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161 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Fluorescein
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-diagnostic aid for corneal abrasions & foreign bodies in the eye (turns it bright green)
-water soluble dye |
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Proparacaine & Tetracaine
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-corneal anesthesia w/i 1 min.
-cannot be self-administered by client -causes loss of blink reflex & decreased eye moisture |
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conjunctivitis
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-pinkeye
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blepharitis
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-inflammation of eyelashes w/ red, pink drainage & crusting
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sty
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-very painful little cysts
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keratitis
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-overgrowth & scaling on the eyelid
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Lubricants are used...
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-PRN (as often as needed, no limit)
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Primary Open Angle Glaucoma
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-90% of glaucoma cases
-main cause is HTN -starts peripheral & progresses to center -no cure (slowing/stop progression is goal) -painless until optic nerve is damaged as a result of the pressure -leading cause of blindness in African Americans & 3rd leading cause in Caucasian Americans |
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Acute Angle-Closure Glaucoma
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-develops suddenly
-very painful -no cure (stop/slow progression is goal) -irreversible vision loss will occur in 1-2 days if untreated -TX is drug therapy to lower IOP & then surgery to open meshwork |
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First line glaucoma meds
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-Beta blockers
-Alpha 2 Adrenergic Agonists -Prostaglandin Analogs |
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2nd line glaucoma meds
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-cholinergic agonist
-carbonic anhydrase inhibitors -non-selective adrenergic agonists |
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Pilocarpine
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-cholinergic drug (2nd line)
-treats glaucoma (OA & AC) -decreases IOP by causing pupillary constriction |
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Miosis
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-pupillary constriction
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Betaxolol
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-beta adrenergic blockers
-decrease production of aqueous humor which lowers IOP -treats OA glaucoma |
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Timolol
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-beta adrenergic blockers
-decrease production of aqueous humor which lowers IOP -treats OA glaucoma (most common) |
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Acetazolamide
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-carbonic anhydrase inhibitor
-diuretic -long time treatment for open angle glaucoma -reduces aqueous humor formation |
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Mannitol
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-osmotic
-treats glaucoma -rapidly reduces IOP (used for acute glaucoma) |
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Mydriatics
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-dilate the pupil
-used for diagnostics & opthalmic surgery -anticholinergic |
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Cycloplegics
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--used for diagnostics & opthalmic surgery
-anticholinergic -paralyzes the muscles of accommodation |
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6 beta blockers currently in use for glaucoma
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-betaxolol
-levobetaxolol -carteolol -levobunolol -metipranolol -timolol *all are 1 drop BID (except levovunolol which depends on strength, can be just 1 drop daily) *all end in -olol |
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Prostaglandin Analogs & Glaucoma
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-decrease IOP by increasing outward flow by relaxing ciliary muscles
-1 dose daily |
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Side Effect of prostaglandin analogs
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-harmless brown discoloration of eyelid & iris
-blurred vision -stinging during administration |
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3 most common prostaglandin analogs for glaucoma
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-Latanoprost
-Travoprost (most effective in African Americans) -Bimatoprost *all end in -oprost |
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Apraclonidine (Lopidine)
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-alpha 2 adrenergic agonist
-short term therapy for OA glaucoma |
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Brimonidine (Alphagan)
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-alpha 2 adrenergic agonist
-long term therapy for OA glaucoma & ocular HTN |
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Alpha 2 Adrenergic Agonists & Glaucoma
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-reduce aqueous humor production
-improve outflow, delay optic nerve degeneration, & protects retinal neuron from ischemic death |
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Alpha 2 Agonists/Beta Blocker Combination Meds
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-treats glaucoma & occular HTN
-lowers IOP by decreasing amount of fluid & opening meshwork |
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Combigan
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-Alpha 2 Agonists/Beta Blocker Combination
-Bromonidine/Timolol combination -treats Glaucoma and Ocular Hypertension -Lowers IOP by decreasing amount of fluid & opening meshwork (like a combination) -1 drop BID (12 hours apart) |
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Cholinergic Agonists & Glaucoma
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-reduce IOP indirectly by contracting the iris sphincter & ciliary muscle
- |
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Pilocarpine administration for AC glaucoma
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-1 drop every 5-10min; then 1 drop every 1-3hrs
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Pilocarpine administration for OA glaucoma
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-1 drop 4X daily
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Echothiophate (Phopholine Iodide)
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-only indirect acting cholinergic agonist/cholinesterase inhibitor for glaucoma
-inhibits breakdown of acetylcholine which produces miosis by contracting the iris sphincter which indirectly reduces IOP in OA glaucoma -administered to the conjunctival sac daily, BID, or every other day (depends on severity) |
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Dipivefrin
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-adrenergic agonist
-converts to epi in the body (caused by ocular enzymes) -treats OA glaucoma -reduces IOP by increasing outflow of aqueous humor |
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Side effects of Dipivefrin
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-headache
-browache -impaired/blurred vision -occular irritation |
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Carbonic anyhydrase inhibitors & glaucoma
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-reduce IOP by reducing aqueous humor production
-topical & systemic (all end in -lamide) |
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Dorzolamide & Brinzolamide
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-topical carbonic anhydrase inhibitors
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Acetazolamide & Methazolamide
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-systemic carbonic anhydrase inbhibitors
-Reduces IOP by reducing production of aqueous humor |
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Atropine
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-muscarinic antagonist commonly used for mydriasis & cycloplegia
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A corneal ulcer is usually treated w/...
