Eye part 1 Flashcards
(90 cards)
1
Q
what are local drug delivery dosage forms
A
eye drops, ointments, gels
2
Q
what are systemic drug delivery dosage forms
A
injections, oral medications
3
Q
what is the eye’s built in defense mechanism to sudden increase in tear volume
A
rapid reflex blinking
4
Q
drug residence time in conjunctiva
A
3-5 minutes
5
Q
what is the tear volume capacity
A
7-9 microliter
6
Q
eye drop administration steps
A
- wash hands with soap and water. remove contacts if applicable.
- while tilting your head back, pull down lower lid of eye with index finger to form pocket.
- hold dropper with other hand, as close to eye as possible without touching it.
- while looking up, squeeze dropper so that single drop falls in pocket of lower lid.
- remove index finger from lower eyelid. close eyes for 2-3 min and tip head down.
- place a finger on tear duct and apply gentle pressure.
7
Q
eye ointment administration steps
A
- wash hands w soap and water. remove contacts if applicable.
- holding the tube between thumb and forefinger, place it as near to eyelid as possible without touching it.
- while tilting your head back, pull lower lid down with index finger to form pocket.
- squeeze ribbon of ointment into pocket made by lower eyelid.
- remove index finger from lower eyelid. blink eye gently; then close for 1-2 min.
- wipe any excess ointment or gel from eyelids and lashes. clean tip of tube with clean tissue.
8
Q
how long should a pt wait after using eye drops before reinserting contacts
A
15 min
9
Q
is it recommended for a pt to reinsert contacts after use w ointment
A
No
10
Q
how long should a pt wait between drops if they require 2 drops of the same medication
A
5 min between drops
11
Q
how long should a pt wait between drops if they require 2 drops of a different medication
A
wait 5-10 min between drops
12
Q
how long should a pt wait if they require 2 ointments
A
wait 30 min between ointments
13
Q
how long should a pt wait if they require 1 ointment and 1 drop
A
- use drop 1st
- wait 5-10 min between
14
Q
bacterial conjunctivitis presentation
A
- redness, discharge
- eye is “stuck shut” in morning
- purulent yellow, white, or green discharge from eye
15
Q
non pharm bacterial conjunctivitis tx
A
- avoid sharing items that touch eye
- remove contact lenses - do not resume until eye is white and there is no discharge for 24h after antibiotics
16
Q
pharm bacterial conjunctivitis tx
A
- topical antibiotics
- antibiotic tx required in contact wearers
- ointment preferred over drops in children and in pts w/ risk of poor compliance
17
Q
how long should pts use antibiotics for bacterial conjunctivitis
A
5-7 days
18
Q
antibiotic agents for bacterial conjunctivitis
A
- erythromycin 5mg/g ointment
- moxifloxacin 0.5% solution
- ofloxacin 0.3% solution
- trimethoprim-polymyxin B 0.1%-10,000 units/mL
19
Q
erythromycin 5mg/g ointment dosing
A
0.5 in strip 4 times daily
20
Q
moxifloxacin 0.5% solution dosing
A
1 drop 2-3x daily
21
Q
ofloxacin 0.3% solution dosing
A
1-2 drops 4x daily
22
Q
trimethoprim-polymyxin B 0.1%-10,000 units/mL dosing
A
1-2 drops 4x daily
23
Q
viral conjunctivitis presentation
A
- watery eyes
- burning, sandy, gritty feeling in eye
- pus is morning crusting followed by watery discharge throughout the day
- other eye often involved within 24-48 h
- part of viral upper respiratory infection
24
Q
non pharm viral conjunctivitis tx
A
- avoid sharing items
- remove contact lenses - do not resume wearing until eye is white and there is no discharge for 24h
25
symptomatic relief viral conjunctivitis tx
- warm or cool compress
- topical decongestant - limit duration of use to avoid rebound congestion
26
decongestants (OTC) for viral conjunctivitis
- naphazoline 0.012-0.2% solution
- tetrahydrozoline 0.05% solution
27
naphazoline 0.012-0.2% solution brand name
Clear eyes redness relief
28
naphazoline 0.012-0.2% solution dose
1-2 drops 4x daily
29
tetrahydrozoline 0.05% solution brand name
visine advanced relief
30
tetrahydrozoline 0.05% solution dose
1-2 drops 4x daily
31
allergic conjunctivitis presentation
- redness, watery discharge, itching
- may have morning crusting
- both eyes often involved
- often accompanied by other allergic Sx: nasal congestion, sneezing, wheezing
- eye rubbing can worsen sx
32
non pharm allergic conjunctivitis tx
- do not rub eyes: can worsen Sx
- cool compresses
- avoidance or reduction of contact w/ known allergen
33
pharm allergic conjunctivitis tx
- antihistamines
- mast cell stabilizers
- multiple acting agents
34
antihistamines for allergic conjunctivitis
- olopatadine 0.1-0.7% solution
- azelastine 0.05% solution
- epinastine 0.05% solution
35
olopatadine 0.1-0.7% solution brand name
Pataday
36
olopatadine 0.1-0.7% solution brand dosing
1 drop daily or BID
