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Chapter 11 - Eye > Allergic and inflammatory eye conditions > Flashcards

Allergic and inflammatory eye conditions Flashcards

1
Q

How long should a pt leave between application of two different eye drops or gels/ointments?

A

One drop more than enough to be put in. Wait 5 mins between each drop and longer if gels/suspensions are used.

Ointments should be applied after drops.

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2
Q

Systemic effects may occur when eye drops leak through nasal mucosa etc.

What can be advised to reduce nasal drainage and systemic absorption from nasal mucosa?

A

Pressure on the lacrimal punctum (inner corner of the eye) for at least 1 min after applying drops.

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3
Q

What are eye lotions usually for? What can be used?

A

To flush out the eye of irritants/ foreign bodies in first aid

Sterile sodium chloride 0.9% or clean water in an emergency

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4
Q

Eye drops in multiple-application containers for domiciliary use should not be used for more than _____ after first opening (unless otherwise advised by manufacturer).

Multiple application use in hospitals to be discarded after ______.

A

At home 4 weeks

Hospitals 1 week

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5
Q

What are the two types of contact lenses?

What is the risk of wearing contact lenses for longer than advised?

A

Rigid - hard, gas permeable

Soft - hydrogel/silicone hydrogel

Infectious or non-infectious keratitis

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6
Q

What is the risk of using eye medications and preservatives whilst wearing soft contact lenses?

What should be done/alternative?

What about hard lenses?

A

They can accumulate in hydrogel lenses and induce toxic adverse effects.

Soft lenses should not be worn during treatment.

Alternative - use unpreserved eye drops.

Eye drops can still be used with rigid corneal contact lenses.

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7
Q

What other preparations should be avoided with contact lenses?

A

Ointments

Oily eye drops

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8
Q

Many drugs given systemically can have adverse effects on contact lens wear.

General groups & examples?

A
  1. Oral contraceptives (esp those with higher oestrogen)
  2. Drugs that reduce blink rate - anxiolytics, hypnotics, antihistamines & muscle relaxants
  3. Drugs that reduce lacrimation - antihistamines, antimuscarinics, phenothiazines, beta-blockers, diuretics and tricyclic antidepressants
  4. Drugs that increase lacrimation - ephederine hydrochloride & hydralazine hydrochloride
  5. Isotretinoin (can cause conjunctival inflammation)
  6. Aspirin (salicylic acid can be in tears & absorbed by lenses - causes irritation
  7. Rifampicin (orange-red) and Sulfasalazine (orange-yellow)
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9
Q

Corticosteroids are used to treat inflammation in the eye. However there are 3 main dangers associated with their use (eye associated)…?

A
  1. Red eye - maybe due to herpes simplex virus and corticosteroid aggravtes the condition - lead to possible damage or even vision loss. bacterial/fungal infection pose similar hazard#
  2. Steroid glaucoma
  3. Steroid cataract - follow from prolonged use
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10
Q

The risk of producing a steroid cataract increases with ….. and ….. of corticosteroid use.

A

Dose and duration

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11
Q

What are three treatments that can be used for anti-inflammatory purposes?

Name examples

A
  1. Antihistamines
    e.g. Antazoline (Otrivine) with xylometazoline (Otrivine Antistin)
    Azelastine hydrochloride
    Epinastine hydrochloride
    Ketotifen
  2. Lodoxamide - licensed for allergic conjunctivitis
  3. Sodium cromoglicate (Opticrom/Optrex Hayfever/Allercrom)
  4. Diclofenac sodium - seasonal allergic conjunctivitis
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12
Q

When can ciclosporin be used for?

A

Severe keratitis in those with dry eye disease which has not improved despite tear substitutes

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13
Q

From what age can Antazoline xylometazoline (otrivine antistin) be used from and how long for?

Indication?
Legal class?

A

For allergic conjunctivitis

Children from age 7

maximum 7 days use

P

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14
Q

Indication
age from
dose
legal class

for azelastine hydrochlroide (Optilast) eye drops?

A
  1. Seasonal allergic conjunctivitis
  2. from 4 years and above
  3. BD increased to QDS if needed
  4. POM
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15
Q

What would a patient complain of if they are applying azelastine hydrochlroide (Optilast) eye drops incorrectly?

A

Taste bitter

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16
Q 
Indication
Drug class
Age from
Dose 
Legal class

for Lodoxamide (Alomide) eye drops?

A
  1. Allergic conjunctivitis
  2. Mast cell stabilisers
  3. From 4 years
  4. Apply QDS - improvement of symptoms may require up to 4 weeks of treatment
  5. POM but 0.1% eye drops can be sold OTC for 4 years and above
17
Q 
Indication
Drug class
Age from
Dose 
Legal class

for Sodium cromoglicate 2%(Opticrom) eye drops?

A
  1. Allergic conjunctivitis / Seasonal keratoconjunctivitis
  2. Mast cell stabilisers
  3. Suitable for child/adult
  4. Apply QDS
  5. POM but can be sold OTC max pack size 10ml
18
Q 
Indication
Drug class
Age from
Dose 
Legal class

for betamethasone 0.1% (Betnesol) eye drops/ointment?

A
  1. Local treatment of inflammation
  2. Corticosteroids - high glucocorticoid and very little mineralocorticoid action
  3. No age restrictions
  4. Apply every 1 -2 hours until controlled then reduce frequency
  5. POM
19
Q

Indication
Drug class
Age
Legal class

for dexamethasone (Dexafree/ Maxidex/Dropodex) eye drops?

A
  1. Local inflammation OR Macular odema (intravitreal injection)
  2. Corticosteroid - high glucocorticoid and very little mineralocorticoid action
  3. Maxidex not licensed for those under 2 years. Dropodex not licensed for children.
  4. POM
20
Q 
Indication
Drug class
Age from
Dose 
Legal class

for hydrocortisone (Softacort) eye drops?

A
  1. local treatment of conjunctival inflammation
  2. Corticosteroid - has equal glucocorticoid and mineralocorticoid activity
  3. Adult only
  4. 2 drops 2-4 times a day for up to 14 days to avoid replase
  5. POM
21
Q

Indication
Age from
Pregnancy use?
Legal class

for prednisolone (Minims 0.5%/ Pred Forte 1%) eye drops?

A
  1. local treatment of conjunctival inflammation
  2. Child and Adult (no age specified?) Pred forte not for children.
  3. 88% of it is inactivated when passes the placenta
  4. POM
22
Q

Which preservative is commonly used in eye products and may cause stinging and irritation?

A

Benzalkonium chloride

23
Q

Can you use use eye drops/ointments with contact lenses?

A

Hard lenses - can still use them whilst wearing lenses

Soft lenses - need to remove before applying or use preservative free drops
this is because drug and preservative can accumulate in lenses

Never wear lenses with ointments/oily eye drops

24
Q

Which drugs can stain contact lenses orange/red? (2)

A
  1. Rifampicin

2. Sulfasalazine

25
Q

Name some examples of drugs for allergic conjunctivitis as well as their drug class?

A
  1. Sodium cromoglicate - mast cell stabiliser
  2. Antazoline, Azelastine (antihistamine)
  3. Xylometazoline, Naphazoline (vasoconstrictors reduce redness )

Chapter 11 - Eye (6 decks)

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