Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Chapter 5: Eye and Ear Disorders > Flashcards

Chapter 5: Eye and Ear Disorders Flashcards

1
Q

typical disorders of the ear canal

A

otitis media

otitis externa

inflammatory conditions

cerumen impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Class of drug used to treat ear inflammation

A

corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

class of drugs used in treatment of ear pain

A

topical antipyrine and benzocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

drug classes used to treat cerumen impaction

A

emulsifiers and emolients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

agents used in treatment of pruritis of the ear

A

emolients such as: glycerin, mineral oil, and olive oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is substitution of ototopical antibiotics reccommended?

Why or why not?

A

No because different preparations can differ in pH, viscosity, and presence of steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Advantage of ototopical cipro

A

better activity against gram- bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

advantage of ototopical ofloxacin

A

longer half-life and higher serum levels

appropriate for aerobic gram-bacilli (staph, strep)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What ABT would you use for urethritis if you suspected Chlamydia was present?

A

ofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is an acceptable substitution for a solution of ofloxacin and why

A

a suspension of ciprofloxacin

has low pH and high viscosity

same chemical classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

drug therapy for otitis externa

A

analgesic and antibiotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

otic anti-infectives:

mild acids and alcohols

A

make the environment inhospitable for pathogens to reproduce

causes drying of cellular infective agents

topical, antibacterial, and antifungal effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

otic anti-infectives:

Fluoroquinolones

A

broad coverage and affect psudomonas species

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

otic anti-infectives:

corticosteroids

A

aid in reducing inflammation and patient symptoms

gives better access for topical medicines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Implications of OTC neomycin topical antibiotics

A

associated with severe ototoxicity (especially with perforated tympanic membrane)

can cause contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

mechanism of action:

topical otic anti-infectives

A

work as either bacteriostatic or bacteriacidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Are topical anti-infectives absorbed

A

Not unless skin is broken

rest of pharmicokinetics is unknown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Examples of otic anti-infectives

A

Ofloxacin (Floxin)

Neomycin (Myciguent)

Ciprofloxacin-hydrocortisone (Cipro HC otic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dosage/administration for topical otic anti-infectives

preparations with and without steroids

A

page 67

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Proper installation of ear drops

Adults

A

pull ear lobe up and back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

poper installation of ear drops

children

A

pull ear lobe down and back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

clinical uses for otic acid-alcohol solutions

A

superficial infections of external auditory canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

examples of otic acid-alcohols

A

acetic acid/aluminum acetate (Domeboro Otic)

isopropyl alcohol/propylene glycol (Ear Sol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Antipyrine

A

otic analgesic

also has anti-inflammatory effects because it affects prostaglandin system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Benzocaine

A

otic analgesic

blocks nerve sodium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What if otitis externa does not clear after 1 week of treatment

A

obtain cultures to guide further treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What should you do if a patient has 2 or more ear infections in a 6 month period

A

further eval for cholesysteatoma, foreign body, or tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Analgesics that can cause ototoxicity

A

ASA and NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

antibiotics that can cause ototoxicity

A

Aminoglycosides

clarithromycin

erythromycin

vancomycin

neomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

antineoplastics that can cause ototoxicity

A

cisplatin

mechlorethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Loop diuretics that can cause ototoxicity

A

bumetanide

ethacrynic acid

furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

dosage/administration of acid-alcohol solutions

A

page 68

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

two combination otic analgesics commonly used today

A

acetic acid and benzocaine/antipyrine/glycerin (Auralgan Otic)

benzocaine/antipyrine/propylen glycol (Tympagesic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

dosage/administration of otic analgesics

A

page 68

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

purpose of cerumenolytics

A

soften and remove ear wax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

classifications of cerumenolytics

A

water based

oil based

nonwater/nonoil based

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

examples of cerumenolytics

A

carbamide peroxide 6.5% (Debrox)

triethanolamine polypeptide oleate (Cerumenex drops)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is used for “swimmer’s ear”

