Senses part 3

Question 1

What glaucoma meds decrease aqueous humor formation?

Answer 1

• beta blockers
• alpha2-adrenergic agonists
• carbonic anhydrase inhibitors

Question 2

What glaucoma meds increase aqueous humor outflow?

Answer 2

• prostaglandin analogs

- cholinergic drugs

Question 3

AE:

heart block, bradycardia, bronchospasm

Answer 3

Beta 2 blockers (Timolol)

first line drug

Question 4

AE:

heart block, bradycardia, hypotension

Answer 4

Beta 1 blockers (Betaxolol) first line drug

Question 5

What are the systemic AE of beta blockers?

Answer 5

• heart: bradycardia, heart block, use with caution with HF pt’s
• Lungs: bronchospasm, wheezing, difficulty breathing

Question 6

What med is a prostaglandin analog?

Answer 6

Latanoprost (xalatan): facilitates aqueous outflow

Question 7

What is a significant AE of Latanoprost (xalatan)?

Answer 7

heightened brown pigmentation of iris (stops when med is DC’d, does not usually regress)

Question 8

What is special about the alpha 2 adrenergic agonist Brimonidine?

Answer 8

• increases outflow

- crosses the BBB

Question 9

What are carbonic anhydrase inhibitors like Brinzolamide useful for?

Answer 9

• useful as an adjunct and alternative
• Not drug of choice
• can be used in long term treatment
• teratogenic

Question 10

What are cycloplegics and mydriatics used for? What classes are they in? What are the important adverse effects?

Answer 10

• cycloplegics: paralyze the colliery muscle
• mydriatics: dilate the pupil
• these are used for diagnosis and surgery
• they are anticholinergics and adrenergic agonists
• AE: precipitation of angle closure of glaucoma

Question 11

What are some medication considerations for an older pt with glaucoma?

Answer 11

• may require other beta blockers
• beta blockers are contraindicated for pt with: heart failure/block, bradycardia
• pt taking high doses of aspirin shouldn’t take carbonic anhydrase
• alpha adrenergic agonists can cause tachycardia and/or HTN

Question 12

Explain a conductive HL?

Answer 12

• outer or middle ear impairment

- impacted cerumen, otitis media, TM tear, otosclerosis, narrow canal

Question 13

Explain sensorineural HL?

Answer 13

• impaired function of the inner ear CN 8.

- congenital, hereditary, noise exposure, aging, Menieres, and trauma

Question 14

What medications cause ototoxicity?

Answer 14

• aminoglycosides: gentamicin, vancomycin, erythromycin
• loop diuretics (Lasix)
• NSAIDs
• antimalarial
• chemo

Question 15

Pure tone quantifies HL

Answer 15

pure tone audiometry

Question 16

Compares hearing by bone conduction and air conduction

Answer 16

Rine test

AC should be heard 2xs as long as BC

Question 17

Stem of vibrating tuning fork is placed on midline of skull or forehead.

Answer 17

Weber- this test is for sensorineural vs conductive loss

Question 18

What are the dB of normal speech?

Answer 18

40 to 65

Question 19

What do HA’s do for a pt?

Answer 19

makes sounds louder not more clear