1. COMBINATII MEDICAMENTOASE TOPICE ALE TIMOLOLULUI
M.Calugaru, D.Calugaru
REZUMAT
Terapia primara standard īn glaucomul cu unghi deschis si hipertensiunea
intraoculara este reprezentata de monoterapia cu analogii sintetici ai
prostaglandinelor. Cei mai multi pacienti glaucomatosi necesita īnsa mai mult
decāt o singura medicatie pentru controlul adecvat al tensiunii
oculare.Timololul reprezinta componentul de baza al acestor combinatii. Sunt
descrise īn mod detaliat asociatiile medicamentoase ale timololului cu
dorzolamida (Cosopt), pilocarpina, latanoprostul (Xalacom), travoprostul si
unoprostonul.
Aproape toate medicatiile antiglaucomatoase asigura baroprotectia īn mod direct prin scaderea tensiunii oculare iar vasoprotectia īn mod indirect, aceasta fiind secundara reducerii tensiunii oculare. Exceptie face Cosoptul, care prin componenta sa dorzolamida, asigura atāt baroprotectie cāt si vasoprotectie īn mod direct prin supresia debitului umorului apos si respectiv prin īmbunatatirea fluxului sanguin retrobulbar, retinian, coroidian si al capului nervului optic.
Avānd īn vedere acest considerente, cāt si faptul ca efectul hipotonizant ocular al Cosoptului si latanoprostului sunt echipotente, pare legitima īntrebarea Cosopt sau latanoprost īn terapia primara a glaucomului?
CUVINTE CHEIE:
Inapoi Sumar Precedentul Urmatorul
ABSTRACT
The primary standard therapy in patients with open-angle glaucoma and ocular
hypertension is carried out by means of monotherapy with synthetic prostaglandin
analogues. Most of the glaucoma patients need more than one medication for
adequate intraocular pressure control.Timolol represents the basic component of
theese combinations. Timolol topical ophthalmic combinations with dorzolamide (Cosopt),
pilocarpine, latanoprost (Xalacom), travoprost and unoprostone are thoroughly
described. Most antiglaucoma medications achieve on one side directly
baroprotection by decreasing intraocular pressure and on the other side they
produce indirectly vasoprotection, that is secondary to intraocular pressure
lowering. The Cosopt, due to its Dorzolamide component, makes an exception since
it produces directly both baroprotection by aqueous humor flow suppression and
vasoprotection by increasing the blood flow within the retina, choroid, optic
nerve head and retrobulbar area.
Given these considerations as well as the fact that the ocular hypotensive effect of both the Cosopt and the latanoprost are equally potent, a question seems reasonable according to accepted standard i.e. Cosopt or latanoprost as primary glaucoma therapy?
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