OPTHALMIC MEDICATIONS FOR GLAUCOMA

1. OPTHALMIC MEDICATIONS FOR GLAUCOMA BARBARA REES

2. GLAUCOMA PATHOLOGY INCREASED INTRAOCULAR PRESSURE AQUEOUS HUMOR PRODUCTION CONTROLLED BY ENZYME CARBONIC ANHYDRASE OPEN ANGLE- DEGENERATIVE CHANGES IMPAIR OUTFLOW

3. AGENTS DECREASE FORMATION OF AQUEOUS HUMOR CARBONIC ANHYDRASE INHIBITORS- DIAMOX OSMOTIC DIURETICS BETA-ADRENERGIC BLOCKING AGENTS- TIMOPTIC, BETOPTIC, BETAGAN

4. DRUGS WHICH INCREASE OUTFLOW OF AQUEOUS HUMOR ACTS TO CONSTRICT PUPIL AND CONTRACT THE CILIARY MUSCLE pilocarpine (Isopto Carpine)

5. CARDIOVASCULAR MEDICATIONS- CARDIAC GLYCOSIDES DIGITALSIS ACTION- for CHF, increases force of myocardial contraction Slows the heart

6. COMMON SIDE EFFECTS GASTROINTESTINAL DISTRESS NEUROLOGICAL EFFECTS VISUAL DISTRUBANCES CARDIAC EFFECTS

7. FACTORS PREDISPOSING A PATIENT TO TOXICITY HYPOKALEMIA RENAL IMPAIRMENT IV DRUG ADMINISTRATION

8. NURSING IMPLICATIONS EVALUATE FOR INTERACTIONS WITH OTHER DRUGS OR FOOD ASSESS APICAL PULSE FOR 1 MINUTE- HOLD IN ADULTS <60, CHILDREN<70, INFANTS<90 ASSESS FOR TOXICITY

9. PATIENT TEACHING TAKE MED AT SAME TIME EVERY DAY DO NOT CHANGE, SKIP OR STOP DOSE NOTIFY DOCTOR IF PULSE<60, >120, IF ERRATIC OR OTHER SE REPORT WEIGHT GAIN OF 2 LB OR > PER DAY TAKE 2 HOURS BEFORE OR AFTER TAKING ANTACIDS, MILK PRODUCTS, ICE CREAM, YOGURT, OR CHEESES

10. ANTIHYPERLIPEDEMIC DRUGS BILE ACID SEQUESTRANTS- (QUESTRAN, COLESTID) BIND BILE AND PREVENT REABSORPTION OF BILE ACIDS HMG-CoA- (MECACOR) BINDS THE PRODUCTION OF THE ENZYME FOR PRODUCING CHOLESTEROL FIBRIC ACID DERIVATIVES- (LOPID) ACTIVATES ENZYME THAT BREAKS DOWN CHOLESTEROL NICOTINIC ACID- (Niacin. Nicotinic Acid) PREVENTS UNOXIDIZED LDL FROM BEING OXIDIZED

11. NURSING IMPLICATIONS OBTAIN THOROUGH HEALTH AND MEDICATION HISTORY CHECK FOR CONTRAINDICATIONS TO USE FOLLOW UP WITH LIVER FUNCTION TESTS

12. PATIENT TEACHING TAKE MEDICATIONS AS ORDER DIET TEACHING- LOW FAT DIET, HIGH FIBER, DRINK LOTS OF FLUID FOLLOW UP WITH LIVER FUNCTION TESTS TAKE OTHER MEDICATIONS 1 HOUR BEFORE OR 4-6 HOURS AFTER

13. ANTIANGINAL AGENTS NITROGLYCERIN- DILATES BLOOD VESSELS; SE- HA, POSTURAL HYPOTENSION, TACHYCARDIA BETA-ADRENERGIC BLOCKING AGENTS

14. REVIEW NERVOUS SYSTEM HAS 2 PARTS - SNS & PNS RECEPTOR SITES FOR CATECHOLAMINES NE & EPI - THESE ARE ADRENERGIC RECEPTORS THESE ARE DIVIDED INTO BETA1 (HEART) & BETA2 (BRONCHIOLES, ARTERIOLES & VISCERAL ORGANS)

15. BETA BLOCKERSGENERIC BRAND atentolol.............Tenormin metroprolol.........Lopressor nadolol................Corgard propranolol..........Inderal

