11/24/14 1 KARLEEN MELODY, PHARMD, BCACP OPHTHALMIC AND OTIC DISORDERS OBJECTIVES • Differentiate ophthalmic and otic disorders based on signs and symptoms • Establish if a patient presenting with an ophthalmic or otic disorder is appropriate for self-care • Given a patient case recommend appropriate non- pharmacologic and pharmacologic treatment for ophthalmic and otic disorders • Provide counseling points on pharmacologic treatment options for ophthalmic and otic disorders including administration OPHTHALMIC DISORDERS
11/24/14 2 ANATOMY • External location • Susceptible to contamination • Natural Defenses • Eyelid • Removes debris • Produce and spread tears • Tears • Lubrication • Removes debris • Antimicrobial action ANATOMY ___________- responsible for most of drug absorption; damage can increase absorption rates (contact wear, trauma, topical anesthetics, UV light) ___________- maintains normal intraocular pressure (IOP) ___________- produces aqueous humor and focuses lens; part of tract which drains aqueous humor; ___________- colored portion of eye regulates amount of light entering eye; Pupil- opening in iris ___________- filled with vitreous humor; “Floaters” are deposits in vitreous humor (no self treatment) ___________- processing and transmitting light; detachment can cause vision loss
11/24/14 3 EXCLUSIONS FOR SELF-TREATMENT OF OPHTHALMIC • Eye pain • Blurred vision • Sensitivity to light • Contact lenses • Blunt trauma • Chemical exposure • Eye exposure to heat, excluding sun exposure • Symptoms lasting more than ______ hours with treatment DRY EYE • Pathophysiology • Aging • Anatomical defects • Disease • Medications • Environmental • Clinical Presentation • White or mildly red eye • Sandy gritty feeling • May present with excessive tearing TREATMENT OF DRY EYE Non-Pharmacological •Avoid dry environmental conditions •Avoid long periods viewing a computer screen •Eye protection •Humidifiers Pharmacological •Ocular lubricants •Increasing viscosity results in prolonged contact time •Artificial tears •Non-medicated ophthalmic ointments
11/24/14 4 ARTIFICIAL TEARS • Mechanism of action • Stabilize tear film, protect the corneal and conjunctival cells, prevent tear evaporation, enhance healing and lubrication • Formulations typically contain • Preservatives • Inorganic electrolytes • Water-soluble polymeric systems ARTIFICIAL TEARS • Vehicle/Lubricants • Cellulose ethers • Hydroxypropyl methylcellulose • Carboxymethylcellulose (CMC) • Povidone • Polyvinyl alcohol (PVA) ARTIFICIAL TEARS •1-2 drops BID typically •Can increase to QID dosing; hourly in severe cases Directions •Preservatives •Toxicity •Interactions with other drops Safety considerations
11/24/14 5 NON-MEDICATED OPHTHALMIC OINTMENTS • Mechanism of action • Enhanced retention time and stabilize tear film White petrolatum •Lubricant and ointment base Mineral oil •Helps ointment melt at room temp Lanolin •Facilitates the incorporation of
You've reached the end of your free preview.
Want to read all 23 pages?
- Fall '14
- clinical presentation, • Eye exposure, • Eye pain, artificial tears