Glaucoma, Allergic Conjunctivitis, Other Ophthalmics & Optics Flashcards
What does the abbreviation ‘AS’ stand for?
Left Ear
What does the abbreviation ‘AU’ stand for?
Each Ear
What does the abbreviation ‘OD’ stand for?
Right Eye
What does the abbreviation ‘OS’ stand for?
Left Eye
What does the abbreviation ‘OU’ stand for?
Each Eye
What’s req b4 using suspensions?
Shake prior to use
What’s glaucoma?
An eye dx caused by an increase in intraocular pressure (IOP)
Types of glaucoma
Angle-closure (closed-closure) - treated in hospital and is a medical
emergency
Open-closure glaucoma - more common, tx with eyedrops
List risk factors for glaucoma
FH
Increased age
African Americans
Nearsightedness (myopia)
List drugs that may increase IOP and/or should be avoided if possible in pts with glaucoma
Cough/cold/motion sickness medications (antihistamines)
Anticholinergics e.g. Oxybutynin, tolterodine, benztropine, trihexyphenidyl, tricyclics
Chronic corticosteroids, esp eye drops such as Prednisolone
Topiramate (Topamax)
What’s first line tx for glaucoma?
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.
MOA of bb in glaucoma?
Timolol 0.25% and 0.5% (Timoptic; XE)
Should bb used in glaucoma pts that also have asthma?
Best to try and avoid bb in asthma, COPD, chronic bronchitis, emphysema, or advanced cardiac dx bcuz they are non-selective bb
MOA of prostaglandin analogs (PAs)?
Increase aqueous outflow
Agents under PAs?
Travoprost (Travatan Z)
Bimatoprost (Lumigan)
Latanoprost (Xalatan)
Unoprostone (Rescula)
Tafluprost (Zioptan)
Whats the brand name of Travoprost? (PAs)
Travantan Z
Whats the brand name of Bimatoprost? (PAs)
Lumigan
Whats the brand name of Latanoprost? (PAs)
Xalatan
How do u use PAs? Exception
Once daily at night
Except Rescula BID
SEs of PAs?
Brown pigment in iris
Longer lashes (goes away once drug is d/c)
Eye redness
Storage of Latanoprost (Xalatan)?
Unopened bottles in refrigerator
Which PAs doesn’t contain benzalkonium chloride (BAK)? Advantage?
Travatan Z
May be helpful in pts with rxn to BAK or dry eye
Which PAs is discarded right after use?
Zioptan
MOA of Miotics?
Increase aqueous outflow
Miotics agents?
Carbachol (Isopto Carbachol, Miostat)
Pilocarpine (Isopto Carpine, Pilopine HS)
MOA of Carbonic Anhydrase Inhibitors?
Reduce aqueous humor production
Carbonic Anhydrase Inhibitors agents?
Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)
Dorzolamide + Timolol (Cosopt, Cosopt PF is single-dose)
Which Carbonic Anhydrase Inhibitors agents comes in an oral formulation?
Acetazolamide (Diamox)
May cause CNS effects (ataxia, confusion), photosensitivity/skin rash (including risk of SJS and TEN), anorexia, nausea and risk of hematological toxicities
MOA of Adrenergic Alpha-2 Agonists
Increase aqueous outflow, reduce production
Agents under Adrenergic Alpha-2 Agonists?
Apraclonidine (Iopidine)
Brimonidine (Alphagan P)
Brimonidine + Timolol (Combigan)
Brand name of Brimonidine? (Adrenergic Alpha-2 Agonists)
Alphagan P
Brand name of Brimonidine + Timolol? (Adrenergic Alpha-2 Agonists + bb)
Combigan
Brand name of Dorzolamide? (Carbonic Anhydrase Inhibitors)
Trusopt
Brand name of Dorzolamide + Timolol? (Carbonic Anhydrase Inhibitors + Timolol)
Cosopt
Cosopt PF (single dose)
What does the pt do after squeezing eye drops into their eye?
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
If pts is using more than 1 glaucoma med, how should they be used?
Wait at least 10 minutes to put 2nd medicine
Why are PAs (Travatan, Lumigan, Xalatan) not usually admin to pts with light eyes who have glaucoma in 1 eye only?
Risk of increase in brown pigment in iris and gradual changes in eye color
Howz unopened Latanoprost (Xalatan) stored?
Refrigerator
Is the use of Bimatoprost (Lattise) recommended with glaucoma med?
No. May reduced effectiveness of glaucoma med
Why is Timolol (Timoptic) not recommended in asthma, COPD, chronic bronchitis, emphysema or advanced cardiac dx?
Timolol may exacerbate these dx sx
Instructions to pt if eye drops are dispensed in Ocudose dispenser?
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
List common agents known to cause vision changes/damage
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)
What’s allergic conjunctivitis?
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
List the difference classes of pharmacologic tx used in allergic conjunctivitis
OTC -
Naphazoline/Pheniramine (Visine and others)
Antihistamine Ketotifen (Zaditor, Alaway)
What’s the brand name of Naphazoline/Pheniramine OTC tx for allergic conjuctivitis?
Naphcon-A
Opcon-A
Visine-A
What’s the brand name of Ketotifen (Antihistamine) OTC tx for allergic conjuctivitis?
Zaditor
Alaway
What’s the brand name of Levocetirizine (antihistamine) Rx tx for allergic conjuctivitis?
Xyzal
What’s the brand name of Emedastine (antihistamine) Rx tx for allergic conjuctivitis?
Emadine
Which Steroids: (short term use, caution for increased IOP) is Rx tx for allergic conjuctivitis?
Prednisolone acetate 1%
Counseling for eye drops use?
Temporary stinging
Limit contact lens use during infection
List Antibiotic eye drops used in pink eye
Azithromycin (Azasite)
Moxifloxacin (Vigamox)
Besifloxacin (Besivance)
Tobramycin/Dexamethasone (Antibiotic/steroid)
What’s the brand name of Azithromycin (antibiotics used in allergic conjunctivitis)?
Azasite
What’s the brand name of Moxifloxacin (antibiotics used in allergic conjunctivitis)?
Vigamox
What’s the brand name of Besifloxacin (antibiotics used in allergic conjunctivitis)?
Besivance
Which antibiotics used in pink eye must be stored in refrigerator?
Azithromycin (Azasite)
Can last 14 days at room temp
What’s first line tx for Blepharitis (Eyelid Inflammation)?
Warm compress such as washcloth to outer eyelids, gentle cleansing and gentle massage
This is considered first-line
Other tx of Blepharitis (Eyelid Inflammation)
Bacitracin or Erythromycin ointment, applied BID to QID
What meds are used for swimmers ear, otitis media pain?
Antipyrine and benzocaine (A/B Otic, Auralgan)
Benzocaine (Americaine Otic)
What meds are used for Outer ear infection (ear drops with antibiotics)?
Ciprofloxacin and hydrocortisone (Cipro HC)
Ciprofloxacin and dexamethasone (Ciprodex)
Ciprofloxacin (Floxin Otic, Floxin Otic Singles)
Neomycin and hydrocortisone (Cortisporin-TC)
What meds are used for Ear wax (cerumen) removal?
Carbamide peroxide (Debrox)
Triethanolamine (Cerumenex)
Antipyrine and benzocaine (Auralgan)
What step may be done in the doctors office after using ear wax removal for 2-3 days?
Ear wax removal
What does the abbreviation ‘AD’ stand for?
Right ear
