opthalmics (eyes) otics (ears)

Question 1

opthalmics

Answer 1

• proper admin techniques p.35 box 3-4 and box 3-5
• press on lacrimal duct for 1-2 min after admin to prevent systemic absorption
• for ointments: expect blurred vision for short time after admin
• always wash hands prior to admin
• do no contaminate vial
• eye trauma or anesthetic = eye patch

Question 2

glaucoma

Answer 2

*chronic, slowly progressive, usually billateral disorder resulting from increased (IOP)interocular pressure caused by congestion of aqueous humor in the eye. Resuling in visual loss, eye pain, and optic nerve damage

Question 3

closed angle glaucoma

Answer 3

refers to optic nerve damage due to a narrow angle between the iris and the cornea which blocks the exit of aqueous humor

Question 4

open angle glaucoma

Answer 4

occurs when the angle is open and normal however there is a diminished outflow of aqueous humor due an impairment of the drainage system

Question 5

glaucoma treatment: miotics

Answer 5

miotics: pilocarpine (Isopto Carpine)
* action: decreases IOP, increases blood flow to retina, and decreases retinal damage and vision loss; constrict the pupil
* implications: system absorption is possible not common
* toxicity:sh vertigo, bradycardia, cardiac dysrhythmia and seizures
* antidote: atropine (anticholinergic)
* contraindicated: retinal detachment

Question 6

glaucoma treatment: beta-adrenergic blocker

Answer 6

timolol maleate (timoptic) most recent approach for open angle glaucoma

• action: decrease production of aqueous humor and decreases IOP
• implications: monitor HR and BP in case of sys-temic absorption

Question 7

glaucoma treatment: carbonic anydrase inhibitors-(diamox)

Answer 7

interferes w/carbonic acid which leads to decrease in aqueous humor and IOP, initially developed as a diuretic.

• implications: used only when others are not effective
• last resort
• monitor: I & O, and electrolytes

Question 8

glaucoma treatment: osmotics-mannitol (osmitrol)

Answer 8

• action: decrease volume of intra-ocular fluid thus decreasing IOP, diuretic effect
• implications: used preop, postop or in an emergency treatment of closed angle glaucoma because of the ability to rapidly reduce IOP.
• monitor I & O, daily weight, and electrolyte imbalances

Question 9

adrenergic mydriatics and cycloplegics

Answer 9

• Mydriatics dilate the pupils; cycloplegics paralyze the muscle of accommodation i.e. atropine sulfate (Atropisol)
• uses of both: diagnostic procedures and surgery
• s/e: eye: local irritation, burning
  vision: blurred near vision/photophobia
  systemic: dry mucous membranes, hypotension, increase or decrease hear rate
• contraindicated: cardiac disorders, glaucoma

Question 10

opthalmics(other classifications)

Answer 10

• topical anesthetics: proparacaine HCL (Ophthaine)
• antiinfectives: tobramycin (Tobrex); gentamicin sulfate (Garamycin Opth)
• Antiinflammatories: dexamethasone (Decadron), prednisolone acetate (Econopred)
• lubricants: ultra tears, tears plus

Question 11

otics

Answer 11

• correct admin-text pg 35. box 3-5; figure 3-11
• adult: pull up and back on auricle
• child: (under age 3) pull down and back on auricle
• after installation of ear drops, have pt maintain position for 2-3 min
• teach pt not to insert any foreign objects into the ear canal
• keep drugs in light resistent container

Question 12

otic drugs

Answer 12

• antibaterials: both oral and topical
• antihistamines/decongestant: promotes drainage from the middle ear
• ceruminolytics for cronic impaction; home preparation of hydrogen peroxide and water or olive oil or mineral oil as effective as prescription or OTC ex. Debrox
• irrigation: gently flush to avoid damage to the eardrum. contraindicated with a perforated eardrum.
• do not use cotton swabs or Q tips