MOA of acetazolamide used in glaucoma:: (A) Increase aqueous production, (B) Increase uveo-scleral outflow, (C) Increase trabecular outflow, (D) Decrease aqueous production
Answer is D. Ans. (d) Decrease aqueous productionRef: A.K. Khurana 6th ed. /451-52* ACETAZOLAMIDE is a carbonic anhydrase inhibitor which acts in OAG by decreasing aqueous production.* Carbonic anhydrase derivatives are: Acetazolamide, Dorzolamide, Brinzolamide* Dorzolamide is mildest carbonic anhydrase inhibitor, hence considered as DOC for glaucoma in children.* Alpha-2 agonist (Brimonidine, Apraclonidine) also act by decreasing aqueous production.* Class of drugs which act by increasing outflow:# | Trabecular outflow: Pilocarpine, Epinephrine# | Uveoscleral outflow: PG Analogue (Latanoprost)Must Know TREATMENT OF Glaucoma* First line DOC for ACG: Mannitol* TOC for ACG: Laser iridotomy* DOC for OAG: PG analogue (Latanoprost)* Most powerful anti glaucoma drug: Latano- prost* DOC for OAG in India- Timolol* Safest anti-glaucoma for children- Dorzolamide