Exam 3 Flashcards
mature bone cells
osteocytes
cell that builds bone and is stimulated by calcitonin
Osteoblast
cell that is stimulated by the parathyroid hormone and consumes bone (resorbs)
Osteoclast
This is released to initiate muscle contraction
Acetylcholine
breaks down acetylcholine
Acetylcholinesterase
This directly controls contraction of muscles
Calcium
causes contractions or spasms of muscle
Hypocalcemia
pain causes by reduced blood flow
ischemic
connects muscle to bone and has little blood supply
Tendons
connects bone to bone and has little blood supply
Ligaments
immovable joints
Synarthroses (skull)
slightly movable joints
Amphiarthroses (ribs, sternum, symphysis pubis)
freely movable joints
Diarthroses (shoulder, knee, elbow)
fluid filled sacs located between tendons and ligaments. provides extra cushioning in the joint
Bursae
Piece of cartilage found where two bones meet (joint space)
Meniscus
diagnostic test that inserts a lens into the joint
Arthroscopy
Measures bone density
Diagnostic test for osteoporosis
Dexa Scan
Differentiate muscle disorders from neurological disorders
Electromyograms (EMG’s)
bone is broken and forms two separate pieces
complete break
partially broken bone
incomplete break
bone break that breaks open skin
open
occurs in the soft bones of children
shaft of bone is bent
tearing on one side but not through the bone
Greenstick fracture
clot forms after bleeding from broken blood vessels
basis for fibrin network for granulation tissue to grow
Hematoma
inflammatory response to a fracture, phagocytes remove debris
Granulation Tissue
Chondroblasts form new cartilage
preliminary bridge repair in bone
not strong enough to bare weight
Procallus
Osteoblast activity whereby damaged bone is replaced by bone not scar tissue
Bony Callus
pathophysiology of a fracture
Hematoma Granulation tussue Procallus Bony Callus Remodeling
Factors that affect healing of bones
Amount of damage Approximation of bone ends Age Circulatory issues Diabetes Nutritional deficits Secondary problems - infection
Pulls bone ends further apart and can cause more soft tissue damage and bleeding and inflammation
Muscle Spasms
Results of edema during first 48 hours after trauma and casting
Ischemia
Occurs with crush injuries such as car accidents. Occurs with more extensive inflammation.
Compartment Syndrome
Occurs after fatty bone marrow escapes from bone marrow into veins during first week. Most common with pelvis and femur fractures.
Fat Emboli
medications for bone pain
NSAIDS
Reduction of the fracture using pressure and traction
closed
Reduction of the fracture using pins, plates, screws
open
Separation of two bones at a joint with loss of contact between the articulating bone surfaces
dislocation
Tear in a ligament
Sprain
Tear in tendons
Strain
complete separation from the bone
Avulsion
RICE
Rest
Ice
Compression
Elevation
type of damage from severe trauma or tearing of periosteum
Nerve Damage
what causes a failure to heal
non-union
deformity- resulted from bone not being stabilized
fracture of epiphyseal plate
stunted growth
signs and symptoms of injury
swelling, tenderness, altered sensation (depending on involvement of nerves)
implications of surgery for third degree muscle tears
scar tissue will form
decreased flexibility and strength.
Causes of Osteoporosis
Age Menopause Decreased mobility Hormonal factors Deficits of calcium, vitamin D, or protein cigarette smoking Excessive caffeine Asiana nd caucasian ethnicity
Signs and symptoms of Osteoporosis
Compression fractures
Spontaneous fractures
Abnormal curvature of spine- Kyphosis + Scoliosis
metabolic bone disorder characterized by decreased bone mass and density. Bone reabsorption exceeds bone formation.
Osteoporosis
Treatments of Osteoporosis
Dietary supplements- Vit. D, calcium and protein.
Fluoride supplements
Weight bearing activity
Kyphosis and Scoliosis surgery
Bisphosphonates have what common suffix?
-dronate
Medication given to prevent and treat osteoporosis. Works by inhibiting osteoclast-mediated bone resorption, thus preventing bone loss.
