide--Paresthesias is notorious for a particular  Brinzolamide adverse effect—whatIf--Hematologic a pt balks is at it? making issues: their eye sting 3x/d, what can It stings you do to ease their suffering (other than d/c’ing it)?  Acetazolamide --Aplastic anemia Dose it bid (it is nearly as efficacious bid as it is tid)  Selective  agonists --Thrombocytopenia Why does it sting?  Apraclonidine The vehicle has--Bitter to be (‘metallic’) somewhat acidictaste to keep  Brimonidine the medicine--Nephrolithiasis in solution  Miotics  Pilo Which of these is associated with topical CAIs?  Rho kinase inhibitor  Netarsudil 200 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost Which two drugs lowers episcleral  Nonselective  agonist venous pressure (EVP)?  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 201 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost Which two drugs lowers episcleral  Nonselective  agonist venous pressure (EVP)?  Epinephrine Iopidine and netarsudil (maybe)  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 202 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Are beta blockers known to cause significant ocular  Prostaglandin analogues side effects?  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 203 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Are beta blockers known to cause significant ocular  Prostaglandin analogues side effects?  Latanaprost No; beta blocker side effects of concern are  Travaprost systemic, not ocular  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 204 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Are beta blockers known to cause significant ocular  Prostaglandin analogues side effects?  Latanaprost No; beta blocker side effects of concern are  Travaprost systemic, not ocular  Bimataprost  Nonselective  agonist What systemic side effects are of particular concern?  Epinephrine 1) Cardiac arrhythmias (so avoid in pts with cardiac  Dipivefrin conduction issues, eg, heart block)  CAI 2) Bronchospasm (so avoid in pts with lung dz,  Dorzolamide especially COPD and asthma)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 205 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Are beta blockers known to cause significant ocular  Prostaglandin analogues side effects?  Latanaprost No; beta blocker side effects of concern are  Travaprost systemic, not ocular  Bimataprost  Nonselective  agonist What systemic side effects are of particular concern?  Epinephrine 1) Cardiac arrhythmias (so avoid in pts with cardiac  Dipivefrin conduction issues, eg, heart block)  CAI 2) Bronchospasm (so avoid in pts with lung dz,  Dorzolamide especially COPD and asthma)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 206 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 207 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost They are all of very similar efficacy  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 208 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost They are all of very similar efficacy  Travaprost  Bimataprost In population-based studies, which prostaglandin analogue has the best tolerability?  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 209 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost They are all of very similar efficacy  Travaprost  Bimataprost In population-based studies, which prostaglandin analogue has the best tolerability?  Nonselective  agonist They are all of very similar tolerability  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 210 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost They are all of very similar efficacy  Travaprost  Bimataprost In population-based studies, which prostaglandin analogue has the best tolerability?  Nonselective  agonist They are all of very similar tolerability  Epinephrine So, doesDipivefrin this mean they are all therapeutically equal? No!CAI The fact that aggregated data fail to find differences in efficacy/tolerability does not mean suchDorzolamide differences do not exist for individual pts. Thus, if you have a pt who either does notBrinzolamide respond to, or is intolerant of, one PGA, you should not give up on the class entirely; Acetazolamide rather, consider switching to a different PGA. As a general rule, at least two PGAsSelective should be agonists tried before you give up on the class.  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 211 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol In population-based studies, which prostaglandin  Prostaglandin analogues analogue is the most efficacious?  Latanaprost They are all of very similar efficacy  Travaprost  Bimataprost In population-based studies, which prostaglandin analogue has the best tolerability?  Nonselective  agonist They are all of very similar tolerability  Epinephrine So, doesDipivefrin this mean they are all therapeutically equal? No!CAI The fact that aggregated data fail to find differences in efficacy/tolerability does not mean suchDorzolamide differences do not exist for individual pts. Thus, if you have a pt who either does notBrinzolamide respond to, or is intolerant of, one PGA, you should not give up on the class entirely; Acetazolamide rather, consider switching to a different PGA. As a general rule, at least two PGAsSelective should be agonists tried before you give up on the class.  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 212 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1)  Travaprost 2)  Bimataprost 3) 4)  Nonselective  agonist 5)  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 213 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 214 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Do PGAs cause acute hyperemia, chronic hyperemia, or both?  CAI Both  Dorzolamide How can you minimize the cosmetic impact of acute hyperemia?  