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A - NAPLEX > Chapter 38: Common Conditions of the Eyes and Ears > Flashcards

Chapter 38: Common Conditions of the Eyes and Ears Flashcards

1
Q

T/F: Ear drops can be used in the eye, but eye drops cannot be used in the ear

A

FALSE - eye drops can be used in the ear, but ear drops cannot be used in the eye
(remember the eye is more sensitive than the ear, so eye products ONLY goes in the eye)

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2
Q

AD

A 
Right ear
(A = auris, D = dextra)
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3
Q

AS

A 
Left ear
(A = auris, S = sinistra)
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4
Q

AU

A

Both ears

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5
Q

OD

A 
Right eye
(O = oculus, D = dextra)
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6
Q

OS

A 
Left eye
(O = oculus, S = sinistra)
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7
Q

OU

A

Each eye

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8
Q

For a eye/ear solution, 1 drop = __ mL

A

0.05 (so, there are 20 drops per mL)

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9
Q

Eye ointments can make vision

A

blurry

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10
Q

For eye gels, what should the patient be counseled to do

A

Invert and shake ONCE to get the medication into the tip before instilling into the eye

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11
Q

Glaucoma is a disease of the eye that results in damage to the _____ and loss of ____

A

optic nerve

loss of the visual field (i.e., the vision straight ahead and peripheral vision)

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12
Q

In most cases, IOP is ____ (increased or decreased) in glaucoma

A

Increased

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13
Q

Which type of glaucoma is a sharp, sudden increase in IOP due to blockage & is a medical emergency that is treated surgically

A

Closed-angle glaucoma

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14
Q

Which key drugs can increase IOP

A
  • Anticholinergics (e.g., oxybutinin, tolterodine, benztropine, trihexyphenidyl, TCAs)
  • Cough, cold and motion sickness meds (e.g,. antihistamines and scopolamine)
  • Chronic steroids, especially eye drops such as prednisolone (Pred Forte)
  • Topiramate (Topamax)
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15
Q

Glaucoma treatment goal is to decrease IOP in 2 ways, which include:

A
  • Reduce aqueous humor production (make less fluid) by using BB like timolol
  • Increase aqueous humor outflow (move fluid out) using PG analogs like latanoprost
  • Or do both with add-on treatment such as a-2 agonists like brimonidine
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16
Q

What are the most effective drugs at decreasing IOP

A

PG analogs (safe and used once daily)

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17
Q

When is a BB preferred in glaucoma

A

if the pressure is high in one eye only

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18
Q

Bimatoprost brand name

A

Lumigan

also Latisse to increase eyelash growth; should not be used with PG analogs indicated for glaucoma

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19
Q

Latanoprost brand name

A

Xalatan, Xelpros

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20
Q

PG analogs MOA

A

increase aqueous humor OUTFLOW

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21
Q

Travoprost brand name

A

Travatan Z

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22
Q

How are PG analogs dosed

A

1 drop QHS

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23
Q

PG analogs warnings

A

darken the iris and eyelashes, eyelash length and number can increase

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24
Q

PG analogs SE

A

blurred vision, stinging, increased pigmentation of the iris/eyelashes, growth of eyelashes

25
Q

Which PG analogs should be refrigerated before opening and once opened, stored at room temp

A

Latanoprost, latanoprostene bunod and tafluprost

26
Q

Timolol 0.25% and 0.5% brand names

A

Timoptic, Timoptic-XE, Istalol

27
Q

Timolol 0.25% and 0.5% + dorzolamide brand name

A

Cosopt, Cosopt PF

28
Q

How is timolol dosed

A

1 drop daily or BID

29
Q

If using an eye gel, how long should a patient wait before administering the gel if they already used another eye drop

A

10 minutes

30
Q

BB SE for glaucoma

A

Burning, stinging, bradycardia/fatigue, bronchospasm with non-selective agents

31
Q

All BB used in glaucoma are non-selective except

A

betaxolol (less likely to cause pulmonary SE in patients with chronic lung disease)

