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Drug Therapy For Disorders of the Eye

Terms in this set (168)

• Topical application: most common route for ophthalmic drugs.
• Systemic absorption of eye drops can be decreased by closing eye & applying pressure over the tear duct (nasolacrimal occlusion) for 3 to 5 minutes after instillation.
• When multiple eye drops required, an interval of 5 to 10 minutes between drops because of limited eye capacity & rapid drainage into tear ducts.
• Absorption of eye medications is increased in eye disorders associated w/ hyperemia and inflammation.
• Available as eye drops (solutions or suspensions) & ointments. Ointments are administered less frequently than drops & often produce higher concentrations of drug in target tissues. However, they also cause blurred vision, which limits their daytime use, at least for ambulatory patients. For some patients, drops may be used during waking hours & ointments at bedtime.
• Topical medications should not be used after the expiration date; cloudy, discolored solutions should be discarded.
• Topical eye medications contain a number of inactive ingredients, such as preservatives, buffers, tonicity drugs, antioxidants, etc. Some contain sulfates; some people may have an allergic reaction.
• Some eye drops contain benzalkonium hydrochloride, a preservative, which is absorbed by soft contact lenses; should not be applied while wearing soft contacts & should be instilled 15 minutes or longer before inserting soft contacts.
• To increase safety & accuracy of ophthalmic drug therapy, the labels and caps of eye medications are color coded.
General Considerations
• Prevent eye disorders, when possible. (e.g.,try to avoid long periods of reading & computer work; minimize exposure to dust, smog, cigarette smoke, & other eye irritants; & wash hands often and avoid touching the eyes to decrease risk of infection. Use protective eyewear when indicated.
• Do not use nonprescription eye drops (e.g., Murine, Visine) on a regular basis for longer than 48 to 72 hours. Report persistent eye irritation & redness to a health care provider.
• Have regular eye examinations and testing for glaucoma after 40 years of age.
• Eye-drop preparations often contain sulfates; can cause allergic reactions in some people.
• If you have glaucoma, do not take any drugs w/out your ophthalmologist's knowledge & consent. Many drugs given for purposes other than eye disorders may cause or aggravate glaucoma. Wear a medical alert bracelet or carry identification that states you have glaucoma. This helps avoid administration of drugs that aggravate glaucoma or to maintain treatment of glaucoma, in emergencies.
• If you have an eye infection, wash your hands before & after contact w/ the infected eye to avoid spreading the infection to the unaffected eye or to other people. Also, avoid touching the unaffected eye.
• If you wear contact lenses, wash your hands before inserting them & follow instructions for care (e.g., cleaning, inserting, or removing, and duration of wear). Improper or infrequent cleaning may lead to infection. Overwearing is a common cause of corneal abrasions and should be avoided to prevent the development of ulcers.
• If you wear soft con contact lenses, do not use any eye medication w/out consulting a specialist in eye care. Some eye drops contain benzalkonium hydrochloride, a preservative, which is absorbed by soft contacts. The medication should not be applied while wearing soft contacts and should be instilled 15 minutes or longer before inserting soft contacts.
• Never use eye medications used by someone else and never allow your eye medications to be used by anyone else. These preparations should be used by one person only, and they are dispensed in small amounts for this purpose. Single-person use minimizes cross-contamination and risks of infection.
• Many eye drops and ointments cause temporary blur-ring of vision. Do not use such medications just before driving or operating potentially hazardous machinery.
• Avoid straining at stool (use laxatives or stool softeners if necessary), heavy lifting, bending over, cough-ing, and vomiting when possible. These activities increase intraocular pressure, which may cause eye damage in glaucoma and after eye surgery.


Self-Administration
• If using more than one eye medication, be sure to administer the correct one at the correct time. Benefits depend on accurate administration.
• Shake the container if instructed on the label to do so. Suspensions should be shaken well to ensure the drug is evenly dispersed in the liquid and not settled in the bottom of the container.
• Tilt the head back or lie down and look up.
• Pull the lower lid down to expose the conjunctiva (mucous membrane).
• Place the dropper directly over the eye. Avoid contact of the dropper with the eye, finger, or any other surface. Such contact contaminates the solution and may cause eye infections and serious damage to the eye, with possible loss of vision.
• Look up just before applying a drop; look down for several seconds after applying the drop.
• Release the eyelid, close the eyes, and press the inside corner of the eye with a finger for 3 to 5 minutes. Closing the eyes and blocking the tear duct helps the medication be more effective by slowing its drainage out of the eye.
• Do not blink for 30 seconds after the administration of eye medications and during the eye examination.
• Do not rub the eye; do not rinse the dropper.
• If more than one eye drop is ordered, wait 10 minutes before instilling the second medication.
• Use the same basic procedure to insert eye ointments.