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Eye Drops and Ointments > Eye drops and ointments from work book > Flashcards

Eye drops and ointments from work book Flashcards

1
Q

Reasons for instilling drops or applying ointments

A

therapeutic medication
to dilate the pupil prior to examination or surgery
to anaesthetise the eye prior to medical or nursing intervention
to lubricate the eye
to treat the lacrimal apparatus

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2
Q

where might ointments be prescribed for application

A

eyelid margins
eyelid/eyebrow wound
instillation into the eye

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3
Q

Common Mydriatics

A

topicamide
atropine
cyclopentolate (Mydrilate)
phenylephrine

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4
Q

Mydriatics

A

A mydriatic is an agent that induces dilation of the pupil. Drugs such as tropicamide are used in medicine to permit examination of the retina and other deep structures of the eye, and also to reduce painful ciliary muscle spasm.

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5
Q

Main reason why you would use topicamide?

A

to dilate the patient’s pupil in order for the doctor to examine the fundus. The wider the pupil the greater the area of the fundus will be seen on examination.

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6
Q

What two strengths does Tropicamide come in?

A

0.5% and 1%

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7
Q

Action of Tropicamide

A

stimulates the dilator muscles and also weakly paralyses (cycloplegic) the ciliary muscles

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8
Q

Effect of tropicamide

A

is to dilate the pupil - mydriasis

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9
Q

Side effects of Tropicamide

A

may cause an attack of acute glaucoma- in patients who are susceptible.
mydriatic drops sting
contact dermatitis - any patient with a known contact dermatitis should not have topicamide.

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10
Q

What two strengths does Atropine come in?

A

1% or 2%

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11
Q

Atropine

A

natural alkaloid of Belladonna, derived from deadly nightshade. It is an infrequently used mydriatic and produces mydriasis in half an hour and almost complete cyclopegia

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12
Q

Is Atropine Long or Short acting?

A

Long its effects can last up to 14 days

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13
Q

miotics and atropine

A

atropine’s action cannot be reversed bby miotics which is a great disadvantage.

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14
Q

Side effects of atropine

A 
raised intraocular pressure
raised blood pressure 
sensitivity 
psychotic disturbance and hallucinations 
contact dermatitis
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15
Q

Cyclopentolate (Mydrilate)

A

Cyclopentolate is a medication commonly used during pediatric eye examinations that dilates the eye (mydriatic), prevents accommodation of the eye to different distances (cycloplegic), and blocks specific receptors called muscarinic receptors (muscarinic antagonist).

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16
Q

how long does it take Cyclopentolate to produce cyclopegia and dilation? and how long will the effect last for?

A

produce cyclopegia and dilation within half an hour

effect lasts for 24 hour

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17
Q

Where must Cyclopentolate be stored?

A

the fridge

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18
Q

Cyclopentolate side effects:

A

Ocular side-effects of mydriatics and cycloplegics include transient stinging and raised intra-ocular pressure; on prolonged administration, local irritation, hyperaemia, oedema and conjunctivitis can occur. Contact dermatitis can occur with the antimuscarinic mydriatic drugs, especially atropine.

Systemic side-effects of atropine and cyclopentolate can occur, particularly in children and the elderly.

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19
Q

Phenylephrine 2.5% or 10%

A 
non-cyclopegic mydriatic 
pwerful mydriatic and is capable of breaking up adhesions (posterior synechiae). 
no effect on accommodation 
stings on instillation 
very irritant in the anterior chamber
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20
Q

posterior synechia

A

adhesion of the iris to the capsule of the lens or to the surface of the vitreous body.

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21
Q

annular synechia

A

adhesion of the whole rim of the iris to the lens.

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22
Q

anterior synechia

A

adhesion of the iris to the cornea.

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23
Q

total synechia

A

adhesion of the whole surface of the iris to the lens.

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24
Q

adhesion

A

union of two surfaces that are normally separate, such as in wound healing or in some pathological process. Surgery within the abdomen sometimes results in adhesions from scar tissue; as an organ heals, fibrous scar tissue forms around the incision and may cling to the surface of adjoining organs. Adhesions are usually painless and cause no difficulties, but occasionally they produce pain, with or without obstruction or malfunction, by distorting the organ.

25
Q

non-cyclopegic mydriatic that is sometimes used in the treatment of Open Angle Glaucoma

A

phenylephrine because of its ability to lower intra-occular pressure.

26
Q

what could a darker iris indicate?

A

more resistance to the effect of mydriatics and caution should be exercised to avoid overdose.

27
Q

Common Miotics

A

Pilocarpine
timoptol
trusopt
cospot

28
Q

Miotics

A

These medications reduce eye pressure by increasing the drainage of intraocular fluid through the trabecular meshwork.

