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PHM PRAC 438 > opthamalic > Flashcards

opthamalic Flashcards

1
Q

Do not self treat eye disorders

A

-pain
-blurred vision
-light sensitivity
-contact lens
-blunt trauma
-chemical exposure to eye
-eye exposure to heat
-symptoms longer than 72 hours

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2
Q

Causes of dry eye

A

-physical abnormalities
-contact lenses
-health conditions: Sjoogren’s syndrome, XXX, RA, thyroid
-Medications: antihistamines, TCAs, diuretics, some XXX
-envirorment

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3
Q

Symptoms of dry eyes

A

-normal to XXX
-discomfort
-blurred vision
-discharge from excessive XXX
-urge to rub eyes
-sensation of something in eye

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4
Q

non pharmacologic dry eyes

A

-avoid enviormental trigggers
-humidify dry air
-change meds
-cool compress

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5
Q

OTC treatments dry eyes

A

-artificial tear
-non medicated ocular gels
-non medicated opthalmic ointment

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6
Q

Follow up reccomendation dry eyes

A

-after 1 week: refer severe discomfort
-worsenting condition

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7
Q

artificial tears MOA

A

-Prevent/reduce tear evaporation, stabilize tear film
-Facilitate wetting of cornea by increasing XXX
-coat surface of eye, protect underlying cornea cells + conjunctiva
-MOA povidone: forms hydrophilic layer on cornea (like mucin)

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8
Q

artificial tears dosing

A

-Initial: BID to once daily
-maintenance: 1-2-3x/daily to hourly

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9
Q

artificial tears side effects

A

-rippled surface of cornea
-preservative toxicity
-cellulose ethers: XXX on eye lids
-Dextran 70: temporary stinging
-temporary blurred vision

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10
Q

artificial tears drug interactions

A

-PVA may react to cause thickening of solution containing PVA: Reacts with: sodium bicarbonate, sodium borate, sodium/potassium/zinc sulfate

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11
Q

artificial tears product selection

A

-balance: number of drops, viscosity, preservatives
- more drops=higher risk of toxicity
-non preserved products: discard unused immediately

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12
Q

ocular gel and ointment MOA

A

Occlusive film on eye
surface

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13
Q

ocular gel ingrediants

A

same as solution with additional agents to creat gel

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14
Q

ointment ingrediants

A

white petroleum, mineral oil, lanolin

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15
Q

How to manage blurred vison

A

XXX or use just at bedtime

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16
Q

symptoms of Allergic Conjunctivitis

A

-red eye and watery discharge
-ocular XXX
-ocular burning
-blurred vision due to tearing

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17
Q

no pharma Allergic Conjunctivitis

A

-cool, moist compress 3-4 times day
-trigger avoidance

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18
Q

OTC treatment for Allergic Conjunctivitis

A

-ocular: lubricants, decongestants, antihistamines, decongestant/antihistamines, antihistamines-mast cell stabilizer
-oral antihistamines
-combo eye and oral

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19
Q

Follow up reccomendations for Allergic Conjunctivitis

A

-24 hours: tears
-72 hours: everything else

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20
Q

Ocular decongestants(-ine drugs) MOA

A

alpha receptor agonism; reduces redness via vasoconstriction
of XXX

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21
Q

Pharmacodynamics of ocular decongestants/vasoconstrictors

A

-Duration:
–Phenylephrine: 30 to 90 minutes
–Tetrahydrozoline: 1-4 hours
–Naphazoline: 3-4 hours
–Oxymetazoline: 4-6 hours
–Brimonidine: 6-8 hours

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22
Q

Ocular decongestants/vasoconstrictors side effects

A

-rebound congestions
-hyperemia
-allergic conjuctivitis
-pupil dilation
-momentary stinging
-epithelial zerosis

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23
Q

Ocular decongestants/vasoconstrictors drug interaction

A

-possible but unlikely: atropine, TCAs, MAOIs, methyldopa

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24
Q

when to avoid Ocular decongestants/vasoconstrictors

A

-glaucoma
-hyperthyroidism
-children < 6
-ASCVD, arrhythmias, DM, BPH
Avoid: use longer than 72 hours! (brimonidine: 4 wks)

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25
Q

Ocular decongestants/vasoconstrictors dosing

A

-1-2 drops
-Tetrahydrozoline: every 4 hr
-Others: every 6 hours

26
Q

Ocular decongestants/vasoconstrictors in pregnancy/lactation

A

likely ok but check with healthcare provider

27
Q

Ocular antihistamines/MC stabilizers MOA

A

-H1 -receptor antagonists: pheniramine
-H1 -receptor antagonist/mast cell stabilizer: ketotifen, olopatadine

