Chapter 57: Opthalmic Drug Therapy

Question 1

Drugs for Glaucoma

Answer 1

Are drugs that mimic or block sympathetic and parasympathetic eye responses to promote drainage or minimize production of eye fluid. The goal of therapy is to reduce intraocular pressure (IOP).

First line of drugs:
1. Prostaglandin analog
2. Beta-adrenergic blockers

Question 2

Beta-adrenergic blockers

Answer 2

They inhibit adrenergic activity in the heart: lower heart rate, BP and cardiac output.

Side effects: slow HR, low BP, fatigue, dizziness, nausea, dry mouth/eyes

Question 3

Latanoprost
(Topical drops)

Answer 3

Treats: Glaucoma

Absorption: absorbed in the cornea
Metabolism: liver
Excretion: through urine

Onset: 2-4 hr
Peak: 2 hr
Duration : 24 hr

Question 4

Timolol
(Topical drops)

Answer 4

Treats: glaucoma

Absorption: absorbed by cornea
Metabolism: liver
Excretion: through urine

Onset: 30 min
Peak: 1-2 hr
Duration: 12-24 hr

Question 5

Loteprednol
(Drops)

Answer 5

A corticosteroid that inhibits inflammatory response.

Effects: reduce post op pain and inflammation. Reduces itching, redness and swelling due to allergies, irritation.

Absorption: low absorption
Metabolism: local ocular tissue
Excretion: unknown

Onset: 2 hours
Peak: none
Duration: none

Question 6

Erythromycin

Answer 6

An antibiotic ointment that inhibits bacterial protein synthesis.

Effects: treats superficial bacterial infection of eyelid, conjunctiva or cornea.

Question 7

Gatifloxacin

Answer 7

A fluoroquinolone antibiotic that inhibits DNA synthesis of gram positive and gram negative bacteria.

Effect: treats bacterial conjunctivitis (pinkeye).

Short onset and duration.

Question 8

What is the action of latanoprost that reduces ocular pressure?

Answer 8

Relax eye blood vessels & promote drainage.

Question 9

How timolol works to relieve glaucoma?

Answer 9

Reduces production of aqueous humor in the eye, reducing intraocular pressure.

Question 10

What is administered to newborn’s eyes to prevent opthalmia neonatorum?

Answer 10

Erythromycin is given to all new borns

Question 11

Latanoprost contraindications

Answer 11

-Hypersensitivity to drug or benzalkonium
-avoid during pregnancy or lactation
-avoid persons with eye infection or angle closure glaucoma

Question 12

Timolol contraindications

Answer 12

-hypersensitivity to drug or benzalkonium
-persons with asthma,bradycardia,heart failure or heart blockage
-person taking oral beta blockers

Question 13

Correct way to administer eye drops and ointment

Answer 13

Give the drops first , wait 5 min, then ointment

Question 14

To minimize systemic absorption of ophthalmic drops, what would the nurse do?

Answer 14

Apply pressure to puncture of inner canthus

Question 15

What the post op eye surgery outcome for a patient who was given loteprednol?

Answer 15

Reduced postoperative pain and inflammation

Question 16

What is the action of fluorescin sodium drops?

Answer 16

Stains eye for better visualization

Question 17

What drug helps protect the eye and minimize dryness?

Answer 17

Clyclosporine

Question 18

Adaptive eye device

Answer 18

May help patients instill eye drops to themselves

Question 19

Safety concerns to teach patient for patient taking Timolol for glaucoma.

Answer 19

• when moving from light room to a dark room, pause a few minutes to allow vision adjustment
• use caution when driving because vision maybe blurred
• dizziness may occur with this drug, move slowly from sitting to standing

Question 20

How to minimize adverse effects of loteprednol (a corticosteroid)

Answer 20

Continue this drug only for the length of time specified by MD.