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64 Cards in this Set
- Front
- Back
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Administration of eye drops
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1. lie dwn & look up
2. pull lower lid 3. administer drops in the cnt of the conjunctival sac 4. press gently on lacrimal duct w/ cotton ball or tissue for 1-2 minutes after instillation to prevent systemic absorption thru lacrimal canal. 5. Instruct client to keep eyes closed for 1-2 minutes to promote absorption 6. ointment blurred vision expected 7. wash hands |
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Topical Anesthetics
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used in selected aspects of a comprehensive eye exam & in the removal of foreign body from eye
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What are the common topical anesthetic drugs for the eye?
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proparacaine HCL, tetracaine HCL
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Corneal anesthesia
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*achieved within one minute
*lasts about 15 minutes *the blink reflex is lost temporarily *the corneal epithelium is not kept moist *a patch is usually worn until the effects of the drugs are gone *don't rub eye to prevent abrasions |
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Antiinfectives for eye infections
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*interfere or destroy microorganisms that cause the following infections:staph, strep, pseudomonas
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Antiinfective drugs for the eyes:
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antibiotics, antifungals, antivirals
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Conjunctivitis
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inflammation of the delicate membrane covering the eyeball & the lining of the eyelid
*can b bacterial or viral pink eye, bacterial, fungal or viral infections, HSV |
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Antiinfective drug types are:
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bacitracin, gentamycin sulfate, tobramycn, anti fungal-natamycin, antiviral - trifluride
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Antiinflammatories
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Decrease edema, redness, scarring & exudates
uses; inflammatory disorders, hypersensitivity conditions |
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Common antiinflammatory drugs are?
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Corticosteroids - maxidex, prednisolone sodium phosphate
non steriods - voltaren - short term use |
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Antiinflammatory side effects:eyes
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increased 1OP, optic nerve damage, decreased visual acuity, cataracts
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Dexamethosone
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used for allergic conditions & inflammation of conjunctiva, cornea or lids
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Flurbiprofen Na
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to decrease corneal edema
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Lubricants
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used for dryness of the eye
*moistens contact lens *maintain integrity of the epithelial surface *used during surgery *available OTC in liquid or ointment |
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Common Lubricant drugs:
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isopto tears, tearisol, ultra tears
*be alert to allergic response to preservatives in lubricants |
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Glaucoma
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open angel & Narrow angle
- a chronic, slowly proressive, usually bilateral disorder, associated with visual loss, eye pain, and optic nerve damage |
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Open angle glaucoma
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Optic nerve damage often associated with elevated intraocular pressure
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Closed angle glaucoma
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occurs when elevated intraocular pressure is associated with closure of the filtration angle
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Miotics
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*exert a parasympathetic response that results in the constriction of the pupil
*contraction f the accomodative muscle *decreased resistance to outfloe of aqueous humor for the end result of the following: a decrease in 1OP:the internal pressure of the eye, regulated by resistance to the flow of aqueous humor, 2. an increase outflow of aqueous humor |
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Miotics are used for?
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Treatment of glaucoma or esotropia(cross eye)
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Miotics in open-angle glaucoma
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they are used to lower the intraocular pressure, thereby increasing blood flow to the retina and decreasing retinal damage & loss of vision
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Two types of Miotics?
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direct acting cholinergics prostaglandin ananlog
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Side effects of Miotics?
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blurred vision
local irratation systemic absorption-possible but not common w/ miotics(give at bedtime & hold pressure on lacrimal sac) |
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Miotic drug types?
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direct acting cholingergics-pilocarpine
carbachol physostigmine salicylate prostaglandin analog - iantanoprost |
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What is the antadote for pilocarpine?
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atropine
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Atropine is the antidote for what?
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Pilocarpine
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treatment of glaucoma is what?
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T o reduce IOP
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Drugs used to lower IOP
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Carbonic anhydrase inhibitors
Beta adrenergic osmotic agents adrenergic drugs |
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Carbonic anhydrase inhibitors do what?
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reduce the am't of aqueous humor produces and thereby lower IOP
EX:Diamoc Daranide Neptazane |
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Beta adrenergic blocking agents do what?
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Decrease the production of aqueous humor and thereby lower IOP
EX:Timoptic Betagan ocupress |
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Osmotic Agents
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increase plasma osmolarity and thereby lower IOP
ex:Glycerin anhydrous Isosorbide Mannitol |
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Adrenergic drugs?
