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eye assess 411 part
part 3
Question | Answer |
---|---|
Primary closed angle glaucoma | (emergency) |
increased IOP - | over 75mmHg |
Pathophysiology : | due to complete blockage of filtering angle caused by a bunching up of iris. |
Maybe precipitated in by | narrow anterior chamber angles of administering anticholinergic drugs (atropine, scopolamine) |
Sxs : | Excruciating, throbbing pain around eyes to radiation to 5th CN region. Rapid loss of vision Nausea and vomiting (oculovagal reflex) Abdominal Pain, cornea - steamy, edema Blurred vision, haloes around light/rainbow around light Edematous eyelids during a |
If untreated, | irreversible blindness |
Aqueous humor backing up because of Iris abnormality - | fluid backing up to Retina - put pressure on Retina - need surgery right away. |
Keep IOP low to prevent | further Optic Nerve damage. |
Cholinergic agonist(Miotics) : | Constrict pupil - more room for draining off. (Pilocarpine, Carbachol - make pupil constriction) |
Prostaglandins - | Reducing aqueous humor. Has no systemic effects. SE : It makes eye pigmentation. Xalatan(Latanoprost). |
Beta blockers : | Decrease AH production.(does not affect pupil. Betagan, Ocupress) - Don't give nonselective B-blocker to COPD pts.(ex. Don’t give Inderal(nonseletive), since it knocks out lungs too) |
Selective Beta blockers | – Betoptic (betaxolol – Selective B1 antagonist) |
Alpha2 adrenergic agonists(negative feedback-inhibitory) | - enhance AH drainage. Closed angle glaucoma - never give adrenergic agonists.(give sympatholytic(cholinergic) drug – to constrict pupil). |
Carbonic Anhydrase inhibitors - | Reduce AH production. Diamox. |
Osmotic diuretics - | Mannitol, Urea, Glycerol, Osmoglyn. Pulling out fluid(AH), lessen the pressure. |