CLASS

MEDICATIONS USED IN TREATMENT OF GLAUCOMA

EXAMPLES
ACTION
SIDE EFFECTS
Iatanoprost (Xalatan),
bimatoprost (Lumigam),
travoprost (Travatan Z)

Relaxes muscles in eyes

interior structure to allow
better outflow of aqueous
humor.

Betaadrenergic
Blockers

betatoxol (Betoptic);
timolol (Timoptic,
Betimol, Isatalol),
levobunolol (Betagan),
carteolol (Occupress),
metipranolol
(OptiPranolol)

Decreases aqueous humor

production.

Alphaadrenergic
Agonists

dipivefrin (Propine);
apraclonidine (Iopidine),
brimonidine (Alphagan P),

Decreases aqueous humor

production and increases
outflow of aqueous humor.

Carbonic
Anhydrase
Inhibitors

Topical
brinzolamide (Azopt),
dorzolamide (Trusopt)
Oral
acetazolamide (Diamox),
methazolamide
(Neptazane)

Decreases aqueous humor

production & secretion.

pilocarpine (Akarpine,
Ocusert Pilo, Isopto
Carpine, Pilocar,
Pilopine), carbachol
(Isopto Carbahol)

Increases outflow of aqueous

humor through trabecular
network. Cause pupil to
constrict which assists in
opening the filtration angle.

Isosorbide solution
(Ismotic), glycerin
(Ophthalagan), mannitol
(Osmitrol)

Increases extracellular
osmolarity moving
intracellular water to
extracellular spaces

Prostaglandin
Analogs

Cholinergics
(miotics)

Hyperosmotic
Agents

Transient eye discomfort with

stinging, eye redness, itching,
burning, foreign body sensation;
blurred vision; increased brown iris
pigmentation & discoloration of
eyelid skin; eyelash growth
Transient eye discomfort, double
vision.
Decreased BP & HR, fatigue, SOB if
respiratory history. Contraindicated
in certain heart & lung conditions
(bradycardia, heart block > 1st
degree, overt heart failure, severe
COPD/asthma);
BS if DM b/c may cause
hypoglycemia,
Impotence & depression are rare SE
Elevated BP & HR, HTN,
stinging/burning on instillation,
blurred vision, blood-shot or itching
eyes, dilated pupils, fatigue,
drowsiness, H/A, dry mouth/nose;
Higher risk of allergic reaction
Transient eye discomfort with
stinging, burning, eye redness;
fatigue, nausea/ loss of appetite,
altered taste esp. with carbonated
beverages (metallic).
Oral: tingling/loss of strength in
hands/feet, stomach upset, mental
fuzziness, H/A, depression,
frequent urination
Transient eye discomfort, blurred
vision, diminished vision, esp. in
dark, brow ache, burning, H/A,
dysrhythmias, hypotension,
diarrhea, vomiting
N/V, H/A, confusion, syncope,
hypotension, dehydration,
dysrhythmias, tachycardia

NURSING
IMPLICATIONS
Once a day dosing in
evening. Remove
contacts 15 min before
instillation.
Assess HR & BP before
administration. Use
caution especially if
also taking systemic
beta blocker.

Assess HR & BP before

administration. Wear
darkened glasses.
Contraindicated if
angle-closure
glaucoma.
Many cannot tolerate
systemic SE. Check for
sulfa allergy. Do not
give if on high-dose
ASA. Shake well
immediately before
use. If oral med: weigh
daily; administer in
AM; rise slowly
Caution patient about
diminished visual
acuity, esp. in
darkened
environment. Check
HR & rhythm.
Assess heart & lung
sounds before
administration at risk
for heart failure/

reducing IOP.

Combination
Drugs

123014

Combigen (timolol +
brimonidine); Cosopt
(timolol + dorzolamide);
Xalacom (timolol +
latanoprost)

pulmonary edema