16. HOW BETA BLOCKERS WORK FOR ANGINA SLOW THE HEART RATE DECREASE CONTRACTILITY GOOD RESULTS: a. decrease myocardial O2 demand and increase O2 delivered to heart b. decrease contractility & conserve energy

17. BETA BLOCKERS OFTEN COMBINED WITH NITRATES ALSO USED AS ANTIHYPERTENSIVES TREAT EXERTIONAL ANGINA SE: FATIGUE & LETHARGY

18. CALCIUM CHANNEL BLOCKERS INHIBITS PASSAGE OF CALCIUM INTO VASCULAR SMOOTH MUSCLE CAUSES VASODILATION REDUCES MYOCARDIAL CONTRACTILITY HELPS TREAT CORONARY ARTERY SPASMS

19. GENERIC BRAND amlodipine......Norvasc nifedipine........Adalat, Procardia diltiazem.........Cardizem verapamil........Calan, Isoptin

20. NURSING IMPLICATIONS CAUTIOUS USE IN PATIENTS WITH HEAD INJURIES, POSTURAL HYPOTENSION, PREGNANCY OR LACTATION TOBACCO & COLD TEMPERATURE REDUCE EFFECTIVENESS CHECK FOR CONDITIONS WITH SLOW HEART RATE OR HYPOTENSION- CHECK VS

21. PATIENT TEACHING TAKE AT FIRST SIGN OF ANGINA SIT OR LIE DOWN SE- HA, FLUSHING, DROP IN BP, NAUSEA IF NOT RELIEVED TAKE TABLET Q 5 MINS. UP TO 3-5 KEEP FRESH SUPPLY KEEP RECORD OF FREQUENCY AND CHARACTERISTICS OF ATTACKS

22. PERIPHERAL VASODILATORS VASOSPACTIC DISORDERS ARE MORE LIKELY TO RESPOND AFFECT SYMPATHETIC NERVOUS SYSTEM OR ACT ON VASCULAR SMOOTH MUSCLE TAZOL, TENSIN, ISMELIN

23. ANTICOAGULANTS HEPARIN COUMADIN(warfarin sodium) NURSING IMPLICATIONS- CONTRAINDICATED IN CONDITIONS WITH RISK OF HEMORRHAGE, CHECK PTT OR PT, SIGNS OF BLEEDING

24. ANTICOAGULANT PATIENT TEACHING GIVE HEPARIN PROPERLY CHECK FOR ADVERSE EFFECTS TEACH SAFETY AND COMFORT DO NOT TAKE ASA OR ASA CONTAINING PRODUCTS REGULAR ADMINISTRATION DO NOT TAKE WITH OTHER DRUGS OR ALCOHOL INFORM OTHER HEALTH PERSONNEL ON ANTICOAGULANTS AVOID DANGEROUS ACTIVITIES

25. DIURETICS & ANTIHYPERTENSIVES ADRENERGIC AGENTS ANGIOTENSIN-CONVERTING ENZYME INHIBITORS-inhibit enzyme responsible for converting Angiotensin I to II THIAZIDE AND THIAZIDE-LIKE LOOP DIURETICS

26. NURSING IMPLICATIONS OFTEN NEED TO BE ON LOW NA DIET EVALUATE FOR LOW K EVALUATE FOR HYPOTENSION AND TAKE SAFETY PRECAUTIONS

27. PATIENT TEACHING DIURETICS OFTEN CAUSE K LOSS- EAT K FOODS OR MEDS IF DIABETIC OR HAVE GOUT- CAN CAUSE HYPERGLYCEMIA OR URIC ACID INCREASE AVOID ALCOHOL, BARBITURATES AND NARCOTICS

28. HYPOGLYCEMIC AGENTS RAPID ACTING INSULIN INTERMEDIATE ACTING LONG ACTING FIXED COMBINATION ORAL ANTIDIABETIC AGENTS

29. NURSING IMPLICATIONS CHECK FOR DRUGS THAT INTERACT CAUSING HYPO OR HYPERGLYCEMIA CHECK ALLERGY TO INSULIN PROPER OR SULFONYLUREAS HYPOGLYCEMIA MOST LIKELY DURING INSULIN PEAK ACTION CHECK FOR SYMPTOMS OR HYPO AND HYPERGLYCEMIA

30. PATIENT TEACHING SIGNS AND SYMPTOMS OF HYPER AND HYPOGLYCEMIA CARRY ID AVOID ALCOHOL CHECK BLOOD GLUCOSE FOOT CARE ETC.