18. ophthalmis and otic medications

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18. ophthalmis and otic medications

  1. 1. Chapter 18 Ophthalmic and Otic Medications Copyright © 2011 Delmar, Cengage Learning
  2. 2. Basic Anatomy and Physiology <ul><li>The ocular system is responsible for vision </li></ul><ul><li>The ocular system is comprised of the eyes and adnexa </li></ul><ul><ul><li>Globe consists of three layers: </li></ul></ul><ul><ul><ul><li>Globe, choroid, and retina </li></ul></ul></ul><ul><ul><li>Adnexa consists of the surrounding structures: </li></ul></ul><ul><ul><ul><li>Orbit, eye muscles, eyelids, eyelashes, conjunctiva, and lacrimal apparatus </li></ul></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  3. 3. Basic Anatomy and Physiology Copyright © 2011 Delmar, Cengage Learning
  4. 4. Ophthalmic Drugs <ul><li>Things to consider when using topical ophthalmic drugs </li></ul><ul><ul><li>They must be absorbed into the anterior chamber </li></ul></ul><ul><ul><li>They may be administered at different frequencies depending on whether they are in ointment or solution form </li></ul></ul><ul><ul><li>They must be relatively easy to administer so that client compliance occurs </li></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  5. 5. Ophthalmic Drugs <ul><li>Diagnostic drugs </li></ul><ul><ul><li>Topical anesthetics such as proparacine and tetracaine are used to help perform comprehensive eye exams or to remove foreign material from the eye </li></ul></ul><ul><ul><li>Fluorescein sodium is applied to the cornea (using sterile saline) to assess any corneal defects (the stain is orange until it adheres to a corneal defect, where it appears green) </li></ul></ul><ul><ul><ul><li>Stain should be washed from the eye after examination is complete </li></ul></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  6. 6. Ophthalmic Drugs <ul><li>Miotics </li></ul><ul><ul><li>Constrict the pupil </li></ul></ul><ul><ul><li>Used to treat open-angle glaucoma by increasing the outflow of aqueous humor (thus decreasing intraocular pressure) </li></ul></ul><ul><ul><li>An example is pilocarpine </li></ul></ul><ul><li>Mydriatics and cycloplegics </li></ul><ul><ul><li>Mydriatics dilate the pupil </li></ul></ul><ul><ul><li>Cycloplegics paralyze the ciliary muscles and minimize pain </li></ul></ul><ul><ul><li>These drugs are used together to achieve desired outcomes </li></ul></ul><ul><ul><li>Examples include atropine, homatropine, phenylephrine (no cycloplegia), tropicamide, and epinephrine </li></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  7. 7. Ophthalmic Drugs <ul><li>Drugs used to treat glaucoma </li></ul><ul><ul><li>Glaucoma is a group of diseases that increase intraocular pressure (drugs used to treat glaucoma decrease intraocular pressure) </li></ul></ul><ul><ul><li>Miotics: covered previously </li></ul></ul><ul><ul><li>Carbonic anhydrase inhibitors interfere with the production of carbonic acid, leading to a decrease of aqueous humor production </li></ul></ul><ul><ul><ul><li>Examples include acetazolamide, dichlorphenamide, and methazolamide </li></ul></ul></ul><ul><ul><li>Beta-adrenergic blockers decrease the production of aqueous humor </li></ul></ul><ul><ul><ul><li>Examples include timolol and betazolol </li></ul></ul></ul><ul><ul><li>Osmotics are diuretics that decrease vitreous humor volume to rapidly decrease intraocular pressure </li></ul></ul><ul><ul><ul><li>Examples include mannitol and glycerin </li></ul></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  8. 8. Ophthalmic Drugs <ul><li>Drugs used to treat glaucoma </li></ul><ul><ul><li>Prostaglandins can be used topically and can reduce intraocular pressure by increasing outflow of aqueous humor </li></ul></ul><ul><ul><li>Alpha-adrenergic agonists are sympathomimetic drugs that reduce aqueous humor secretion and thus decrease intraocular pressure </li></ul></ul><ul><ul><ul><li>Side effects include diarrhea, and vomiting in dogs and cats </li></ul></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  9. 9. Ophthalmic Drugs <ul><li>Drugs used to treat KCS </li></ul><ul><ul><li>KCS is a disease in which tear production is decreased, resulting in mucopurulent conjunctivitis and corneal scarring/ulceration </li></ul></ul><ul><ul><li>Examples of drugs used to treat KCS: </li></ul></ul><ul><ul><ul><li>Artificial tears </li></ul></ul></ul><ul><ul><ul><li>Antibiotic-steroid preparations </li></ul></ul></ul><ul><ul><ul><li>Lacrimogenics (increase tear production) such as pilocarpine </li></ul></ul></ul><ul><ul><ul><li>Immunomodulators (interfere with interleukin production by T-lymphocytes) such as cyclosporine </li></ul></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  10. 10. Ophthalmic Drugs <ul><li>Other ophthalmic drugs used to treat ocular diseases include: </li></ul><ul><ul><li>Antibiotics </li></ul></ul><ul><ul><li>Antifungals </li></ul></ul><ul><ul><li>Antivirals </li></ul></ul><ul><ul><li>Corticosteroids </li></ul></ul><ul><ul><li>NSAIDs </li></ul></ul><ul><ul><li>Tear supplements </li></ul></ul><ul><li>See Table 18-1 in your textbook for a list of anti-infectives, anti-inflammatories, and tear supplements used in veterinary medicine </li></ul>Copyright © 2011 Delmar, Cengage Learning
  11. 11. Basic Anatomy and Physiology <ul><li>The ear is the sensory organ that allows hearing and maintains balance </li></ul><ul><li>The ear is comprised of three parts: </li></ul><ul><ul><li>Outer: pinna and external auditory canal </li></ul></ul><ul><ul><li>Middle: tympanic membrane, auditory ossicles, eustachian tube, oval window, and round window </li></ul></ul><ul><ul><li>Inner: vestibule, cochlea, and semicircular canals </li></ul></ul><ul><li>Otitis interna is an inner ear infection </li></ul><ul><ul><li>Side effects include head tilt toward the infected side, ataxia, nausea, and vomiting </li></ul></ul>Copyright © 2011 Delmar, Cengage Learning
  12. 12. Basic Anatomy and Physiology Copyright © 2011 Delmar, Cengage Learning
  13. 13. Otic Medications <ul><li>Many drug combinations are used in veterinary medicine to treat ear disease, including: </li></ul><ul><ul><li>Antibiotics </li></ul></ul><ul><ul><li>Antiparasitics </li></ul></ul><ul><ul><li>Antifungals </li></ul></ul><ul><ul><li>Corticosteroids (in combination with anti-infectives) </li></ul></ul><ul><ul><li>Otic drying agents </li></ul></ul><ul><ul><li>Otic cleansing agents </li></ul></ul><ul><ul><li>Otic dewaxing agents </li></ul></ul><ul><li>Refer to Table 18-2 in your textbook for a complete list of otic drugs </li></ul>Copyright © 2011 Delmar, Cengage Learning

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