Drugs for eyes and otitis media Glaucoma- Visual field loss secondary to optic nerve damage Leading cause of preventable blindness 2 forms: ● Primary open-angle glaucoma (POAG) ● Acute angle-closure glaucoma Primary open-angle glaucoma (POAG) Progressive optic nerve damage Most common form of glaucoma No s/s until significant irreversible optic nerve damage has occured Risks: elevation of IOP African/south american ancestry Tx: drugs that lower IOP → gets aqueous humor fluid ( clear fluid filling the space in the front of the eyeball between the lens and the cornea) out of eye and reduces production of aqueous humor fluid. Prefered to be given topical (eye drops) Combined drug therapy better than monotherapy Surgery if meds dont work First Line drugs: Beta-adrenergic blocking agents → Timolol Alpha 2 -adrenergic agonists → Brimonidine [Alphagan] Prostaglandin analogs → Latanoprost [Xalatan] Angle-Closure Glaucoma (narrow-angle glaucoma) Caused by displacement of the iris which prevents exit of aqueous humor fluid Develops suddenly and extremely painful No tx, irreversible vision loss in 1-2 days Less common than POAG
Drugs for Glaucoma Beta blockers Timolol (Timoptic), levobunolol (betagan)- decrease IOP by decreasing the amount of aqueous humor produced S/E: systemic effects monitoring (pulse) Nursing care: hold gentle pressure on the nasolacrimal duct for 30 to 60 seconds immediately after instilling the drops Prostaglandin analogs Latanoprost, Travoprost (travatan)--- increase aqueous humor outflow through the relaxation of ciliary muscle Use for pts who could not tolerate or respond to other IOP lowering drugs S/E: brown pigmentation of iris, eyelid skin darkening, changes in eyelashes Alpha2 agonist Brimonidine → decrease aqueous humor production by possibly increasing aqueous humor outflow Pilocarpine : second line drug → causes miosis (pupil constriction) and decrease IOP Action: direct-acting muscarinic agonist by stimulating cholinergic receptors in the eye to cause miosis and contraction of the ciliary muscle A/R: blurred or poor vision, photophobia Mydriatic and Cycloplegic Mydriatics cause pupil dilation, cycloplegics paralyze the iris sphincter Action: anticholinergic action leaves the pupil under unopposed adrenergic influence, causing it to dilate Indication : diagnosis Medications : atropine, cyclopentolate ADR: blurred vision, photophobia, tachycardia, dry mouth et al ■ Mydriatic: phenylephrine---do not cause cycloplegia Otitis Media Ear infection Tx: Antibiotics Nursing care:
Warm medication by gently rolling container between hands. Cold drops might cause dizziness. Gently shake suspensions. Pt. should sleep with affected ear upward. Keep pt. Side-lying for 5 min with affected ear up after installing drops and place small piece of cotton in ear loosely A patient is admitted to the hospital for treatment of symptomatic bradycardia and atrioventricular (AV) heart block. Which topical medication for the eye should the nurse withhold and discuss with the healthcare provider before administration?
- Spring '14
- Cell Cycle, Chemotherapy