Eyes, Ears, And Skin Drugs

Front 1

Glaucoma

Back 1

Loss of vision due to optic nerve damage


-Leading cause of preventable blindness

Front 2

2 types of glaucoma:

Back 2

Open angle
Closed angle

Front 3

Open angle glaucoma:

Back 3

Angle that allows fluid to drain out of the anterior chamber is open, but for whatever reason the fluid passes too slowly and the fluid builds up, and the pressure inside the eye increases.

Front 4

Pressure in the front of the eye:

(Glaucoma)

Back 4

If it is NOT controlled, there will be damage to the optic nerve, CAUSING VISION LOSS

Front 5

Need regular eye exams

Back 5

Because glaucoma can happen without any symptoms

Front 6

2 mechanisms to treat glaucoma with drugs;

Back 6

-Reducing production of aqueous humor
-Assisting outflow of aqueous humor

Front 7

Even though the medications are ___________, they can cause systemic effects

Back 7

Local eye drops

Front 8

Beta Blockers for Glaucoma: Timolol

Back 8

-Reduce PRODUCTION of aqueous humor
-non-selective, block beta1 and beta 2 in lungs (not good for people with asthma)

Front 9

Adverse effects of beta blockers for

Back 9

-Local: stinging, blurred vision, dry eyes
-Systemic: bradycardia, AV heart block, bronchoconstriction. careful for people with CHF and asthma

Front 10

Alpha2 adrenergic agonists for glaucoma (Brimonidine, Alphagan)

Back 10

-Reduces PRODUCTION of aqueous humor by agonizing alpha2 adrenergic receptors in the eye

Front 11

Adverse effects of Brimonidine

Back 11

Local: burning/stinging, dry mouth, itching
Systemic: can cross BBB which will decrease outflow to blood vessels

Can get onto contacts, let dry (evaporate) for 15 minutes before putting on contacts

Front 12

Prostoglandin Analogs for Glaucoma treatment

Back 12

Latanoprost (Xalatan)

Assists the outflow of aqueous humor by relaxing the ciliary muscle, which increases outflow of aqueous humor and decreases IOP

Front 13

A/E of Latanoprost

Back 13

Browning of the iris/eyelid/eyelashes (irreversible)

Little systemic effects

Front 14

Cholinergics for glaucoma treatment

Back 14

Pilocarpine

Assists the outflow of aqueous humor by widening the space where the aqueous humor drains to decrease IOP

Front 15

A/E of Pilocarpine

Back 15

-Effects can be systemic, avoid in asthmatics

-retinal detachment, decreased visual acuity (decreased near vision)
-Bradycardia, bronchospasm, hypotension, urinary urgency, diarrhea

Front 16

Reversal drug for Pilocarpine (cholinergic) would be:

Back 16

Anticholinergic drugs
(i.e. Atropine)

Front 17

ANS drugs can cause __________ of glaucoma

Back 17

WORSENING because they increase IOP

Front 18

Anything that __________ the eye causes an increase of IOP

Back 18

Dilates the eye, anything for an eye exam, i.e. Atropine

Front 19

How to administer eye medications:

Back 19

-Wash hands
-Patient should lean head back or be lying down flat if someone else is applying the med
-clean/gloved finger is used to pull down the the lower lid
-Drop eye drops in the lower lid pocket, NOT DIRECTLY ONTO THE EYE
-ointment applied in a small strip in the pocket
-blinking distributes the med over the eye

Front 20

Conjuntivitis

Back 20

-A seasonal allergic reaction
-A secondary infection, in this case it is HIGHLY contagious

Front 21

Treatment of Conjunctivitis

Back 21

Antihistamine drops for immediate but temporary relief
NSAIDs for anti-inflammatory properties

Front 22

Long term A/E of OTC decongestant medications for conjunctivitis:

Back 22

-Cataracts
-Glaucoma
-Eye infection
-Rebound congestion if med is discontinued

Front 23

Eye exam drugs:

Back 23

Mydriatics (to dilate the pupil)
Cycloplegics (to paralyze the ciliary muscle so the eye cannot respond to light)

Front 24

Atropine for eye exams, plus s/e

Back 24

Anticholinergic, dilates the pupil

A/E are blurred vision (concerned for safety), photophobia (sunglasses), may have systemic effects

Front 25

Adrenergic Alpha1 agonists for eye exams, plus s/e

Back 25

Phenylephrine. activates alpha1 receptors on the eye causing mydriasis

s/e include occular pain, acute IOP, systemic (rare): HTN, MI, sweating, blanching, confusion

