Management of Ocular Pain (F)

Question 1

What are common examples of acute ocular pain?

Answer 1

1. conjunctival or corneal FB
2. severe corneal abrasion
3. traumatic iritis
4. herpes zoster
5. post surgical

Question 2

What are the specialized nerve endings in tissue that transmit pain signal? 1. What activates these? 2. Where in the brain does this message get sen to? 3

Answer 2

1. nociceptors
2. substance P from from prostaglandins
3. cerebral cortex

Question 3

What are the methods of peripheral acting agents for pain management (with examples)?

Answer 3

1. inhibit substance P (capzasin)

2. inhibit prostaglandin synthesis (NSAIDs)

Question 4

What are the methods of signal inhibiting agents for pain management (with examples)?

Answer 4

prevent pain signal from traveling to cortex (anesthetics)

Question 5

What are the methods of central acting agents for pain management (with examples)?

Answer 5

act on pain perception centers in the cortex (opioids/narcotics)

Question 6

What are the effects of NSAIDs?

Answer 6

1. analgesic
2. anti-inflammatory
3. anti-pyretic
4. anti-platelet

Question 7

What are the advantages of COX-2 inhibitor NSAIDs? 1. Disadvantages? 2

Answer 7

1. preserves normal PG production to reduce gastric distress

2. increased risk of cardiac SE’s

Question 8

What is the terms for schedule I controlled substances? 1. Schedule II? 2. Schedule III? 3. Schedule IV? 4. Schedule V? 5

Answer 8

1. very high abuse potential
2. high abuse potential with dependency liability
3. moderate dependency, abuse potential
4. less dependency/abuse potential
5. limited abuse potential

Question 9

What are the prescribing limitations for optometrists for opiods?

Answer 9

1. no more than 60mg of codeine
2. no more than 7.5mg of hydrocodone
3. total quantity prescribed shall not exceed single 4 day supply
4. no more than 100mg tramadol

Question 10

What are the laws for prescribing controlled substances in Ohio?

Answer 10

1. Rx must be written or E-Rx’ed
2. recommend you take a log
3. Notify of addictive nature and give patient handout to patients

Question 11

What is the website allowing authorized healthcare providers to look up Rx narcotic drug history of patients?

Answer 11

Ohio Automated Rx Reporting System (OARRS)

Question 12

What can most cases of ocular pain be managed with?

Answer 12

1. cycloplegia
2. bandage CL
3. topical NSAID

Question 13

What is the hierarchy of significant ocular pain management?

Answer 13

1. oral NSAID then
2. oral acetaminophen then
3. oral opioid

Question 14

What should all patients have if they are given a drug for ocular pain?

Answer 14

a follow up appointment