I. Miotics

A) Action: increase drainage out of the eye, through the trabecular meshwork, to lower pressure in the eye.

B) Types Dosage per Day
- Pilocarpine (4)
- Carbachol (3)
- Phospholine Iodide-rarely available (2)



Side Effects: Dim vision, Blurry Vision, Brow Aches

II. Beta Blockers

A) Action: Decrease the formation of aqueous humor to lower eye pressure.

B) Types Dosage per Day
- Timolol (Timoptic) (also available in preservative free) (4)
- Timolol GFS (Timoptic XE) (1)
- Timolol (Betimol) (1)
- Levobunolol (Betagan) (1)
- Betaxalol (Betoptic-S) (1)
- Carteolol (Ocupress) (1)
- Metipranolol (Optipranolol) (1)



Side Effects: Breathing difficulties, Irregular heartbeat, Depression, Dizziness, Loss of libido, Loss of hair (rare)

III. Carbonic Anhydrase Inhibitors

A) Action: Decrease the formation of aqueous humor to lower eye pressure.

B) Types Dosage per Day
Pills
- Diamox (3-4)
- Neptazane (3-4)
Eyedrop Types
- Dorzolamide (Trusopt) (2-3)
- Brinzolamide (Azopt) (2-3)



Side Effects: Nausea, Diarrhea, Rash, Decreased appetite, Lethargy, Depression, Rare bone marrow depression, Bad taste in mouth

IV. Alpha 2 Agonists

A) Action: Decrease the formation of aqueous humor and decrease in venous pressure in blood vessels on the eye.

B) Types Dosage per Day
- Apraclonidine (Iopidine) (2-3)
- Brimonidine (Alphagan) (2-3)
- Brimonidine (Alphagan-P) (2-3)



Side Effects: Nausea, Diarrhea, Rash, Decreased appetite, Lethargy, Depression, Rare bone marrow depression, Bad taste in mouth

V. Prostoglandin Analogs

A) Action: Increase uveoscleral outflow

B) Types Dosage per Day
- Latanoprost (Xalatan) (1)
- Travaprost (Travatan) (1)
- Bimatoprost (Lumigan) (1)
- Zioptan (preservative free) (1)
- Unoprostone (Rescula) (2)



Side Effects: Blurred vision, Redness, Burning, Stinging, Darker, longer eye lashes,Respiratory tract infection/cold, Eye turns darker color, Atrophy of fat tissues around eye

Combination Drugs

A) Action: See each drug (above) for their combined actions and side effects.

B) Types Dosage per Day
Timolol and Dorzolamide (Cosopt) (also available in preservative free)  (2)
Timolol and Brimonidine (Combigan)  (2)
Brinzolamide and Brimonidine (Simbrinza) (2)


We Educate Our Patients