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Therapeutics 4 > Prescription Ophthalmics > Flashcards

Prescription Ophthalmics Flashcards

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1
Q

glaucoma

What drugs should be avoided in glaucoma?

A
  • corticosteroids
  • antineoplastics
  • anticholinergics
  • topical sympathomimetics
  • sulfonamides
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2
Q

glaucoma

What are the S/S of open-angle glaucoma?

A
  • increased IOP (20-30mmHg w/o symptoms)
  • optic disk changes
  • visual field disturbances
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3
Q

glaucoma

What are the S/S of closed-angle glaucoma?

A
  • increased IOP (40-90mmHg w/ symptoms)
  • blurred vision
  • halos around eyes
  • N/V
  • hyperemic conjuctiva
  • edematous optic disk
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4
Q

glaucoma

What are the treatment options for glaucoma?

A
  • topical agents: prostagladin analogs, beta-blockers, alpha-2 agonists, carbonic anhydrase inhibitors)
  • parasympathomimetics
  • other systematic agents
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5
Q

glaucoma

What is the first line therapy for glaucoma?

A

prostagladin analog or beta blocker

alternative: brimonidine

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6
Q

glaucoma

What products are topical prostaglandin analogs?

A
  • lantanoprost (Xalatan) 0.005% 1 drop every night
  • bimatoprost
  • travoprost
  • tafluprost
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7
Q

glaucoma

What are the adverse effects of topical prostaglandins analogs?

A
  • discoloration of the iris or periocular discoloration
  • hypertrichosis (long eyelashes)
  • uveitis (middle eye inflammation)
  • intraocular inflammation
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8
Q

glaucoma

What are the precautions associated with prostaglandin analogs?

A

ocular inflammatory conditions

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9
Q

glaucoma

What drugs are topical beta blockers?

A
  • timolol (Timoptic) 0.25-0.5% 1 drop BID
  • betaxolol
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10
Q

glaucoma

What are the adverse effects of topical beta blockers?

A
  • conjuctivitis/eye irritation
  • exacerbation of pulmonary conditions
  • bradycardia
  • tachyphylaxis (stops working)
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11
Q

glaucoma

What are the precautions associated with topical beta blockers?

A
  • heart block
  • respiratory conditions
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12
Q

glaucoma

What drugs are topical alpha agonists?

A

brimonidine (Alphagan) 1 drop TID

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13
Q

glaucoma

What are the adverse effects of topical alpha agonists?

A
  • allergic reactions
  • dizziness
  • fatigue
  • dry mouth
  • somnolence
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14
Q

glaucoma

What are the precautions associated with topical alpha agonists?

A
  • cardiovascular disease
  • blood pressure
  • renal disease
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15
Q

glaucoma

What drugs are topical carbonic anhydrase inhibitors?

A
  • dorzolamide
  • brinzolamide
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16
Q

glaucoma

What are the adverse effects of topical carbonic anhydrase inhibitors?

A
  • blurred vision
  • stinging/tearing
  • conjuctivitis
  • photophobia
  • keratitis
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18
Q

glaucoma

What drugs are parasympathomimetic agents?

19
Q

glaucoma

What are the adverse effects of parasympathomimetic agents?

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A
  • accommodative spasms
  • blurred vision/irritation
  • eyelid twitching
  • retinal detachment
  • may percipitate closed-angle glaucoma
20
Q

glaucoma

What is the indication for systemic carbonic anhydrase inhibitors?

Study These Flashcards
A

lack of response to topical therapy, acute elevation of IOP (closed-angle glaucoma)

21
Q

glaucoma

What drugs are systemic carbonic anhydrase inhibitors?

Study These Flashcards
A

acetazolamide

22
Q

glaucoma

What are the adverse effects of acetazolamide?

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A
  • metabolic acidosis
  • lethargy
  • N/V
  • kidney stones
  • anemias (long term)
23
Q

glaucoma

What are the precautions associated with carbonic anhydrase inhibitors?

Study These Flashcards
A
  • sulfa allergy
  • sickle-cell disease
  • respiratory acidosis
24
Q

glaucoma

What is the MOA of netarsudil (Rhopressa)?

Study These Flashcards
A

Rho kinase inhibitor

25
# glaucoma What are the adverse effects of Rhopressa?
- conjuctival hyperemia - corneal verticillata - instillation site pain - conjectival hemorrhage
26
# glaucoma What are the monitoring parameters for glaucoma products?
- S/S of adverse effects - IOP every 4-6 weeks until in acceptable range - visual field/disk changes every 6-12 months - adhearance
27
# glaucoma What medications decrease aqueous fluid production?
- Alpha agonists - Beta blockers - Carbonic anhydrase inhibitors | ABCs
28
# glaucoma What medications increase aqueous fluid outflow?
- prostaglandin analogs - parasympathomimetic agents | PP
29
# glaucoma What are the benefits of combination products for glaucoma?
- increased compliance - increased efficacy - lower washout risk - reduced exposure to preservatives
30
# glaucoma What is the treatment for acute angle closure crisis?
iridectomy only definitive treatment, but pilocarpine, osmotics, and steriods may be used
31
# glaucoma What are important patient education points with topical agents for glaucoma?
- wash hands - pull down lower eyelid to create pocket to insert drops - close eyes and apply pressure for 1-3 minutes - seperate eye drops by 5 minutes
32
# conjunctivitis What are the S/S of conjunctivitis?
- red eyes - chemosis - foreign body sensation - difficult to open eyes due to stickiness/crustiness - drainage
33
# conjunctivitis What is the common cause of hyperacute conjunctivitis?
neisseria gonorrhoeae
34
# conjunctivitis How is hyperacute conjunctivitis categorized?
- rapid onset - eyelid edema - chemosis - severe - purulent discharge - PAIN
35
# conjunctivitis What is the common cause of chronic conjunctivitis?
chlamydia trachomatis
36
# conjunctivitis What is the treatment of acute conjunctivitis?
watch and wait, antibiotics may be used after 2-3 days of cold compresses
37
# conjunctivitis What is the treatment for hyperacute and chronic conjunctivitis?
systemic and topical treatment
38
# conjunctivitis What topical antibiotics may be used in conjunctivitis?
- bacitracin - ciprofloxacin - gentamicin - erythromycin - sulfacetamide
39
# xerosis What is the treatment for dry eyes?
- avoid exacerbating causes - warm compresses and gentle washing - artificial tears - surgical plugs - used of specific contact lenses - medications
40
# xerosis What topical agents may be used for dry eyes?
- topical corticosteroids (prednisolone) - immunosuppressants (cyclosporine (RESTASIS)) - topical NSAIDS (ketorolac)
41
# xerosis What systemic agents may be used for dry eyes?
muscarinic agonists (cevimeline, pilocarpine) | not FDA approved for this use

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