Otic And Opthamic Preparations Flashcards
Cerumen
Ear wax
Cycloplegia
Paralysis for the ciliary muscle, resulting in an inability to focus the eye
Intraocular pressure
Pressure within the eye
Miosis
Construction of the pupil of the eye
Mydriasis
Dilation of the pupil
Otitis media
Infection of the middle ear, characterized by an accumulation of fluid in the middle ear
3 categories of otic preparations
Antibiotics, antibiotic/steroid combinations and misc preparations
Misc otic preparations usually include
Benzocaine, phenylephrine, hydrocortisone, glycerin, antipyrine, acetic acid, boric acid, benzalkonium, benzethonium, or carbamide peroxide
Otic preparations use
Instilled in the external auditory canal and can be used to relive pain, treat infection and inflammation, aid in the removal of cerumen,
When the patient has an inner ear infection, what is recommended
Systemic antibiotic therapy
Otic preparations side effects
Local ear irritation, itching and burning. Prolonged use of antibiotics can cause superinfection
Otic preparations precautions
Pregnancy and lactation,
Drugs to remove cerumen contraindications
If there is ear drainage, discharge, pain, or irritation, if the eardrum is perforated, or after ear surgery,
Ofloxacin pregnancy cat
C, should only be administered if benefit justifies risk to fetus
Otic preparations infants considerations
Look for signs of pulling, grabbing or tugging at an infants ears as a sign of ear pain
Pediatric administration of otic preparations
If younger than 3, pull ear down and back
Otic preparations administration
Pull ear up and back, and and hold container in hand for a few mins to warm it up. Stay lying down with ear up for 5 mins
Glaucoma
Increase in IOP, causing progressive atrophy of the optic nerve with deterioration of vision
Open angle glaucoma vs angle closure glaucoma
Open angle is when the angle where aqueous humor drains is normal, but doesn’t function properly, and angle closure glaucoma, the iris is bent at an angle and limits the flow of aqueous humor into the eye
Brimonidine MOA
Alpha 2 adrenergic, and
Brimonidine use
Lower IOP with open angle glaucoma or ocular hypertension, it reduces the production of aqueous humor and increases the outflow of it
Sympathomimetic ophthalmic preparations MOA
Increase the outflow of aqueous humor in the eye, lowering IOP
Apraclonidine use
Control or prevent postoperative elevations in IOP
Dapiprazole MOA
Blocking the alpha adrenergic receptor in smooth muscle and causes miosis through an effect on the dilator muscle of the iris
Dapiprazole use
After opthalmic operations to reverse the diagnostic mydriasis
Beta adrenergic blocking ophthalmic preparations MOA
Decrease the rate of production of aqueous humor, lowering IOP
Beta adrenergic blocking drugs ophthalmic preparations use
Glaucoma
Miotics MOA
Contract the pupil of the eye, resulting in an increase in the space through which aqueous humor flows
Drug of choice for glaucoma
Beta adrenergic blocking ophthalmic preparations
Carbonic anhydrase inhibitors ophthalmic preparations MOA
Decrease aqueous humor secretion
Carbonic anhydrase inhibitors ophthalmic preparations use
Elevated IOP as seen in open angle glaucoma
Carbonic anhydrase inhibitors ophthalmic preparations administration
Systemically, except for dorzolamide and brinzolamide
Prostaglandin agonists ophthalmic preparations MOA
Lower IOP by increasing outflow of aqueous humor through the trabecular network
Prostaglandin Agonists use
Lower IOP in people with open angle glaucoma who don’t tolerate or respond to other IOP lowering methods
Mast cell stabilizers ophthalmic preparations MOA
Inhibit the antigen induced release of inflammatory mediators from human mast cells
Mast cell stabilizers ophthalmic preparations use
Prevent itching of the eye caused by allergic conjuntivitis
NSAIDs ophthalmic preparations use
