Eyes and ears Flashcards

1
Q

presentation of dry eye disease

A

discomfort, sandy or gritty feeling, sensation that something is in the eye, and mildly red eye

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2
Q

causes of dry eye disease

A

aging, dry or dusty working environments, humidity, vitamin A deficiency, surgery, or anticholinergic drugs

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3
Q

examples of drug classes that can cause dry eye disease

A
  1. antihistamines
  2. TCAs
  3. decongestants
  4. diuretics
  5. beta blockers
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4
Q

goals of therapy for dry eye disease

A
  1. alleviate ocular surface dryness
  2. relieve symptoms; improv QOL
  3. prevent tissue damaga
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5
Q

non- pharm treatment or DED

A

warm compresses, humidifier, good eyelid hygiene, and environmental modifications

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6
Q

first line pharm treatment for dry eye disease

A

artificial tears

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7
Q

other treatments for dry eye disease

A

nonmedicated ophthalmic ointments

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8
Q

exclusions for self-care of DED

A
  1. pain
  2. unresponsive to therapy for more than 72 hours
  3. evidence of damage to cornea
  4. suspected systemic disease
  5. severe discomfort
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9
Q

examples of ocular lubricants

A

polyethylene glycol, polyvinyl alcohol, povidone, and propylene glycol

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10
Q

examples of preservatives

A

benzalkonium chloride, chlorhexidine, chlorobutanol, methyl paraben, propylparaben, sodium perborate

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11
Q

shelf-life for eye drop medications containing preservatives

A

typically 28 days after opening

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12
Q

shelf-life for eye drop medications that are preservative free

A

discard immediately after open and used

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13
Q

do you look down at the floor or up at the ceiling after applying eyedrops

A

down at the floor and apply gentle pressure with finger to tear duct opening

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14
Q

how long do you wait between multiple drops

A

at least 5 minutes

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15
Q

would you place a suspension first or last if you had more than one dosage form

A

last

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16
Q

drops need to be administered _____________ before ointment

A

10 minutes

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17
Q

presentation of allergic conjunctivitis

A

pruritis, red eye + watery discharge, excessive tearing

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18
Q

causes of allergic conjunctivitis

A

pollen, animal dander, topical eye preparations

19
Q

goals of therapy for AC

A

remove or avoid allergen, reduce severity of allergic reaction, relieve symptoms, and protect ocular surface

20
Q

non pharm treatment for AC

A

cold compress 3-4 times daily, check pollen count, run air condition, use air filters, wear sunglasses

21
Q

first line treatment for AC

A

artificial tears prn

22
Q

second line treatment for AC

A

ketotifen fumarate

23
Q

MOA of ketotifen fumarate

A

blocks histamine release, inhibits release of mediators from mast cells, and contains preservatives

24
Q

third line treatment for AC

A

add an oral antihistamine or ophthalmic decongestants

25
Q

presentation of loose foreign substances in the eye

A

mild pain and tearing/watering of eye

26
Q

treatment for loose foreign substances in the eye

A

irrigation

  • rinse with ocular irrigate solution
  • nonmedicated eye petroleum application at bedtime
27
Q

exclusions to self-care of loose foreign substances

A
  1. systemic symptoms
  2. wood or metal fragments
  3. severe eye pain
  4. vision changes
  5. continued redness or irritation
  6. condition persists or worsens after treatment
  7. open would in or near the eyes
28
Q

presentation of minor eye irritation

A

eye redness or feeling of sand in eyes

29
Q

causes of minor eye irritation

A

loose foreign substances in the eye, contact lens, wind/sun/snow, chemical fumes, chlorine

30
Q

first line therapy for minor eye irritation

A

artificial tears

31
Q

other treatments for minor eye irritation

A

non medicated ointments or zinc sulfate

32
Q

exclusions for minor eye irritation

A
  1. systemic symptoms
  2. eye pain
  3. blurred vision
  4. blunt trauma to eye
  5. chemical exposure
  6. sensitivity to light
  7. history of wearing contacts
  8. symptoms longer than 72 hours
33
Q

presentation of excessive or impacted cerumen

A

ear fullness or dull pain, discomfort, itching, tinnitus, dizziness, vertigo, cough, hearing loss

34
Q

causes of excessive or impacted cerumen

A

narrowing or irregular shape of EAC, presence of excessive hair, irritation from foreign objects, use of cotton-tipped swabs, increasing age

35
Q

non pharm treatment for excessive or impacted cerumen

A

only remove when migrated to outer portion, curette –> removes cerumen

36
Q

pharm treatment for excessive cerumen if symptomatic

A

carbamide peroxide 6.5%

37
Q

application of carbamide peroxide

A

twice daily for up to 4 days, 5-10 drops instilled and leave in ear up to 15 minutes

38
Q

ADE carbamide peroxide

A

pain, rash, irritation, tenderness, redness, discharge, and dizziness

39
Q

exclusions for impacted or excessive cerumen

A
  1. systemic symptoms or signs of infection
  2. incapable of following instructions
  3. less than 12 years
  4. pain with or without ear discharge
  5. bleeding/signs of trauma
  6. ruptured tympanic membrane
  7. tympanostomy tubes present
  8. ear surgery within prior 6 weeks
  9. after 4 days symptoms or ADE persist
40
Q

presentation of water-clogged ears

A

sensation of hearing impairment, localized discomfort, and sensation of fullness

41
Q

causes of water-clogged ears

A

excessive moisture, wax or debris buildup, excessive hair growth, narrowing of ear canal, overproduction or the absence of cerumen, sweating, humidity, and swimming

42
Q

non pharm treatment for water-clogged ears

A

prevention of water retention (ear plugs/bathing cap), lowest heat setting on blow dryer

43
Q

pharm treatment for water-clogged ears

A

isopropyl alcohol 95% in anhydrous glycerin 5% (drying agent, 4-5 drops in ear)

44
Q

exclusions for self-care of water-clogged ears

A
  1. systemic symptoms or signs of infection
  2. pain associated with ear discharge
  3. bleeding or trauma
  4. ruptured tympanic membrane
  5. tympanostomy tubes present
  6. ear surgery in past 6 weeks
  7. ear surgery in past 6 weeks
  8. no improvement after 4 days of therapy
  9. < 12 years of age