Pharm Chapter 42: Drugs Used to Treat Glaucoma and Other Eye Disorders

Corticosteroids

Dexamethasone -Maxidex Loteprednol- lotemax Prednisone - Pre Mild Used for allergic reaction of the eye and non- infectious inflammatory conditions; conjunctiva, sclera, cornea and anterior uveal tract

The nurse is preparing a patient for an ophthalmic examination. Which action occurs when the nurse instills eyedrops to produce mydriasis?

Extreme dilation of the pupil

Diagnostic agents

Fluorescein Used in finding hard contact lenses and aid in identifying foreign bodies in the eye and cornea abrasions

Anti-inflammatory agents

Flurbiprofen sodiume Ketorolac tromethamine Bromfenac Nepafenac Diclofenac Sodium Fenac & Ketorlac

nonsteroidal anti-inflammatory drugs (NSAIDs)

Gray

Miotics therapeutic class

Green

Acute closed-angle glaucoma requires

Immediate treatment to refuce IOP

IOP build up and is not treated can cause what?

Loss of vision

Vascular endothelial growth factor (VEGF)

Macular degeneration Pegaptanib- Macugen Aflibercept - eylea Broblucizumab-Beovu

Antifungal agents

Natacyn (natamycin) is used to treat fungal infections of the eye, such as blepharitis, conjunctivitis, and keratitis. Yeast Sensitivity to bright light

Rho kinase inhibitors

Netarsudil (Rhopressa) Action - decrease IOP by increasing trabecular mesh work overflow

wet macular degeneration

New blood vessels growing beneath the retina leak blood and fluid, damaging the retinal cells. These small hemorrhages usually result in rapid and severe vision loss.

Anticholinergics agents

Producing mydriasis (extreme dilation of pupils) and cycloplegia( paralysis Medication safety alert- can cause increase IOP with pt with narrow anterior chamber angle: in infants, children & older adults and in pt with HTN, hyperthyroidism and DM. Sensitivity to light

Mydriatic and cycloplegics therapeutic class

Red

antibiotics

Azithromycin- AzaSite Bacitracin Ciprofloxacin- ciloxan Erythromycin Ofloxacin- Ocuflox Tobramycin- Tobrex Used to treat superficial eye infection or prophylaxis against gonarrhea in newborns

dry macular degeneration

Age and thinning of the tissue caused by the slow deterioration of the cells of the macula

Alpha Adrenergic agent

Apraclonidine -Lopidine Brimonidine- Alphagan P Phyenylephrine- Altafrin ( dilation in uveitis, open angle glaucoma) Tetrahydrozline- Visine ( reduce redness)

Acute closed-angle glaucoma occurs when

A sudden increase in IOP caused by mechanical obstruction of the trabecular in the iridocorneal angle It occur on pt who have narrow anterior chamber angle

Antihistamines

Alcaftadine Azelastine Bepotastine Cetirzine Emedastine Epinastine Ketotifen Olopatadine Ine and en- antihistamine

Anticholinergics agents

Antropine sulfate - Isopto-Atropine( don't use on infants) Cyclopentolate- Cyclogyl Homatropine hydrobromide- homatropaire Topicamide- Mydriacyl ( CNS disturbance hallucinations, LOC

antiviral agents

Acyclovir- Avaclyr Ganciclovir- Zirgan Clovir- anti viral Action- inhibiting viral replication Used- herpetic keratitis chlamydia Don't use more 7 to 14 days, if used 21 days of cont treatment potential toxicity

Carbonic Anhydrase Inhibitors

Acetazolamide (diamox), brinzolamide (azopt), dorzolamide (trusopt) Lamide- opt

Carbonic Anhydrase Inhibitors

Action- inhibits of enzyme, result in a decreasing in the production of aqueous humor decreasing IOP Used- in conjunction with other control IOP in intracular HTN, closed angle and open angle glaucoma

Alpha Adrenergic agent

Action- pupil dilation increase outflow of aqueous humor, basal construction, relaxation of ciliary muscle (open up pupils) Used- to lower IOP in open angle glaucoma

Beta-adrenergic blocking agents

Actions Used in ophthalmology to reduce elevated IOP, exact mechanism unknown Used- to reduce IOP in pt with chronic open angle glaucoma or ocular HTN

Bets adrenergic blocking agents

Betaxolol - Betoptics ( weeks of treatment to get effects of dose) Timolol- Timoptic ( onset with in 30 mins)

Prostaglandins Agonist

Bimatoprost- Lumigan Latanoprost- Xalatan ( do not exceed dosage decrease IOP) Tafluprost - Zoltan Prost- Tans

anti-infective therapeutic class

Brown or tan

Beta-adrenergic blocking agents therapeutic class

Yellow, blue or both

7. What information will the nurse include when teaching the patient and family about postoperative care for a trabeculectomy? (Select all that apply.)

a. Use aseptic technique for all dressing changes and medication administration. c. Avoid heavy lifting. d. Redness in the eye, pain, and swelling are common occurrences after surgery. e. Avoid straining on defecation. ANS: A- use aseptic technique for all dressing changes and medication administrations C- avoid heavy lifting D- redness in the eye, pain and swelling are common occurrences after surgery E- avoid straining on deification

The nurse is educating a patient about a newly prescribed cholinergic agent. When relaying common adverse effects of this type of medication, the nurse will include information about (Select all that apply.)

a. conjunctival irritation. b. headache. ANS: A, B

Prostaglandin agonist

action- lowers IOP by dilating blood vessels in the trabecular mesh use- allow more fluid to leave eye Adverse effects- darkens eye color, lengthens eye lashes