Brinzolamide By having the pt use their PGA at bedtime, when cosmesis is not  Acetazolamide an issue  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 215 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Do PGAs cause acute hyperemia, chronic hyperemia, or both?  CAI Both  Dorzolamide How can you minimize the cosmetic impact of acute hyperemia?  Brinzolamide By having the pt use their PGA at bedtime, when cosmesis is not  Acetazolamide an issue  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 216 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Do PGAs cause acute hyperemia, chronic hyperemia, or both?  CAI Both  Dorzolamide How can you minimize the cosmetic impact of acute hyperemia?  Brinzolamide By having the pt use their PGA at bedtime, when cosmesis is not  Acetazolamide an issue  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 217 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Do PGAs cause acute hyperemia, chronic hyperemia, or both?  CAI Both  Dorzolamide How can you minimize the cosmetic impact of acute hyperemia?  Brinzolamide By having the pt use their PGA at bedtime, when cosmesis is not  Acetazolamide an issue  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 218 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to darken, light irides or dark irides?  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 219 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to darken, light irides or dark irides?  CAI Light  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 220 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamide to experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  Apraclonidine Because the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 221 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 222 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 223 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 224 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 225 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 226 Ocular Hypotensives: List the common agents

  blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Which are more likely to get PGA-associated CME, phakic or pseudophakic eyes? Pseudophakic  CAI  DorzolamideWhat event during cataract surgery will render a pseudophakic eye even more likely  Brinzolamideto experience PGA-associated CME? Posterior-capsule rupture  Acetazolamide  Selective  agonistsWhy is the term cystoid macular edema something of a misnomer for this condition?  ApraclonidineBecause the condition is usually ‘dry’ (ie, there is no edema present)  Brimonidine  Miotics For this reason, the condition is sometimes described as cystoid macular degeneration (ie, CMD)  Pilo  Rho kinase inhibitor  Netarsudil 227 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin What is Prostaglandin-Associated Periorbitopathy (PAP)?  CAI A constellation of orbital/periorbital changes including deepening of the sulcus, atrophy of periorbital fat, enophthalmos, and tight eyelids  Dorzolamide  BrinzolamideIs PAP reversible with cessation of PGA therapy?  AcetazolamideUnknown  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 228 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin What is Prostaglandin-Associated Periorbitopathy (PAP)?  CAI A constellation of orbital/periorbital changes including deepening of the sulcus, atrophy of periorbital fat, enophthalmos, and tight eyelids  Dorzolamide  BrinzolamideIs PAP reversible with cessation of PGA therapy?  AcetazolamideUnknown  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 229 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin What is Prostaglandin-Associated Periorbitopathy (PAP)?  CAI A constellation of orbital/periorbital changes including deepening of the sulcus, atrophy of periorbital fat, enophthalmos, and tight eyelids  Dorzolamide  BrinzolamideIs PAP reversible with cessation of PGA therapy?  AcetazolamideUnknown  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 230 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin What is Prostaglandin-Associated Periorbitopathy (PAP)?  CAI A constellation of orbital/periorbital changes including deepening of the sulcus, atrophy of periorbital fat, enophthalmos, and tight eyelids  Dorzolamide  BrinzolamideIs PAP reversible with cessation of PGA therapy?  AcetazolamideUnknown  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 231 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Note that of the five side effects identified, four are related to cosmesis.  CAI This implies that caution should be exercised in long-term use of PGAs in one class of pts (other than supermodels). Which pts are these?  Dorzolamide Those with unilateral glaucoma  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 232 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol Prostaglandin analogues have a number of  Prostaglandin analogues notable side effects. Identify 5 of them:  Latanaprost 1) Eyelash growth  Travaprost 2) Conjunctival hyperemia  Bimataprost 3) Darkening of irides 4) Cystoid macular edema (CME)  Nonselective  agonist 5) PG-associated periorbitopathy (PAP)  Epinephrine  Dipivefrin Note that of the five side effects identified, four are related to cosmesis.  CAI This implies that caution should be exercised in long-term use of PGAs in one class of pts (other than supermodels). Which pts are these?  