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Chapter 61. Glaucoma

Student Questions

The preferred treatment option for a 67-year-old male with POAG, no significant PMH, and allergy to benzalkonium chloride is:

A. Tafluprost

B. Latanoprost

C. Brinzolamide

D. Carbachol

Answer: A

Option A: Correct. Tafluprost is available in preservative-free single use dosing containers. Benzalkonium chloride is a common preservative for ophthalmic dosage forms. The ocular hypotensive lipids are considered a first-line therapy because of once-daily dosing and minimal systemic adverse effects.

Option B: Incorrect. Latanoprost is an ocular hypotensive lipid. The ocular hypotensive lipids are considered a first-line therapy because of once-daily dosing and minimal systemic adverse effects. However, latanoprost is not available in a preservative-free dosage form. Benzalkonium chloride is a common preservative for ophthalmic dosage forms.

Option C: Incorrect. Brinzolamide is not available in a preservative-free dosage form. Benzalkonium chloride is a common preservative for ophthalmic dosage forms. Additionally, carbonic anhydrase inhibitors are considered third line agents for glaucoma.

Option D: Incorrect. Indirect-acting cholinergics are considered last-line of use for glaucoma. Additionally, carbachol is not available in a preservative-free dosage form. Benzalkonium chloride is a common preservative for ophthalmic dosage forms.

An appropriate counseling statement for timolol is:

A. Do not use this medication if you are allergic to sulfonamides

B. This medication may cause mydriasis

C. This medication may cause bradycardia

D. This medication may cause an increase in iris pigmentation

Answer: C

Option A: Incorrect. Timolol, a β-adrenergic antagonist, is not associated with allergic cross-sensitivity with sulfonamides.

Option B: Incorrect. Timolol, a β-adrenergic antagonist, would not cause mydriasis. A β-adrenergic agonist would cause mydriasis by stimulating the contraction of the iris radial muscle.

Option C: Correct. Timolol, a β-adrenergic antagonist, has the potential to cause bradycardia. β-Blockers can cause significant systemic adverse effects through systemic absorption via the mucus membranes in the nasal-pharyngeal cavity.

Option D: Incorrect. Timolol, a β-adrenergic antagonist, is not associated with the increase in iris pigmentation.

An appropriate counseling statement for tafluprost is:

A. Do not use this medication if you are allergic to sulfonamides

B. This medication may cause mydriasis

C. This medication may cause bradycardia

D. This ...

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