Bisphosphonates
Implications of Bisphosphonates
Esophagitis if not taken correctly
How to administer Bisphosphonates
30 minutes before eating, full glass of water
Patients need to be sitting or standing 30 mins after administration
Nothing by mouth other than water for the next 30 mins
Contraindications of Bisphosphonates
Esophageal strictures and disorders
Hypocalcemia
Patients unable to sit or stand for 30 minutes
Interactions of Bisphosphonates
Calcium supplements or diary products cannot be given within 30 minutes because it will decrease adsorption
SERMs have what common suffix?
-oxifen or -oxifene
Adverse effects of SERMs
Endometrial cancer
Pulmonary Emboli
Deep vein thrombosis
hot flashes
Med that increases the risk of endometrial cancer and blocks access to estrogen receptors in breast tissue.
SERMs
Med that stimulates estrogen receptors on bone and increases bone density. Used to treat Osteoporosis. Decreases bone loss. Decreases bone resorption.
SERMs
SERMs contraindications
pregnant/breastfeeding
current or past history of DVT
Special instructions to patients taking SERMs
Medication will need to be discontinued 72 hours before prolonged immobility such as surgery
Consume adequate amounts of vitamin D and calcium
hormone that acts on bone to decrease osteoclast activity. used to treat osteoporosis.
Calcitonin
Adverse effects of calcitonin
hypersensitivity or anaphylactic reaction to fish
hypocalcemia
only drug on the market that stimulates bone formation and activates osteoblasts
teriparatide (Forteo)
side effects of hypercalcemia
nausea and vomiting
constipation
polyuria
depression
adverse effects of calcium supplements
hypercalcemia
kidney stones
Patient instructions with calcium supplements
call with hypercalcemia
increase fluids, fiber and activity
do not take with other medications
Cause of osteomyelitis
placement of hardware
infection somewhere in the body
what is osteomyelitis
inflammation of muscles and bone
Disease characterized by the degeneration of skeletal muscle over time.
Muscular Dystrophy
most common form of muscular dystrophy that affects young boys
Duchennes Muscular Dystrophy
Signs and symptoms of Duchennes Muscular Dystrophy
motor weakness and regression
waddling gait, weakness in climbing steps
Gowers maneuver
Tests to determine muscular dystrophy
Elevates creatine kinase levels
electromyography
muscle biopsy
progression of muscular dystrophy
death usually by age 20
respiratory or cardiac failure
can be prolonged by ventilator
degenerative disease caused by wear and tear on joints
Osteoarthritis
type of arthritis that does not have systematic effects
Osteoarthritis
Signs and symptoms of osteoarthritis
pain (insidious or mild) joint movement limited due to enlargement Heberdens nodes (distal, fingers) Bouchards nodes (proximal, knuckles and hands)
treatment of osteoarthritis
PT Massage Glucosamine-Chondroitin supplements injection of synovial fluid surgery (hip/knee replacements)
How to manage osteoarthritic pain
NSAIDS
Autoimmune disorder that causes chronic systemic inflammatory disease
Rheumatoid arthritis
occurs in fingers, wrists, elbows and knees
red, swollen, painful joint
RF found in blood and synovial fluid
Rheumatoid Arthritis
remissions and exacerbations lead to progressive damage to joints such as…?
Ankylosis- joint fixation and deformity that develops
Rheumatoid Arthritis can cause what changes?
atrophy of muscles
alignment of bones in the joint shifts due to erosion of cartilage
Muscle spasms caused by inflammation and pain
Contractors and deformity
mobility suffers
Signs and symptoms of Rheumatoid Arthritis
insidious onset
inflammation in fingers and wrists at first
red, swollen, painful joints
fatigue, anorexia, fever, generalized lymphadenopathy. aching
Treatment of Rheumatoid Arthritis
balance rest and activity PT/OT heat and cold splinting of joints during exacerbations Meds
DMARDs 1
Methotrexate
DMARDs 2
Etanercept (Enbrel)
Drugs that exhibit anti inflammatory, anti arthritic, and immunomodulating effects.
Slow onset of action, several weeks. Give with NSAIDS at first.
