eye & ear conditions (NAPLEX)

Can you use eye drops in the ear?

Yes

Can you use ear drops in the eye?

No

1 drop = ____ mL

0.05 mL

How many times should you shake gels?

Invert and shake once

Medications that can increase IOP (4)

Anticholinergics (antihistamines, benztropine, oxybutynin, TCAs, tolterodine, trihexypenidyl, scopolamine)

Decongestants (pseudoephedrine)

Chronic steroids (esp eye drops)

Topiramate

Glaucoma TX ** studygal

Reduce aqueous humor production (make less fluid):

Beta blockers (timolol)

Carbonic anhydrase inhibitors (dorzolamide)

Increase aqueous humor outflow (move fluid out):

Prostaglandin analog (latanoprost)

OR BOTH - add on TX with alpha-2 agonist (brimonidine)

Prostaglandin analogs MOA & options (3)

Increase aqueous humor outflow

Bimatoprost (Lumigan)

Latanoprost (Xalatan)

Travoprost (Travatan Z)

What class can increase eyelashes?

Prostaglandin analogs

Prostaglandin analogs (ex: bimatoprost) adverse effects (4)

Blurred vision

Stinging

dark pigmentation of iris/eyelashes

Eyelash growth

Beta blockers MOA & options (1)

Reduce aqueous humor production

Timolol 0.25% and 0.5% (Timoptic, Timoptic XE, Istalol)

Timolol dosing (2)

Timoptic: 1 drop daily or BID

Timoptic-XE: 1 drop daily

Timolol gel should be shaken once and then use ___ mins later

10

Timolol adverse effects (4)

Burning

Stinging

Bradycardia/fatigue

Bronchospasm

Timolol/dorzolamide brand

Cosopt

Dorzolamide MOA

Carbonic anhydrase inhibitor that reduces aqueous humor production

Dorzolamide: avoid in patients with ____ allergy

Sulfonamide

What medication is used for acute mountain altitude sickness?

Acetazolamide

Brimonidine MOA

Adrenergic alpha-2 agonist that increases aqueous humor outflow and reduces aqueous humor production

What is conjunctivitis?

Pink eye

Prevention of pink eye (4)

Avoid touching eyes

Proper hand hygiene

Change towels and washcloths daily

Discard eye cosmetics

VIRAL PINK EYE

cause, tx

Adenovirus

No topical TX

BACTERIAL PINK EYE

bacteria (3), treatment, drugs (4)

Staph aureus or more severe N gonorrhea or Chlamydia

TX: topical eye drops or ointments

Moxifloxacin (Vigamox)

Neomycin/polymyxin B/dexamethasone (Maxitrol)

Ofloxacin (Ocuflox)

Trimethoprim/polymyxin B (Polytrim)

Azithromycin eye drops (AzaSite) is stored in the fridge or stable at room temp for ___ days

14

ALLERGEN PINK EYE

causes, txs (3)

dust, pollen, mold

TX:

Mast cell stabilizers

Antihistamines: azelastine, olopatadine (pataday)

Antihistamine/mast cell stabilizer: Ketotifen (Alaway, Zaditor)

What is blepharitis & what is the treatment?

Eyelid inflammation

Warm, moist washcloth

What preservative is commonly added to eye drop? (studygal)

BAK (Benzalkonium chloride)

Eye drop administration if you have contacts

remove contact lenses, apply eye drops, replace contact lenses 15 minutes later

Eye inflammation TX (2)

Prednisolone (Pred Forte, Pred Mild) - steroids

Ketorlolac (Acular) - NSAID

Steroid eye drops should be used short term due to risk of increased ____

IOP

Eye dryness TX (2)

Refresh

Systane

Chronic dry eye dx TX (1)

Cyclosporine emulsion eye drops (Restasis)

Eye redness TX (3)

Naphazoline (Clear Eyes Redness Relief)

Naphazoline/Pheniramine (Naphcon A, Visine A)

Tetrahydrozoline (Visine)

What RX can cause intraoperative floppy iris syndrome and therefore difficulty in cataract surgery?

Alpha-blockers (tamsulosin)

What RX can cause yellow/green vision?

Digoxin (toxicity)

What RX can cause greenish tinge around objects?

PDE-5 Inhibitors

What RX can cause optic neuropathy? (3)

Amiodarone

Ethambutol

Linezolid

What RX can cause retinal changes/retinopathy? (2)

Chloroquine

Hydroxychloroquine

What RX can cause decrease night vision, dryness, & irritation?

Isotretinoin

What can you use to treat ear wax blockage?

Carbamide peroxide (debrox) limited to 3-5 days

TX of otitis externa (swimmers ear) (2)

Mild: Acetic acid/glucocorticoid (VoSol HCl) ear drops

Moderate to severe: Ciprofloxacin/dexamethasone (Ciprodex) ear drops

How long should you want between eye drops of different drugs?

5-10 mins

Where do you apply opthalmic ointments?

pocket inside the lower eyelid