Chapter 29: Book Qs & Evolve Flashcards
- Which brand name drugs belong to the prostaglandin agonist class? Select all that apply.
A. Betaxon B. Iopidine C. Lumigan D. Ocupress E. Piloptic F. Travatan G. Trusopt H. Xalatan
C F H
- Which adverse effect can occur as a result of excessive use of prostaglandin agonists?
A. Asthma B. Hypertension C. Urinary retention D. Increased body hair
D
- For which eye-drop-delivered drug is it most important that the corneal surface be intact?
A. dorzolamide (Trusopt) B. metipranolol (OptiPranolol) C. pilocarpine (Akarpine) D. travoprost (Travatan)
D
- Which eye drops for glaucoma are most likely to cause miosis? Select all that apply.
A. brimonidine (Alphagan) B. brinzolamide (Azopt) C. carbachol (Isopto) D. dipivefrin (AK-Pro) E. echothiophate (Phospholine Iodide) F. latanoprost (Xalatan) G. methazolamide (Neptazane) H. timolol (Timoptic)
C E H
- Which patient problem is a contraindication for use of the beta-adrenergic antagonist drugs?
A. Asthma B. Blurred vision C. Constipation D. Diabetes type 1
A
- Which drug for glaucoma must be avoided for patients who have an allergy to sulfa drugs?
A. carteolol (Ocupress) B. dorzolamide (Trusopt) C. levobunolol (Betagan) D. dipivefrin hydrochloride (Propine)
B
- You are teaching a family member to apply eye drops before a patient’s surgery. Into which exact area do you instruct the drops to be instilled?
A. The corner of the eye nearest the nose B. The corner of the eye nearest the side of the head C. The center of the eye where the pupil is located D. The pocket created by pulling down the lower lid
D
- Which patient response is most important to check after administering an adrenergic agonist for control of glaucoma?
A. Heart rate and rhythm B. 24-hour urine output C. Level of consciousness D. Pupil size and shape
A
The nurse is preparing to administer two different types of eye drops to a patient. How many minutes apart should these eye drops be instilled into the same eye?
1
2
5
10
10
Check to see whether any other eye drops are to be administered. If so, wait at least 10 minutes after instilling the first set and before instilling the second set of eye drops to prevent a drug interaction or dilution of drug concentration. One, two, or five minutes are not long enough to wait between installations.
The nurse is discharging a patient with a new prescription for a glaucoma medication. For which medication is it most important to remind the patient to wear sunglasses when in bright light?
Travoprost (Travatan)
Timolol (Timoptic)
Apraclonidine (Iopidine)
Carbachol (Carboptic)
Apraclonidine (Iopidine)
Apraclonidine (Iopidine) is an adrenergic agonist. This drug dilates the pupil, causing increased sensitivity to light. Patients should be taught to wear sunglasses when in the sunlight or in other bright light conditions. Prostaglandin agonists do not affect pupil size, so light sensitivity is not an issue. Beta-adrenergic blockers and cholinergic drugs constrict the pupil, causing the need for additional light, so sensitivity to light is not an issue.
The nurse is preparing to administer eye ointment to a patient. Which routine action done before the instillation of the ointment best reduces the chance of instilling contaminated medication into a patient’s eyes?
Squeezing a small amount out of ointment onto a tissue
Wiping the tip of the ointment tube with a tissue
Using a separate ointment tube for each eye
No specific actions are necessary; the eye’s immune system protects it
Squeezing a small amount out of ointment onto a tissue
For ointments, after removing the cap from the ointment tube, squeeze a small amount out onto a tissue (without touching the tip of the tube or letting it come into contact with the tissue) and discard this ointment. This action reduces the chance of instilling contaminated ointment into the patient’s eye. Check to be sure that a tube of ointment is for ophthalmic (eye) use. Some drugs for the eye are also available as regular topical ointments, but these contain larger particles that should not be placed in the eye. Instruct patients not to share the eye ointment with anyone else to prevent spreading eye infections from one person to another. Wipe any excess drug from the patient’s skin to prevent systemic side effects. The tip of the ointment tube should not come into contact with the tissue. Using a separate ointment tube is only necessary if one eye is infected and the other is not. The eye is not well protected by its immune system.
The nurse is giving a glaucoma medication to a patient. For which medication is it most important for the nurse to check whether the patient is taking a monoamine oxidase (MAO) inhibitor?
Travoprost (Travatan)
Timolol (Timoptic)
Apraclonidine (Iopidine)
Carbachol (Carboptic)
Apraclonidine (Iopidine)
Apraclonidine (Iopidine) is an adrenergic-agonist eye medication. Adrenergic-agonist eye drops for glaucoma should not be administered to anyone who is taking an MAO inhibitor or who has taken a drug from this class within the last 14 days.MAO inhibitors are not contraindicated with travoprost, timolol, or carbachol.
What drug category offers an oral form medication to control glaucoma?
Prostaglandin agonists
Beta-adrenergic blockers
Adrenergic agonists
Carbonic anhydrase inhibitors
Carbonic anhydrase inhibitors
Carbonic anhydrase inhibitors (CAIs) are a type of diuretic that also can lower intraocular pressure (IOP) by reducing production of aqueous humor by as much as 60%. IOP is the fluid pressure inside the eyeball that helps to maintain the correct shape of the eye. The normal range for IOP is 10 to 20 mm Hg. Carbonic anhydrase inhibitors can be taken orally and as eye drops to control glaucoma. Acetazolamide (Diamox) and methazolamide (Neptazane) are both carbonic anhydrase inhibitors that can be taken orally. Prostaglandin agonists, beta-adrenergic blockers, and adrenergic agonists are available in eye drop form only.
A patient has been prescribed travoprost (Travatan). Which instruction, particular to travoprost, should you include in patient teaching?
Travoprost may cause eyelashes to fall out.
This drug may cause your eye color to darken.
Use the drug in both eyes to ensure eye color similarity.
Contact your health care provider right away if eyes become itchy or reddened.
This drug may cause your eye color to darken.
Travoprost (Travatan) is a prostaglandin agonist. One of the most common side effect of this drug is a permanent change in the iris color from lighter colors to brown. Other side effects include eye itching, eye redness, thickening and lengthening of the eyelashes, and darkening of the skin on the eyelids. If only one eye has glaucoma, the color and lash changes will occur only in that eye. While this is especially true for prostaglandin agonists, it is true of all glaucoma drugs. Travoprost will not cause eyelashes to fall out and the drug should not be used in the eye that does not have glaucoma just to ensure the same eye color. Contacting the health care provider right away if eyes become itchy or reddened is not necessary because this is an anticipated side effect.
A patient with diabetes who is taking timolol (Timoptic) drops is admitted to the unit. What recommendations might you expect the health care provider to suggest?
Increased fall precautions
Increased insulin doses
Increased eye drop doses
Increased blood sugar checks
Increased blood sugar checks
Timolol (Timoptic) drops is a beta blocker and can mask the symptoms of hypoglycemia if the drug is absorbed systemically. Blood glucose levels may need to be checked more often. Increased fall precautions may be necessary due to pupil constriction, but the nurse can initiate fall precautions without consulting with the health care provider. An increase in insulin doses is not indicated, because diabetes does not alter the amount of glaucoma medication needed. An increase in eye drop doses is not necessary and contraindicated for a patient with diabetes.