DMARDs
Drug that has anticancer properties, given once a week in Arthritis patients.
Methotrexate
Supplement to give to patients taking methotrexate to prevent toxicity
folic acid
Adverse effects of Methotrexate
liver damage-
bone marrow suppression
increased risk of infection
pulmonary fibrosis
symptoms of pulmonary fibrosis
respiratory distress
decreased oxygenation
contraindications to Methotrexate
active bacterial or viral infections
active or latent TB
acute or chronic hep B or C
patients with peptic ulcer disease
Methotrexate interacts with…?
alcohol- liver damage
NSAIDS, Salicylates, Sulfonamides - increase toxicity
What should you make sure the patient is clear of before administering Methotrexate?
TB
pregnancy (six months after treatment)
Monitor for what during Methotrexate treatment
reduction in pain
more mobility in joints
less exacerbations
symptom control during periods of emotional stress
Adverse effects or Enbrel
headache
heart failure
injection site + skin reactions
pancytopenia (all red, white and platelet levels decreased)
may increase risk of infections - no live vaccines
administration on enbrel
subcutaneous injection twice weekly
may give with methotrexate
Contraindications of Enbrel
active infection
hematologic disease
malignancy
If Enbrel and Methotrexate are given together… what is the interaction?
bone marrow suppression increased
Deposits of uric acid crystals in the joint, results in inflammation of joints
Gout
What is Hyperuricemia
inadequate renal excretion
overproduction
sudden rise in uric acid precipitates an attack of what? Causing inflammation, pain, redness swelling on a single joint.
Gout
Medications to take during an attack of gout
NSAIDS
Allopurinol (Zyloprim)
colchine
probenecid (Benemid)
medication that decreases uric acid production, prevents acute tumor lysis syndrome, and treats acute attacks of gout.
allopurinol (Zyloprim)
Adverse effects of allopurinol
pancytopenia
exfoliative dermatitis
Stvens-Johnson Syndrome
toxic epidermal necrolysis
med that reduces inflammatory response to the deposits of uric crystals in joint tissue, relieves pain, used for short term management or prevention of gout
colchicine
adverse effects of colchicine
short term leukopenia
gastrointestinal and urinary tract bleeding
med that inhibits the reabsorption of uric acid in the kidney and thus increases the excretion of uric acid, used for the prevention of gout
probenecid (Benemid)
high-purine foods
organ meats, bacon, beef, sardines, scallops, anchovies, broth, mincemeat, gravy, yeast, wine, beer
when taking probenecid, what patient precautions should be taken?
limit excessive purine foods
functional and structural unit in the human body, differentiated based on requirements
cells
Cells that have no function
Deprives other cells of nutrients
Expands and creates pressure on surrounding structures.
New Neoplasm Cells
malignancy of epithelial tissue
carcinoma
malignancy of connective tissue
sacroma
indicates a benign tumor
oma
type of tumor that reproduces at a higher rate
benign tumor
excapsulated expands does not spread moveable causes tissue damage not life threatening reproduces at a higher rate differentiated cells
benign tumor
undifferentiated nonfunctional reproduce rapidly not encapsulated no cellular connections infiltrate into surrounding tissues
Malignant tumors
cells that are programmed to spread, invade, and destroy tissue. considered immortal
malignant cells
tumor angiogenesis
tumor develops its own blood vessels
cancer risk factors
genetics viruses radiation chemical exposure biologic factors age diet smoking gender
viruses that could cause cancer
HPV - cervical cancer
Hep B- liver cancer
HIV - kaposi sarcoma
Warning signs of cancer
unusual bleeding or discharge change in a wart or mole unexplained weight loss persistent cough solid lump detected. often painless
infection around the tumor
tissue necrosis
severe tissue wasting
cachexia - hard to increase weight
systemic effects of malignant tumors
weight loss cachexia anemia severe fatigue infections bleeding paraneoplastic syndrome
substances released by tumor affect necrologic functioning, causes blood clotting, or have hormonal effects
paraneoplastic syndrome
spread of cancer to distant sites via blood or lymphatics
metastasis
common sites for secondary tumors
liver and lungs
spread of cancer cells in body fluids or along membranes usually in body cavities
seeding
this is essential to determine potential treatments and outcomes of cancer
staging cancer
no metastasis, no lymph nodes
stage I
local invasion into lymph nodes; no metastasis
stage II
nodes involves, no metastasis
stage III
metastasis present in this stage
stage IV
treatment intended to reduce manifestations and complications related to the cancer
palliative
treatment used with cancers that produce secondary tumors too small to be detected
Prophylactic
ex: breast cancer: follow complete removal of localized tumor with chemotherapy and radiation
heat is used to destroy small single tumors commonly in the lung or liver
Radiofrequency ablation
causes mutations or alterations in target DNA, prevents mitosis. Most effective when used to kill rapidly dividing cells. Damages blood vessels to cut off blood supply to tumor cells.
