Question

A patient has been diagnosed with Primary Open Angle Glaucoma. On elliciting history, it was observed that the patient is a known case of bronchial asthma. What is the drug of choice for POAG in this patient?

• A. Latanoprost
• B. Gemeprost
• C. Carboprost
• D. Alprostadil

Answer 1

The Correct Option is A

In the case of Primary Open Angle Glaucoma (POAG), the objective is to reduce intraocular pressure (IOP) to prevent optic nerve damage. Various medications are available to lower IOP, but patient-specific factors must be considered when selecting a treatment, such as contraindications due to existing conditions. In this scenario, the patient also suffers from bronchial asthma.

Beta-blockers like Timolol are commonly prescribed for POAG but can exacerbate asthma symptoms. Therefore, they are contraindicated in this patient. Instead, Prostaglandin analogs like Latanoprost are preferred.

Latanoprost, a prostaglandin F2α analog, is effective in reducing IOP by increasing the outflow of aqueous humor through the uveoscleral pathway. It does not affect airway function and is thus safe for patients with asthma.

Here's the breakdown of medication options:

Drug	Type	Suitability for Asthmatic Patient
Latanoprost	Prostaglandin Analog	Suitable (does not affect asthma)
Gemeprost	Prostaglandin Analog	Not typically used for POAG
Carboprost	Prostaglandin Analog	Not indicated for POAG
Alprostadil	Prostaglandin Analog	Not used in glaucoma treatment

Given the patient's condition and the need to avoid beta-blockers, Latanoprost is the optimal choice for treating POAG in a patient with asthma. It effectively lowers IOP and avoids adverse respiratory effects.