Common Conditions of the Eyes and Ears Flashcards
Why can’t you use ear drops in the eyes?
They may not have the right pH, may not be isotonic, and may not be sterile
What does this abbreviation mean
AD
Right ear
What does this abbreviation mean
AS
Left ear
What does this abbreviation mean
AU
Each ear
What does this abbreviation mean
OD
Right eye
What does this abbreviation mean
OS
Left eye
What does this abbreviation mean
OU
Each eye
How many mL are in 1 drop?
0.05 mL
How many drops are in 1 mL?
20 drops
Normal range for intraocular pressure
12-22 mmHg
What can increase introcular pressure?
Anticholinergics
Cough, cold, and motion sickness medications
Chronic steroids, especially eye drops such as prednisolone
Topiramate
What are the 2 types of glaucoma?
Open angle and closed-angle
What methods are used to treat open angle glaucoma?
Eye drops or surgery
What methods are used to treat closed angle glaucoma?
Emergency surgery
What is the most common cause of closed angle glaucoma?
Sudden increase in IOP due to a blockage
What are the 3 mechanisms of medication treatment for open angle glaucoma?
Reduce aqueous humor production
Increase aqueous humor outflow
Both of the above
How much does each class of medication decrease IOP in glaucoma?
Prostaglandins: 30%
Beta blockers: 22%
What medications that are used for glaucoma are prostaglandin analogs
Bimatoprost (Lumigan)
Latanoprost
Tavoprost
What is the difference between Bimatoprost (Lumigan) and Bimatoprost (Latisse)?
Lumigan is used for glaucoma
Latisse is used for inadequate growth of eyelashes
Prostaglandin analog warnings and SE
Warnings: darkening of the iris, eyelid skin and eyelashes; eyelash length and number can increase
SE: Blurred vision, stinging, increased pigmentation of the iris/eyelashes, eyelash growth
How to tell if a medication is a prostaglandin analog?
Has -prost in the name
Latanoprost storage
Fridge until opening then room temp
Which eye drops increases aqueous humor outflow to treat glaucoma?
Prostaglandin analogs
Cholinergics
Adrenergic alpha-2 agonist
Rho Kinase Inhibitors
Which eye drops decrease aqueous humor production to treat glaucoma?
Beta-blockers
Carbonic anhydrase
adrenergic alpha-2 agonists
What medications are beta blockers and used for glaucoma?
Timolol Betaxolol Carteolol Levobunolol Metipranolol
What medications are cholinergics (mitotics) and used to treat glaucoma?
Carbachol
Pilocarpine
What medications are carbonic anhydrase inhibitors and used to treat glaucoma?
Dorzolamide
Brinzolamide
Acetazolamide and Methazolamide (oral)
What medications are adrenergic alpha-2 agonists and used to treat glaucoma
Brimonidine
Apraclonidine
Brimonidine
What medications are rho kinase inhibitors and used to treat glaucoma?
Netarsudil
Beta-blocker eye drop CI and SE
CI: sinus bradycardia, heart block, cardiogenic shock, uncompensated cardiac failure, bronchospastic disease
SE: burning, stinging, bradycardia/fatigue, bronchospasms, light sensitivity
Cholinergics (mitotics) eye drop SE
Poor vision at night (pupil constriction), corneal clouding, burning, hypotension, bronchospasm, abdominal cramps
What is BAK?
Benzalkonium chloride
A preservative in some eye drops that can cause a reaction
Carbonic anhydrase warnings and SE
Warnings: sulfonamide allergy
SE: burning, blurred vision, blepharitis, dry eye
Adrenergic alpha-2 agonists warnings and SE
Warnings: CNS depression
SE: sedation, dry mouth, dry nose
Rho kinase inhibitor SE
Burning/eye pain, corneal disease, conjuctival hemorrhage and conjuctival hyperemia
Causes and treatment for
viral conjunctivitis
Causes: adenovirus
Treatment: none
Causes and treatment for
Bacterial conjunctivitis
Causes: staph aureus, strep pneumo, H. influ, M cattarrhalis
Treatment: Moxifloxacin, neomycin/polymyxin/dexamethasone, ofloxacin, trimethoprim/polymyxin
Causes and treatment for
Allergic conjunctivitis
Causes: allergens
Treatment:
Mast cell stabilizers (alcaftadine, cromolyn, lodoxamine, nedocromil)
Antihistamines (azelastine, olopatadine)
How to treat eye inflammation
Severe: steroid eye drop (prednisolone, dexamethasone)
Mild: NSAID drops (ketorolac, nepafenac, bromfenac)
How to treat eye dryness
Refresh or Systane (OTC)
How to treat chronic dry eye syndrome
Cyclosporine emulsion eye drops (restasis)
Lifitegrast (Xiidra)
How to treat eye redness
Naphazoline (Clear eyes redness relief)
Naphazoline/pheniramine (Naphcon A, Visine A)
Tetrahydrozoline (Visine)
What medications can cause retinal changes and retinopathy?
Chloroquine
Hydroxychloroquine
What medications can cause optic neuropathy?
Amiodarone (plus corneal deposits)
Ethambutol
Linezolid
What medications can cause floppy iris syndrome resulting in difficulty in cataract surgery
Alpha-blockers (digoxin)
What medications can cause color discrimination?
Digoxin - with toxicity
PDE-5 inhibitors - greenish tinge around objects
Voriconazole - color vision changes
What medications can cause vision loss/abnormal vision?
Digoxin (with toxicity) - blurriness, halos
PDE-5 inhibitors - vision loss in one or both eyes (can be permanent)
Isotretinoin - decreased night vision, dry eyes irritation
Vigabatrin - permanent vision loss (high risk)
Voriconazole - abnormal vision, photophobia
What antibiotic ear drops are used for ear infections?
Ciprofloxacin and dexamethasone (ciprodex)
Ciprofloxacin and hydrocortisone (Cipro HC)
Neomycin, colistin, hydrocortisone, and thonzonium
What medications are used for ear wax removal?
Carbamide peroxide and triethanolamine
Can be used every 4-8 weeks as preventative measure
How long should a patient wait between two eye drops of the same medication?
5 minutes
Which should you apply first, eye drops or eye gel?
Eye drops
How long before/after eye drops do you have to wait to remove/reinsert contact lenses?
right before
wait 15 minutes after