Radiation Therapy
Methods of radiation therapy
External - cobalt machine
internal insertion of radioactive material
radioisotopes in solutions placed into body cavity
adverse reactions to radiation therapy
bone marrow depression
epithelial cell damage
infertility
cancer therapy using 2-4 drugs at a time.
chemotherapy
why does chemo use 2-4 drugs at one time?
lessen adverse effects
ensure destruction of cancer cells by working at different stages of the cell cycle.
adverse effects of chemotherapy
bone marrow depression nausea and vomiting hair loss breakdown of skin and mucus membranes nutritional issues
cessation of chemotherapy until levels rise
meds are dose limiting - must have blood drawn every session
nutritional issues associated with chemotherapy
changes in taste anorexia vomiting diarrhea stomatitis
hormones taken to increase appetite, decrease fatigue and inflammation around tumor.
corticosteroids
when is cancer free state generally defined?
5 years remission
no clinical signs of cancer, client may experience several of these during treatment
remission
returns excess interstitial fluid and protein to blood
filters and destroys unwanted material from the body fluids
initiates an immune response
Lymphatic system
are lymphatic vessels thinner or thicker than blood vessels?
thinner
where do lymphatic vessels originate?
capillaries in direct contact with tissue cells
malignant neoplasms involving lymphocyte proliferation in the lymph nodes
Lymphomas
What can make the incidence of lymphomas higher?
incidence is higher in adults that received radiation as children
Painless enlarged lymph node Adults 20-40 yrs Men older than 50 yrs night sweats Reed-Steinburg cells T lymphocytes appear defective and count is down
Hodgkins Lymphoma
Signs and symptoms of hodgkins lymphoma
night sweats
weight loss
generalized pruritis
recurrent infections
first indicator of hodgkins lymphoma
painless enlarged lymph node
treatment of hodgkins lymphoma
radiation
chemotherapy
surgery
Staging of hodgekins Lymphoma
1- single lymph node affected
4- Widespread
Type of lymphoma distinguished by multiple node involvement in the early stages. Intestinal nodes and organs can be effected.
Non-Hodgkins Lymphoma
Lymphoma that is due to increasing numbers due to numbers associated with HIV
Non-Hodgkins Lymphoma
occurs in older adults involves the mature B lymphocytes insidious onset frequent infections pathologic fractures thrombocytopenia + anemia impaired kidney function
Multiple Myeloma
This condition is characterized by: Blood cell production impairment
antibody production impairment
multiple tumors in bone
impaired kidney function
Multiple Myeloma
Tissues in extremities swell due to an obstruction of the lymphatic vessels and accumulation of lymph
Lymphedema
Causes of Lymphedema
congenital
parasites -> elephantiasis
structural blockage -> tumors
treatment of lymphedema
Diuretics strict bed rest massage of affected area elevation of affected extremity compression garments surgery
therapeutic index of antineoplastic drugs
narrow therapeutic index
normal WBC levels
5,000-10,000
when to hold antineoplastic drugs due to dose limiting affects
when neutrophil levels are below 500 cells/mm3
loss of hair
alopecia
emetic potential
vomiting potential
bone marrow cell depression
myelosuppression
point at which WBC’s are expected to be at their lowest.
