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Ophthalmic Drugs
moas and indications
44
Pharmacology
Undergraduate 3
11/15/2014

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Term
Mydriatics
Definition
(apraclondine)
dilate the pupil
Term
Miotics
Definition
(acetylcholine, pilocarpine)
constrict the pupil
Term
Cycloplegics
Definition
(atropine, cyclopentolate)
paralyze the ciliary body
have mydriatic properties
cycloplegia: paralysis of accommodation
Term
Ocular Drugs
Definition
Antiglaucoma drugs
Antimicrobial and antiinflammatory drugs
topical anesthetics
diagnostic drugs
antiallergic drugs
lubricants and moisturizers
Term
Glaucoma
Definition
1. inhibition of the normal flow and drainage of aqueous humor
2. results in increased intraocular pressure IOP
3. pressure against the retina destroys neurons, leading to impaired vision and eventual blindness
Term
When administering eyedrops for glaucoma, the nurse understands the desired drug effect causes
Definition
decreased intraocular pressure
Term
Cholinergic Drugs Indications
Definition
open angle glauscoma
angle closure glaucoma
ocular surgery
convergent strabismus (cross eye)
opthalmologic exams
Term
Cholinergic Drugs Adverse Effects
Definition
1. most limited to local effects
2. if sufficient amounts enter the bloodstream, systemic effect may occur (most likely with indirect acting)
3. hypotension, bradycardia, tachycardia, headache, nausea, vomiting, diarrhea, abdominal cramps, asthma attacks
Term
Sympathomimetics Indications
Definition
1. chronic open angle glaucoma (to reduce (IOP)
2. reduction of perioperative IOP
3. reduction of ocular hypertension
Term
Sypathomimetics Adverse Effects
Definition
1. primarily limited to ocular effects - burning, eye pain, lacrimation
2. rare systemic effects - hypertension, tachycardia, extrasystoles, headache, faintness
Term
Beta- Adrenergic Blockers - indications
Definition
1. reduction of elevated IOP (chronic open angle glaucoma, ocular hypertension)
2. treatment of some forms of angle-closure glaucoma
Term
Beta-Adrenergic Blockers - Adverse Effects
Definition
1. primarily ocular effects - transient burning and discomfort; blurred vision; pain; photophobia; others
2. limited systemic effects - headache, dizziness, cardiac irregularities, bronchospasm
Term
Carbonic Anhydrase Inhibitors - Indications
Definition
1. treatment of glaucoma - open angle and angle closure
2. preoperatively to reduce intraocular pressure
Term
Carbonic Anhydrase Inhibitors - Adverse Effects
Definition
1. oral forms can produce systemic effects - drowsiness, confusion, transient myopia, tinnitus, anorexia, vomiting, diarrhea,
2. pts with sulfa allergies may develop cross- sensitivities
Term
Osmotic Diuretics - indications
Definition
acute glaucoma episodes
before and after ocular sugery to reduce IOP
Term
Osmotic Diuretics - adverse effects
Definition
nausea, vomiting, headache, may cause fluid and electrolyte imbalance
Term
Prostaglandin Agonists
Definition
may cause permanent eye color change
Term
Which antiglaucoma drug works by increasing the outflow of aqueous humor between the uvea and sclera as well as via the usual exit through the trabecular meshwork?
Definition
Prostaglandins
Term
Which statement about use of corticosteroids for ocular inflammation does the nurse identify as being true.
Definition
They are used during the acute phase of the injury process to prevent fibrosis and scarring which result in visual impairment
Term
A patient receiving tetrahydrozoline asks how the drug works. The best response by the nurse will include that the drug works by
Definition
promoting vasoconstriction of blood vesselss in and around the eye
Term
Nursing Implications
Definition
assess the pt's history, including med. history
2. assess baseline vitals, visual acuity, and perform a physical assessment of the eye and surrounding structures
3. assess for contraindications to specific drugs
Term
Nursing Implications
Definition
1. follow specific guidelines for administration of ophthalmic drugs
2. avoid touching the eye with the tip of the dropper or container
3. apply ointments as a thin layer in the conjunctival sac
Term
When administering eyedrops to a pt, the nurse places the drop
Definition
into the lower conjunctival sac
Term
Nursing Implications
Definition
1. when applying eyedrops, have the pt look up to the ceiling and place the drop in the conjunctival sac
2. pressure may be applied to the inner canthus for at least 1 minute to reduce systemic absorption of the drug
Term
Nursing Implications
Definition
If more than one eye medication is ordered, clarify the correct order and intervals for admin.
2. if pt wears contact lenses, check t see if they should be removed during therapy with eye meds.
3. provide pt/family education on correct procedures for administration of eye meds.
Term
A 60 year old male with a history of benign prostatic hypertrophy and hypertension is seen in the ER because he was trimming his shrubs and got something in right eye. He complains of a pain rating of 8 on a scale of 1 to 10 in the right eye. Which med. does the nurse anticipate administering via eyedrop to help control the pt's pain?
Definition
tetracaine

