ophthalmology Flashcards

lecture 59

1
Q

risk factors glaucoma

A

age (40+) or race
corneal thickness or eye injury
use of steroids or hypertension (can affect pressure)
nearsighted or farsighted
diabetes or sickle cell anemia (especially untreated)

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2
Q

symptoms of open

A

none in the early stage
patchy blind spots in peripheral vision
vision difficulty in central vision

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3
Q

diagnosis of open

A

measuring of IOP
testing for optic nerve damage
vision loss assessment
corneal thickness measurement
inspection of drainage canal

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4
Q

symptoms of closed

A

medical emergency!!
severe HA or blurred vision
severe pain or halos around light
NV or redness in eye/cloudy cornea

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5
Q

drugs that increase aqueous humor outflow

A

prostaglandins
rho kinase inhibitors
cholinergics

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6
Q

drugs that block aqueous humor production

A

beta blockers
carbonic anhydrase inhibitors

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7
Q

drugs that increase outflow and reduce production

A

alpha-2 agonists

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8
Q

how is open glaucoma treated?

A

either by increasing aqueous humor outflow, blocking aqueous humor production, or both

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9
Q

what drugs are prostaglandins?

A

latanoprost
bimatoprost
travoprost
tafluprost
bimatoprost

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10
Q

goal of prostaglandins

A

decrease IOP by 30%

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11
Q

warnings of prostaglandins

A

eyelash increase (both length/number)
darkening of eyelid, iris, skin, and eyelash

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12
Q

se of prostaglandin

A

blurred vision
stinging
light sensitivity

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13
Q

drug of rho kinase inhibitors

A

netarsudil/latanoprost

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14
Q

SE of rho kinase inhibitors

A

burning
corneal disease
conjunctival hemorrhage
conjunctival hyperemia

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15
Q

drugs of cholinergics

A

carbachol
pilocarpine

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16
Q

cholinergic warnings

A

use caution in patients with history of retinal detachment or corneal abrasion

17
Q

SE of cholinergics

A

corneal clouding
pupil constriction
hypotension
bronchospasm
cramping in the abdomen/GI distress

18
Q

beta blocker drugs

A

betaxolol
timolol
carteolol
levobunolol

19
Q

CI of beta blockers

A

sinus bradycardia
other heart related conditions
bronchospastic disease

20
Q

SE of beta blockers

A

blurred vision
stinging
bradycardia
breathing problems

21
Q

how would the SE of beta blockers be minimized?

A

closing eyes for 1-2 minutes

22
Q

carbonic anhydrase inhibitor drugs

A

dorzolamide/timolol (drop)
acetazolamide (oral)
brinzolamide/brimonidine (drop)
methazolamide (oral)

23
Q

warnings of carbonic anhydrase inhibitors

A

sulfonamide allergy

24
Q

SE of eye drop carbonic anhydrase inhibitors

A

blurred vision
burning
blepharitis
taste disturbance

25
Q

SE of oral carbonic anhydrase inhibitors

A

ataxia
confusion
photosensitivity
nausea
metabolic acidosis

26
Q

alpha-2 agonists drug

A

apraclonidine
brimonidine
brimonidine/timolol/brinzolamide

27
Q

warnings of alpha-2 agonists

A

CNS depression

28
Q

SE of alpha-2 agonists

A

blurred vision
dry eyes
xerostomia
sedation/confusion
conjunctival hyperemia (redness)

29
Q

what is first line treatment of open glaucoma?

A

prostaglandins analogs
beta blockers
alpha-2 agonists (ish)

30
Q

what is second line treatment of open glaucoma?

A

carbonic anhydrase inhibitors
alpha-2 agonists (ish)

31
Q

what is third line treatment for open glaucoma?

A

rho kinase inhibitors

32
Q

what is the last line treatment for open glaucoma?

A

cholinergics

33
Q

treatment of closed glaucoma

A

hyper osmotic agents
surgery

34
Q

hyperosmotic agents drug

A

mannitol (IV)
glycerin (po)

35
Q

surgery option

A

iridotomy –> tiny holes in iris to allow fluid drainage

36
Q

what medications are safe to take after iridotomy?

A

anticholergics
topiramate
chronic steroids
decongestants
antidepressants