29
Q

Preparations pilocarpine comes in

A

1%, 2%, 4% and occasionally 6%

30
Q

Pilocarpine

A

commonly used miotic
can be used for long periods without causing irritation of the eye
used in the treatment of open angle glaucoma

31
Q

Pilocarpine action

A

acts to contract the pupil and ciliary muscles
miosis lasts up to four hours - therefore can be instilled sometimes four times per day.
spasms of accommodation lasts about 2 hours

32
Q

Pilocarpine side effects

A

small pupil
blurring of vision
browache

33
Q

Timoptol

A

beta-blocker
works by reducing the production rate of aqueous tumour
use twice per day

34
Q

Timoptol side effects

A

can have systemic effects e.g. broncho constriction

35
Q

trusopt 2%

A

a buffered, slightly viscous, aqueous solution of dorozolamide
when used alone may be instilled three times per day
with adjunct treatment trusopt is instilled twice per day
effective in the treatment of open angle glaucoma and ocular hypertension

36
Q

trusopt 2% side effects

A

ocular burning and stinging, blurred vision, itching, tearing, conjunctivitis, lid inflammation, irritation, redness. some patients complain of signs and symptoms including: headache, fatigue, dizziness, skin rash, bitter taste in mouth.
USE IN CAUTION IN PATIENTS WITH HEPATIC DISEASE

37
Q

cospot

A

isotonic, slightly buffered, viscous aqueous solution
contains 20mg dorzolomide and 5mg timolol
used to treat intraocular pressure and open angle glaucoma

38
Q

corticosteriod drops

A

betamethasone

dexamethasone

39
Q

betamethasone 0.1% supplied as betnesol or

betnesol-N - containing antibiotic Neomycin sulphate 0.5%

A

indicated for use in the short term treatment of inflammation.
should not be used in the treatment of undiagnosed red eye- because if the red eye is caused by a virus the corticosteriods could aggravate the condition and cause blindness
prolonged treatment could result in the condition steroid glaucoma in patients predisposed to this condition.

40
Q

Dexamethasone supplied as maxidex 0.1% or

Maxitrol 0.1% which contains 0.35% Neomycin

A

used in the short term local treatment of inflammation

41
Q

Local anaesthetics

A

Minims Benoxinate
Lignocaine
fluorescein

42
Q

minims benoxinate

A

oxybuprocaine 0.4% widely used topical local anaesthetic

43
Q

Lignocaine and fluorescein

A

lignocaine 4% and fluorescein 0.25%

topical local anaesthetic combined with fluorescein both of which are necessery for tonometry.

44
Q

Diagnostic drops

A

fluorescein

rose bengal

45
Q

Fluorescein 2%

A

orange coloured dye
does not penetrate, intact cell membranes
if there is damage to the epithelial layer, it gains access to the bowmans membrane, the stroma and the aqueous.

46
Q

what colour is damaged tissue visualised as with fluorescein

A

green fluorescence

47
Q

alternative uses for fluorescein

other than diagnosis of abraded, broken surface of the cornea

A

contact lens fitting
goldman applanation tonometry
siedel’s test for leaking cornea-scleral wound
test for patency of lacrimanl drainage system
fundu photography

48
Q

goldman applanation tonometry

A

Applanation tonometry: measures IOP by providing force which flattens the cornea.
Variable force applanation tonometers (Goldmann, Perkins, Draeger, MacKay-Marg, and Tono-Pen and Pneumatonometer): area of the cornea being applanated held constant, variable for applied.

49
Q

siedel’s test for leaking cornea-scleral wound

A

the test used to reveal ocular leaks from the cornea, sclera or conjunctiva following injury or surgery and sometimes disease is called Seidel test.

50
Q

fundu photography

A

Fundus photography documents the retina, the neurosensory tissue in our eyes which translates the optical images we see into the electrical impulses our brain understands. The retina can be photographed directly as the pupil is used as both an entrance and exit for the fundus camera’s illuminating and imaging light rays. The patient sits at the fundus camera with their chin in a chin rest and their forehead against the bar. An ophthalmic photographer focuses and aligns the fundus camera. A flash fires as the photographer presses the shutter release, creating a fundus photograph like the picture above. Ophthalmologists use these retinal photographs to follow, diagnose, and treat eye diseases.

51
Q

Rose Bengal

A

dye selectively stains all devitalised corneal and conjunctival cells a readily visible red colour. More effective than flourescein and is considered a more sensitive test for keratoconjunctivitis sicca - sjorgen’s syndrome.
discomfort and irritation

52
Q

eye drop antibiotics

A 
chloramphenicol 
ciprofloxacin 
gentamicin 
fucithalmic
floxacin
53
Q

chloramphenicol

A

in drop and ointment form
when used systemically can cause blood dyscrasions
penetrates the cornea

54
Q

ciprofloxacin

A

broad spectrum antibiotic
used to treat superficial bacterial infections
especially useful in the treatment of bacterial ulcers

55
Q

ciprofloxacin side effects

A

local burning and itching
crusting on the lid margins
not recommended for children under 12 and should be used in caution with those pregnant of breast feeding.

56
Q

Gentamicin 0.3%

A

broad spectrum antibiotic particulary useful in infections caused by pseudomonas auruginosa
toxic if used for long term therapy

57
Q

fucithalmic 1%

A

useful for treating staphylococcal infections. presents as eyedrops in a gel base.

58
Q

floxacin 0.3%

A

broad spectrum antibiotic
side effects
local irritation, photophobia, dizziness, nausea and vomiting, headache.

59
Q

antivirals

acyclovir 1%

A

herpes simplex

Eye Drops and Ointments (1 decks)

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