Current Considerations in the Treatment of Glaucoma
Current Considerations in the Treatment of Glaucoma
It is vital that pharmacists understand the pathophysiology of glaucoma and the goals of therapy. Pharmacists should counsel patients that the goal of treatment is to prevent progression of glaucoma by lowering IOP. Pharmacists also need to remind patients that many of the adverse effects of the medications are brief and will go away in time. This may help to improve adherence to the regimen.
Absorption of certain medications, especially beta-blockers and drugs that can produce anticholinergic effects, may produce serious systemic side effects. Therefore, pharmacists should counsel patients on the proper instillation of eyedrops, including the use of punctal occlusion (pressing on the bridge of the nose to prevent the drops from entering the nasolacrimal duct). Simply closing the eye (but not blinking) is an equally effective alternative. Either of these procedures should be done for about 2 minutes.
Adherence is a problem with glaucoma patients. In one study, 45% of patients were shown to take <75% of their doses. Pharmacists can play an important role in helping to improve adherence by thoroughly counseling patients about the disease and the medications used to treat it. In the case of poor adherence to therapy, pharmacists can recommend that the prescriber consider a combination product. Pharmacists should also consider recommending a preservative-free product for patients experiencing ocular side effects as previously discussed. A combination product may also be a good recommendation if a patient is experiencing side effects due to preservatives and a preservative-free product is not commercially available.
Pharmacist Intervention
It is vital that pharmacists understand the pathophysiology of glaucoma and the goals of therapy. Pharmacists should counsel patients that the goal of treatment is to prevent progression of glaucoma by lowering IOP. Pharmacists also need to remind patients that many of the adverse effects of the medications are brief and will go away in time. This may help to improve adherence to the regimen.
Absorption of certain medications, especially beta-blockers and drugs that can produce anticholinergic effects, may produce serious systemic side effects. Therefore, pharmacists should counsel patients on the proper instillation of eyedrops, including the use of punctal occlusion (pressing on the bridge of the nose to prevent the drops from entering the nasolacrimal duct). Simply closing the eye (but not blinking) is an equally effective alternative. Either of these procedures should be done for about 2 minutes.
Adherence is a problem with glaucoma patients. In one study, 45% of patients were shown to take <75% of their doses. Pharmacists can play an important role in helping to improve adherence by thoroughly counseling patients about the disease and the medications used to treat it. In the case of poor adherence to therapy, pharmacists can recommend that the prescriber consider a combination product. Pharmacists should also consider recommending a preservative-free product for patients experiencing ocular side effects as previously discussed. A combination product may also be a good recommendation if a patient is experiencing side effects due to preservatives and a preservative-free product is not commercially available.
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