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VISUAL ALTERATION

Learn about the visual alteration caused by glaucoma and the various drug therapies available. Explore the purpose and examples of drugs such as prostaglandin agonists, adrenergic agonists, beta-adrenergic blockers, cholinergic agonists, and carbonic anhydrase inhibitors. Discover surgical treatments for open-angle and closed-angle glaucoma. Watch a video on glaucoma surgery and learn about postoperative nursing care.

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VISUAL ALTERATION

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  1. VISUAL ALTERATION GLAUCOMA TREATMENT

  2. Glaucoma Drug Therapy • Purpose: - constrict the pupil -reduce production or increase absorption of aqueous humor • DRUGS • Prostaglandin agonists • Adrenergic agonists • Beta-adrenergic blockers • Cholinergic agonists • Carbonic anhydrase inhibitors

  3. DRUGS: PROSTAGLANDIN AGONIST HOW DO THESE TREAT GLAUCOMA? • EXAMPLES OF DRUGS: -Latanoprost (Xalatan) -bimatoprost (Lumigan) -travoprost (Travatan): not to be used with pregnancy

  4. DRUGS: Adrenergic Agonists EXAMPLES: -brimonidine tartrate ( Alphagan): • Nursing Implications: -cannot combine with MAOI (monoamine oxidase inhibitor) -Can precipitate hypertensive crisis -Instill without contact lens in

  5. DRUGS: BETA ADRENERGIC BLOCKERS EXAMPLES: -levobunolol HCl (Betagen Liquifilm) -betaxolol HCl (Betoptic) -timolol (Betimol, Timoptic) Nursing Implications -WHAT PRECAUTIONS MUST BE USED WITH ORAL BETA BLOCKERS AND CALCIUM CHANNEL BLOCKERS?

  6. Drugs: Cholinergics • EXAMPLES -carbochol(Carboptic, Isopto Carbachol, Miostat) -pilocarpine(Adsorbocarpine, Piloptic, Pilopine) Nursing Considerations: -can cause increase with saliva, sweating -pupil becomes smaller (miosis)

  7. DRUGS: CARBONIC ANHYDRASE INHIBITORS: EXAMPLES: -brinzolamide (Azopt), -dorzolamide (Trusopt) Nursing Implications : -check if allergic to sulfonamide -has a diuretic effect -don’t use with contacts

  8. SURGERY FOR BOTH TYPES OF GLAUCOMA • PURPOSE: to create a permanent way to drain fluid • TYPES (Open Angle Glaucoma) -Laser trabeculectomy: laser burns trabecular meshwork -Filtering microsurgery: creates drainage hole in iris If patient doesn’t respond to surgery, then a shunt or glaucoma drainage device may be implanted Closed Angle Glaucoma: peripheral iridectomy

  9. Glaucoma Surgical Treatment

  10. Glaucoma Video • http://video.google.com/videoplay?docid=-2504983511038511848#

  11. POSTOP NURSING CARE • Clinical setting: outpatient services • Precautions: measures to prevent increased IOP • Postop complications: choroidal hemorrhage

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