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OTC 812 Exam 2 > Ophthalmic & Otic > Flashcards

Ophthalmic & Otic Flashcards

1
Q

Dry Eyes

A

White or mildly red eye, and patients may complain of a sandy, gritty feeling or a sensation that something is in the eye.

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2
Q

dry eyes treatment

pharm

A

Artificial tears, non medicated ointments, non medicated gels

Primary ingredient in non medicated ointment is white petrolatum, mineral oil, and lanolin

Gels offer some advantage to patients in that they do not disturb vision as much as ointments do and are better tolerated.

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3
Q

Allergic conjunctivitis:

A

Red-eye w/ watery discharge.

itching & vision can be blurred b/c of excessive tearing.

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4
Q

Allergic conjunctivitis treatment:

non pharm

A

Cold compresses

1st line of tx: Avoidance of allergic response such as pollen, keeping doors and windows closed.

Complementary therapies
Similasan Eye Drops #2 - ingredients are Apis, Euphrasia, and Sabadilla

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5
Q

Corneal edema

A

May occur from overwear of contact lenses, surgical damage to the cornea, & inherited corneal dystrophies. Fluid accumulation distorts the optical properties of the cornea, halos or starbursts around lights are hallmark symptoms of corneal edema.

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6
Q

Presence of loose foreign debris in the eye

A

The immediate response of the eye is watering (tearing). If substance causes only minor irritation & does not abrade eye surface, self-treatment is appropriate

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7
Q

Minor ocular irritation:

A

Redness of eye is common symptom. Show blindness, other burns from UV light, or arc welder’s burns (bright flash, like sunburn of eye), pain & feeling of “sand in eyes” are additional symptoms.

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8
Q

eye drops administration

A
  • —– If difficulty determining whether eyedrops have been administered properly, refrigerate the solution.
  • Wash hands and face area, remove contact lense unless product says so
  • Tilt head back
  • Grasp lower eyelid
  • Place dropper over the eye by looking directly at it
  • Look up before applying the single drop
  • – Close eyes gently for 3 minutes
  • Use a finger to put pressure on the opening of tear duct
  • Blot excess solution from around the eye
  • – Wait 5 min before instilling the next drop
  • —– If drops and ointment therapy are indicated, instill the drops at least 10 min before the ointment
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9
Q

eye ointment administration

A
  • wash hands and area around the face and eyes
  • If drops and ointment therapy are indicated, instill the drops at least 10 min before the ointment
  • Tilt head back
  • Grasp lower outer eyelid, pull eyelid away from the eye
  • Place ointment tube over the eye by looking directly at it
  • With a sweeping motion, place strip of ointment
  • — Release eyelid and close eye for 1-2 min
  • Blot excess ointment
  • – Vision may be blurred
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10
Q

ophthalmic disorders & conditions that necessitate medical referral

A

Blunt trauma, foreign particles trapped/embedded, ocular abrasions, infections of eyelid/eye surface, eye exposure to chemical splash, solid chemical or chemical fumes, thermal injury, bacterial conjunctivitis, viral conjunctivitis, chlamydial conjunctivitis

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11
Q

blunt trauma

A
  • ruptured blood vessels, bleeding not eyelid tissue space, swelling, ocular discomfort, facial drooping
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12
Q

Foreign particles trapped/embed in the eye

A

Foreign particles trapped/embed in the eye- Reddened eyes, profuse tearing, ocular discomfort

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13
Q

Ocular abrasions

A

Partial/total loss of corneal epithelium, blurred vision, profuse tearing, difficulty opening eye

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14
Q

Infection of eyelid/eye surface

A

Red, thickened lids, scaling, ocular discharged and matting of the lashes

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15
Q

Eye exposure to chemical splash, solid chemical, or chemical fumes-

A

Reddened eyes, watering, difficulty opening eye

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16
Q

Thermal injury to eye

A

reddened eyes, pain, and sensitivity to light

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17
Q

Bacterial conjunctivitis

A

Reddened eyes with purulent, colored (mucous) discharge, ocular discomfort, eyelid stuck together an awakening

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18
Q

Viral conjunctivitis

A

reddened eyes with watery, clear or white discharge, ocular discomfot, hyperemia, matting of the lashes

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19
Q

Chlamydial conjunctivitis

A

watery or white or yellow mucous discharge, ocular discomfort, low-graded fever, possible blurred vision

20
Q

Dicongestant products

A

Phenlyephrine
Nophazoline
Oxymetazolin
Tetrahydrozoline

21
Q

Antihistamine/Mast Cell stabilizer

A

Katoifen
onset of action 8-12 hours
duration >72 hours

22
Q

Phenlyephrine

A

onset of action- .5-1.5

duration 72 hours

23
Q

Nophazoline

A

onset of action- 3-4 hours

duration 72 hours

24
Q

oxymetazolin

A

onset of action- 4-6 hours

duration 72 hours

25
Q

Tetrahydrozoline

A

onset of action- 1-4 hours

duration 72 hours

26
Q

decongestant/antihitsamine products

A 
naphozloine/pheniramine
-onset of action- 3-4 hours 
- duraiton -72 hours
naphazoline/antazoline 
-duraiton 72 hours
27
Q

