For a client having an episode of acute narrow-angle glaucoma, a nurse expects to give which of the following medications?
A. Acetazolamide (Diamox)
B. Atropine
C. Furosemide (Lasix)
D. Urokinase (Abbokinase)
Correct Answer: A. Acetazolamide (Diamox)
Acetazolamide, a carbonic anhydrase inhibitor, decreases intraocular pressure (IOP) by decreasing the secretion of aqueous humor. Acetazolamide is a classic treatment option for glaucoma as it causes a reduction in aqueous humor. As well, it is useful for the treatment of altitude sickness, because of its underlying mechanism of action.
Option B: Atropine dilates the pupil and decreases the outflow of aqueous humor, causing a further increase in IOP. Ophthalmic atropine is used before eye examinations to dilate (open) the pupil, the black part of the eye through which you see. It is also used to relieve pain caused by swelling and inflammation of the eye.
Option C: Lasix is a loop diuretic. Furosemide inhibits tubular reabsorption of sodium and chloride in the proximal and distal tubules and the thick ascending loop of Henle by inhibiting the sodium-chloride cotransport system resulting in excessive excretion of water along with sodium, chloride, magnesium, and calcium.
Option D: Urokinase is a thrombolytic agent; they aren’t used for the treatment of glaucoma. Thrombolytics or fibrinolytics are a group of medications used in the management and treatment of dissolving intravascular clots. They are in the plasminogen activator class of drugs.
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