Glaucoma, Allergic Conjunctivitis, Other Ophthalmics & Optics Flashcards

0
Q

What does the abbreviation ‘AS’ stand for?

A

Left Ear

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1
Q

What does the abbreviation ‘AD’ stand for?

A

Right ear

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2
Q

What does the abbreviation ‘AU’ stand for?

A

Each Ear

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3
Q

What does the abbreviation ‘OD’ stand for?

A

Right Eye

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4
Q

What does the abbreviation ‘OS’ stand for?

A

Left Eye

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5
Q

What does the abbreviation ‘OU’ stand for?

A

Each Eye

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6
Q

What’s req b4 using suspensions?

A

Shake prior to use

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7
Q

What’s glaucoma?

A

An eye dx caused by an increase in intraocular pressure (IOP)

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8
Q

Types of glaucoma

A

Angle-closure (closed-closure) - treated in hospital and is a medical
emergency

Open-closure glaucoma - more common, tx with eyedrops

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9
Q

List risk factors for glaucoma

A

FH

Increased age

African Americans

Nearsightedness (myopia)

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10
Q

List drugs that may increase IOP and/or should be avoided if possible in pts with glaucoma

A

Cough/cold/motion sickness medications (antihistamines)

Anticholinergics e.g. Oxybutynin, tolterodine, benztropine, trihexyphenidyl, tricyclics

Chronic corticosteroids, esp eye drops such as Prednisolone

Topiramate (Topamax)

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11
Q

What’s first line tx for glaucoma?

A

Prostaglandin Analogues (PAs) - lowers pip more than bb and approved for initial use

Beta-blockers - inexpensive and used if only 1 eye needs tx due to color discoloration from PAs.

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12
Q

MOA of bb in glaucoma?

A

Timolol 0.25% and 0.5% (Timoptic; XE)

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13
Q

Should bb used in glaucoma pts that also have asthma?

A

Best to try and avoid bb in asthma, COPD, chronic bronchitis, emphysema, or advanced cardiac dx bcuz they are non-selective bb

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14
Q

MOA of prostaglandin analogs (PAs)?

A

Increase aqueous outflow

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15
Q

Agents under PAs?

A

Travoprost (Travatan Z)

Bimatoprost (Lumigan)

Latanoprost (Xalatan)

Unoprostone (Rescula)

Tafluprost (Zioptan)

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16
Q

Whats the brand name of Travoprost? (PAs)

A

Travantan Z

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17
Q

Whats the brand name of Bimatoprost? (PAs)

A

Lumigan

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18
Q

Whats the brand name of Latanoprost? (PAs)

A

Xalatan

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19
Q

How do u use PAs? Exception

A

Once daily at night

Except Rescula BID

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20
Q

SEs of PAs?

A

Brown pigment in iris

Longer lashes (goes away once drug is d/c)

Eye redness

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21
Q

Storage of Latanoprost (Xalatan)?

A

Unopened bottles in refrigerator

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22
Q

Which PAs doesn’t contain benzalkonium chloride (BAK)? Advantage?

A

Travatan Z

May be helpful in pts with rxn to BAK or dry eye

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23
Q

Which PAs is discarded right after use?

A

Zioptan

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24
Q

MOA of Miotics?

A

Increase aqueous outflow

25
Q

Miotics agents?

A

Carbachol (Isopto Carbachol, Miostat)

Pilocarpine (Isopto Carpine, Pilopine HS)

26
Q

MOA of Carbonic Anhydrase Inhibitors?

A

Reduce aqueous humor production

27
Q

Carbonic Anhydrase Inhibitors agents?

A

Acetazolamide (Diamox)

Brinzolamide (Azopt)

Dorzolamide (Trusopt)

Dorzolamide + Timolol (Cosopt, Cosopt PF is single-dose)

28
Q

Which Carbonic Anhydrase Inhibitors agents comes in an oral formulation?

A

Acetazolamide (Diamox)

May cause CNS effects (ataxia, confusion), photosensitivity/skin rash (including risk of SJS and TEN), anorexia, nausea and risk of hematological toxicities

29
Q

MOA of Adrenergic Alpha-2 Agonists

A

Increase aqueous outflow, reduce production

30
Q

Agents under Adrenergic Alpha-2 Agonists?

A

Apraclonidine (Iopidine)

Brimonidine (Alphagan P)

Brimonidine + Timolol (Combigan)

31
Q

Brand name of Brimonidine? (Adrenergic Alpha-2 Agonists)

A

Alphagan P

32
Q

Brand name of Brimonidine + Timolol? (Adrenergic Alpha-2 Agonists + bb)

A

Combigan

33
Q

Brand name of Dorzolamide? (Carbonic Anhydrase Inhibitors)

A

Trusopt

34
Q

Brand name of Dorzolamide + Timolol? (Carbonic Anhydrase Inhibitors + Timolol)

A

Cosopt

Cosopt PF (single dose)

35
Q

What does the pt do after squeezing eye drops into their eye?

A

Press a finger btw their eye and the top of ur nose.

Press for at least 1 full min (or longer if instructed by dr)

This way, more of the medicine stays in your eye

You will be less likely to have SE

36
Q

If pts is using more than 1 glaucoma med, how should they be used?