Exclusion for eyelid disorders

A
  • sings and symptoms of infection
  • blunt trauma to eye
  • exposure of eye to chemicals
  • Head lice
  • Macular degeneration
  • Hordeolum, chalazion, blepharitis
28
Q

Exclusion for reddening of eye surface

A
  • eye pain
  • blurred bison not associated with use of ophthalmic ointments
  • sensitivity to light
  • history of contact lens wear
  • blunt traumatizes eye
  • chemical exposure to eye
  • eye exposure to heat, excluding sun exposure
  • > 72
29
Q

treatment

Dry eyes: mild/moderate

A

low viscosity artificial tears, ointments

30
Q

treatment

Dry eyes: severe

A

high viscosity artificial tears or non-preserved artificial tears, non-pharm

31
Q

treatment

Allergic conjunctivitis

A

Antihistamines, mast cell stabilizers, ocular decongestants

32
Q

treatment

Corneal edema

A

Saline solution (sodium chloride).

33
Q

treatment

Loose foreign debris

A

Ophthalmic petrolatum ointment

34
Q

treatment

Minor ocular irritation

A

Minor ocular irritation: zinc chloride

35
Q

Excessive or impacted cerumen

A

Fullness or pressure in ear & gradual hearing loss, dull pain, vertigo, tinnitus, chronic cough, or pain.

36
Q

Water-Clogged Ears

A

Feeling of wetness or fullness in ear, accompanied by gradual hearing loss. Trapped moisture can compromise natural defenses of the external auditory canal (EAC), causing tissue maceration that, in turn, can lead to itching, pain, inflammation, or infection.

37
Q

Exclusion for self treatment (For excessive or impacted cerumen + Water- Clogged Ear)

A
  1. sign of infection.
  2. pain associated with the ear discharge.
  3. Bleeding or sign of trauma.
  4. Presence of ruptured tympanic membrane.
  5. Ear surgery within or prior 6 weeks.
  6. tympanostomy tube present.
  7. incapable of following proper instruction.
  8. Hypersensitivity for recommended agents.
  9. < 12 years old
38
Q

impacted cerumen:

Non- pharm:

A
  1. earwax should be removed only when it migrated to the most outer portion of the ear.
  2. Do not insert object into the ear to remove earwax. That may cause ear canal injury or push the was further into the ear.
    The non- pharm option to remove the cerumen is the curette (Clinere Ear Cleaners).. need training to use.
39
Q

impacted cerumen:

Pharm medication

A

Carbamide peroxide 6.5% in anhydrous glycerin (Only FDA approved)

Indication: For use of the removal of hardened or impacted cerumen within the EAC.
Age: 12 years old and older. ( under 12 only under the advice of physican).

Patient consultation: Twice a day up to 4 days. place 5- 10 drops of the cerumen softening solution into the ear canal (do not allow the tip of the applicator to enter to the ear canal.. and caution with eye)
allow the solution to stay on the ear at least 15 min.

Adverse effects: pain, rash , redness, discharge, dizziness, tenderness, irritation.

40
Q

Water- Clogged Ear:

Non- pharm:

A
  1. Tactic to prevent exposure to and accumulation moisture within the ear canal.
  2. Recommend the usage of ear plug or bathing cap for swimming.
  3. Recommend the usage of the products intended to protect the ear like (AguaEars, BioEars, and ClearEars) to absorb the trapped water for 5- 10 min, adult supervision is required for child younger than 11 years old.
  4. Blocking the ear canal enters with cotton swap with petrolatum jelly before exposure to moister.
41
Q

Water- Clogged Ear:

Pharm medication:

A
  • Isopropyl alcohol 95 % in anhydrous glycerin 5% (Only FDA approved):

Indication: For aid of ear drying

Age: non minimum age.
Patient consultation: place 4-5 drops. The active ingredients are flammable!! and caution with eye.

If symptoms has not relieved within several days of using the medication, medical referral.

Adverse effects: medical referral if pain, burning, irritation occurs using the applicator.

-50:50 acetic acid:alcohol mixture: used after swimming/bathing; mixture w/ white vinegar, isopropyl alcohol

42
Q

Dry Eye

Non-pharm tx

A

Non-pharm tx
Avoid dry or dusty places

Using humidifiers or repositioning workstations away from heating and air conditioning vents may help alleviate dry eyes.

Avoid prolonged use of computer screens and wearing eye protection in windy, outdoor environments

43
Q

Allergic Conjunctivitis

pharm

A

First line of defense is instill artificial tears as needed

Ketotifen fumarate (antihistamine/mast cell stabilizer) for anyone >3 years old

Oral antihistamine can be added to the second regimen

Non-prescription
Decongestants/alpha-adrenergic agonists:

Use if they are allergic to artificial tears or ketotifen. Last line of defense. Do not use in pt with heart problems (hypertension, heart failure)

Antihistamines: Pheniramine and antazoline

antihistamine/decongestant combo:

antihistamine/mast cell stabilizer combo: Ketotifen fumarate

44
Q

Decongestants/alpha-adrenergic agonists:

A

Decongestants/alpha-adrenergic agonists: Naphazoline, tetrahydrozoline, phenylephrine, oxymetazoline.

45
Q

antihistamine/decongestant combo:

A

antihistamine/decongestant combo: naphazoline/pheniramine and naphazoline/antazoline

OTC 812 Exam 2 (7 decks)

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