Nadir
what happens when a toxic solution is given through an IV and the IV dislodges causing the toxic solution to destroy tissue
Extravasation
what to give when premedication antineoplastic drugs
Antihistamines, corticosteroids, and acetaminophen
Ultimate goal of chemotherapy
kill every neoplastic cell and produce a cure
is not achieved in most cases
some patients immune systems may be able to clear the remaining tumor
common relative contraindications of chemotherapy
weakened status of patient
pregnancy/fertility
elderly - reduced dosing needed
Cell Cycle specific drugs:
antimetabolites - Methotrexate
antimitotics - Vincristine
Topoisomerase I Inhibitors- Ironotecan
these drugs work by interfering with synthesis of compounds critical to cellular reproduction. Folate antagonists.
Antimetabolites
contraindications of Methotrexate
active bacterial or viral infections
Active or latent TB
Acute or chronic hep. B or C
peptic ulcer disease
Adverse effects of Methotrexate (6)
Tumor lysis syndrome Palmar-plantar synesthesia Stevens-Johnsons syndrome toxic epidermal necrolysis liver damage severe bone marrow suppression
rescue drug given to treat severe bone marrow depression caused by methotrexate
Leucovorin - rapidly converts into form of folic acid which prevents the death of normal cells
drugs that contribute to increased methotrexate toxicity
NSAIDS
Salicylates
Sulfonamides
which is the most neurotoxic antineoplastic drug
Vincristin
Very Injurious to Nerves
VINcristin
Vincristin
Peripheral Neuropathy
Extravasation
Low Myelosuppression
adverse reaction to irinotecan
Cholinergic Diarrhea
cell-cycle nonspecific drugs
Cyclophosphamide (Cytoxan)
daunorubicin, doxorubicin
Belomycin
SERMS
Adverse affects of Cyclophosphamide(Cytoxan)
Nephrotoxicity
Ototoxicity
Peripheral neuropathy
Extravasation
classification of antibacterials to avoid with Cyclophosphamide (Cytoxan) because of similar effects.
gentamicin + aminoglycosides
Cytotoxic antibiotics (so toxic it can only be used for cancer)
Daunorubicin, doxorubicin, Bleomycin
what condition is associated with large amounts of doxorubicin?
Cardiomyopathy
type of cytotoxic antibiotic that causes acute left ventricular failure
daunorubicin + doxorubicin
what may occur when taking bleomycin?
pulmonary fibrosis
Hormonal neoplastic drug
Tamoxifen (Nolvadex)
Adverse effects of Tamoxifen (Nolvadex)
hot flashes
hypercalcemia
risk for uterine cancer
increased risk for thrombophlebitis & thromboembolism
Care of a patient undergoing therapy for cancer
double flush patients bodily secretions int he commode
special spills kits to clean up even small spills
health care providers should wash hands and affected areas after administration of vesicant medications.
Common adverse effects of toxic medications used for cancers
weight loss
sores in the mouth
changes in taste
dryness and crackling sides of mouth
signs and symptoms of thrombocytopenia
Petechiae Bruising Gum bleeding excessive or prolonged bleeding from puncture sites unusual joint pain blood in stool or urine or vomitus
Patient education on bone marrow suppression from antineoplastic drugs
Take periods of rest
call with fever
avoid people who are sick and recently vaccinated
take drugs to accelerate WBC recovery as ordered
wash fruits and veggies and make sure food is well cooked
frequent oral care
use soft bristled tooth brush
Indications of oncologic emergencies
fever above 100.5 and/or chills new sores or white patches in mouth swollen tongue bleeding gums new and persistent cough changes in bladder function or pattern blood in urine or stools changed in GI or bowel movements
drug classification that is used to treat cancer that increases appetite, decreases fatigue, and decreases inflammation around tumor
corticosteroids
syndrome caused by release of substances by tumors that affect neurological functioning
Paraneoplastic
agent given to treat bladder cancer
BCG
lymph empties into these veins
subclavian
term indicating cancer cells have spread from original tumor
metastasis
tumors complete this process to get blood supply
angiogenesis
