Issue link: https://viewer.e-digitaledition.com/i/1238403
Be aware of side effects and Other Drug Interactions of Glaucoma Medications Ophthalmologist Anita Campbell, MD, is a fellowship- trained glaucoma specialist at Grene Vision Group. She provides the latest treatments available, including minimally invasive glaucoma surgery. ACCORDING TO THE American Academy of Ophthalmology, people over age 60 are at an increased risk for glaucoma. People in that age demographic also take multiple prescriptions, according to a 2019 poll by the Kaiser Family Foundation, a nonprofit that tracks health issues. Nearly 90% of Americans ages 65 and older and nearly 75% of 50- to 64-year-olds take prescription drugs, the study found. For this article, Dr. Campbell talks about four major classes of antihyper- tensive eye drops used to treat glaucoma and their potential side effects and interactions, which can be helpful for physicians in determining causes of certain symptoms or in prescribing drugs that can interact with glaucoma medication. As newer glaucoma drugs are being developed, new drug classes are being added to the glaucoma treatment arsenal, but they have fewer systemic side effects, Dr. Campbell said. Many glaucoma patients require treatment with eye drops in different classes. Systemic side effects are more likely to occur if the patient doesn't follow directions to facilitate the drop being absorbed in the eye. One minute of eyelid closure allows >90% ocular absorption. The remaining medication drains through the nasolacrimal duct into the vascular nasopharyngeal mucosa where systemic absorption can occur. Some sources recommend digital pressure near the bridge of the nose to prevent flow through the nasolacrimal duct, but it is hard for patients to find this landmark, so Dr. Campbell does not recommend it. ALPHA-2 ADRENERGIC AGONIST A commonly prescribed eye drop in this class is brimonidine, which decreases the production of intraocular fluid to reduce pressure. This drug may cause dizziness or dysequilibrium. Dr. Campbell avoids this medication in patients at risk of falls, such as the elderly or those using canes or walkers. The drug may also cause other symptoms such as lethargy, headaches and dryness in the mouth and nose. BY AMY GEISZLER-JONES WITH OLDER AMERICANS BEING MORE AT RISK FOR GL AUCOMA AND THAT SAME POPUL ATION TAKING MULTIPLE PRESCRIPTION MEDICATIONS, IT'S IMPORTANT FOR PRIMARY CARE PHYSICIANS TO UNDERSTAND THE SIDE EFFECTS AND POSSIBLE DRUG INTER ACTIONS OF THE VARIOUS PRESCRIPTION GL AUCOMA E YE DROPS, SAYS ANITA CAMPBELL, MD, A FELLOWSHIP-TR AINED GL AUCOMA SPECIALIST WITH GRENE VISION GROUP IN WICHITA. 1 4❱❱❱❱❱ S P E C I A L C L I N I C A L S E C T I O N : N E U R O L O G I C A L H E A LT H