Treat postoperative pain and inflammation after cataract surgery, for the relief of the itching of the eyes caused by allergies, and during eye surgery to prevent miosis
Corticosteroids ophthalmic preparations use
Inflammatory convictions such as, allergic conjunctivitis, keratitis, herpes zoster keratitis, and inflammation of the iris, and can be used after injury to the cornea or after corneal transplantation to prevent rejection
Antibiotics ophthalmic preparations use
Treatment of eye infections
Sulfonamides ophthalmic preparations use
Conjunctivitis, corneal ulcer, and other superficial infections of the eye
Silver proteinate use
Treatment of eye infections
Silver nitrate use
Prevent gonorrheal ophthalmic neonatorum
Silver nitrate in newborns considerations
Has been replaced by ophthalmic tetracycline and erythromycin
Antiviral drugs ophthalmic preparations use
Herpes simplex infections of the eye, in immunocompromised patients with cytomegalovirus retinitis and for the prevention of CMV retinitis in patients undergoing transplants
Natamycin ophthalmic preparations use
Antifungal activity against a variety of yeast and other fungi
Mydriatics MOA
Constrict superficial blood vessels of the sclera and decrease the formation of aqueous humor
Mydriatics use
Before eye surgery in the treatment of glaucoma, relief of minor eye irritation, and to dilate the pupil for eye examinations
Cycloplegic mydriatics MOA
Cause mydriasis and cycloplegia
Cycloplegic mydriatics use
Treatment of inflammatory conditions of the iris and uveal tract of the eye and for eye examinations
Artificial tear solutions MOA
Lubricate the eyes.
Artificial tear solutions use
Dry eyes and eye irritation caused by inadequate tear production
Ophthalmic preparations side effects
Are rare, but can cause blurry vision, local irritation and burning, reactions usually resolve within a few mins
Glaucoma Drugs side effects
Usual,y mild, and include local burning and stinging, headache, blurry vision, tearing, foreign body sensation, ocular allergic reactions, and ocular itching. And systemic fatigue, drowsiness, palpitations and nausea
Corticosteroids ophthalmic preparations side effects
Elevated IOP with optic nerve damage, loss of visual acuity, cataract formation, delayed wound healing, secondary ocular infection, exacerbation of corneal infection, dry eyes, ptosis, blurred vision, discharge, ocular pain, foreign body sensations, and pruritus
Antibiotic and sulfonamide ophthalmic preparations side effects
Well tolerated, and include transient irritation, burning, itching, stinging, inflammation, and blurred vision. With prolonged or repeated use, a superinfection can occur
Antiviral ophthalmic preparations side effects
Local irritation, pain, pruritus, inflammation, edema of the eyes or eyelids, foreign body sensation, and corneal clouding
Antifungal ophthalmic preparations side effects
Rare, but local irrtiucan occur
Artificial tear solutions side effects
Rare, but redness or irritation can occur
Adrenergic based ophthalmic preparations Drugs contraindications
MAOIs
Epinephrine ophthalmic preparations contraindications
Patients with narrow angle glaucoma, patients with a narrow angle but no glaucoma, and aphakia
Epinephrine ophthalmic preparations precautions
Soft contact lenses,
Drugs to treat glaucoma precautions
Pregnancy and lactation, cardiovascular disease, depression, cerebral of coronary insufficiency, hypertension, hyperthyroidism, or raynaud phenomenon
Epinephrine pregnancy cat
B
Apraclonidine pregnancy cat
C
Brimodine interactions
CNS depressants can have additive effect,
Brimonidine precautions
Antihyeortendive Drugs, and cardiac glycosides because a synergistic effect can occur
Adrenergic blocking ophthalmic preparations contraindications