begins to work in 25 seconds and lasts for 15 to 20 minutes. numbs eye
Term
After administering an ophthalmic anesthetic drug, what adverse effects possibly develop
Definition
stinging, burning, redness, lacrimation, blurred vision
Term
The ophthamologist tells the pt that she is going to place a dye onto the pt's eye to help identify the location of the foreign object. Which drug does the nurse anticipate the ophthamologist will use?
Definition
fluorescein (AK Fluor)
Term
A foreign particle is removed from the pt's eye. He tells the nurse that he previously forgot to metion that he takes eyedrops for glaucoma. He can't remember the name of the drug, but he knows the eyedrop bottle has a purple lid. The nurse identifies a purple lid as most likely containing which type of antiglaucoma drug?
Definition
Sympathomimetics

Sympathomimetics are usually in a bottle that has a purple lid. Direct Acting cholinergics have a green lid. Prostaglandin agonist - teal or clear lid and carbonic anhydrase inhibitors have an orange lid
Term
pilocarpine (Pilocar)
Definition
1. antiglaucoma drug - direct-acting cholinergic drug
2. used as a miotic in the treatment of glaucoma
3. available as an ocular gel and solution
4. ocular inset applied once/week
Term
echothiophate (Phospholine Iodide)
Definition
1. antiglaucoma
2. indirect-acting cholinergic tht has an onranophosphate structure and acts by phosphorylating cholinesterase enzymes.
3. effect is normally irreversible until new enzymes are synthesized by the body, which may take days to weeks
4. long acting
Term
dipivefrin
Definition
1. synthetic sympathomimetic miotic drug
2. prodrug of epinephrine that has little or no pharmacologic activity until hydrolyzed in the eye to two chemically modified forms of epinephrine
2. has enhanced lipophilicity and canbetter penetrate into tissues of the anteriour chamber of the eye
Term
betaxolol (Betopic)
Definition
1. beta selective beta blocker
2. one of the most potent and selective beta blocking drugs.
3. Its ability to decrease aqueous humor formation and reduce intraocular pressure
Term
timolol
Definition
1. differs slightly from other beta blockers in that it may increase the outflow of aqueous humor as well as deccrease its formation
2. indicated for treatment of open angle glaucoma and ocular hypertension
3. available with or without preservatives
also available as a gel
Term
dorzolamide (Trusopt)
Definition
indicated for treatment of elevated IOP associated with either ocular hypertension or open angle glaucoma
Term
latanoprost
Definition
naturally occurring prostaglandin
2. it is converted by hydrolysis to prostaglandin with in turn reduces IOP
3. iris pigmentation - changes eye color
Term
gentamicin
Definition
1. effective against a wide variety of gram negative and gram positive organisms including staph and strept that have developed resistance to other antibiotics
2. available as an ointment and a solution
Term
erythromycin
Definition
1. macrolide antibiotic
2. indicated for treatment of various ophthalmic infections
3. oral an IV formsand as an ointment
4. indicated to treat pediatric conjunctivitis and prevention of eye infections in newborns that may be caused by gonorrhoeae
Term
bacitracin
Definition
1. used to treat various eye infections
2. single and combo products
3. available as ointment
Term
ciprofloxacin
Definition
1. synthetic quinolone antibiotic
2. ointment and solution
3. indicated for the treatment of bacterial keratitis and conjunctivitis
4. adverse reaction is appearance of white, crystalline precipitates occuring within any corneal lesions that do not affect clinical outcome
Term
sulfacetamide
Definition
most commonly used ophthalmic sulfonamide antibacterial
2. available as solution or ointment
Term
dexamethasone
Definition
1. synthetic corticosteroid
2. used to treat inflammation of eye, eyelids, conjunctiva and cornea and may also be used in treatment of uveitis, iridocyclitis, allergic conditions and burns and in removal of foreign bodies
3. available as an ointment, suspension, solution
Term
atropine sulfate
Definition
1. solution and ointment are used as mydriatic and cycloglegic drugs
2. drug dilates the pupil and paralyzes the ciliary muscle
3. used to assist in eye exam to treat uveal tract inflammatory states
Term
artificial tears
Definition
an array of products available OTC to provide lubrication
1. indicated in dry, irritated eyes
2. contain buffers to adjust Ph
3. eyedrops restasis is an ophthalmic form of the immunosuppressant drug cyclosporine and can be used with artificial tears
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