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produce a vasoconstrictive effect, which decreases the production of aqueous humor
and decreases IOP *often give witha CAI agent EX: Propine & Epinal |
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Uses of drugs that lower IOP?
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* open & closed glaucoma
*before and after surgery |
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Side effects of the drugs that lower IOP are?
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*bradycardia
*headache *fatigue *stinging when giving it *fluid imbalance |
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Warning about CAI & osmotic drugs?
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They are diuretics and increase urine production. Monitor electrolyte levels and advise client ti sinstill early in the AM
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Nursing Implications:
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-beta blockers - monitor VS, especially for decreases in HR & BP
- teach how to administer and that stinging is not normal -client should not rub eyes |
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Common CAI drugs?
(carbonic anhydrase inhibitors) |
Diamoc
Daranide Neptazane |
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Common osmotic drugs
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Glycerin anhydrous
Isosorbide Mannitol |
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Common Beta blockers for the eye
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Timoptic
Betagan ocupress |
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Common Adrenergic drugs?
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Propine
Epinal |
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Mydriatics do what?
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Dilate the pupils
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Cyclopegics do what?
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paralyze the muscles of accommodation
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Mydriatics and Cycloplegics drugs:
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sympathomimetic
anticholinergic agents prostaglandin inhibitors adrenergic drugs alpha adrenergic blockers *both are used diagnostic procedures & surgery |
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Mydriatics and Cycloplegics side effects:
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local irratation
burning blurred near vision photophobia Systemic reactions- dry mucous membranes hypotension increase/decrease heart rate |
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Mydriatics & cycloplegics can contraindicate what?
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Closed-angle glaucoma
Some can increase IOP, causing ocular congestion |
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Nursing Implications for Mydriatics and Cycloplegics
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*Wear sunglasses until vision clears
*teach proper instillation *hold pressure on lacrimal sac |
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Atropine toxicity signs are:
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dry mouth
blurred vision photophobia fever tachycardia confusion coma Toxicity is treated with physostigmine |
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Common mydriatics & cycloplegics drugs
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*Sympathomimetic - epinepherine hydrochloride
*Anticholinergic - atropine sulfate *prostaglandin inhibitor - dicofenac *Adrenergic drugs - phenyephrine hydrochloride *Alpha adrenergic blocker drugs - dapiprazole hcl - counter acts dilation induced by the adrenergic drugs |
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Drugs for the ears
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antibacterials
antihistamines-decongestants ceruminolytics antiinflammatory agents |
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Antibacterials
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*inhibit or destroy gram- or gram+ microorganisms that cause the ear infection
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Antibacterial uses
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treat external auditory canal infections-otitis externa & midle ear infections - otitis media
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Antibacterial side effects
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Superinfections; hypersensitivity
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Common Antibacterial drugs
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topical - chloramphenicol, neosporin
oral - ampicillin, trimethoprim(septra) pcn, amox, ceclor |
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Antihistamines - decongestants
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*thought to reduce nasal & middle ear congestion in acute otitis medis
*reduction of the edema around the orifice of the Eustachian tube - promotes drainage of the middle ear |
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Types of antihistamines
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Actifed, allerest, dimetapp, ornade
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Common side effects
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drowsiness, dry mucous membranes
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Ceruminolytics
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*used to losen cerumen from teh ear canal
*cerumen is produced by glands in the outer half of the ear canal |
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Types of ceruminolytics
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hydrogen peroxide diluted with water
*chronic impact - 2 drops of olive oil or mineral oil softens the wax. Prescription cerumenex & OTC debrox cost more & dont work better |
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Antiinflammatory Agents for ear do?
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inhibit edema and fibrin deposition to decrease inflammation of the ear
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Antiinflammatory Agents Uses
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decrease inflammation in the external ear canal
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Side effects
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Mask underlying otic infections
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Common Antiinflammatory Agents
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dexamethasone sodium phosphate
(ak -dex) |
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Administrating Ear medications
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Adults-pull up & back
Under 3 - pull dwn and back stays there for 2-3 minutes *irrigation - need to be able to see the eardrum |
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Irrigation Solutions for ear
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burrows solution - 3% hydrogen peroxide and vinegar solution
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