Bronchial asthma, obstructive pulmonary disease, sinus bradycardia, heart block, HF, or carcinogenic shock, where pupil constrictions aren’t desirable (iris inflammation) and for IOP in open angle glaucoma
Beta adrenergic blocking drugs ophthalmic preparations precautions
Pregnancy (cat C), lactation, cardiovascular disease, diabetes (may mask signs of hypoglycemia), and may mask signs of hyperthyroidism,
Beta adrenergic blocking drugs ophthalmic preparations interactions
Additive effects with oral beta adrenergic blocking drugs, and additive hypotensive effect with phenothiazines
Timolol interactions
Calcium antagonists can cause hypotension, left ventricular failure, and condition disturbances in the heart
Mío tic drugs contraindications
Conditions where construction is undesirable (iritis, uveitis, acute inflammatory disease of the anterior chamber)
Miotics precautions
Corneal abrasion, pregnancy (cat C), lactation, cardiac failure, bronchial asthma, peptic ulcer, hyperthyroidism, GI spasm, UTI, Parkinson’s, renal or hepatic impairment, and recent MI or hypotension or hypertension and angle closure glaucoma
Cholinesterase inhibitors ophthalmic preparations precautions
Myasthenia gravis, before and after surgery, chronic angle closure glaucoma, those with anatomically narrower angles,
Cholinesterase inhibitors ophthalmic preparations interactions
Systemic anti cholinesterase drugs can have additive effect, and those working with carbamate-organophosphate insecticides or pesticides are at risk for systemic effects
Ophthalmic mast cell stabilizers precautions
People with contact lenses,
Ophthalmic NSAIDs precautions
Bleeding tendencies, when used topically, there is less risk of interactions
Corticosteroids ophthalmic preparations precautions
Sulfite sensitivity , infectious conditions of the eye, prolonged use can cause elevated IOP and optic nerve damage
Antibiotics ophthalmic preparations precautions
Sulfite sensitivity, pregnancy (cat B or C), and lactation
Antibiotics ophthalmic preparations contraindications
Epithelial herpes simplex keratitis, varicella, mycobacterial infection of the eye, and fungal eye diseases
Corticosteroids and antibiotic combinations (solutions) otic preparations
Hydrocortisone and neomycin, hydrocortisone and polymyxin
Corticosteroids and antibiotic combinations (suspensions) otic preparations
Hydrocortisone and neomycin and polymyxin, hydrocortisone and neomycin, hydrocortisone and ciprofloxacin
Otic antibiotic ex
Ofloxacin
Alpha 2 adrenergic Agonists ophthalmic preparations ex
Brimonidine
Ophthalmic sympathomimetic ex
Apraclonidine, dipivefrin, epinephrine
Alpha adrenergic blocking drugs ophthalmic preparations ex
Dapiprazole
Beta adrenergic blocking drugs ophthalmic preparations ex
Betaxolol, carteolol, levonetaxolol, Levobunolol, metipranolol, timolol,
Miotics ex
Carbachol, pilocarpine, echothiphate iodide
Carbonic anhydrase inhibitors ophthalmic preparations ex
Brinzolamide, dorzolamide
Prostaglandin Agonists ophthalmic preparations ex
Latanoprost, travoprost, bimatoprost
Mast cell stabilizers ophthalmic preparations ex
Necocromil, pemirolast
NSAIDS ophthalmic preparations ex
Bromfenac, diclofenac, flurbiprofen, ketorolac, nepafenac
Corticosteroids ophthalmic preparations ex
Dexamethasone, difluoprednate, fluoromethalone, loteprednol, prednisolone
Antibiotics ophthalmic preparations ex
Azithromycin, bacitracin, ciprofloxacin, erythromycin, gatifloxacin, gentamicin, levofloxacin, moxifloxacin, norfloxacin, ofloxacin, polymyxin, tobramycin, sulfacetamide, sulfisoxaxole
Silver compound ophthalmic preparations ex
Silver nitrate
Antiviral ophthalmic preparations ex
Ganciclovir, idoxuridine, trifluridine, vidarabine,
Antifungal ophthalmic preparations ex
Natamycin
Mydriatics ex
Oxymetazoline, phenylephrine, tetrahydrozoline,
Cycloplegic/mydriatics ex
Atropine, homatropine hydrobromide
Ocular lubricants ex
Benzalkonium chloride