Chapter 18 - Eye And Ear Medications

Question 1

Anti-infective ophthalmic topical ointments and solutions

P. 321-322

Answer 1

Are available for the treatment of superficial infections of the eye caused by susceptible organisms.

• Medication used in the treatment of infections; includes antibiotics, antifungals, and antivirals.

Question 2

Anti-inflammatory ophthalmic agents (Corticosteroids)

P. 323

Answer 2

Are used to relieve inflammation of the eye or conjunctiva in allergic reactions, burns, irritation from foreign substances or post-operatively.

Question 3

Nonsteroidal Anti-inflammatory ophthalmic drops (NSAIDS)

P. 324

Answer 3

Are used to treat post-operative inflammation following cataract surgery.

Question 4

Ophthalmic Immunologic Agent

P. 324

Answer 4

(e.g. topical cyclosporine [Restasis])

Increases shoe production in patients with tear production is presumed to be suppressed due to ocular inflammation. It is an immunosuppressive agent for organ transplant rejection prophylaxis when administered systemically.

Question 5

Ophthalmic antihistamines or decongestants

P. 325

Answer 5

Blocks histamine receptors in the conjunctiva, relieving ocular pruritis associated allergic conjunctivitis. Ophthalmic administration of decongestants causes vasoconstriction of blood vessels, thereby providing relief for minor eye irritation and redness.

Question 6

Ophthalmic lubricants

P. 325

Answer 6

Ocular lubricant such as artificial tears solution provide a barrier function at the level of the conjunctival mucosa. They help dilute and plus various allergens and inflammatory mediators that may be present on the ocular surface. Artificial tear products that contain preservatives may cause allergic reactions and should be stopped immediately.

Question 7

Glaucoma

P. 326

Answer 7

Abnormal condition of the eye with increased intraocular pressure (IOP) because of obstruction of the outflow of aqueous humor.

• this causes deterioration of and damage to the optic nerve (which carries images on the retina to the brain), resulting in vision loss.

Question 8

Acute (angle-closure) glaucoma

P. 326

Answer 8

Characterized by a sudden onset of pain, blurred vision, and a dilated pupil, this condition is considered a medical emergency. Although uncommon, if left untreated, blindness can result in a few hours or days.

Question 9

Chronic (open-angle) glaucoma

P. 326

Answer 9

Much more common and often bilateral, this condition develops slowly over a period of years with few symptoms except a gradual loss of peripheral vision and possibly blurred vision. Halos around lights and central blindness are late manifestations.

Question 10

The first step in glaucoma therapy is ____________________.

P. 326

Answer 10

Early diagnosis via screening and ensuring the patient abstains from medications that may exacerbate glaucoma.

Question 11

Antiglaucoma drugs

P. 326

Answer 11

Given to lower intraocular pressure.

Question 12

The five main categories of Antiglaucoma drugs:

P. 326-327

Answer 12

1. Carbonic anhydrase Inhibitors, for example dorzolamide (Trusopt). Act by decreasing the formation of aqueous humor and have a diuretic effect.
2. Miotics, for example pilocarpine. Act by increasing the aqueous humor outflow.
3. Beta-adrenergic Blockers, for example timolol (Timoptic). Act be decreasing the rate of aqueous humor production.
4. Alpha-agonists, for example brimonidine (Alphagan-P). Decrease the production of aqueous humor and increase outflow.
5. Prostaglandin analogs, for example latanoprost (Xalatan). Act by increasing aqueous outflow.

Question 13

Intraocular pressure

P. 326

Answer 13

Pressure within the eyeball.

Question 14

Carbonic Anhydrase Inhibitors (CAIs)

P. 327

Answer 14

Such as acetazolamide reduce the formation of hydrogen and bicarbonate ions, which have a diuretic effect and reduce the production of aqueous humor.

Question 15

Miotics, direct-acting

P. 328

Answer 15

Are medications that cause the pupil to contract. Miotics reduce IOP by increasing the aqueous humor outflow. The act by contracting the ciliary muscle; this mechanism also leads to blurred vision.

Question 16

Beta-Adrenergic blockers

P. 329

Answer 16

Are used topically to lower IOP in open-angle glaucoma by decreasing the rate of aqueous humor production.

Question 17

Alpha-Agonists

P. 330

Answer 17

Decreases the formation and increases the outflow of aqueous humor.

Question 18

Prostaglandin Analogs

P. 330-331

Answer 18

Regarded as first-line agents; the greatest reduction in IOP by increasing the outflow of aqueous humor.

Question 19

Mydriatics

P. 332

Answer 19

(e.g. atropine) are used topically to dilate the pupil for ophthalmic examinations.

• also acts as a cycloplegic (paralyzes the muscles of accommodation).

Question 20

cycloplegic

P. 332

Answer 20

paralyzes the muscles of accommodation.

Question 21

Local ophthalmic anesthetics

P. 333

Answer 21

Such as tetracaine (TetraVisc), are applied topically to the eye for minor Surgical and diagnostic procedures, removal of foreign bodies, or painful injury.

Question 22

The ear is made up of three parts:

P. 334

Answer 22

The outer, middle, and inner ear.

Question 23

The outer, middle, and inner ear; these parts serve two main purposes:

(P. 334)

Answer 23

Hearing and balance.

Question 24

There are two main categories of common ear conditions:

P. 334

Answer 24

1. Ear infections
2. Earwax buildup

• these two types of conditions generally involve only the outer and middle ear.

Question 25

Otitis Media

P. 335

Answer 25

Ear infections; occur most commonly in children, but can also occur in adults.

• they are caused most commonly by bacteria in the middle ear, which leads to inflammation (Otitis media).

Question 26

Ear infection symptoms:

P. 335

Answer 26

Symptoms of pain (dull pulsing to sharp stabbing), tenderness, a feeling of “fullness” in the ear, fever, and difficulty hearing.

• it should be noted that infants or small children who cannot talk yet will often become fussy and cry while reaching toward the affected ear. This is an indicator that they may have an ear infection.

Question 27

Topical otic antibiotics

P. 335

Answer 27

Are best suited for outer ear infections (“swimmers ear”).

Question 28

Otic

P. 334-335

Answer 28

Relating to the ear.