Glaucoma agents

Glaucoma agents

Drug monograph · NCLEX study reference
Therapeutic class	Antiglaucoma
Pharmacologic class	Prostaglandin analog, ophthalmic beta blocker, alpha-2 agonist, carbonic anhydrase inhibitor, cholinergic
Onset / peak / duration	Latanoprost once daily at night; others one to three times daily.
Half-life / level	Local; no routine level.
Routes	Ophthalmic
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Supportive care.
Pregnancy / lactation	Use only if clearly needed.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Glaucoma agents — Antiglaucoma; Prostaglandin analog, ophthalmic beta blocker, alpha-2 agonist, carbonic anhydrase inhibitor, cholinergic.

Identification

• Therapeutic class: Antiglaucoma.
• Pharmacologic class: Prostaglandin analog, ophthalmic beta blocker, alpha-2 agonist, carbonic anhydrase inhibitor, cholinergic.

Pharmacology

• Mechanism of action: Lower intraocular pressure by increasing aqueous outflow (latanoprost, pilocarpine) or decreasing aqueous production (timolol, brimonidine, dorzolamide).
• Onset / peak / duration: Latanoprost once daily at night; others one to three times daily.
• Half-life / therapeutic level: Local; no routine level.

Clinical use

• Indications: Open-angle glaucoma and ocular hypertension.
• Usual dose, route, frequency: One drop per affected eye, frequency by agent.
• Maximum dose / adjustments: Space different drops by at least 5 minutes.

Safety

• Contraindications: Timolol with asthma, COPD, bradycardia, or heart block (systemic absorption).
• Black box warning: None.
• Interactions: Systemically absorbed timolol adds to oral beta blockers; dorzolamide is a sulfonamide.
• Pregnancy / lactation: Use only if clearly needed.
• High-alert: No.

Adverse effects

• Common side effects: Eye stinging and redness; latanoprost darkens the iris and lengthens and darkens eyelashes; pilocarpine causes miosis and dim vision.
• Serious effects to report: Timolol systemic effects (bradycardia, bronchospasm), severe eye pain or vision change.
• Antidote / reversal: Supportive care.

Nursing process

• Assessment before administration: Intraocular pressure, respiratory and cardiac history (timolol), eye appearance.
• Interventions during therapy: Apply punctal occlusion (press the inner corner) for 1 minute to reduce systemic absorption; wait 5 minutes between different drops; do not touch the dropper to the eye.
• Monitor: Intraocular pressure, heart rate and breathing (timolol), eye changes.
• Evaluation / expected outcome: Lowered intraocular pressure.

Patient teaching

• Patient teaching: Latanoprost may permanently darken eye color and lashes; press the inner corner after drops; do not touch the tip to the eye; never stop glaucoma drops abruptly.
• Notify provider if: Eye pain, vision changes, slow heartbeat or wheezing (timolol).
• Administration tips: Punctal occlusion; 5 minutes between drops; ointment last.