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antibiotics (bc main risk is infection)
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Allergic Conjunctivitis
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-inflammation of the conjunctiva in response to allergen
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Mast Cell Stabilizers
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-take days to weeks to be beneficial
-treats allergic conjunctivitis |
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Histamine Receptor Antagonist
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-immediate relief
-antihistamine -treats allergic conjunctivitis -Emedastine |
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Ocular Decongestants
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-treats allergic conjunctivitis
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Gluccocorticoids
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-inhibits the release of prostaglandins but increases risk of infection
-treats allergic conjunctivitis & other inflammatory disorders of the eye |
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Gluccocorticoids increase the risk for...
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infections (must warn pts of this)
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NSAIDS
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-nonsteroidal anti-inflammatory drugs
-treats allergic conjunctivitis -Ketamiac |
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Decongestant/H1 Blocker
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-treats allergic conjunctivitis
-decreases redness & edema -Naphazoline |
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Age-Related Macular Degeneration (ARMD)
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-painless, progressive disease that blurs central vision & limits perception of detail
-leading cause of blindness in older Americans -starts central & goes peripheral -can't see details -management depends on type (dry vs. wet) |
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Dry ARMD
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-atrophic ARMD
-85% of cases |
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Wet ARMD
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-neovascular ARMD
-15% of cases |
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Management of dry ARMD
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-high dose of antioxidants & zinc (reduce risk of advancement)
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Management of wet ARMD
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-laser therapy
-photodynamic therapy -angiogenesis inhibitors -Pegaptanib, Ranibizumab , & Bevacizumab |
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Bevacizumab (Avastin)
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-angiogensis inhibitor
-cheapest management for wet ARMD |
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What type of pink eye is more contagious?
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-viral (clear drainage)
*bacterial drainage is green |
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4 drugs that treat viral infections of the eye (conjunctivitis)
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-Trifluridine (Viroptic)
-Vidarabine (Vira-A) -Ganciclovir (Cytovene) -Idoxuridine (Opthalmic route) |
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All eye disorders carry the possibility of...
