Which of the following drug should not be given in a patient with a acute angle closure glauocoma
ref; KD Tripathi Pharmacology 7th edition(page no;441) Katzung 10/e p461 clozapine and other atypical antipsychotics have weak D2 blocking action and significant 5-HT2 and a1 blocking action. Alpha receptor blockade can precipitate glaucoma by causing pupil dilation. apraclonidine, brimonidine are alpha agonists used in glaucoma. a1 and a2 receptor mediated action cause decrease in aqueous production All anti psychotics (except atypical) have potent dopamine D2 receptor blocking action; so it is not contraindicated in glaucoma Paroxetine is a sho acting SSRI and doesn't have anticholinergic effect so it is not contraindicated in glaucoma Pilocarpine is the preferred miotic used in glaucoma treatment
Pilocarpine
Clozapine
Fluphenazine
Paroxetine
Autonomic nervous system