A

isopropyl alcohol and glycerin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What happens if triethanolamine polypeptide drops are left in the ear longer than 30 minutes

A

inflammation occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

cerumenolytics:

patient education

A

may hear bubling with Debrox d/t action of releasing O2 from cerumen

using carbamide peroxide longer than 4 days can damage tympanic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

common eye infections

A

conjunctivitis

blepharitis

hordeolum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What should be monitored when patient

is being treated for eye disorder

A

effectiveness of treatment

intraocular pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

consideration for infants and children being treated for eye disorders

A

erythromycin ointment has good coverage and is easier to administer than drops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

classes of opthalmic anesthetics

A

tetracaine (Pontocaine)

proparacaine (Ophthaine, Ophthetic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What can result from improper use of opthalmic anesthetics

A

deep corneal infiltrates

ulceration

perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

mechanism of action:

opthalmic anesthetics

A

agents penetrate to sensory nerve endings in corneal tissue

(tetracaine, proparacaine)

locally stabilize and block initiation and conduction of nerve impulses by decreasing neuronal membrane’s sensitivity to sodium ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

doasge/administration of opthalmic anesthetics

A

page 71

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

acute conjunctivitis is usually caused by

A

virus

(pink eye)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

how can you recognized hepres infections of the eyes

A

severity

vesicular nature

corneal involvement or nerve distribution

patient population

50
Q

cases to refer to opthalmologist

A

herpes infections of the eyes

deeper infection of the globe or eye socket is suspected

51
Q

what do contact lenses place at risk for

A

fungal infections

52
Q

treatment of allergic conjunctivitis

A

antihistamines

NSAIDs

leukotriene inhibitors

corticosteroids

53
Q

best way to treat viral eye infections

A

saline drops

warm compresses

and time

54
Q

most common organisms that cause bacterial conjunctivitis

A

staphylococcus aureus

streptococcus pneumoniae

haemophilus influenzae

55
Q

opthalmic anti-infectives mechanism of action

A

bacteriostatic or bacteriocidal

56
Q

most commonly used opthalmic anti-infectives

A

tobramycin (Tobrex)

sulfacetamide (Sulamyd, Bleph-10)

sulfacetamide/prednisolone (Blephamide)

fluoroquinolones (Cipro drops)

57
Q

opthalmic anti-infectives

contraindications

A

tobramycin should not be used if systemic aminoglycosides are being used because it could affect serum levels and lead to toxicity

58
Q

Which opthalmic anti-infective may cause transient blurry vision

A

bacitracin

59
Q

patent education :

sulfacetamide solution

A

when it turns dark it has lost its potency and should be discarded

60
Q

opthalmic mast cell stabilizers mechanism of action

A

inhibit degranulation of mast cells after exposure to an antigen

61
Q

clinical uses of mast cell stabilizers

A

allergic conjunctivitis and keratitis

62
Q

examples of opthalmic mast cell stabilizers

A

Nedcromil (Alocril)

Cromolyn (Opticrom)

Lodoxamide (Alomide)

63
Q

dosage/administration of mast cell stabilizers

A

page 73

64
Q

opthalmic antihistamines mechanism of action

A

blocks the effects of histamine released during allergic reactions and blunts its symptoms

65
Q

clinical use of opthalmic antihistamines

A

relief of itching associated with seasonal allergies and allergic conjunctivitis

66
Q

examples of opthalmic antihistamines

A

azelastine (Optivar)

epinastine (Elestat)

antazoline (Vasocon)

amedastine (Emadine)

ketotofen (Zaditor)

levocabastine (Livostin)

olopatadine (Patanol)

