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Pharm1-final3
Eye meds from study guide
| Question | Answer |
|---|---|
| Administration of eye meds | Wash hands, place ordered dose in lower conjunctival sac, avoid touching dropper or applicator to eye, occlude the nasolacrimal duct with one finger 1-2min after administration (prevents overflow), wait 3mins in between drops, monior pt pulse, wash hands. |
| Mydriatic eye drops are used for: | dilating the pupil for eye exams, treating chonic glaucoma, blocks the muscarinic receptors of the spincter muscles (can't contract) and paralyze ciliary muscles (can't accommodate); Anticholinergic or adrenergic drugs used |
| Anticholinergic action: | dilates pupils (mydriasis) and blurred vision (cytoplegia) |
| Phenylieprine hydrochloride | used to obtain obtain maximum mydraisis in 60-90 min.; recovery takes about 6hours |
| Physostigmine salicylate is what/ | antidote to dilated pupils |
| How are mydriatic eye drops applied? | Directly to the pupil |
| Chronic (open-angle) glaucoma | Most common, you never know it's there (no pain) |
| Acute (closed-angle) glaucoma | an EMERGENCY, very painful |
| Beta-blockers | Decrease production of aqueous humor, applied directly to the eye, onset 30-60min, drug of choice for open angle glaucoma, neither pupil size or reactivity to light is altered |
| Betaxolo (betoptic) | Beta-blocker; IOP tx; Selective; preferred for those with pulmonary problems (asthma) |
| Timolo (timoptic) | Beta-blocker; IOP tx; Nonselective; tx for glaucoma r/t to specific cause; as effective as pilocarpine or epinephrine in lowering IOP and is generally better tolerated. |
| Adrenergics | Decrease production of aqueous humor |
| Epinephrine | aka Epifrin, Epinal, Eppy, Glaucon; Dilates the pupil |
| Dipivefrin | aka Propine; Another form of epinephrine, pro-drug that is inactive but converted to epinephrine |
| Cholinomimetics | Mimics something; improves uptake of aqueous humore, effectiveness results from the spread of the trabecular spaces of the anterior chamber when the sphincter muscles contract |
| Pilocarpine and Carbachol | mimic actions of ACH |
| Carbachol | more potent and slightly longer acting than pilocarpine |
| Pilocarpine | used in emergency acute angle claucoma before and after surger |
| Anticholinesterase Miotics | Improves uptake of aqueous humore, inhibits the degradation of ACH causing miosis-get spread of trabecular spaces which improves uptake; poor vision in dim light |
| Carbonic Anhydrase Inhibitors | Decrease formation of aqueous humore by 50-60% by blocking ocular carbonic anhydrase, fall in IOP w/ glaucoma only, not for L-T use, |
| Acetazolamide (Diamox) | pill form of carbonic anhydrase inhibitor |
| Dorolamide (trusopt) | Carbonic Anhydrase Inhibitor; apply directly to eye; most common SE is bitter taste; Contraindication: Hx of kidney stones |
| prostaglandin Analog | Acts to increase outflow of aqueous humor, applied daily in the evening, may increase brown pigment in iris, as effective as beta-blockers w/ less SE, becoming 1st in line. Ex: Iatanoprost (Xalatan) |
| Osmotic Agents | Short term tx for IOP; lowers IOP of glaucoma before surgery or emergency tx of acute glaucoma |
| Glycerin | aka Glyrol, Osmoglyn; Osmotic Agent; IOP tx; oral, lasts 5hrs |
| Mannitol | Osmitrol; Osmotic Agent; IOP tx; lowers IOP in 30-60min, lasts 6-8hrs, Given IV |
| Urea | aka Ureaphill Osmotic Agent; IOP tx; less satisfactory thatn mannitol b/c it can penetrate the eye and cause rebound increased IOP. Last 8-12hrs. Highly irritation on injection. Given IV |
| Fluorscein | Nontoxic water-soluble dye, can be applied to the cornea. Stains scraches bright green, foreign bodies green ringed, lossed conjuctiva areas yellow |
| Fluorscein (other uses) | Used to lift hard contact lenses, test lacrimal patency, and ID defects in retinal pigment epithelium in retinal photography |
| Closed angle glaucoma | Acute, very painful, EMERGENCY. Iris builds up to shut off access to aqueous humor to the anterior chamber-> may damage optic nerve and cause blindness |
| Tx for glosed angle glaucoma | cholinomimetic drugs, a carbonic anhydrase inhibitor, epinephrine, and an osmotic diuretic. This provides transient tx for pt surgery |
| Analgesics | inhibit pain sensation so the eye can be examined, foreign bodies removed, or superficial surgery performed. Contraindicated: hypersensitivity, heart disease, hyperthyroidism |
| Analgesics SE | stinging, burning, tearing, conjunctival redness, and photophobia, delayed wound healing, CNS distrubance occasionally occur and are r/t systemic absorption |
| Tetracaine hydrochloride, proparacain hydrochloride | produces in 13-36sec, duration of 15-20min |
Created by:
Keller_KI
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