name for severe tissue wasting
cachexia
type of blood cancer that can result from exposure to radiation
leukemia
electrolyte that controls contraction of muscle cells
calcium
preliminary bridge repair in bone
Procallus
this pulmonary disease can occur when taking methotrexate
fibrosis
adverse effects of calcium supplements that include constipation, polyuria, and nausea
hypercalcemia
syndrome that occurs with extensive inflammation of a fracture
compartment
released to initiate muscle contraction
acetylcholine
medication used to decrease uric acid production
allopurinol
this type of scan diagnoses osteoporosis
DEXA
medication used only to prevent outbreak of gout
probenecid
medication used to decrease pain with acute outbreaks of gout
colchicine
tear in a ligament
sprain
fluid filled sacs located between tendons and ligaments
bursae
only drug that stimulates bone formation in osteoporosis
Teriparatide
drug class that may cause blood clots or even endometrial cancer
SERMS
if patient is allergic to this, may have a hypersensitivity reaction to calcitonin
fish
receptors for touch, pressure, temperature and pain
located close to the body surface
Exteroceptors
Sensory receptors that provide information around viscera
located internally
Visceroreceptors
Provider information about body movement, orientation, and muscle strength
Proprioceptors
sensory receptors stimulated by touch and pressure
mechanoreceptors
sensory receptors impacted by various chemicals
chemoreceptors
warm and cold receptors stimulated by changes in temperature
thermoreceptors
receptors stimulated by light
photoreceptors
receptors that are stimulated by pain, tissue injury
Nocioceptors
receptors that are stimulated by changes in osmotic pressure of bodily fluids
Osmoreceptors
Protection of the eye:
bony orbit of the skull eyelashes and eyelids conjunctiva tears line eyelids
anterior cavity of the eye
aqueous humor
posterior cavity of the eye
vitreous humor
dark vascular layer interior of sclera that absorbs light for focus
Choroid
middle layer of the eye
uvea
system that helps the eye dilate
sympathetic nervous system (SNS)
system that helps the eye constrict
parasympathetic nervous system (PNS)
inner layer of the eye that contains no pain receptors and has photoreceptor cells
retina
dim light, night vision (black and white)
rods
color vision
cones
reflects pressure in brain
optic nerves
half of the fibers from each optic nerve cross to pass to the occipital lobe in opposite hemisphere
Optic Chiasm
Test that assesses intraocular pressure
Tonometry
near sightedness
image focused in front of lens
Myopia
far sightedness
image focused behind the retina
eyeball is too short
Hyperopia
far sightedness associated with aging
loss of elasticity reduces accommodation
Presbyopia
Irregular curvature in the cornea or lens
blurred vision
Astigmatism
Double vision
important to treat in children to correct permanent vision problems
Strabismus
involuntary abnormal movement of one or both eyes
causes inner ear or cerebellar disturbances
Nystagmus
Double vision caused by trauma to the cranial nerves such as paralysis, stroke
loss of depth perception
Diplopia
Infection involving hair follicle on eye lid
swollen red mass
warm compress can cause spontaneous recovery
Stye
superficial inflammation of conjunctiva lining eyelids and covering sclera
can be caused by allergens, irritating chemicals, bacteria, viruses
redness, itching, and excessive tearing
Conjunctivitis (Superficial)
Staphylococcus aureus
sclera is red with purulent discharge
Pink eye
caused by chlamydia trachoma’s
follicles form on inner surface of eyelids
globally most common cause of vision loss
Trachoma
inflammation of cornea infection bacteria, viruses, parasite non-infectious minor injury wearing contact lenses too long
Keratitis
symptoms of Keratitis
eye redness + pain
excessive tearing or other discharge
sensitivity to light
Inhibition of the normal flow and drainage of aqueous humor resulting in increased intraocular pressure. Pressure against retina destroys neurons, leading to impaired vision and even blindness.
