drugs used to treat glaucoma and other eye disorders chapter 43 mosby items and derived items ©...
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Drugs Used to Treat Glaucoma and Other Eye Disorders
Chapter 43Chapter 43
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
Chapter 43
Lesson 43.1
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Slide 3
ObjectivesObjectives
• Describe the anatomy and physiology of the eye
• Describe the normal flow of aqueous humor in the eye
• Identify the changes in normal flow of aqueous humor caused by open-angle and closed-angle glaucoma
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
Anatomy and Physiology of the EyeAnatomy and Physiology of the Eye
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Slide 5
Anatomy and Physiology of the Eye Anatomy and Physiology of the Eye (cont’d)(cont’d)
• The cornea Outermost part of the eyeball Transparent, allows light to enter Lacks blood vessels Diffused air provides oxygen to the cornea Resistance to infections Contains sensory fibers that release pain if
damaged Injury to corneal tissue is replaced by scar
tissue
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
Flow of Aqueous HumorFlow of Aqueous Humor
• Produced by the ciliary body, it bathes and feeds the lens
• Flows between the lens and the iris into the anterior chamber of the eye
• Drains through channels located near the cornea and the sclera, and then drains into a meshwork that leads into Schlemm’s canal and into the venous system of the eye
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
Major Types of GlaucomaMajor Types of Glaucoma
• Glaucoma characterized by elevated intraocular pressure (IOP); caused by an increased production of aqueous humor or an outflow obstruction
• Primary Closed-angle glaucoma Open-angle glaucoma
• Secondary
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Slide 8
Effect of Light or Ophthalmic Effect of Light or Ophthalmic Agents on the Iris of the EyeAgents on the Iris of the Eye
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Slide 9
Chapter 43
Lesson 43.2
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Slide 10
ObjectivesObjectives
• Explain baseline data that should be gathered when an eye disorder exists
• Develop teaching plans for a person with an eye infection and a person receiving glaucoma medication
• Review the correct procedure for instilling eye drops or eye ointments
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Slide 11
General Considerations for General Considerations for Topical Ophthalmic Drug TherapyTopical Ophthalmic Drug Therapy
• Topical application• Safety and color coding• Check which eye is being medicated• Proper administration
Wash hands Tilt patient’s head back slightly Administer near inner portion of eye Have patient close eye for a minute after
administration
Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 12
Drugs Class: Osmotic AgentsDrugs Class: Osmotic Agents
• Actions Reduce volume of intraocular fluid
• Uses Reduce IOP in patients with acute narrow-
angle glaucoma
• Serious adverse effects Thirst, nausea, dehydration, electrolyte
imbalance, headache, circulatory overload
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Slide 13
Drug Class: Drug Class: Carbonic Anhydrase InhibitorsCarbonic Anhydrase Inhibitors
• Actions Inhibit the enzyme carbonic anhydrase,
decreasing the production of aqueous humor
• Uses In conjunction with other medications to
control IOP
• Serious adverse effects Electrolyte imbalance, dehydration,
dermatologic, hematologic, neurologic reactions, confusion, drowsiness
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Drug Class: Cholinergic AgentsDrug Class: Cholinergic Agents
• Actions Produce strong contractions of the iris and
ciliary body
• Uses Lower IOP by widening the angle to allow
outflow of aqueous humor
• Common adverse effects Reduced visual acuity, conjunctival irritation,
erythema, headache, pain, discomfort
• Serious adverse effects Systemic toxicity
Slide 14Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Drug Class: Cholinesterase InhibitorsCholinesterase Inhibitors
• Drug: echothiophate iodide (Phospholine Iodide)• Actions
Prevent metabolism of acetylcholine resulting in increased cholinergic activity which decreases IOP
• Uses Treat open-angle glaucoma
• Common adverse effects Reduced visual acuity, conjunctival irritation,
erythema, headache, lacrimation
• Serious adverse effects Systemic adverse effects
Slide 15Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Adrenergic AgentsDrug Class: Adrenergic Agents
• Actions Cause pupil dilation, increased outflow of
aqueous humor, vasoconstriction, relaxation of ciliary muscle
• Uses Lower IOP in open-angle glaucoma
• Common adverse effects Sensitivity to bright lights, conjunctival irritation,
lacrimation• Serious adverse effects
Systemic adverse effects, diaphoresis, trembling
Slide 16Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Drug Class: Beta-Adrenergic Blocking AgentsBeta-Adrenergic Blocking Agents
• Actions Exact mechanism unknown; thought to reduce
production of aqueous humor
• Uses Reduce IOP with chronic open-angle
glaucoma
• Common adverse effects Conjunctival irritation, lacrimation
• Serious adverse effects Systemic adverse effects
Slide 17Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Prostaglandin AgonistsDrug Class: Prostaglandin Agonists
• Actions Increase the outflow of aqueous humor
• Uses Reduce IOP in patients with chronic open-
angle glaucoma not responding to other agents
• Common and serious adverse effects Conjunctival irritation, lacrimation, burning and
stinging, eye pigment changes
Slide 18Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Anticholinergic AgentsDrug Class: Anticholinergic Agents
• Actions Relax smooth muscle of the ciliary body and iris
to produce mydriasis and cycloplegia
• Uses To examine the interior of the eye, measure
refraction, and rest the eye in inflammatory conditions
• Common adverse effects Sensitivity to bright light, conjunctival irritation,
lacrimation
• Serious adverse effects Systemic adverse effects
Slide 19Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Antifungal AgentsDrug Class: Antifungal Agents
• Drug: natamycin (Natacyn)• Actions
Alter the cell wall of fungus causing death of the fungus
• Uses Effective against Candida, Asperigillus, and
Fusarium infections
• Common adverse effects Sensitivity to bright light, blurred vision,
lacrimation, redness
• Serious adverse effects Eye pain, worsening of symptoms
Slide 20Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Drug Class: Antiviral AgentsDrug Class: Antiviral Agents
• Drugs: ganciclovir (Vitrasert), trifluridine (Viroptic)
• Actions Inhibit viral replication
• Uses Treat herpes simplex keratitis, treat recurrent
infections
• Common adverse effects Visual haze, lacrimation, redness, burning,
sensitivity to bright light
• Serious adverse effects Allergic reactions
Slide 21Mosby items and derived items © 2010, 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.