pharm eyes and ears Flashcards by Amanda S.

uvea

Choroid, iris, ciliary body = uvea

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Mydriatics (apraclonidine) (my big app and pupil)

Dilate the pupil

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Miotics (acetylcholine, pilocarpine)

Constrict the pupil

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Cycloplegics (atropine, cyclopentolate) (cyclyopse is paralyzed)

 Paralyze the ciliary body (so we can look inside the eye)
 Have mydriatic (dilation) properties
 Cycloplegia: paralysis of accommodation

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Cholinergic Drugs cause

pupil constriction (miosis)

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sympathomimetics

reduces the rate of aqueous humor production

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sympathomimetics - adverse rare (think sympathetic)

Hypertension Tachycardia Extrasystoles Headache Faintness

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Ocular Antibacterial Drugs

erythromycin, azithromycin

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NSAIDs ex. (NSAIDs are my bro)

bromfenac (xibrom)

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topical opthalmic anesthetics - long or short term use?

short-term use only

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Glaucoma (eye aquarium)

Inhibition of the normal flow and drainage of aqueous humor

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types of glaucoma (this is a dangerous angle)

 Angle-closure glaucoma (medical emergency)
 Open-angle glaucoma

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Angle-closure glaucoma helps with (cross the angle)

cross eyes

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sympathomimetics open or close pupil? (fight or flight)

Stimulate the dilator muscle to contract  Result is increased pupil size (mydriasis)

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sympathomemtics - Stimulate the dilator muscle to contract  Result is increased pupil size (mydriasis) selective and non-selective - use caution with (sympathy for the beta is no good)

pts who are already taking beta blockers

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beta blockers - do what? (alpha and beta part the seas)

reduce IOP (intraocular pressure) by reducing aquous humor formation and increasing aqeuous humor outflow

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beta blockers - side effects (betas burn the COPD’ers)

burning, blurred vision, pain, photophobia, LIMITED - bronchospasm - be careful with ashtma pts.

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carbonic anhydrase (ana reduces water)

reduces aqueous humor formation in the eye. treats both types of glaucoma.

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osmotic diuretics

Create ocular hypotension by producing an osmotic gradient
 Water is forced from the aqueous

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osmotic diuretics - Glycerin (glycerin is sugar, so diabetics beware)

Glycerin usually tried first. Can cause hyperglycemia - careful w/ diabetics

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Prostaglandin Agonists last how long? (prostie just once a day)

Most drugs allow for single daily dosing because effects last 20 to 24 hours - advantage over other drugs

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Which antiglaucoma drug works by increasing the outflow of aqueous humor between the uvea and sclera as well as via the usual exit through the trabecular meshwork? (prostie uvea)

Prostaglandins

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Prostaglandins do what? (latisse is a prostie)

change eye color

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Macrolides for eye infections - ex. (glide in myocins)

erythromycin, azithromycin

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erythromycin (eerie gonhorrhea)

used for prevention of Neisseria gonorrhoeae eye infections in newborns or neonatal conjunctivitis caused by Chlamydia trachomatis

antibacterial - Polypeptides (bac to poly)

bacitracin (AK-Tracin), polymyxin B

red glass eye (red fungus)

fungal infection

viral eye infections - easy or hard to treat?

most difficult to treat. may need implant in eye. CMV.

NSAIDs

bromfenac (Xibrom)

steroids do what? (no scars for roids)

quickly. only use short term. they will prevent scarring.

Which statement about use of corticosteroids for ocular inflammation does the nurse identify as being true? (a cutie steroid)

They are used during the acute phase of the injury process to prevent fibrosis and scarring, which result in visual impairment.

Topical Ophthalmic Anesthetics - ex (caines for anesthetics)

Anesthetics are short term only! main ex. is tetracaine.

Ophthalmic Diagnostic Drugs

Cycloplegic mydratics - open pupil. Ophthalmic dye - to highlight part of eye.

Used for seasonal allergy symptoms

mast cell stablizers and Decongestants.

A patient receiving tetrahydrozoline asks how the drug works. The best response by the nurse will include that the drug works by (tetris constricts my eyes)

promoting vasoconstriction of blood vessels in and around the eye.

Ophthalmic Lubricants

cyclosporine) Restasis® - it's an immunosuppressant and treats dry eye. It can be used together with artificial tears, if the drugs are given 15 minutes apart

if you give 2 different eye drops at the same time,

space out at least 15 min bc the eye can only absorb so much.

eye drop application

Apply ointments as a thin layer in the conjunctival sac - one corner to the other

When administering eyedrops to a patient, the nurse places the drop

into the lower conjunctival sac.

When applying eyedrops

have the patient look up to the ceiling, and place the drop in the conjunctival sac  Pressure may be applied to the inner canthus for at least 1 minute to reduce systemic absorption of the drug

If the patient wears contact lenses

check to see if they should be removed during therapy with eye medications

A 60-year-old male with a history of benign prostatic hypertrophy and hypertension is seen in the Emergency Department because he was trimming his shrubs and got something in his right eye. He complains of a pain rating of 8 on a scale of 1 to 10 in the right eye. Which medication does the nurse anticipate administering via eyedrop to help control the patient’s pain?

tetracaine

After administering an ophthalmic anesthetic drug, which adverse effects does the nurse anticipate as possibly developing in the patient? (Select all that apply.)

all can occur - A. Stinging B. Burning C. Redness D. Lacrimation E. Blurred vision

The ophthamologist tells the patient that she is going to place a dye onto the patient’s eye to help identify the location of the foreign object. Which drug does the nurse anticipate the ophthamologist will use? (fluorescent dye)

fluorescein (AK-Fluor®)

A foreign particle is removed from the patient’s eye. He tells the nurse that he previously forgot to mention that he takes eyedrops for glaucoma. He can’t remember the name of the drug, but he knows the eyedrop bottle has a purple lid. The nurse identifies a purple lid as most likely containing which type of antiglaucoma drug? (purple rain has sympathy)

B. Sympathomimetics

A 2-year-old is seen in the pediatrician’s office with a bacterial middle ear infection. Which medication does the nurse anticipate being prescribed for the child?

amoxicillin

anti-fungal for middle ear (cortney is a fungus)

Cortic

When teaching an adult patient about eardrops, which statement will the nurse include?