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blindness
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Acute Otitis Media
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-ear infection
-doesn't always need meds (reverses on own) -inflammation & fluid in middle ear -S/S=fever, vomiting, irritability, sleeplessness, purulent drainage |
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Recurrent Otitis Media
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-occurs 3+ in 6 months or 4+ in 12 months
-debate between prophylactic antibiotics effectiveness |
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Otitis Media w/ Effusion
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-occurs after ear infection
-fluid still present that may cause hearing los but will eventually go away -no meds needs -may persist for weeks or months |
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Otitis Externa
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-swimmer's ear
-bacterial infection that must be treated w/ antibiotics |
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Treatment for Acute Otitis Media
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-pain meds (acetaminophene, ibuprofen, & codiene)
-antibiotics only if clearly indicated (amoxicillin) |
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Treatment for Recurrent Otitis Media
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-no putting to bed w/ bottle
-quit smoking -short term antibiotics (amoxicillin) -influenza vaccines & treatment -typanostomy tubes *sometimes prophylactic antibiotic therapy (debated) |
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Tympanostomy Tubes
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-treats recurrent otitis media
-facilitates drainage & aeration of middle ear -children outgrow them & they fall out |
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Otitis Media w/ Effusion treatment
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-none
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Ofloxacin (Floxin Otic)
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-treats acute otitis externa & necrotizing otitis externa
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Acute Otitis Externa treatment
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-Topical antimicrobals
-Fluroquinolones (Ciprofloxacin plus hydrocortisone (Cipro HC), Ciprofloxacin plus dexamethasone (Ciprodex), Ofloxacin (Floxin Otic)) -keep ear clean & dry (very important) |
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Treatment for Necrotizing Otitis Externa
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-Ofloxacin (Floxin Otic)
-Ciprofloxacin (Cipro)-oral therapy -Imipenem/cilastatin (Primaxin)-IV therapy (indicated for severe cases) -Meropenem (Merrem IV) indicated for severe cases -Ciprofloxacin (Cipro IV) indicated for severe cases |
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Ciprofloxacin plus hydrocortisone (Cipro HC) &
Ciprofloxacin plus dexamethasone (Ciprodex) |
-treatment for acute OE
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Acute OE cause
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-Pseudomonas aeruginosa
-Staphylococcus aureus |
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Nectrotizing OE cause
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-Pseudomonas aeruginosa
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Ciprofloxacin (Cipro)
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-oral therapy for necrotizing OE
-IV for severe cases |
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Imipenem/cilastatin (Primaxin)
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-IV for severe cases of necrotizing OE
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Meropenem (Merrem)
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-IV for severe cases of necrotizing OE
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Fungal OE (Otomycosis) cause
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-aspergillus (80-90%)
-candida |
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Treatment for fungal OE
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-acidifying drops (2% actic acid solution 3-4 times /day for 7 day)
-antifungal drops (1% clotrimazole (Lotrimin) BID for 7 days; Itraconazole (Sporanox) & Fluconazole (Diflucan)) *all end in -azole |
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Only type of ear infection we use drops for
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-fungal otitis externa (otomycosis)
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Clotrimazole (Lotrimin)
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-treats fungal OE
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Fluconazole (Diflucan)
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-treats fungal OE
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Clotrimazole (Lotrimin)
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-treats fungal OE
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Itraconazole (Sporanox)
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-treats fungal OE
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Antihistamines & Decongestants & the Ear
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-reduce nasal & middle ear congestion for otitis media
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Fluconazole (Diflucan)
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-treats fungal OE
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ceruminolytics
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-loosen/remove ear wax
-includes hydrogen peroxide irrigation, olive oil/miner oil |
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Itraconazole (Sporanox)
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-treats fungal OE
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Cerumenex
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-prescription ceruminolytic
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Antihistamines & Decongestants & the Ear
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-reduce nasal & middle ear congestion for otitis media
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Debrox
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-OTC ceruminolytic
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ceruminolytics
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-loosen/remove ear wax
-includes hydrogen peroxide irrigation, olive oil/mineral oil |
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Infant med that can be used for ear infections
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-Colas drops (infant constipation drops)
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Cerumenex
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-prescription ceruminolytic
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Covina often causes...
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-major upset stomach
*fixed by decreases clonivate & increasing amoxicillin |
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Debrox
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-OTC ceruminolytic
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Chickenpox
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-vesicular rash that itches
-herpes zoster |
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Infant med that can be used for ear infections
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-Colas drops (infant constipation drops)
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Covina often causes...
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-major upset stomach
*fixed by decreases clonivate & increasing amoxicillin |
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Chickenpox
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-vesicular rash that itches
-herpes zoster |
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Shingles
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-flat rash in a long line that follows a nerve
-very painful -herpes zoster |
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Tinea captitis (ringworm)
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-can get them anywhere (soil dogs, etc)
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impetigo
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-bacterial infection that itches & looks like scabies
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contact dermatitis
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-skin erruption w/ wheels & hives
-itching, swelling, blistering, oozing, scaling -chemical/plant irritation (poison ivy, oak, perfumes, clothing, latex) |
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Topical glucocorticoids
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-relieve inflammation & itching
-treats insect bites, minor burns, seborrheic dermatitis, psoriasis, & eczema -topical antipsoriasis med (short term bc of risk of infection) |
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Salicylic acid
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-dandruff treatment @ low concentration (3-6%)
-removes warts & corns @ high concentration (up to 40%) |
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Sulfur
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-treats acne, dandruff, psoriasis, & Seborheic dermatitis
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High zinc content may cause...