67
Q

opthalmic antihistamines and contact lenses

A

dont wear while using them

wait 15 minutes before re-applying them

replace them if eye is red

68
Q

opthalmic vasoconstrictors mechanism of action

A

weak sympathomimetic agents that constrict

blood vessels in conjunctiva

69
Q

clinical use for opthalmic vasoconstrictors

A

relief of eye redness caused by irritants or allergies

70
Q

opthalmin vasoconstrictors contraindications

A

narrow angle glaucoma

71
Q

examples of opthalmic vasoconstricotrs

A

oxymetazoline (Afrin)

tetrahydrozine (Visine)

72
Q

dosage/administration of opthalmic vasoconstrictors

A

page 74

73
Q

dosage/administration of opthalmic antihistamines

A

page 73

74
Q

opthalmic vasoconstricotrs interactions

A

increased pressor effects with MAOIs

75
Q

cyclosporin (Restasis)

A

polycyclic polypeptide that inhibits interleukin 2

76
Q

clinical uses of Restasis

A

prevents organ rejection after transplant surgery

opthalmic preparation to prevent rejection of corneal implant

77
Q

opthalmic lubricants actions

A

contain agents that provide hydration. maintain moisture, and protect eye

can be viscous or non-viscous

78
Q

clincal uses of opthalmic lubricants

A

supplement natural tears for dry eyes or to wash away irritants

viscosity enhancers

(promotes increased contact time of an opthalmic agent with an ocular surface)

secondary corneal edema

79
Q

Types of agents used to treat glaucoma

A

direct and indirect acting miotics

topical prostaglandin agonists

carbonic anhydrase inhibitors

sympathomimetic agents

alpha-2 adrenergic agonists

beta blockers

opthalmic osmotics

80
Q

Miotics mechanism of action

A

contracts the iris sphincter muscle, resulting in miosis

(pupillary constriction)

81
Q

Examples of direct acting miotics

A

carbachol (Isopto Carbachol)

82
Q

examples of indirect-acting miotics

A

echothiophate (Phospholine)

83
Q

How do miotics decrease intra-ocular pressure

A
  • when the pupil constricts, it also constricts the ciliary muscles attached to the trabecular mesh work
  • This opens the canal of Schlemm which increases the outflow of aqueous humor
  • which decreases IOP
84
Q

dosage/administration of miotics

A

page 77

85
Q

clinical uses of miotics

A

glaucoma

Sjogren’s syndrome

86
Q

Miotics adverse reactions

A

abdominal cramps, diarrhea, watery mouth, excessive sweating, urinary incontinence, muscle weakness

87
Q

Miotics contraindications

A

active inflammation of the eye

88
Q

Patient education on miotics

A

it will impair adjustment to changes in light

89
Q

topical prostaglandin agonists mechanism of action

A

stabilized, synthetic analogues of prostaglandin that increase outflow of intraocular aqueous humor to lower IOP

(acts on RF prostaglandin receptor)

90
Q

examples of topical prostaglandin agonsits

A

latanoprost(Xalatan)

bimatoprost (Lumigan)

travoprost (Travatan)

unoprostone (Recula)

91
Q

clinical use of topical prostaglandin agonists

A

open-angle glaucoma

92
Q

dosage/administration of topical prostaglandin agonists

A

page 78

93
Q

absorption of topical prostaglandin agonists

A
  • through cornea ad hydrolyzed into active compound:
    • Latanoprost and bimatoprost
  • not absorbed but active on the cornea:
    • travoprost and unoprostone
94
Q

distribution of topical prostaglandin agonists

A
  • bimatoprost: 80% protein bound
  • lataoprost: 4h in aqeous humor and 1 hour in plasma
  • travoprost: 1 hour in plasma then rapidly eliminated
  • unoprostone: not reported
95
Q

metabolism of topical prostaglandin agonists

A
  • latanoprost: hydrolyzed in liver
  • bimatoprost: oxidated in liver
  • travoprost and unoprostone: hydrolyzed by esterases in the cornea
96
Q

