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NR 565 Week 5 Chapter 26, 47, Study Guides, NR 565: Advanced Pharmacology Fundamentals, Chamberlain $12.49   Add to cart

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NR 565 Week 5 Chapter 26, 47, Study Guides, NR 565: Advanced Pharmacology Fundamentals, Chamberlain

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NR 565 Week 5 Chapter 26, 47, Study Guides, NR 565: Advanced Pharmacology Fundamentals, Chamberlain

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  • May 22, 2023
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  • 2022/2023
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NR 565 Week 5 Chapter 26: Drugs used in treating eye &
ear disorders
NR 565: Advanced Pharmacology Fundamentals

,NR 565 Week 5 Chapter 26: Drugs used in treating eye &
ear disorders
Contraindications for topical beta blockers Beta blockers
 Suppress conduction through the atrioventricular (AV) node; therefore, topical beta
blockers are contraindicated in patients with bradycardia or advanced AV block.
 Do not use in patients with compromised ventricular dysfunction, cardiogenic shock, or
with systolic congestive HF
 D/c at first sign of cardiac failure
 Contraindicated with hypotension
 Use with caution: poorly controlled DM and hyperthyroidism
 Surgical patients should be monitored closely for cardiac failure
o Withdraw before surgery 2 days prior
 Contraindicated with Raynaud’s disease or PVD, CVD
 Preg cat C: fetal anomalies and fetotoxicity in animal studies

Prophylaxis for opthalmia neonatorum

 Common patient group: infants younger than 1 month who presents with conjunctivitis
should have Gram's stain, antigen detection tests, and cultures of the eye discharge to
rule out gonococcal, chlamydial, or HSV origin.
 Chlamydia is the most common cause of neonatal conjunctivitis
 Gonococcal conjunctivitis is the most serious cause of ophthalmia neonatorum owing to
concerns about the bacteria causing blindness
 Prophylaxis: Administration of antibiotic eye medication within 1 hour of delivery
 Erythromycin ointment 0.5% (0.25 to 0.5-inch ribbon in each eye)
 Chlamydial conjunctivitis is not prevented by prophylactic use of erythromycin at birth
therefore any mucopurulent eye discharge in the first few weeks of life should be
evaluated for chlamydia.

Glaucoma: Treatment, dosing, and patient education:

 IOP damages the optic nerve
 Leading cause of blindness worldwide
 6-8 times more likely in African Americans than Caucations
 Antiglaucoma medications are prescribed by ophthalmologists. Dosage is determined by
the clinical condition of the patient.

, Treatment and dosing
 Current medical therapies are aimed at
o decreasing the production of aqueous humor at the ciliary body and
o Increasing the outflow of this fluid from the angle structures
 Requires evaluation and treatment by an ophthalmologist
o FNPs need to be aware of the medications prescribed, drug interactions, and
ADRs
 Antiglaucoma agents are prescribed by ophthalmologists and dosage is determined by
the clinical condition of the patient
 Four categories: Beta Blockers, adrenergic agonists, miotics, and carbonic anhydrase
(CA) inhibitors
o Beta Blockers:
 Betaxolol, carteolol, metipranolol, levobunolol, timolol
o Adrenergic Agonists
 Apraclonidine, brimonidine
o Miotics
 Carbachol, pilocarpine, echothiophate
o Carbonic Anhydrase Inhibitors
 Acetazoleamide, brinzolamide, dorzolamide, methazolamide
Patient education
 The patient should be instructed to administer the medication exactly as the
ophthalmologist has prescribed
 Abruptly stopping the medication can increase adverse effects.
 The patient should have been instructed by the ophthalmologist regarding the adverse
effects of the medication.
o Reinforcement may be necessary. If the patient is experiencing adverse effects
from the medication, the primary care provider can facilitate a referral back to
the ophthalmologist.


Allergic or Vernal conjunctivitis: Treatment, dosing, and patient education
 Occurs in response to a variety of allergens
 Vernal conjunctivitis refers to conjunctivitis that occurs primarily in the spring, usually
because of an allergen.
 The mast cell stabilizers (lodoxamide, cromolyn sodium) may be used to treat vernal
conjunctivitis and may be used safely for up to 3 months.
Treatment and Dosing
 Ketotifen (H1 blocker) for allergic conjunctivitis and ocular pruritus.
o The dose used in adults and children over age 3 is 1 drop in the affected eye every
8 to 12 hours
 Levocabastine (H1 blocker): allergic conjunctivitis and ocular pruritis

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