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immunosuppression
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Sunscreens are now based off of what?
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UVA & UVB ratings
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UVB
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-cannot penetrate glass
-based on 4 star ratings |
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UVA
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-can penetrate glass
-based off low (2-14), medium (15-29), high (96.7), & highest (>96.7) |
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UV radiation can cause
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-burns
-premature aging -skin cancer -immunosuppresion -interactions w/ drugs |
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Accutane
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-acne drug that is very photosensitive
-derived from Vitamin A -Pregnancy Category X -iPLEDGE program (30 day supply, preg. test & proof of birth control) -liver & kidney function must be monitored -mood disorders *discontinued except for extreme cases |
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acne vulgaris
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-most common skin disorder in US
-85% of teens affected -papules, nodules, cysts |
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Benzoyl peroxide
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-topical antiacne med
-loosens outer layer of epidermis |
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Tretinoin (Retin-A)
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-topical antiacne med
-alters keratinization -derived from Vitamin A -causes skin slothing |
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_____ may be added as part of treatment regimen for acute breakouts & problems areas (acne)
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-topical antibiotics
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Tetracyclines
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-systemic antiacne med
-causes photosensitivity (caution, sunscreen 30 min before sun exposure) |
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Erythromycin
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-systemic antiacne med
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Psoriasis
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-chronic skin disorer
-erythematous papules & plaques w/ silvery scales -usually on scalp, elbows, palms, knees, soles of feet -no cure (may fade though) -can start as injury & become a systemic reaction |
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Calcipotriene (Dovonex)
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-topical antipsoriasis med
-very expensive -results in 1-2 months -vitamin D analog |
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Anthralin (Anthre-Derm)
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-causes erythema
-topical antipsoriasis -stains clothing, skin, & hair (tell pt to make sure fully dry before putting on clothes, etc) |
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Estar & PsoriGel
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-coal tar derivaties that are antipsoriaisis meds
-topical forms include shampoo, lotions, & creams |
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Methotrexate (Rheumatrex)
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-systemic antipsoriasis med
-antineoplastic drug (slows high growth fraction of cells) |
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Many antipsoriasis meds are also used to treat...
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rheumatoid arthritis
*Amevive, Raptiva, Enbrel, & Remicade (biological therapies for psoriasis) |
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Calamine
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-treats contact dermatitis
-contains zinc oxide |
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Burrow's solution
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-treats contact dermatitis
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Diphenhydramine (Bendaryl)
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-PO or topical treatment for contact dermatitis
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Dexamethasone (Decadron)
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-topical treatment for contact dermatitis
-hydrocortisone cream |
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Minoxidil (Rogaine)
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-treats baldness
-2% (women & men) -5% (only men) -when drug discontinued hair loss occurs w/i 3-4 months -causes vasodilation which increases cutaneous blood flow & stimulates hair follicle growth -systemic absorption minimal |
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Treatment for 1st degree burns
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-cold, wet compress
-antibacterial ointment (Bacitracin w/ polymixin B <Polysporin>) bc skin integrity is compromised |
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Treatment for 2nd & 3rd degree burns
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-burn center & IV therapy
-always give pain meds before debriment (narcs & non narcs) - |
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Clean 2nd & 3rd degree burns w/...
