This document discusses issues related to pharmacology in ophthalmic nursing. It covers key topics like the basic concepts of pharmacokinetics, pharmacodynamics and pharmacotherapeutics. It also addresses determining contraindications to drug use, minimizing adverse reactions, and managing special patient populations. Special considerations are discussed for pregnancy, pediatrics, geriatrics and patients with visual impairments. The role of the eye nurse practitioner as a prescriber is also mentioned.

1. Issues and Trends in Ophthalmic Nursing
Pharmacology
RANGSIMA TOSANGUAN
PUBLIC HEALTH NURSING
FACULTY OF NURSING, CHIANG MAI UNIVERSITY
E mail: rangsima.p@cmu.ac.th
Facebook: Nursing Room By Rangsima
Slideshare: Nursing Room By Rangsima

2. What is pharmacology?
Pharmacology is the
scientific study of the
origin, nature,
chemistry, effects,
and uses of drugs.
It is essential to
providing safe and
accurate medication
administration to the
patients.
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3. Three basic concepts of pharmacology
Pharmacokinetics
—the absorption,
distribution,
metabolism, and
excretion of drugs
by the body
Pharmacodynamics
—the biochemical
and physical effects
of drugs and the
mechanisms of
drug actions
Pharmacotherapeutics
—the use of drugs to
prevent and treat
diseases
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4. Other important aspects of pharmacology
How drugs are named and classified
How drugs are derived
How drugs are administered
How new drugs are developed
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5. Pharmacotherapy of the ophthalmic patients refer to…
the use of diagnostic drugs
• to facilitate the examination and diagnosis of patients
undergoing comprehensive assessment
• example: Local anesthesia, mydriatics drug
the use of therapeutic drugs
• for the treatment of patients with eye or vision problems
• example: ABO, Anti-inflammation 14/02/61Rangsima Tosanguan
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6. Individuals with eye problems…
…may have unique
medical histories -
systemic conditions
Cold Asthma RA Diabetes
…may take medications
that can interact with
administered or prescribed
ocular drugs
…vary in their need to
overcome health problems
…may have
socioeconomic
disadvantages that make
prescribed medications
unaffordable
These issues that must be
addressed if each
ophthalmic patient is to
benefit fully from
pharmacotherapy
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7. The decision to use drugs for diagnosis or treatment
Applanation
tonometry?- topical
anesthetics
Fundus examinations-
mydriatics?
Glaucoma -
pharmacologic
intervention?
Mild blepharitis - need
antibiotics?
Dry eye syndrome-intermittent symptoms/ no ocular
surface abnormalities- pharmacotherapeutic
intervention?
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8. Factors relate to the decision to use diagnostic or
therapeutic pharmaceutical agents
 Symptoms/signs
 Knowledge of the natural history of the disease process
 Potential for morbidity
 Identification of any underlying ocular/ general medical
contraindications
 Pharmacoeconomics of drug therapy
 Medication adherence/ compliance* education, instruction, written
dosage schedules 14/02/61Rangsima Tosanguan
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9. DETERMINING CONTRAINDICATIONS
TO DRUG USE
 Successful diagnosis and management of ocular
disease require rational drug selection and
administration
 Poorly chosen or contraindicated drug regimens can
contribute to iatrogenic ocular or systemic disease
with potentially adverse medicolegal consequences
 A careful patient history alerts practitioners to
possible adverse drug reactions and enables
practitioners to select the most appropriate
pharmacotherapy for the patient 14/02/61
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Tosanguan
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10. Adverse Interactions Between Antiglaucoma and
Systemic Medications
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11. MINIMIZING DRUG TOXICITY AND OTHER
ADVERSE REACTIONS
 Adverse reactions are usually
manifestations of drug hypersensitivity
(allergy) or toxicity- occurs locally in
the ocular tissues.
 Adverse reactions can manifest as a
systemic response; erythema multiforme
potentiated by sulfonamide agents
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14.  Practitioners must be aware of the effects of systemic
medications on vision and ocular health.
 Many drug induced changes are common- dry eye
associated with anticholinergic drugs
 Some instances can be vision threatening - ethambutol-
induced optic neuropathy.
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15. MANAGING SPECIAL PATIENT POPULATIONS
Pregnancy-
minimally effective doses and for as short
a time as possible
*Timolol –Hi conc. In breast milk
Pediatric Pt.
-Dosage calculations
- route of drug administration
Geriatric Pt.
- Polypharmacy-more adverse drug from
systemic disease and multiple drug
therapy
- Poor compliance
Visual Impairment
-limit the proper use of topical or systemic
medications
Special Considerations
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16. Medication Errors
 The National Coordinating Council for Medication
Error Reporting and Prevention (nccmerp.org)
 defines a medication error as “any preventable event
that may cause or lead to inappropriate medication use
or patient harm while the medication is in the control
of the health care professional, patient, or consumer.
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17. Medication Errors
…may be related to professional practice, health
care products, procedures and system
including prescribing; order communication;
product labeling, packaging; distribution;
administration; education; monitoring; and use”
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Follow the eight “rights” of medication administration
Right drug
Right patient
Right dose
Right time
Right route
Right reason
Right response
Right documentation

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21Communication
Patient Education
Reporting medication errors
Using technology to promote safety
Abbreviations to avoid

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23. THE ROLE OF THE EYE NURSE PRACTITIONER
AS PRESCRIBER
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ให้ยาได้ตามข้อกาหนดการรักษาโรคเบื้องต้นและการให้ภูมิคุ้มกันโรค
สาหรับผู้ประกอบวิชาชีพการพยาบาลชั้นหนึ่ง โดยสภาการพยาบาล

24. Any QUESTIONS?
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