Carbonic Anhydrase Inhibitors for Glaucoma, Uses and Safety Guide

Introduction:

Carbonic anhydrase inhibitors are important agents for lowering intraocular pressure. They work by reducing aqueous humor production in the ciliary body. They are available as topical drops for long-term management and as oral therapy for acute situations.

Uses:

• Primary open-angle glaucoma.

• Ocular hypertension.

• Acute angle-closure crisis, as adjunct therapy with oral acetazolamide.

Carbonic Anhydrase Inhibitors for Glaucoma, Uses and Safety Guide

Drug Class:

Topical drugs that block carbonic anhydrase II in the ciliary epithelium.

This action lowers intraocular pressure in glaucoma and ocular hypertension.

Mechanism:

• Reduce aqueous humor production.

• Produce a steady fall in intraocular pressure.

• Support optic nerve protection when used consistently.

Carbonic Anhydrase Inhibitors for Glaucoma, Uses and Safety Guide

Common Drugs:

• Dorzolamide eye drops.

• Brinzolamide eye drops.

• Acetazolamide tablets, used in acute angle-closure attacks or refractory cases.

Carbonic Anhydrase Inhibitors for Glaucoma, Uses and Safety Guide

Adverse Effects:

• Ocular burning or stinging.

• Blurred vision.

• Bitter taste.

• Conjunctivitis.

• Systemic acidosis, rare, with oral acetazolamide.

Contraindications:

• Sulfonamide allergy.

• Severe renal disease.

• Hyperchloremic acidosis.

• Caution in sickle cell disease.

Drug Interactions:

• High-dose aspirin increases risk of metabolic acidosis with acetazolamide.

• Diuretics increase electrolyte imbalance.

• Topiramate increases risk of metabolic acidosis.

Clinical Tips:

• Shake brinzolamide suspension before use.

• Press the nasolacrimal duct after application to reduce systemic absorption.

• Avoid oral acetazolamide in pregnancy.

• Monitor serum electrolytes during systemic therapy.

Key Takeaway:

Carbonic anhydrase inhibitors lower intraocular pressure by reducing aqueous humor formation. They work well for long-term therapy and are essential in acute angle-closure events when used with oral acetazolamide. Proper administration and monitoring improve safety and outcomes.

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