Dorzolamide Those with unilateral glaucoma  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 233 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost A small number (~1%) of PGA pts will experience an idiosyncratic reaction  Bimataprost significant enough to warrant discontinuation. What is that reaction? Uveitis  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 234 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost A small number (~1%) of PGA pts will experience an idiosyncratic reaction  Bimataprost significant enough to warrant discontinuation. What is that reaction? Uveitis  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 235 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost A small number (~1%) of PGA pts will experience an idiosyncratic reaction  Bimataprost significant enough to warrant discontinuation. What is that reaction? Uveitis  Nonselective  agonist  Epinephrine  Dipivefrin Another commonly-used med on the list is can cause uveitis, specifically a granulomatous anterior uveitis. Which one?  CAI Brimonidine  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 236 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost A small number (~1%) of PGA pts will experience an idiosyncratic reaction  Bimataprost significant enough to warrant discontinuation. What is that reaction? Uveitis  Nonselective  agonist  Epinephrine  Dipivefrin Another commonly-used med on the list is can cause uveitis, specifically a granulomatous anterior uveitis. Which one?  CAI Brimonidine  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 237 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 238 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 239 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 240 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 241 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 242 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol What corneal condition is a strong contraindication to PGA use?  Carteolol HSV keratitis  Prostaglandin analogues  Latanaprost Are we talking about active dz only, or does this apply also to a history of HSV keratitis?  Travaprost Both  Bimataprost  Nonselective  agonist Why the contraindication?  Epinephrine PGA use has been associated with prolongation and/or recurrence of HSV keratitis  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 243 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin These three are pro-drugs; i.e., they become  CAI activated via cleavage by corneal esterases: --  Dorzolamide --  Brinzolamide --  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 244 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost Latanaprostene bunod  Nonselective  agonist  Epinephrine  Dipivefrin These three are pro-drugs; i.e., they become  CAI activated via cleavage by corneal esterases: --Travaprost  Dorzolamide --Latanaprost  Brinzolamide --Latanaprostene bunod  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 245 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which class must be used cautiously in  Bimataprost patients who take MAOIs and/or tricyclics?  Nonselective  agonist (Monoamine oxidase inhibitors)  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 246 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost Which class must be used cautiously in  Bimataprost patients who take MAOIs and/or tricyclics?  Nonselective  agonist The selective  agonists  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 247 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonistTopical CAIs are relatively contraindicated in Fuchs dystrophy  Epinephrine pts. Why? Because they may cause/exacerbate corneal edema  Dipivefrin  CAI What is the mechanism for CAI-induced corneal edema?  Dorzolamide Recall that endothelial cells make use of carbonic anhydrase in  Brinzolamide performing their pump function to maintain K deturgescence.  Acetazolamide In addition to inhibiting aqueous formation, topical CAIs inhibit  Selective  agonists K endothelial pump function. If endothelial pump function is  Apraclonidine already tenuous (as it is in Fuchs), the addition of a CAI could  Brimonidine lead to the occurrence or worsening of edema.  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 248 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonistTopical CAIs are relatively contraindicated in Fuchs dystrophy  Epinephrine pts. Why? Because they may cause/exacerbate corneal edema  Dipivefrin  CAI What is the mechanism for CAI-induced corneal edema?  Dorzolamide Recall that endothelial cells make use of carbonic anhydrase in  Brinzolamide performing their pump function to maintain K deturgescence.  Acetazolamide In addition to inhibiting aqueous formation, topical CAIs inhibit  Selective  agonists K endothelial pump function. If endothelial pump function is  Apraclonidine already tenuous (as it is in Fuchs), the addition of a CAI could  Brimonidine lead to the occurrence or worsening of edema.  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 249 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonistTopical CAIs are relatively contraindicated in Fuchs dystrophy  Epinephrine pts. Why? Because they may cause/exacerbate corneal edema  Dipivefrin  CAI What is the mechanism for CAI-induced corneal edema?  Dorzolamide Recall that endothelial cells make use of carbonic anhydrase in  Brinzolamide performing their pump function to maintain K deturgescence.  Acetazolamide In addition to inhibiting aqueous formation, topical CAIs inhibit  Selective  agonists K endothelial pump function. If endothelial pump function is  Apraclonidine already tenuous (as it is in Fuchs), the addition of a CAI could  Brimonidine lead to the occurrence or worsening of edema.  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 250 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost  Travaprost  Bimataprost  Nonselective  agonistTopical CAIs are relatively contraindicated in Fuchs dystrophy  Epinephrine pts. Why? Because they may cause/exacerbate corneal edema  Dipivefrin  CAI What is the mechanism for CAI-induced corneal edema?  