Lie on the opposite side of that of your affected ear for about 5 minutes after instilling the drug

what can be used with a perforated eardrum? (flock of seagulls in my perforated ear)

Ciprofloxacin and ofloxacin can be used with perforated eardrums.

Warm eardrops to approximately

body temperature before instillation. cold can cause dizziness and vomiting.

While administering medications, the nurse finds a patient’s eardrops in the medication refrigerator. If the nurse gives the eardrops immediately, what response might the patient have?

A vestibular-type reaction

When administering eardrops to children younger than 3 year

Hold the pinna down and back

Gentle massage of the tragus area of the ear after administering eardrops results in

increased coverage of the medication in the ear canal.

cholinergic drugs - side effects

Most limited to local effects  If sufficient amounts enter the bloodstream, systemic effect may occur (most likely with indirect-acting)  Hypotension, bradycardia, or tachycardia  Headache, nausea, vomiting, diarrhea, abdominal cramps, asthma attacks  Others

Sympathomimetics: Indications (sympathy for open glaucoma)

Chronic, open-angle glaucoma (to reduce IOP)  Reduction of perioperative IOP  Reduction of ocular hypertension

beta blockers (beta stops all humor)

Do not affect pupil size, accommodation, or night vision.  Reducing aqueous humor formation  Increasing aqueous humor outflow

beta blockers for

Reduction of elevated IOP  Chronic open-angle glaucoma  Ocular hypertension  Treatment of some forms of angle-closure glaucoma

Administration of systemic beta blockers with high doses of ophthalmic beta blockers may result

t in additive effects

Carbonic Anhydrase Inhibitors - ex (Ana dolamide)

brinzolamide (Azopt®)  dorzolamide (Trusopt®)

Carbonic Anhydrase Inhibitors - oral forms side effects (Ana makes me drowsy)

Oral forms can produce systemic effects  Drowsiness, confusion  Transient myopia, tinnitus  Anorexia, vomiting, diarrhea  Several others

prostaglandins - ex (it's in the name)

 latanoprost (Xalatan®)  travoprost (Travatan-Z®)  bimatoprost (Lumigan®)

prostaglandins - mechanism of action (prosties increase outflow)

Reduce IOP by increasing the outflow of aqueous fluid Increase uveoscleral outflow of fluid Used in the treatment of glaucoma Most drugs allow for single daily dosing because of effects lasting for 20 to 24 hours

Use of ophthalmic antibiotics with corticosteroids may make it more

difficult to rid the eye of infection

Ocular Antiviral Drugs - adverse effects - (anti- viral ain't anti-glaucoma)

trifluridine (Viroptic®,1% ophthalmic drops)  Used for ocular infections (keratitis and keratoconjunctivitis) caused by types 1 and 2 of the herpes simplex virus  Applied topically as drops  Significant adverse effects include secondary glaucoma, corneal punctate defects, uveitis, and stromal edema (edema in the tough, fibrous, transparent portion of the cornea known as the stroma)

occular anti-inflammatory

Act on various parts of the arachidonic acid metabolic pathway  Reduce the production of various inflammatory mediators  As a result, pain, erythema, and other inflammatory processes are reduced

fluorescein (AK-Fluor®) - uses

Diagnostic dye used to identify corneal defects and to locate foreign objects in the eye  Used in fitting hard contact lenses  Various defects are highlighted in either bright greeen or yellow-orange, and foreign objects have a green halo around them

external ear

 Physical trauma  Dermatitis

middle ear

Otitis media

Otitis media: middle ear infection

Most often afflicts children and follows an upper respiratory tract infection  In adults, usually results from foreign objects or water sports

cholenergic drugs - If sufficient amounts enter the bloodstream,

systemic effect may occur (most likely with indirect-acting)

cholergic = increases outflow, Sympathomimetics = Reduce the rate of aqueous humor production  IOP is reduced

beta blockers do both =  Reducing aqueous humor formation and Increasing aqueous humor outflow

beta blockers can treat

open glaucoma and some forms of closed glaucoma

ana treats both

open and closed glaucoma and Preoperatively to reduce intraocular pressure

Carbonic Anhydrase Inhibitors - adverse effects

Oral forms can produce systemic effects  Drowsiness, confusion  Transient myopia, tinnitus  Anorexia, vomiting, diarrhea  Several others

osmotic diuretics - which is tried first?

Glycerin usually tried first. Mannitol used if glycerin is unsuccessful

osmotics used for what type of glaucoma?

acute, and  Before and after ocular surgery to reduce IOP

trifluridine (Viroptic®,1% ophthalmic drops)

 Used for ocular infections (keratitis and keratoconjunctivitis) caused by types 1 and 2 of the herpes simplex virus

trifluridine (Viroptic®,1% ophthalmic drops) = adverse effects

Significant adverse effects include secondary glaucoma, corneal punctate defects, uveitis, and stromal edema (edema in the tough, fibrous, transparent portion of the cornea known as the stroma)

NSAIDs - ocular anti-inflammatory

bromfenac (xibrom)

Pressure may be applied to the inner canthus for at least

1 minute to reduce systemic absorption of the drug

pharm eyes and ears Flashcards

(80 cards)