32
Q

BB MOA for glaucoma

A

Reduce (block) aqueous humor production

33
Q

Cholinergics (miotics) can cause what side effect

A

pupil constriction

34
Q

Dorzolamide + timolol (Cosopt) warning

A

Sulfonamide allergy

remember: -zolamide, caution with sulfonamide allergy

35
Q

Dorzolamide + timolol (Cosopt) dosing

A

1 drop BID

36
Q

Conjunctivitis can be due to

A

virus, bacteria or allergen

37
Q

Which virus most commonly causes conjunctivitis

A

Adenovirus

38
Q

What is the treatment for viral conjunctivitis

A

No topical treatment

39
Q

Which bacteria most commonly cause conjunctivitis

A

Staph aureus

More severe cases caused by Neisseia gonorrhoeae or Chlamydia

40
Q

Treatment for bacterial conjunctivitis

A 
Moxifoxacin (Vigamox)
Neomycin/Polymyxin B/Dexamethasone (Maxitrol)
Ofloxacin (Oxyflox)
Trimethoprim/Polymyxin B (Polytrim)
Azithromycin (AzaSite)
41
Q

Azithromycin for bacterial conjunctivitis storage & stability

A

store in refrigerator and stable for 14 days at RT

42
Q

Treatment for allergen-induced conjunctivitis

A
  • Mast cell stabilizers
  • Antihistamines - Azelastine, olopatadine (Patanol, Pataday)
  • Antihistamine/mast cell stabilizer - Ketotifen (Alaway, Zatidor)
43
Q

Treatment for blepharitis (eyelid inflammation)

A

Apply warm compress over eye for a few min then use a warm, moist washcloth to wipe away debris

44
Q

Which meds can be used to treat eye inflammation

A
  • Steroid eye drops (severe): Prednisolone (Pred Forte, Pred Mild) – use short-term d/t risk of ↑ IOP
  • NSAIDs (mild): ketorolac (Acular)
45
Q

Which meds can be used for eye dryness

A

Refresh, Systane

often referred to as Artificial Tears

46
Q

Which med can be used for chronic dry eye syndrome

A

Cyclosporine Emulsion Eye Drops (Restasis)

47
Q

Which med can be used for eye redness

A
  • Naphazoline (Clear Eyes Redness Relief)
  • Nephazoline/pheniramine (Naphcon A, Visine A)
  • Tetrahydrozoline (Visine)
48
Q

What is the most common preservative in eye drops

A

BAK

49
Q

What should a patient do if they are using an eye drop with BAK and wear contact lenses

A

Remove the lenses before using eye drops and wait 15 min after administration before reinserting

50
Q

Common drugs that cause retinal changes/retinopathy

A

Chloroquine & hydroxychloroquine

51
Q

Common drugs that cause optic neuropathy

A

Amiodarone (plus corneal deposits)
Ethambutol
Linezolid

52
Q

Common drugs that cause floppy iris syndrome, which causes difficulty in cataract surgery

A

Alpha-blockers (e.g., doxazosin)

53
Q

Common drugs that cause color discrimination

A

Digoxin (with toxicity) - yellow/green vision
PDE5-i - greenish tinge around objects
Voriconazole - color vision changes

54
Q

Common drugs that cause vision loss/abnormal vision

A

Digoxin (with toxicity) - blurriness, halos
PDE5-i - vision loss in 1 or both eyes
Isotretinoin - ↓ night vision, dry eyes
Vigabatrin - permanent vision loss (high risk)
Voriconazole - abnormal vision, photophobia

55
Q

Treatment for otitis externa

A

Cipro and dexamethasone (Ciprodex)

56
Q

Ppx for cerumen blockage

A

carbamide peroxide (Debrox), triethanolamine

57
Q

How long should a patient wait to insert another drop of the same eye medication

A

5 minutes

58
Q

How long should a patient wait to insert a drop of a different eye medication

A

5-10 min

A - NAPLEX (83 decks)

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