Dorzolamide Recall that endothelial cells make use of carbonic anhydrase in  Brinzolamide performing their pump function to maintain K deturgescence.  Acetazolamide In addition to inhibiting aqueous formation, topical CAIs inhibit  Selective  agonists K endothelial pump function. If endothelial pump function is  Apraclonidine already tenuous (as it is in Fuchs), the addition of a CAI could  Brimonidine lead to the occurrence or worsening of edema.  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 251 Ocular WhatHypotensives: is the ‘nonresponder’ List the common rate for the agents  blockers, ie, what Q percent of pts will not manifest a meaningful decrease in IOP?   blockers 10-20  Timolol  Betaxolol What is a well-known cause of nonresponding that should  Carteolol probably keep you from trying a  blocker in the first place?  Prostaglandin analoguesIf the pt is on a systemic  blocker (eg, for HTN). In such pts, a topical  blocker is unlikely to move IOP much.  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 252 Ocular WhatHypotensives: is the ‘nonresponder’ List the common rate for the agents  blockers, ie, what A percent of pts will not manifest a meaningful decrease in IOP?   blockers 10-20  Timolol  Betaxolol What is a well-known cause of nonresponding that should  Carteolol probably keep you from trying a  blocker in the first place?  Prostaglandin analoguesIf the pt is on a systemic  blocker (eg, for HTN). In such pts, a topical  blocker is unlikely to move IOP much.  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 253 Ocular WhatHypotensives: is the ‘nonresponder’ List the common rate for the agents  blockers, ie, what Q percent of pts will not manifest a meaningful decrease in IOP?   blockers 10-20  Timolol  Betaxolol What is a well-known cause of nonresponding that should  Carteolol probably keep you from trying a  blocker in the first place?  Prostaglandin analoguesIf the pt is on a systemic  blocker (eg, for HTN). In such pts, a topical  blocker is unlikely to move IOP much.  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 254 Ocular WhatHypotensives: is the ‘nonresponder’ List the common rate for the agents  blockers, ie, what A percent of pts will not manifest a meaningful decrease in IOP?   blockers 10-20  Timolol  Betaxolol What is a well-known cause of nonresponding that should  Carteolol probably keep you from trying a  blocker in the first place?  Prostaglandin analoguesIf the pt is on a systemic  blocker (eg, for HTN). In such pts, a topical  blocker may not move IOP much.  Latanaprost  Travaprost  Bimataprost  Nonselective  agonist  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 255 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 256 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 257 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 258 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 259 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 260 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 261 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them What treatment options fall under ‘none’? --SuspendDipivefrin all treatment during pregnancy--just monitor the pt, and resume tx after delivery  --CAI Which are Class B? -- Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 262 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them What treatment options fall under ‘none’? --Suspend Dipivefrin all treatment during pregnancy--just monitor the pt, and resume tx after delivery  --IfCAI suspending tx seems imprudent, considerWhich SLT are Class B?

--If conditionsDorzolamide warrant it, consider incisionalBrimonidine.two words surgery (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 263 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them What treatment options fall under ‘none’? --Suspend Dipivefrin all treatment during pregnancy--just monitor the pt, and resume tx after delivery  --IfCAI suspending tx seems imprudent, considerWhich SLT are Class B? --If conditionsDorzolamide warrant it, consider incisionalBrimonidine. surgery (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 264 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 265 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol %?  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25%% strength rather than the usual 0.5%%  Rho kinase inhibitor  Netarsudil 266 A Ocular Hypotensives: List the common agents   blockers  Timolol 0.5/0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 267 Q Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)

 Brinzolamide You probably know that the cap color for T.5 is…yellow  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 268 A Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)

 Brinzolamide You probably know that the cap color for T.5 is…yellow  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 269 Q Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)

 Brinzolamide You probably know that the cap color for T.5 is…yellow  Acetazolamide OK then, how should glaucoma be managed during pregnancy? But Selectivedo you know  theagonists cap color for T. ? Light blue With25 as few meds as possible (preferably none)  Apraclonidine  Brimonidine If meds are to be used, which is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 271 Q Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  ApraclonidineWon’t the 0.25 strength be only half as effective as the 0.5?  BrimonidineFar from it. In fact, inIf manymeds pts, are it to works be used, just aswhich well is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 272 A Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide OK then, how should glaucoma be managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  ApraclonidineWon’t the 0.25 strength be only half as effective as the 0.5?  