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How do carbonic anhydrase inhibitors help patients with acute or chronic glaucoma?
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They decrease aqueous humor production
Acetazolamide (Diamox), Dichlorphenamide (Daranide), and Methazolamide (Neptazane)are all _________ carbonic anhydrase inhibitors.
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Systemic
Acetazolamide (Diamox), Dichlorphenamide (Daranide), and Methazolamide (Neptazane) all have the same side effects, they are:
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Paresthesias, especially tingling in the extremities, hearing dysfunction or tinnitus, loss of appetite, taste alterations, GI disturbances, drowsiness, confusion
What are the nursing considerations for Acetazolamide (Diamox), Dichlorphenamide (Daranide), and Methazolamide (Neptazane)?
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They are sulfa based drugs, so if a patient has ever had an allergic reaction to a sulfonamide (like Bactrim, Septra) or sulfa-type drug they shouldn't take any of these. It has a diuretic effect that can impact electrolyte levels and the drug should not be given to anyone on high aspirin dose therapy
Brinzolamide (Azopt) and Dorzolamide (Trusopt) are __________carbonic anhydrase inhibitors.
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Topical
What are the common side effects experienced by patients using Brinzolamide (Azopt) and Dorzolamide (Trusopt)?
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Transient stinging, blurred vision, and redness.
What are the nursing considerations for a patient on any carbonic anhydrase inhibitor, whether it is systemic or topical?
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They are sulfa based drugs, so if a patient has ever had an allergic reaction to a sulfonamide (like Bactrim, Septra) or sulfa-type drug they shouldn't take any of these. It has a diuretic effect that can impact electrolyte levels and the drug should not be given to anyone on high aspirin dose therapy
Which two drugs are used in combination in the drug (Cosopt) to treat glaucoma?
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Brinzolamide (Azopt)=a carbonic anhydrase inhibitor and Timolol maleate (Timoptic)=beta adrenergic blocker
What side effects would be expected for a patient on the combination therapy Cosopt?
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Transient stinging, blurred vision, redness, photophobia, blepharoconjunctivitis, bradycardia, decreased BP, bronchospasm, headache, or depression.
What are the hyperosmolar agents used to treat acute and chronic glaucoma?
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Glycerin liquid (Opthalgan, Osmoglyn Oral), Isosorbide solution (Isomotic), and Mannitol solution (Osmitrol)
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What is the method of action common to hyperosmolar agents?
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Increases extracellular osmolarity so intracellular water moves to the extracellular and vascular spaces decreasing intraocular pressure.
What are the side effects experienced by patients on Glycerin liquid (Opthalgan, Osmoglyn Oral)?
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Nausea, vomiting, headache, disorientation, dysrhythmias, severe dehydration
What are the side effects experienced by patients on Isosorbide solution (Isomotic)?
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Nausea, vomiting, headache, disorientation, confusion, syncope, lethargy and irritability
What are the side effects experienced by patients on mannitol solution (Osmitrol)?
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Nausea, vomiting, diarrhea, headache, hypertension, hypotension, tachycardia, thrombophlebitis
What are the nursing considerations for all hyperosmolar drugs used to treat glaucoma?
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They are used in acute glaucoma attacks or preoperatively when decreased intraocular pressure is desired. A patient needs to be assessed for pulmonary edema and heart failure prior to administration
________ glaucoma is managed by treating the underlying problem and by using antiglaucoma drugs.
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Secondary
________ glaucoma that doesn't respond to treatment can progress to absolute glaucoma resulting in a hard, sightless and usually painful eye that will require enucleation (removal of the eye).
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Secondary
What would your recommendation be for a Caucasian patient in his 40's with respect to frequency of ophthalmologic examinations?
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Should be done every 2-4 years for patients 40-64
What would your recommendation be for an African American patient in his 40's with respect to frequency of ophthalmologic examinations?
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African Americans have a higher incidence of glaucoma and should therefore have their ophthalmologic exams more frequently than the standard recommendation of 2-4 years. He should be seen every 1-2 years.
What would your recommendation be for a Caucasian patient in his 70's with respect to frequency of ophthalmologic examinations?
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He should get an exam every 1-2 years.
What would your recommendation be for a African American patient in his 70's with respect to frequency of ophthalmologic examinations?
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African Americans are more susceptible to glaucoma and therefore should have their exams more frequently than the standard recommendation of 1-2 years for this age range. He should be seen yearly.
  
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