28
Q

Ocular antihistamines/MC stabilizers pharmacodynamics

A

-Pheniramine: 3-4 hours
* Ketotifen: 8-12 hours
* Olopatadine: depends on dosing: Twice daily with lower concentration: 8 hours or Once daily with higher concentration: 16 hours

29
Q

Ocular antihistamines/MC stabilizers side effects

A

momentary stinging/burning, eye redness, pupil dilation

30
Q

When to avoid Ocular antihistamines/MC stabilizers

A

not for contact lens irritation, avoid if narrow-angle glaucoma;
72 hour warning for pheniramine combo

31
Q

Ocular antihistamines/MC stabilizers Dosing

A

-5 min apart from other eye meds,10 minutes before inserting contact lenses
-Pheniramine combo: 1-2 drops 3-4x/day
-Ketotifen: 1 drop twice daily (age 3 & older)
-Olopatadine: 0.1%: 1 drop twice daily, separated ___ hours, ages 2 & older, 0.2%: 1 drop ONCE daily (ages 2 & older)

32
Q

Ocular astringents MOA

A

help dry eye

33
Q

Ocular astringents

A

-zinc sulfate and benzalkonium chloride(BAK_
-combination with and decongestant or antihistamine/MC stabilizer

34
Q

Causes of corneal edema

A

-prolonged wearing of contacts
-surgical damage
-hereditary conditions
-glaucoma
-iritis
-infection

35
Q

corneal edema symptoms

A

-blurred/foggy vision
-light halos/starbursts
-blisters which may rupture

36
Q

OTC treatments corneal edema

A

-sodium chloride: 2% soln., 5% soln., 5% oint

37
Q

corneal edema follow up recomendations

A

-1 week

38
Q

corneal edema treatment algorithm

A

-1st line: 2% soln 4x/day
-2nd line: add 5% oint at night
-3rd line: switch to 5% soln 4x/day and continue ointment

39
Q

Sodium chloride 2%, 5% MOA

A

increase tonicity of tear film which moves water from cornea to tears
–> removed by tear flow

40
Q

Sodium chloride 2%, 5% side effects

A

momentary burning, eye irritation, eye redness, vision
changes (all = more common with ____)

41
Q

Sodium chloride 2%, 5% dosing

A

-1-2 drops every 3/4 hours
-ointment: thin ribbon at bedtime

42
Q

Sodium chloride 2%, 5% in pregnancy/lactation

A

check with healthcare provider

43
Q

Removal of foreign object in eye

A

-blink/tear
-flush with water

44
Q

Avoid with Ophthalmic irritants

A

open wounds in/near eyes, eye pain, vision changes, ongoing
redness/irritation, EYE CUPS

45
Q

how to use ocular irritant solution

A

1)wash hands
2)head over sink with head tilted
3)hold eyelids apart and flush with solution
4) discard remaining solution and bottle

46
Q

non pharma Minor eye irritation

A

-cool, moist compress

47
Q

Minor eye irritation OTC treatment

A

-artificial tears/ointments
-zinc sulfate soln

48
Q

Minor eye irritation follow up recomendation

A

72 hours

49
Q

Zinc sulfate ophthalmic solution MOA

A

astringent; shrinks mildly inflamed tissues; dries excess
secretions

50
Q

Zinc sulfate ophthalmic solution side effects

A

eye irritation, reddness

51
Q

Zinc sulfate ophthalmic solution dosing

A

1-2 drops 4x/day

52
Q

Avoid Zinc sulfate ophthalmic solution in…

A

children younger than XXX

53
Q

causes of Blepharitis

A

S. epi, S. aureus,
seborrheic dermatitis

54
Q

Blepharitis symptoms

A

-pruritis
-burning
-eyelids: red, scaly, thickened, loss of eyelashes

55
Q

non-pharma Blepharitis

A

-hot compress 15-20 min BID to QID

56
Q

OTC treatments for Blepharitis

A

-lid scrubs: baby shampoo, eye scrub soln, lid wipes, ocu soft soln.

57
Q

Hordeolum (Stye) symptoms

A

-nodule
-tender, palpable
-eyelid swelling

58
Q

Hordeolum (Stye) referral

A

> 1 week or chronic

59
Q

Hordeolum (Stye) non pharma treatment

A

-hot compress 3-4 times day for 5-10 min
-gentle pressure

60
Q

Hordeolum (Stye) pharmacologic treatment

A

-internal: oral antibiotic after 1 week of compresses
-external: topical antibiotic if not cleared after 1 week of compresses
-surgery

PHM PRAC 438 (29 decks)

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