37
azelastine 0.05% solution brand name
optivar
38
azelastine 0.05% solution dosing
1 drop BID
39
epinastine 0.05% solution dosing
1 drop BID
40
mast cell stabilizers for allergic conjunctivitis
- cromolyn sodium 4% solution
- lodoxamide 0.1% solution
- nedocromil 2% solution
41
cromolyn sodium 4% solution brand name
crolom
42
cromolyn sodium 4% solution dosing
1-2 drops 4-6x daily
43
lodoxamide 0.1% solution brand name
alomide
44
lodoxamide 0.1% solution dosing
1-2 dros 4x daily
45
nedocromil 2% solution brand name
alocril
46
nedocromil 2% solution dosing
1-2 drops BID
47
multi-acting agents for allergic conjunctivitis
- ketotifen 0.025% solution
- alcaftadine 0.025% solution
48
ketotifen 0.025% solution brand names
Zaditor, Alaway
49
ketotifen 0.025% solution dosing
1 drop BID
50
alcaftadine 0.025% solution brand name
Lastacaft
51
alcaftadine 0.025% solution dosing
1 drop daily
52
what is uveitis
intraocular inflammation
53
anterior uveitis presentation
- patterned (wagon wheel) redness associated w/ iritis
- dilated pupil
- complains of discomfort and sensitivity to light
54
tx for anterior uveitis
- topical glucocorticoids
- mydriatic/cycloplegic
55
how long is tx for uveitis
4-6 weeks
56
what should a pharmacist do if a pt comes in w/ uveitis
referral to ophthalmologist or optometrist for tx
57
what are risk factors for uveitis
primary open-angle glaucoma, ocular htn, elderly, children, connective tissue disease, T1DM w/ myopia
58
what can be caused from ophthalmic steroid toxicity
secondary infections, secondary open angle glaucoma
59
what is dry macular degeneration
- common >50 yo
- usually both eye affected
- gradual loss in vision
- 90% of macular degeneration cases
60
what is wet macular degeneration
- advanced macular degeneration
- vision loss may be rapid
- loss of central vision due to abnormal growth of new blood vessels
61
what is the leading cause of blindness
macular degeneration
62
what are the top risk factors for macular degeneration
smoking and age
63
macular degeneration tx goals
- slow progression
- prevent severe visual impairment or blindness
64
what is the difference between AREDS1 and AREDS2 for macular degeneration
- AREDS1 has no B keratine
- B keratine has higher risk of lung cancer for smokers
65
vascular endothelial growth factor inhibitors (VEGFi) for macular degeneration
- important for formation of new blood vessels and vascularization of tissues
66
what is vascular endothelial growth factor inhibitors (VEGFi)
antineoplastic agents typically used to treat certain forms of cancer and prevent tumors from creating blood vessels
67
vascular endothelial growth factor inhibitors (VEGFi) use in age-relate macular degeneration
- shown to slow disease progression
- may cause moderate gains in vision
68
vascular endothelial growth factor inhibitors (VEGFi) SEs
increased BP, retinal detachment, increased IOP, eye infection, vitreous floaters
69
how is vascular endothelial growth factor inhibitors (VEGFi) administered
injected directly into eye (intravitreal)
70
VEGFi agents
- Bevacizumab
- Ranibizumab
- Aflibercept
- Pegaptanib
- Verteoprofin
71
Bevacizumab brand name
Avastin
72
bevacizumab dosing
1.25 mg every 4,6, or 8 weeks for 1 year
73
ranibizumab brand name
lecentis
74
ranibizumab dosing
0.5 mg every 4 weeks
75
aflibercept brand name
eylea
76
aflibercept dosing
2 mg then 4 weeks for 12 weeks, then every 8 weeks maintenance
77
pegaptanib brand name
macugen
78
pegaptanib dosing
0.3 mg every 6 weeks
79
verteporfin brand name
visudyne
80
verteporfin dosing
6 mg/m2 BSA; may repeat at 3 month intervals
81
dry eyes causes
- decreased tear production (Sjogren's sydrome v non-Sjogren's syndrome)
- increased evaporative loss
82
what is sjogren's syndrome
autoimmune disease characterizied by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes
83
risk factors for dry eyes
advanced age, female, contact lens wearers, low humidity environment, meds
84
presentation of dry eyes
dryness, red eyes, general irritation, gritty sensation, blurred vision, light sensitivity
85
aqueous tear supplementation for dry eyes
- carboxymethylcellulose (Refresh, TheraTears)
- hydroxypopylcellulose (Genteal)
- polyethylene glycol, propylene glycol (Systane)
86
lipid tear supplementation for dry eyes
- DMPG, propylene glycol (Systane balance)
- mineral oil (Retaine MGD)
87
nonpharmacologic therapy for drug induced dry eyes
- warm compress
- increased fluid intake
- use humidifier
88
how to increase tear volume for drug induced dry eyes
artificial tears or other ocular lubricants
89
how to decrease inflammation for drug induced dry eyes
Restasis or Xiidra eye drops
90
what med changes is needed for drug induced dry eyes
- d/c causative agent if possible
- switch to preservative free eye drops