excretion of topical prostaglandin agonists

A
  • latanoprost and bimatoprost: urine
  • travoprost and roprostone: urine (rapid and undetectable in an hour)
97
Q

half-life of topical prostaglandin agonists

A
  • latanoprost: 45 minutes
  • bimatoprost: about 45 minutes
  • travoprost: 45 minutes
  • unoprostone: unreported
98
Q

topical prostaglandin agonist adverse reactions

A

sensation of foreign body in the eye

permanent discoloration of iris with brown pigment

eyelash changes

conjunctival hyperuremia

99
Q

topical prostaglandin agonist contraindications

A

pregnancy category C

not for children

pulmonary diseases

100
Q

carbonic anhydrase inhibitors

(CAIs)

A

not first-line therapy

used as diuretics

101
Q

topical CAIs

A

brinzolamide (Azopt)

dorzolamide (Trusopt)

102
Q

oral CAIs

A

Diamox

Neptazane

page 78

103
Q

CAI pharmacookinetics

A

page 78

104
Q

CAI adverse reactions

A
  • DERM: rash, alopecia, STEVENS-JOHNSON SYNDROME
  • GI: anorexia, bitter or altered sense of tast with dorzolamide and brinzolamide
  • GU: kidney stones
  • HEME: blood dyscrasias, bone marrow supression
  • META: metabolic acidosis
  • MISC: weakness and myalgia, groin/leg pain, malaise, fatigue
  • NEURO: depression, headache, nervousness, numbness/tingling
105
Q

CAI interactions:

acetazolamide and methimazole

A

sulfa derivatives so interacts with salicylates, phenytoin, quinidine, and cyclosporine

106
Q

contraindications to sympathomimetic agents

A
  • hypersensitivities
  • cerebrovascular insufficiencies
  • cardiovascular disease
  • DM
  • hyperthyroidism
  • parkinson’s
  • HTN
107
Q

interactions for alpha-2 agnosits

A

use with MAOIs can cause HTN crisis

108
Q

most common agent to treat open-angle glaucoma

A

beta blocker eye drops

109
Q

contraindications for opthalmic beta blockers

A

glaucoma who also have bradycardia, AV block, or HF

DM because it intereferes with glycolysis

hyperthyroidism

Raynaud’s or any other peripheral vascular disorder

110
Q

Opthalmic osmotics mechanism of action

A

makes osmotic pressure of glomerular filtrate hypertonic allowing water and electrolytes to be passively pulled out of cellular and interstitial spaces

excess fluid is excreted in urine

111
Q

clinical use for opthalmic osmotics

A

interupt acute attack og glaucoma or hypertensive crisis

extremely high IOP

cerebral edema

112
Q

example of opthalmic osmotic

A

mannitol

113
Q

Mannitol adverse reactions

A
  • EENT: blurry vision, rhinitis
  • CV: transient volume expansion, chest pain, edema, tachycardia
  • GI: N/V, thirst
  • GU: renal failure
  • META: dehydration, hyperkalemia, hypernatremia, hypokalemia, hyponatremia
  • MISC: phlebitis at injection site
  • NEURO: confusion, headache
114
Q

Mannitol interactions

A

hypokaleia can potentiate digoxin toxicity

115
Q

Mannitol contraindications

A

cardiac impairement, sever liver dysfunction, dehydration, intracranial bleeding, kidney impairement

116
Q

administration of mannitol

A

infuse over 30 minutes to reduce IOP

117
Q

pupillary constricters mechanism of action

A

paralyze accomodation reflex (cytoplegia)

used for eye exams (to examine retina)

118
Q

contraindication for pupillary constrictors and why

A

closed-angel glaucoma

iris dilation occludes outflow of aqueous humor and increases IOP

119
Q

examples of pupillary constrictors

A

cyclopentolate (Cyclogyl)

tropicamide (Mydral)

120
Q

pregnancy, geriatric, and pediatric considerations

A

page 83

Pharmacology (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions