Suvremeni principi farmakoterapije glaukoma

master's thesis

• Title (english): Current principles of glaucoma pharmacotherapy
• Author: Klara Živković
• Mentor: Mia Zorić Geber (mentor)
• Committee member: Davor Vagić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Mia Zorić Geber (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Glaukom je kronična, progresivna optička neuropatija koja rezultira propadanjem vidnog polja i gubitkom vidne funkcije. Drugi je najčešći uzrok sljepoće te predstavlja značajan javnozdravstveni problem diljem svijeta. Etiopatogeneza glaukoma još uvijek nije potpuno razjašnjena unatoč brojnim pretpostavkama i teorijama. Glavni čimbenik rizika za nastanak glaukoma je povišeni intraokularni tlak (IOT), a njegovo smanjenje jedina je dokazana metoda liječenja. Stoga je glavni cilj liječenja glaukoma postizanje individualne ciljane vrijednosti IOT-a da bi se priječila progresija bolesti i posljedično nastanak sljepoće. S obzirom na to da je medikamentozno liječenje glaukoma najčešći oblik liječenja, naglasak je na odabiru vrste lijeka, njihovim kombinacijama i načinu primjene. Prvi izbor u liječenju glaukoma su analozi prostaglandina, dok u drugu liniju spadaju β-blokatori, α-agonisti, inhibitori karboanhidraze, agonisti kolinergičkih receptora te inhibitori RhO-kinaze. Zbog kroničnog karaktera glaukomske bolesti koja zahtijeva doživotnu terapiju, suvremeni pristup medikamentoznog liječenja glaukoma bazira se na individualnom pristupu i postizanju ciljanog IOT-a s najmanjim brojem lijekova i minimalnim štetnim učincima uz održivu kvalitetu života bolesnika. Suvremena farmakoterapija snažno sugerira što manji broj dnevne primjene lijeka prepisivanjem fiksnih kombinacija. Također se preporučuje primjena topičke terapije bez konzervansa, jer poboljšava kvalitetu života pacijenata, pridržavanje i ustrajnost u terapiji, poboljšava ishod kirurškog liječenja, odnosno kontrolu bolesti i očuvanje vida. Današnji razvoj novih farmaceutskih oblika za primjenu lijekova uključuje ispitivanja implantata kao i kombiniranu učinkovitost više različitih implantata.

Abstract (english)

Glaucoma is a chronic, progressive optic neuropathy that results in visual field loss and loss of visual function. It is the second most common cause of blindness and is a significant public health problem worldwide. The etiopathogenesis of glaucoma is still not fully elucidated despite numerous assumptions and theories. The main risk factor for glaucoma is elevated intraocular pressure (IOP), and its reduction is the only proven method of treatment. Therefore, the main goal of glaucoma treatment is to achieve an individual IOP target value in order to prevent disease progression and consequent blindness. Since the drug treatment of glaucoma is the most common form of treatment, the emphasis is on the choice of drug type, their combinations and method of administration. Prostaglandin analogues are the first choice in the treatment of glaucoma, while the second line includes β-blockers, α-agonists, carbonic anhydrase inhibitors, cholinergic receptor agonists and RhO-kinase inhibitors. Due to the chronic nature of glaucoma disease that requires lifelong therapy, the modern approach to drug treatment of glaucoma is based on an individual approach and achieving the target IOP with the least number of drugs and minimal adverse effects with sustainable quality of life of patients. Modern pharmacotherapy strongly suggests a fewer number of daily drug intakes by prescribing fixed combinations. It also recommends the use of topical therapy without preservatives because it improves the quality of life of patients, adherence, and persistence in therapy, improves the outcome of surgical treatment and disease control and preservation of vision. Today's development of new pharmaceutical forms for drug administration includes implant testing as well as the combined efficacy of several different implants.

• Keywords: glaukom; farmakoterapija; liječenje
• Keywords (english): glaucoma; pharmacotherapy; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:235030
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta unio ključne riječi.
• Created on: 2022-06-07 08:37:24