Front 26

Otitis Media

Back 26

Inflammation of the middle ear
Painful, common in peds
Can be chronic, recurring, damaging to hearing
80% resolve on their own in 7-10 days
If child is <6 months, give antibiotics

Front 27

Antibiotics for AOM

Back 27

Amoxicillin (given with clavulanate because of resistance)

Axithromycin if severe penicillin allergy

Front 28

Pain meds for OM

Back 28

Acetaminophen
NSAIDs
things with anti-inflammatory properties

Front 29

Ways to prevent AOM

Back 29

Smoke-free house
Everyone in the house getting a flu shot
Eliminate pacifier use after 6 months of age
No bottles in bed unless its just water
Decrease use of tympanostomy for fluid drainage

Front 30

Otitis externa

Back 30

"swimmer's ear"
Infection of the external ear cannal

Front 31

Treatment of otitis externa

Back 31

-Topical drops, 2% alcohol and acetic acid to dry infection and lower pH
-Antibiotics: ciprofloxacin if 18+, cephalexin if <18

Front 32

How to administer Ear medications

Back 32

Wash hands
WARM THE SOLUTION
tug pinna to straighten canal (adults up and out, children back and down)
instil while the patient is lying down ON THEIR SIDE
patient should stay there for 30-60 seconds, can massage med in

Front 33

Glucocorticoids for anti-inflammation of the skin: what they treat

Back 33

Dermatitis
Psoriasis
Eczema
Bites

Front 34

A/E of glucocorticoids as a skin drug

Back 34

Thinning of skin, irritation, acne

Front 35

Administration of glucocorticoids as a skin drug;

Back 35

Clean hands
Apply a THIN layer only
Occlusive drug: only if advised

Front 36

Acne: hygiene and diet

Back 36

Gently clean acne areas 2-3 times/day to decrease skin oils
Avoid oil-based moisturizers
Dietary changes apparently do not help

Front 37

Acne: drug treatment:

Back 37

Topical:
Antibiotics
Retinoids

Oral:
Antibiotics
Retinoids
Hormones

Other:
Laser, dermabrasion, invasive removal, surgery to repair scarring

Front 38

Benzoyl Peroxide in lotions/creams as OTC acne med

Back 38

-Works by changing pH to make it more acidic, reduces inflammation, encourages peeling of the epidermis

Front 39

Nursing teaching using Benzoyl Peroxide

Back 39

Advise to start with a lower concentration and then advance as skin begins to tolerate it
1X/day initially, advise as tolerated
Do not use on inflamed skin
Avoid eyes/mouth
Potential for allergic reaction

Front 40

Oral drugs for acne

Back 40

Antibiotics: Retin-A, Vibramicin. Use for as short amount of time as possible.

Front 41

Accutane:

Back 41

Treatment of severe acne
Use for a single course, 15-20 weeks in duration
Drug of last choice because of serious teratogenicity (Category X)
Must sign iPLEDGE, use 2 forms of birth control, get pregnancy tests

Front 42

Accutane a/e:

Back 42

Nosebleeds
Inflammation of the lips/eyes/nose/skin
Back pain
Hair loss
Loss of skin from palmar surfaces
May stop long bone growth in teens
Sun sensitivity: wear extra sunscreen
Triglyceride level may rise
Rare but significant: depression, vision or hearing loss

Front 43

Hormones for acne:

Back 43

Three combination OC:
Ortho Tri-Cyclen
Yaz
Estrostep

Front 44

Sunscreens:

Back 44

protect from UVA and UVB, SPF only tells you amount of protection from UVB

Front 45

Melanoma ABCD:

Back 45

Asymmetry
Border irregularity
Color variation
Diameter>6mm, bigger than eraser on a pencil

Front 46

Physical sunscreens contain;

Back 46

Zinc Oxide

Front 47

Organic sunscreens contain:

Back 47

mixture of compounds to protect against full range of UVA and UVB

Front 48

PABA

Back 48

A preservative in sunscreen that people can be allergic to

Front 49

Psoriasis:

Back 49

Red, scaly skin patches
appears in older adulthood, NOT contagious
Due to excessive activity of T lymphocytes, and accelerated growth of keratin cells
Chronic, unpredictable growth
Quality of life may be affected
Can be triggered by stress
No sure, only palliative treatments

Front 50

Treatment of psoriasis:

Back 50

Topical:
Glucocorticoids but NOT to the face, groin, axillary
Vits D and A
Salycyic acid

Systemic:
Methotraxate (only for severe cases0

Phototherapy:
use with caution because it increases the risk of skin cancer