A

Wait at least 10 minutes to put 2nd medicine

37
Q

Why are PAs (Travatan, Lumigan, Xalatan) not usually admin to pts with light eyes who have glaucoma in 1 eye only?

A

Risk of increase in brown pigment in iris and gradual changes in eye color

38
Q

Howz unopened Latanoprost (Xalatan) stored?

A

Refrigerator

39
Q

Is the use of Bimatoprost (Lattise) recommended with glaucoma med?

A

No. May reduced effectiveness of glaucoma med

40
Q

Why is Timolol (Timoptic) not recommended in asthma, COPD, chronic bronchitis, emphysema or advanced cardiac dx?

A

Timolol may exacerbate these dx sx

41
Q

Instructions to pt if eye drops are dispensed in Ocudose dispenser?

A

Unscrew cap by turning as indicated by the arrows on the top of cap, to open bottle

Don’t pull the cap directly up and away from the bottle

Pulling the cap directly up prevent the dispenser from operating properly

42
Q

List common agents known to cause vision changes/damage

A

Alpha blockers (floppy iris syndrome - cause difficulty in cataract surgery)

Amiodarone (corneal deposits, optic neuropathy)

Bisphosphonates (ocular inflammation)

Digoxin (yellow/green vision, blurriness, halos)

Ethambutol, Linezolid (optic neuropathy, esp, with chronic use)

Ezogabine (Potiga) (.retinal changes, vision loss)

Hydroxychloroquine (Plaquenil) (retinopathy)

Isoniazid (optic neuritis)

Isotretinion (reduced night vision which may be permanent, dry eyes/irritation)

Quinolones (retinal detachment)

Sildenafil (Viagra) and other PDE-5 inh used for ED and PAH (greenish tinge around objects, possible permanent vision loss in 1 or both eyes)

Tamoxifen (Nolvadex) (corneal changes, decreased color perception)

Telithromycin (blurry vision, diplopia)

Voriconazole (VFEND) (abnormal vision, color vision change, photophobia)

43
Q

What’s allergic conjunctivitis?

A

Clear thin membrane called the conjunctiva covers the eyeball and inside of the eyelids. If something irritates this covering,the eyes can become red, swollen and may itch

44
Q

List the difference classes of pharmacologic tx used in allergic conjunctivitis

A

OTC -

Naphazoline/Pheniramine (Visine and others)

Antihistamine Ketotifen (Zaditor, Alaway)

45
Q

What’s the brand name of Naphazoline/Pheniramine OTC tx for allergic conjuctivitis?

A

Naphcon-A

Opcon-A

Visine-A

46
Q

What’s the brand name of Ketotifen (Antihistamine) OTC tx for allergic conjuctivitis?

A

Zaditor

Alaway

47
Q

What’s the brand name of Levocetirizine (antihistamine) Rx tx for allergic conjuctivitis?

A

Xyzal

48
Q

What’s the brand name of Emedastine (antihistamine) Rx tx for allergic conjuctivitis?

A

Emadine

49
Q

Which Steroids: (short term use, caution for increased IOP) is Rx tx for allergic conjuctivitis?

A

Prednisolone acetate 1%

50
Q

Counseling for eye drops use?

A

Temporary stinging

Limit contact lens use during infection

51
Q

List Antibiotic eye drops used in pink eye

A

Azithromycin (Azasite)

Moxifloxacin (Vigamox)

Besifloxacin (Besivance)

Tobramycin/Dexamethasone (Antibiotic/steroid)

52
Q

What’s the brand name of Azithromycin (antibiotics used in allergic conjunctivitis)?

A

Azasite

53
Q

What’s the brand name of Moxifloxacin (antibiotics used in allergic conjunctivitis)?

A

Vigamox

54
Q

What’s the brand name of Besifloxacin (antibiotics used in allergic conjunctivitis)?

A

Besivance

55
Q

Which antibiotics used in pink eye must be stored in refrigerator?

A

Azithromycin (Azasite)

Can last 14 days at room temp

56
Q

What’s first line tx for Blepharitis (Eyelid Inflammation)?

A

Warm compress such as washcloth to outer eyelids, gentle cleansing and gentle massage

This is considered first-line

57
Q

Other tx of Blepharitis (Eyelid Inflammation)

A

Bacitracin or Erythromycin ointment, applied BID to QID

58
Q

What meds are used for swimmers ear, otitis media pain?

A

Antipyrine and benzocaine (A/B Otic, Auralgan)

Benzocaine (Americaine Otic)

59
Q

What meds are used for Outer ear infection (ear drops with antibiotics)?

A

Ciprofloxacin and hydrocortisone (Cipro HC)

Ciprofloxacin and dexamethasone (Ciprodex)

Ciprofloxacin (Floxin Otic, Floxin Otic Singles)

Neomycin and hydrocortisone (Cortisporin-TC)

60
Q

What meds are used for Ear wax (cerumen) removal?

A

Carbamide peroxide (Debrox)

Triethanolamine (Cerumenex)

Antipyrine and benzocaine (Auralgan)

61
Q

What step may be done in the doctors office after using ear wax removal for 2-3 days?

A

Ear wax removal