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.