Glaucoma
symptoms of glaucoma
halos around lights at night
loss of peripheral vision
pain
Drugs that cause mitosis to treat Glaucoma
Cholinergic drugs
direct acting cholinergic drugs
acetylcholine
pilocarpine
adverse effects of direct acting cholinergic drugs
decreased visual acuity frontal headache hypotension bradycardia seizures
antidote to direct acting cholinergic drugs
Atropine Sulfate
Minics the sympathetic neurotransmitters epinephrine and norepinephrine
Sympathomimetics
Used for chronic open-angle glaucoma, reduction of preoperative IOP and reduction of ocular hypertension
Sympathomimetics
Drug that dilates pupil and enhances the aqueous humor outflow through the canal of Schlemm
Sympathomimetics - Epinephryl
Adverse effects of Sympathomimetics
burning
eye pain
lacrimation
Beta Blockers have what suffix
-olol
Adverse effects of beta blockers
transient burning and discomfort blurred vision pain headache hypotension Bradycardia Bronchospasm
Administration of systemic beta blockers with high doses of what can cause additive effects?
ophthalmic beta blockers
Carbonic Anhydrase Inhibitors have what suffix?
-amide
Patients with what allergies should avoid carbonic anhydrase inhibitors?
sulfa allergies
Drugs that inhibit the enzyme carbonic anhydrase, which reduces aqueous humor formation int eh eye. Results is decreased IOP.
Carbonic Anhydrase Inhibitors
systemic effects of carbonic anhydrase inhibitors
drowsiness, confusion
tinnitus
anorexia, vomiting, diarrhea
transient myopia
These drugs create ocular hypotension by producing an osmotic gradient; water is forced from the aqueous and vitreous humors into the bloodstream. Result is reduced volume of intraocular fluid, thus reduced IOP.
Osmotic Diuretics
The first osmotic diuretic to be tried
Glycerin, then Mannitol if unsuccessful
Prostaglandin Agonists have what suffix?
-prost
These drugs have effects on eye color such as people with hazel, blue or green eyes will have permanently brown eyes.
Prostaglandin Agonists
Progressive opacity or clouding of the lens, interferes with light transmission. Causes blurred vision over time and causes darkening over time.
Cataracts
Treatment of cataracts
surgical replacement of lens
most common cause of visual loss in older adults
Macular Degeneration
Central vision becomes blurred, then lost. Due to loss of retinal cells in fovea.
Macular Degeneration
sound is blocked in the external ear, accumulation of wax, foreign objects or scar tissue
Conduction Deafness
Damage to the organ of Corti or auditory nerve, can be caused by infection or trauma or ototoxic drugs such as Gentamycin. Can also be caused by prolonged exposure to loud noise
Sensorineural Impairment
most common cause of age related deafness
Presbycusis
Inflammation or infection of the middle ear cavity causing pressure on the tympanic membrane that may cause rupture.
Ear infection- otis media
Infection of the external auditory canal and pinna. usually bacterial, sometimes fungal. Purulent drainage. Hearing deficit. Pain usually increases with movement of pinna
Ear infection- otic externa
Inner ear disorder caused by stretching of the membranes and interfering with the function of the hair cells in the cochlea and vestibule Marked by acute episodes, followed by brief periods of relief.
Meniere’s Syndrome
symptoms of Menieres Syndrome attack
severe vertigo falls nausea sweating tinnitus unilateral hearing loss
Treatment of Menieres Syndrome
Dimenhydrinate - during attack stress reduction avoid smoking, drinking caffeine low sodium diet mild diuretic
Medication used for acute closure and only given in ICU
Mannitol
Pupil responds to PNS by doing this
constrict
This type of vision is not lost with macular degeneration
Peripheral
symptom of glaucoma that appears later in the disease process
halos of light
medication used to treat nausea and dizziness that occurs with vertigo in Menieres syndrome
Dimenhydinate
Pain is elicited by moving this part of the ear in otitis external which differentiates it from otitis media
pinna
chief symptom of Menieres Syndrome
Vertigo
Infection that may occur if otitis media is left untreated
Mastoiditis
Medication used to treat Otitis Media for first 48 hours
Ibuprofen
Test done to determine intraocular pressure
Tonometry
Pupil responds to SNS by doing this
dilate
This habit can contribute to macular degeneration
smoking
