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64 Cards in this Set

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Administration of eye drops
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
Topical Anesthetics
used in selected aspects of a comprehensive eye exam & in the removal of foreign body from eye
What are the common topical anesthetic drugs for the eye?
proparacaine HCL, tetracaine HCL
Corneal anesthesia
*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
Antiinfectives for eye infections
*interfere or destroy microorganisms that cause the following infections:staph, strep, pseudomonas
Antiinfective drugs for the eyes:
antibiotics, antifungals, antivirals
Conjunctivitis
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
Antiinfective drug types are:
bacitracin, gentamycin sulfate, tobramycn, anti fungal-natamycin, antiviral - trifluride
Antiinflammatories
Decrease edema, redness, scarring & exudates
uses; inflammatory disorders, hypersensitivity conditions
Common antiinflammatory drugs are?
Corticosteroids - maxidex, prednisolone sodium phosphate
non steriods - voltaren - short term use
Antiinflammatory side effects:eyes
increased 1OP, optic nerve damage, decreased visual acuity, cataracts
Dexamethosone
used for allergic conditions & inflammation of conjunctiva, cornea or lids
Flurbiprofen Na
to decrease corneal edema
Lubricants
used for dryness of the eye
*moistens contact lens
*maintain integrity of the epithelial surface
*used during surgery
*available OTC in liquid or ointment
Common Lubricant drugs:
isopto tears, tearisol, ultra tears

*be alert to allergic response to preservatives in lubricants
Glaucoma
open angel & Narrow angle
- a chronic, slowly proressive, usually bilateral disorder, associated with visual loss, eye pain, and optic nerve damage
Open angle glaucoma
Optic nerve damage often associated with elevated intraocular pressure
Closed angle glaucoma
occurs when elevated intraocular pressure is associated with closure of the filtration angle
Miotics
*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
Miotics are used for?
Treatment of glaucoma or esotropia(cross eye)
Miotics in open-angle glaucoma
they are used to lower the intraocular pressure, thereby increasing blood flow to the retina and decreasing retinal damage & loss of vision
Two types of Miotics?
direct acting cholinergics prostaglandin ananlog
Side effects of Miotics?
blurred vision
local irratation
systemic absorption-possible but not common w/ miotics(give at bedtime & hold pressure on lacrimal sac)
Miotic drug types?
direct acting cholingergics-pilocarpine
carbachol
physostigmine salicylate
prostaglandin analog - iantanoprost
What is the antadote for pilocarpine?
atropine
Atropine is the antidote for what?
Pilocarpine
treatment of glaucoma is what?
T o reduce IOP
Drugs used to lower IOP
Carbonic anhydrase inhibitors
Beta adrenergic
osmotic agents
adrenergic drugs
Carbonic anhydrase inhibitors do what?
reduce the am't of aqueous humor produces and thereby lower IOP
EX:Diamoc
Daranide
Neptazane
Beta adrenergic blocking agents do what?
Decrease the production of aqueous humor and thereby lower IOP
EX:Timoptic
Betagan
ocupress
Osmotic Agents
increase plasma osmolarity and thereby lower IOP
ex:Glycerin anhydrous
Isosorbide
Mannitol
Adrenergic drugs?
produce a vasoconstrictive effect, which decreases the production of aqueous humor
and decreases IOP
*often give witha CAI agent

EX: Propine & Epinal

Uses of drugs that lower IOP?
* open & closed glaucoma
*before and after surgery
Side effects of the drugs that lower IOP are?
*bradycardia
*headache
*fatigue
*stinging when giving it
*fluid imbalance
Warning about CAI & osmotic drugs?
They are diuretics and increase urine production. Monitor electrolyte levels and advise client ti sinstill early in the AM
Nursing Implications:
-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
Common CAI drugs?
(carbonic anhydrase inhibitors)
Diamoc
Daranide
Neptazane
Common osmotic drugs
Glycerin anhydrous
Isosorbide
Mannitol
Common Beta blockers for the eye
Timoptic
Betagan
ocupress
Common Adrenergic drugs?
Propine
Epinal
Mydriatics do what?
Dilate the pupils
Cyclopegics do what?
paralyze the muscles of accommodation
Mydriatics and Cycloplegics drugs:
sympathomimetic
anticholinergic agents
prostaglandin inhibitors
adrenergic drugs
alpha adrenergic blockers

*both are used diagnostic procedures & surgery
Mydriatics and Cycloplegics side effects:
local irratation
burning
blurred near vision
photophobia
Systemic reactions-
dry mucous membranes
hypotension
increase/decrease heart rate
Mydriatics & cycloplegics can contraindicate what?
Closed-angle glaucoma
Some can increase IOP, causing ocular congestion
Nursing Implications for Mydriatics and Cycloplegics
*Wear sunglasses until vision clears
*teach proper instillation
*hold pressure on lacrimal sac
Atropine toxicity signs are:
dry mouth
blurred vision
photophobia
fever
tachycardia
confusion
coma
Toxicity is treated with physostigmine
Common mydriatics & cycloplegics drugs
*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
Drugs for the ears
antibacterials
antihistamines-decongestants
ceruminolytics
antiinflammatory agents
Antibacterials
*inhibit or destroy gram- or gram+ microorganisms that cause the ear infection
Antibacterial uses
treat external auditory canal infections-otitis externa & midle ear infections - otitis media
Antibacterial side effects
Superinfections; hypersensitivity
Common Antibacterial drugs
topical - chloramphenicol, neosporin
oral - ampicillin, trimethoprim(septra)
pcn, amox, ceclor
Antihistamines - decongestants
*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
Types of antihistamines
Actifed, allerest, dimetapp, ornade
Common side effects
drowsiness, dry mucous membranes
Ceruminolytics
*used to losen cerumen from teh ear canal
*cerumen is produced by glands in the outer half of the ear canal
Types of ceruminolytics
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
Antiinflammatory Agents for ear do?
inhibit edema and fibrin deposition to decrease inflammation of the ear
Antiinflammatory Agents Uses
decrease inflammation in the external ear canal
Side effects
Mask underlying otic infections
Common Antiinflammatory Agents
dexamethasone sodium phosphate
(ak -dex)
Administrating Ear medications
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
Irrigation Solutions for ear
burrows solution - 3% hydrogen peroxide and vinegar solution