Glaucoma
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| Medications: Glaucoma. What are some examples of Beta-Adrenergic Blockers? Pg.1322 | Timolol, Levobunolol, Carteolol, Metipranolol
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| Medications: Glaucoma. What are the mechanisms of action for Beta-Adrenergic Blockers? Pg.1322 | Decreases the production of aqeous humor in the eye, causing decreased intraocular pressure
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| Medications: Glaucoma. What are the Nursing considerations for Beta-Adrenergic Blockers? Pg.1322 | 1.Systemic absorption may occur: hypotension, bradycardia, SOB
2.Assess for contraindications: asthma, COPD, heart block, heart failure
3.Teach client to close eye & occlude lacrimal duct to avoid systemic effect
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| Medications: Glaucoma. What are some examples of Prostaglandin Analogs? Pg.1322 | Latanoprost, Bimatroprost, Travoprost
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| Medications: Glaucoma. What are the mechanisms of action for Prostaglandin Analogs? Pg.1322 | Increases drainage of aqous humor through the uveoscleral pathway. Reduces intraocular pressure by 30%
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| Medications: Glaucoma. What are the Nursing considerations for Prostaglandin Analogs? Pg.1322 | 1.Client may have change in iris color
2. Blurred vision, eye pain, eye redness may occur
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| Medications: Glaucoma. What are some examples of Alpha2-Adrenergic Agonists? Pg.1322 | Brimonidine tartate, Apraclonidine
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| Medications: Glaucoma. What are the mechanisms of action for Alpha2-Adrenergic Agonists? Pg.1322 | Decreases production of aqueous humor in the eye & increases drainage through the uveoscleral pathway
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| Medications: Glaucoma. What are the Nursing considerations for Alpha2-Adrenergic Agonists? Pg.1322 | 1. Assess for contraindications: Acute angle-closure glaucoma, HTN, CAD, & dysrhythmias
2.Assess for CNS side effects: Anxiety, nervousness, muscle tremors
3.Allergic reaction: eye& eyelid erythema
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| Medications: Glaucoma. What are some examples of Carbonic Anhydrase Agonist? Pg.1322 | Acetazolamide & Methazolamide (oral only)
Brinzolamide &Dorzolamide
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| Medications: Glaucoma. What are the mechanisms of action for Carbonic Anhydrase Agonist? Pg.1322 | Decrease the production of aqueous humor into the eye. Related to sulfa drugs.
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| Medications: Glaucoma. What are the Nursing considerations for Carbonic Anhydrase Agonist? Pg.1322 | 1.Oralmeds may cause periorbital numbness& tingling in fingers& toes
2.May cause loss of potassium; Access daily wgt & electrolytes
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| Medications: Glaucoma. What are some examples of Combination Medications? Pg.1322 | Cosopt (Beta-blocker plus carbonic anhydrase inhibitor)
Combigan (beta-blocker with alpha2-adrenergic agonist)
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| Medications: Glaucoma. What are the mechanisms of action for Combination Medications? Pg.1322 | mechanism of action depends on the medication combination
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| Medications: Glaucoma. What are the Nursing considerations for Combination Medications? Pg.1322 | 1. Same med implications of individual meds
2. May be beneficial to clients to have one medication & may reduce cost
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| Medications: Glaucoma. What are some examples of Miotics (Parasympathomimetics)? Pg.1322 | Pilocarpine (Isopto Carpine, Pilopine, Pilostat)
Carbachol
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| Medications: Glaucoma. What are the mechanisms of action for Miotics (Parasympathomimetics)? Pg.1322 | Increases drainage of aqueous humor through the trabecular meshwork via pupillary constriction
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| Medications: Glaucoma. What are the Nursing considerations forMiotics (Parasympathomimetics)? Pg.1322 | 1.Rarely used due to side effects
2. May help with narrow-angle glaucoma
3.Myopic clients have increased risk for retinal detachment
4.Assess: HA, eye pain, & dim vision in low light
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| What is glaucoma? Pg.1318 | condition characterized by optic neuropathy with gradual loss of peripheral vision, (usually) increased intraocular pressure of eye
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| What are the symptom(s) of glaucoma? Pg.1318 | Client experiences gradual narrowing of visual field vision, happens so slowly it often goes unnoticed until late in disease process, painless, eventual blindness
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| What is normal intraocular pressure? Pg.1318 | 12-15mmHg (slide show said 12-22mmHg)
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| How is intraocular pressure maintained? Pg.1318 | Maintained by a balance between the production of aqueous humor in the ciliary body, it flows through the pupil form the posterior to the anterior chamber of the eye, & outflow or absorption through trabecular network & canal of Sclemm
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| How is the balance in the intraocular pressure disrupted? Pg.1318 | Decrease in outflow or absorption of aqueous humor usually results in an increase in pressure
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| What can occur when the intraocular pressure increases? Pg.1318 | Injury to the optic nerve
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| What are the two major forms of primary glaucoma? Pg.1318 | open-angle glaucoma & angle-closure glaucoma
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| What are the two categories of pediatric glaucoma? Pg.1318 | primary & seconday
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| What is primary congenital glaucoma? Pg.1318 | Occurs in 1 in every 10,000 in the US.
Caused by an abnormal development in the ocular drainage system.
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| What are some of the major causes for Secondary glaucoma in adults? pg.1319 | long-term steroid use or eye injury
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| In what populations is open-angle glaucoma found and what might contribute to its formation? Pg.1319 | Population: Latinos & African Americans
Contribution: Cardiovascular disease & Diabetes
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| What causes the gradual vision loss in open-angle glaucoma? Pg.1319 | Neuronal ischemia and optic nerve degeneration lead to gradual vision loss
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| In what populations is angle-closure glaucoma found in? Pg.1319 | Inuits, indigenous people, Asians
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| What are some intermittent symptoms of angle-closure glaucoma? Pg.1319 | Intermittent pain & photophobia (sensitivity to light)
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| What medications should someone diagnosed with angle-closure glaucoma? Pg.1319 | Atropine & other anticholinergics
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| What is mydrasis? Pg.1319 | dilation of the pupil
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| What is the leading cause of blindness in the world? Pg.1319 | Glaucoma
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| What are the primarily identified risk factors for glaucoma? Pg.1319 | Age & race
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| What medications from the carbonic anhydrase inhibitor class would you administer as eyedrops? Pg.1322 | Dorzolamide & Brinzolamide should be administered as eye drops
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| What medications from the carbonic anhydrase inhibitor class can you administer orally, IM, or IV? Pg.1322 | Acetazolamide
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| What are the conditions in which contraindicate a prescription for beta blockers? Pg.1322 | heart failure or reactive airway disease
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| If beta blockers are contraindicated what is the next medication to be recommended? Pg.1322 | Dorzolamide, carbonic anhydrase inhibitor or Acetazolamide, systemic carbonic inhibitor
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| When would a diuretic be used in angle-closure glaucoma? Pg.1322 | surgical intervention, Helps achieve rapid decrease in intraocular pressure prior to proceedure
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