Senses part 3 Flashcards
What glaucoma meds decrease aqueous humor formation?
- beta blockers
- alpha2-adrenergic agonists
- carbonic anhydrase inhibitors
What glaucoma meds increase aqueous humor outflow?
- prostaglandin analogs
- cholinergic drugs
AE:
heart block, bradycardia, bronchospasm
Beta 2 blockers (Timolol)
first line drug
AE:
heart block, bradycardia, hypotension
Beta 1 blockers (Betaxolol) first line drug
What are the systemic AE of beta blockers?
- heart: bradycardia, heart block, use with caution with HF pt’s
- Lungs: bronchospasm, wheezing, difficulty breathing
What med is a prostaglandin analog?
Latanoprost (xalatan): facilitates aqueous outflow
What is a significant AE of Latanoprost (xalatan)?
heightened brown pigmentation of iris (stops when med is DC’d, does not usually regress)
What is special about the alpha 2 adrenergic agonist Brimonidine?
- increases outflow
- crosses the BBB
What are carbonic anhydrase inhibitors like Brinzolamide useful for?
- useful as an adjunct and alternative
- Not drug of choice
- can be used in long term treatment
- teratogenic
What are cycloplegics and mydriatics used for? What classes are they in? What are the important adverse effects?
- 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
What are some medication considerations for an older pt with glaucoma?
- 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
Explain a conductive HL?
- outer or middle ear impairment
- impacted cerumen, otitis media, TM tear, otosclerosis, narrow canal
Explain sensorineural HL?
- impaired function of the inner ear CN 8.
- congenital, hereditary, noise exposure, aging, Menieres, and trauma
What medications cause ototoxicity?
- aminoglycosides: gentamicin, vancomycin, erythromycin
- loop diuretics (Lasix)
- NSAIDs
- antimalarial
- chemo
Pure tone quantifies HL
pure tone audiometry
Compares hearing by bone conduction and air conduction
Rine test
AC should be heard 2xs as long as BC
Stem of vibrating tuning fork is placed on midline of skull or forehead.
Weber- this test is for sensorineural vs conductive loss
What are the dB of normal speech?
40 to 65
What do HA’s do for a pt?
makes sounds louder not more clear
