1- Ophthalmic and Otic Disorders Flashcards
What ophthalmic disorders are self treatable?
dry eyes and allergic conjuctivitis
What otic disorders are self treatable?
excessive or impacted cerumen and water clogged ears
What are exclusions for self care for ophthalmic disorders?
-severe eye pain
-blunt trauma to eye
-chemical exposure to eye
-heat exposure
-blurred vision
-sensitivity to light
-contact lense wearer
-symptoms last or worsen > 72h
What is the recommended duration of use of ophthalmic products?
72h
What drugs can be used to treat dry eyes?
-artificial tear solution/gel
-non-medicated lubricant ointment
What drugs can be used to treat allergic conjuctivitis?
-artificial tears solution/gel
-antihistamine/mast cell stabilizer drops
-decongestant (w/ or w/o antihistamine)
-decongestant/astringent drops
What are the signs/symptoms of dry eyes?
-mild red eye
-gritty feeling in eye with sensation of something stuck in eye
-possible excessive tearing as a compensatory mechanism
What are the causes of dry eyes?
-age
-allergens
-corneal or lid defects
-dry air
-loss of lid tissue turgor
-menopause
-thyroid disorders
-medications (antihistamines, beta blockers, decongestants, diuretics)
What are the treatment goals for dry eyes?
-alleviate and control dryness of the ocular surface
-relieve symptoms (irritation)
-prevent possible tissue/eye damage
What are nonpharmacological recommendations for dry eyes?
-avoid dusty/dry areas
-avoid wind or air flow
-avoid prolonged viewing of computers
-eliminate offending medications (add supplements such as omega-3 or flaxseed)
-humidifier
-warm compress to eyelids
-wear sunglasses or goggles when outdoors
What is the first line treatment for dry eyes?
artificial tear solution
When would preservative-free formulations of artificial tears be preferred?
frequent use due to less ocular surface irritation
What characteristics of artificial tear products may increase side effects?
increased viscosity and preservatives
What is the dosing for artificial tears preparations?
-mild= 1-2 times a day
-moderate= 3-4 times/daily up to hourly
What is the use of demulcents in ophthalmic preparations?
increase viscosity to slow drainage of active ingredients and increase retention time and bioavaliability
What is the use of non-medicated lubricant ointment for dry eyes?
last line treatment, but reduces burning and stinging and also prevents evaporation- apply 2 times daily up to every couple hours if needed
note: causes blurred vision
What are the signs and symptoms of allergic conjuctivitis?
-red eyes
-watery discharge
-itching
-blurred vision due to excess tears
-bilateral
What are the causes of allergic conjuctivitis?
animal dander, pollen, topical eye preparations
What are the treatment goals of allergic conjuctivitis?
-remove and avoid the allergen
-limit or reduce allergic reaction severity
-provide symptomatic relief
-protect the ocular surface
What are the nonpharmacological recommendations for allergic conjuctivitis?
-close windows and doors
-change home filters regularly
-cold compress 3-4 times daily
-use sunglasses outside
-avoid contact lenses until condition resolves
What is the first line treatment for allergic conjuctivitis?
artificial tears solution/gel
What is the second line treatment for allergic conjuctivitis?
2nd gen ophthalmic antihistamine/mast cell stabilizer (with or without oral antihistamine, note oral antihistamine may cause dry eyes)
What drugs are 2nd gen Ophthalmic H1 Antihistamine/Mast Cell Stabilizer?
-ketotifen
-OLOPATADINE
-alcaftadine
What is the dosing of olopatadine?
-0.1%= twice daily, be sure to leave 6-8h between each dose
-0.2%/0.7%= once daily
What drugs are oral antihistamines?
-cetirizine
-chlorpheniramine
-clemastine
-diphenhydramine
-fexofenadine
-levocetirizine
-loratadine
What drugs are ophthalmic decongestants?
-brimonidine
-naphazoline
-oxymetazoline
-phenylephrine
-tetrahydrozoline
What is the MOA of ophthalmic decongestants?
alpha-adrenergic receptor agonists
What is the dosing of ophthalmic decongestants?
1-2 drops up to 4 times a day
What are the contraindications for ophthalmic decongestants?
age <6 yo, angle closure glaucoma, contact lens user, and pregnancy
USE CAUTION in cardiovascular disease, diabetes, HTN, hyperthyroidism
What are the adverse effects of ophthalmic decongestants?
stinging, burning, rebound congestion, epithelia xerosis
What drugs are ophthalmic antihistamines?
pheniramine maleate and antazoline phosphate
What is the MOA of ophthalmic antihistamine?
H1 blocker
What are the adverse effects of ophthalmic antihistamines?
pupil dilation and discomfort upon instillation
What is the use of ophthalmic astringent (zinc sulfate 0.25%) for allergic conjuctivitis?
eliminate mucous build up on the eye due to debris exposure to relieve symptoms from environmental irritants (pollen, dust, or smoke)