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betadine
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Silvadene
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- topical antibiotic treatment mainly for 2nd degree burns (but may be 3rd degree also)
-contains silver nitrate -may cause bluish grey/brown discoloration of skin (inform pt of this) |
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Sulfamylon
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-topical antibiotic treatment for 2nd & 3rd degree burns
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Nursing considerations for burns
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-INFECTION
-oozing culture (esp. if green) -vitals -fluid status -pain control (esp. before debridement & topical antibiotics) |
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Prostacyclin Analogs
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-treats PAH (improves short-term survival)
-Epoprostenol (Flolan): Approved in 1995 -Trepostinil (Remodulin): Approved in 2002 -Iloprost (Ventavis): Approved in 2004 -decrease pulmonary pressure & resistance -increase exercise tolerance |
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Endothlin-1 Receptor Antagonists
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-treats PAH (delays symptom progression)
-improves exercise tolerance -Bosentan (Tracleer)- Approved in 2001 -Ambrisentan (Letairis)-Approved in 2007 *all end in -sentan |
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Sildenafil (Revatio)
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-treats PAH & pulmonary HTN
-enhances vasodilation -decreases pulmonary arterial pressure, resistance, & proliferation of pulmonary vascular smooth muscle cells -usually IV -same as viagra |
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Sepsis
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-severe life threatening condition triggered by systemic microbial infection
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Activated Drotrecogin Alfa (Xigris)
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-treats sepsis in critical care settings
-IV -anticoagulant & antiinflammatory actions (must monitor bleeding) |
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Adverse effects of Xigris
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Bleeding (must monitor bleeding)
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Neonatal Respiratory Distress Syndrome
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-primary cause of morbidity & mortality in premature infants
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Lung Surfactant
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-treatment for Neonatal Resp. Distress Syndrome
-direct intratracheal administration -lowers surface tension forces that cause alveolar collapse |
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Poractant alfa (Curosurf),
Calfactant (Infasurf), & Beractant (Survanta) |
-lung surfactant med for neonatal resp. distress syndrome
*all end in -actant |
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Dexamethasone & Betamethasone
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-accelerates fetal lung maturation
-prenatal & postnatal glucocorticoids |
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Cystic Fibrosis (CF)
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-damages the lungs, pancreas, & other organs
-no cure (earlier treatment can prolong benefits though) |
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Nutritional drug therapies for CF
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-pancreatic enzymes (lipase, protease, & amylase)
-fat-soluble vitamins (A, E, D, & K) |
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Tobramycin
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-inhalation CF med
-suppresses chronic infections w/ P. aeruginosa |
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Dornase Alfa (Pulmozume)
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-inhalation CF med
-decreases viscosity of sputum |
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Oral Ibuprofen
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-slows progression of pulmonary damage in pts w/ mild lung disease caused by CF
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Salmeterol (Serevent Diskus)
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-Beta 2-Adrenergic Agonists
-improves lung function during CF |
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Sickle Cell Anemia
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-inherited blood disorder w/ abnormal hemoglobin, chronic anemia, & painful episodes
-reduced life expectancy |
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Pain w/ sickle cell anemia is caused by...
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-sickles literally scraping the vessels
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Methylprednisolone (Medrol)
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-glucocorticoid that can shorten the duration of sickle cell crisis
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Hydroxyurea (Droxia, Hydrea)
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-reduces # of sickle cell pain crisis
-only approved for use in adults |
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Hyperuricemia
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-elevation of uric acid levels
-common consequence of cancer chemotherapy |
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Rasburicase (Elitek)
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-treats hyperuricemia
-accelerates uric acid removal in GOUT pts |
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Allopurinol (Zyloprim)
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-treats hyperuricemia
-blocks uric acid production in GOUT pts |
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Gamma-Hydroxybutyrate
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-ONLY drug treatment for cataplexy in narcolepsy (very good tx for narcolepsy)
-reduces cataplexy & daytime sleepiness -improves night time sleep quality, |
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Riluzole (Rilutek)
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-ONLY drug for ALS
-prolongs life -delays need for tracheostomy (up to 6 months) |
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Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s
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-neuromuscular disorder characterized by progressive muscle wasting & loss of strength
-ascending (from lower to upper) -eventually causes paralysis of diaphragm & respiratory distress (ventilation) -no cure -die in 3-5yrs of diagnosis |
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hyperphosphatemia
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-common complication of end stage renal disease
-dialysis -TX: reduce phosphate intake in diet, remove phosphate w/ hemodialysis, & reduce intestinal absorption of phosphate using phosphate binding drugs |
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Calcium carbonate (Os-Cal 500; Caltrate-600) & Calcium acetate (Phoslo)
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-calcium based phosphate binding drugs that treat hyperphophatemia
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Sevelamer carbonate (Renvela), Sevelamer hydrochloride (Renagel), & Lanthanum carbonate (Fosrenol)
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-Calcium free phosphate binders (very expensive)
-treat hyperphosphatemia |
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