BrimonidineFar from it. In fact, inIf manymeds pts, are it to works be used, just aswhich well is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 273 Q Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide What about nursing mothers—should T.25 be used for them as well?  Acetazolamide No, because  blocker OKmetabolites then ,how get cshouldoncentrated glaucoma in breast be milk managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  ApraclonidineWon’t the 0.25 strength be only half as effective as the 0.5?  BrimonidineFar from it. In fact, inIf manymeds pts, are it to works be used, just aswhich well is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 274 A Ocular Hypotensives: List the common agents   blockers  Timolol 0.25  Betaxolol  Carteolol  Prostaglandin analogues  Latanaprost With respect to pregnancy, and under the  Travaprost former system of classifying drugs:  Bimataprost  Nonselective  agonist Which are Class A?  Epinephrine None of them  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide What about nursing mothers—should T.25 be used for them as well?  Acetazolamide No, because  blocker OKmetabolites then ,how get cshouldoncentrated glaucoma in breast be milk managed during pregnancy?  Selective  agonists With as few meds as possible (preferably none)  ApraclonidineWon’t the 0.25 strength be only half as effective as the 0.5?  BrimonidineFar from it. In fact, inIf manymeds pts, are it to works be used, just aswhich well is the best option?  Miotics Most experts would probably recommend timolol, but at the  Pilo 0.25% strength rather than the usual 0.5%  Rho kinase inhibitor  Netarsudil 275 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Why not use a PGA in pregnant women?  Latanaprost ReachWith wayrespect back to to pregnancy,your Ob/Gyn and rotation under and the recall  Travaprost thatformer prostaglandins system of are classifying involved in drugs: inducing labor .  Bimataprost Given this, it should not be surprising to learn that  Nonselective  agonist oneWhich shouldn’t are Classgive a pregnantA? woman a  Epinephrine prostaglandinNone of them analogue.  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 276 Q/A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Why not use a PGA in pregnant women?  Latanaprost ReachWith wayrespect back to to pregnancy,your Ob/Gyn and rotation under and the recall  Travaprost thatformer prostaglandins system of are classifying involved in drugs: inducingtwo words labor .  Bimataprost Given this, it should not be surprising to learn that  Nonselective  agonist oneWhich shouldn’t are Classgive a pregnantA? woman a  Epinephrine prostaglandinNone of them analogue.  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 277 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Why not use a PGA in pregnant women?  Latanaprost ReachWith wayrespect back to to pregnancy,your Ob/Gyn and rotation under and the recall  Travaprost thatformer prostaglandins system of are classifying involved in drugs: inducing labor .  Bimataprost Given this, it should not be surprising to learn that  Nonselective  agonist oneWhich shouldn’t are Classgive a pregnantA? woman a  Epinephrine prostaglandinNone of them analogue.  Dipivefrin  CAI Which are Class B?  Dorzolamide Brimonidine. (The rest are all Class C.)  Brinzolamide  Acetazolamide  Selective  agonists  Apraclonidine  Brimonidine  Miotics  Pilo  Rho kinase inhibitor  Netarsudil 278 Q Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Why not use a PGA in pregnant women?  Latanaprost ReachWith wayrespect back to to pregnancy,your Ob/Gyn and rotation under and the recall  Travaprost thatformer prostaglandins system of are classifying involved in drugs: inducing labor .  Bimataprost Given this, it should not be surprising to learn that  Nonselective  agonist oneWhich shouldn’t are Classgive a pregnantA? woman a  Epinephrine prostaglandinNone of them analogue.  Dipivefrin  CAI Why not useWhich a CAI? are Class B?  Dorzolamide CAIs have beenBrimonidine. shown to be(The teratogenic rest are in all mice. Class For C.) this  Brinzolamide reason, the BCSC Glaucoma book states flatly that “oral CAIs  Acetazolamide should not be used by women in their childbearing years.”  Selective  agonists That said, the Neuro-Oph book considers oral CAIs to be first-line tx for IIH—a condition most commonly found in  Apraclonidine women in their…childbearing years. Caveat emptor.  Brimonidine  Miotics As for topical CAIs in pregnancy, the Glaucoma book doesn’t  Pilo address them directly.  Rho kinase inhibitor  Netarsudil 279 A Ocular Hypotensives: List the common agents   blockers  Timolol  Betaxolol  Carteolol  Prostaglandin analogues Why not use a PGA in pregnant women?  Latanaprost ReachWith wayrespect back to to pregnancy,your Ob/Gyn and rotation under and the recall  Travaprost thatformer prostaglandins system of are classifying involved in drugs: inducing labor .  Bimataprost Given this, it should not be surprising to learn that  Nonselective  agonist oneWhich shouldn’t are Classgive a pregnantA? woman a  Epinephrine prostaglandinNone of them analogue.  Dipivefrin  CAI Why not useWhich a CAI? are Class B?  Dorzolamide CAIs have beenBrimonidine. shown to be(The teratogenic rest are in all mice. Class For C.) this  Brinzolamide reason, the BCSC Glaucoma book states flatly that “oral CAIs  Acetazolamide should not be used by women in their childbearing years.”  Selective  agonists That said, the Neuro-Oph book considers oral CAIs to be first-line tx for IIH—a condition most commonly found in  Apraclonidine women in their…childbearing years. Caveat emptor.  Brimonidine  Miotics As for topical CAIs in pregnancy, the Glaucoma book doesn’t  Pilo address them directly.  Rho kinase inhibitor  Netarsudil