【病例学习第19期】Glaucoma（青光眼）

From Pharmacy Times(www.pharmacytimes.com)
Thanks to the author Craig I. Coleman, PharmD(Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.)

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Glaucoma

OA is a 64-year-old African American woman who comes to the pharmacy with a prescription for combination timolol-dorzolamide eye drops. She tells the pharmacist that she has just come from her ophthalmologist appointment and that her glaucoma was still not well-controlled. The pharmacist looks at OA?s profile and notices that OA has been taking timolol eye drops for the past 6 months. OA asks the pharmacist, "Why do I need to take another eye drop, especially because my glaucoma does not bother me?"

How should the pharmacist reply to OA?


ANSWER

Glaucoma is a disease of the optic nerve, affecting over 4 million Americans (disproportionately affecting African Americans), and results in decreased visual acuity. Ninety percent of glaucoma patients have open-angle disease, which develops slowly and is associated with few symptoms. Glaucoma results from decreased drainage of aqueous humor from the eye, which results in increased intraocular pressure (IOP). Patients are typically treated with a single antiglaucoma eye drop, most commonly a beta-blocker (such as timolol). In patients like OA who do not respond to monotherapy, however, an agent from a different class (carbonic anhydrase inhibitor, nonspecific adrenergic agonists, prostaglandin analogs, or cholinergic agonists) or combination therapy is required. The pharmacist should tell OA that the goal of glaucoma treatment is to preserve visual function by reducing IOP. It should be explained to OA that the 2 eye drops (a beta-blocker and carbonic anhydrase inhibitor) work in different ways to decrease fluid production and pressure in the eye. Because poor adherence to glaucoma medications is common, OA should be counseled regarding the importance of using the drops even though she has no noticeable signs or symptoms.

青光眼
OA 是一位非洲裔美国妇女，她拿着开具了噻吗洛尔滴眼液和多佐胺滴眼液的处方到药房取药。经过眼科医生检查发现其病情并没有得到很好控制。药师查看OA的病史档案发现其在过去六个月一直在使用噻吗洛尔滴眼液。OA问药师：“在我感觉我的病情并没有对我造成影响时，为什么我需要再使用另一种滴眼液？”药师应如何回答？
回答：
在美国大约有四百万人患有青光眼（其中包括非洲裔美国人），青光眼是一种视神经病变疾病，最终会导致视力下降。90%的青光眼属于开角型，开角型青光眼病情进展缓慢且症状轻微难于察觉。青光眼是由于眼睛房水不能顺利排除而导致眼内压升高而导致的。通常采用β-受体阻滞剂例如噻吗洛尔滴眼剂治疗。像OA这样用噻吗洛尔治疗不理想的患者，则需要换另一种作用机制不同药物（碳酸酐酶抑制剂、非特异性肾上腺素受体激动剂、前列腺素类似物或胆碱类药物）治疗或联合治疗。药师应告知OA青光眼治疗是通过降低眼内压而维持正常的视觉功能。联用β-受体阻滞剂和碳酸酐酶抑制剂这两种滴眼剂，采用不同的作用机制
作用于不同的靶位以减少房水的产生和降低眼内压。青光眼治疗需长期坚持，患者应意识到持续使用滴眼剂的重要性，即使症状较轻微也应继续使用。

The pharmacist looks at OA?s profile and notices that OA has been taking timolol eye drops for the past 6 months.
应为The pharmacist looks at OA‘s profile and notices that OA has been taking timolol eye drops for the past 6 months.

呵呵O(∩_∩)O~先认领翻译试试

青光眼
OA 是一位非洲裔美国妇女，她拿着开具了噻吗洛尔滴眼液和多佐胺滴眼液的处方到药房取药。经过眼科医生检查发现其病情并没有得到很好控制。药师查看OA的病史档案发现其在过去六个月一直在使用噻吗洛尔滴眼液。OA问药师：“在我感觉我的病情并没有对我造成影响时，为什么我需要再使用另一种滴眼液？”药师应如何回答？
回答：
在美国大约有四百万人患有青光眼（其中包括非洲裔美国人），青光眼是一种视神经病变疾病，最终会导致视力下降。90%的青光眼属于开角型，开角型青光眼病情进展缓慢且症状轻微难于察觉。青光眼是由于眼睛房水不能顺利排除而导致眼内压升高而导致的。通常采用β-受体阻滞剂例如噻吗洛尔滴眼剂治疗。像OA这样用噻吗洛尔治疗不理想的患者，则需要换另一种作用机制不同药物（碳酸酐酶抑制剂、非特异性肾上腺素受体激动剂、前列腺素类似物或胆碱类药物）治疗或联合治疗。药师应告知OA青光眼治疗是通过降低眼内压而维持正常的视觉功能。联用β-受体阻滞剂和碳酸酐酶抑制剂这两种滴眼剂，采用不同的作用机制
作用于不同的靶位以减少房水的产生和降低眼内压。青光眼治疗需长期坚持，患者应意识到持续使用滴眼剂的重要性，即使症状较轻微也应继续使用。

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