Term
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Definition
inflammation of conjunctiva due to allergens; characterized by red eyes w/ watery discharge;
Hallmark symptom: itching;
no visual impairment, may be blurred due to excessive tearing;
Do not use contact lenses until condition resolves; |
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Term
| Treatment Goals for Allergic Conjunctivitis |
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Definition
remove or avoid allergens;
limit or reduce severity of allergic reactions;
provide symptomatic relief;
protect ocular surface;
prevent future allergic symptoms; |
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Term
| Artificial Tears (OTC) - cellulose ethers [hydroxypropyl methylcellulose (Tears Naturale), hydroxyethylcellulose [Comfort Tears], methylcellulose [Murocel Lubricant Ophthalmic], carboxymethylcellulose [Refresh Plus]), polyvinyl alcohol (Nu-Tears), povidone (Refresh), glycerine (Refresh Endura) |
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Definition
MoA: dilutes or removes allergens while lubricating eyes;
Dosage: 1-2 drops bid-qid prn;
No side effects or C/Is;
Formulations w/o preservatives are less likely to irritate ocular surface than those with preservatives;
Use PVA cautiously in pts w/ contact lenses; |
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Term
| Preservative Free Artificial Tears |
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Definition
| Bion Tears, Celluvisc, Hypo Tears Preservative Free, Refresh Plus |
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Term
| Nonmedicated Opthalmic Ointments - Akwa Tears, Artifical Tears PF, Dry Eyesa, DuraTears Naturale, Moisture Eyes PM, Hypo Tears, Refresh PM, Stye, Tears Renewed |
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Definition
MoA: enhanced retention time in eye enhances moisturizing;
Dosing: administerd BID;
NO side effects or C/Is;
Instill at bedtime to keep eyes moist during sleep & improve morning symptoms of dry eye;
Counsel pts on blurred vision associated w/ ointments; |
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Term
| Opthalmic Decongestants - phenylephrine (Relief), naphazoline (Clear Eyes), tetrahydrozoline (Visine Original), oxymetazoline (Ocu-Clear) |
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Definition
MoA: constricts conjunctival vessels reducing eye redness;
Side Effects:
Local - rebound ocular congestion, stinging, dry eyes, pupil dilation;
Systemic: rare;
C/Is: angle-closure glaucoma;
Caution pts against using while pregnant; |
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Term
Opthalmic Antihistamines - OTC: pheniramine & naphazoline (Naphcon A, Opcon-A, Visine-A), ketotifen (Alaway, Claritin Eye, Zaditor, Zyrtec Itchy Eye);
RX: azelastine (Optivar), olopatadine (Patanol) |
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Definition
MoA: blocks H-1 receptors resulting in rapid relief of symptoms associated w/ allergic conjunctivitis;
Side Effects:
Local - burning, itching, discomfort, pupil dilation;
Systemic: rare;
C/Is: angle-closure glaucoma;
Use with a decongestant b/c it is MORE effective than either agent alone; |
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Term
| Opthalmic Immunosuppressant - cyclosporine 2% (Restasis) |
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Definition
MoA: suppresses immune response to allergens;
Dosage: 1 gtt BID;
Side Effects:
Local - burning, pruritus, stinging;
Systemic: rare;
C/Is: active ocular infections;
Used only in severe conjunctivitis w/ corneal damage; |
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Term
| Non-Pharm Therapy for Allergic Conjunctivitis |
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Definition
Remove or avoid exposure to offending allergen;
Apply cold compresses to eye TID-QID to reduce redness & itching |
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Term
| Tx for Allergic Conjunctivitis |
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Definition
1st line: instill artificial tears PRN;
If Sx persist, switch to ophthalmic decongestant/antihistamine product;
Add oral antihistamine if needed;
Medical referral necessary if Sx do not resolve after 3 days |
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Term
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Definition
inflammation of conjunctiva due to viral infection;
self-limiting infection lasting 1-3 wks;
most common form: "pink eye";
highly contagious, pink eyes w/ watery discharge;
Sx: ocular discomfort, mild-moderate foreign object sensation in eye;
vision may be blurred w/ low-grade fever |
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Term
| Etiology of Viral Conjunctivitis |
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Definition
| recent cold, sore throat or exposure to someone w/ viral conjunctivitis |
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Term
| Treatment Goals for Viral Conjunctivitis |
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Definition
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Term
| Pharm Therapy for Viral Conjunctivitis |
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Definition
artificial tears;
opthalmic decongestants |
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Term
| Non-PHarm Therapy for Viral Conjunctivitis |
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Definition
Wash hands after touching infected eye;
Properly dispose of any tissues used to blot an infected eye;
Avoid sharing towels or other objects that may come in contact w/ infected eye; |
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Term
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Definition
conjunctivitis caused by bacterial pathogens;
most commonly Gram-Neg organisms - Strep. pneumoniae (+), Staph. aureus (+), H. influenzae (-), Moraxella (-);
Sx: purulent ocular discharge without itching; |
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Term
| Treatment Goals for Bacterial Conjunctivitis |
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Definition
Complete resolution of bacterial conjunctivitis;
Prevent adverse consequences of infection;
Preserve functionality of eye; |
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Term
| Pharm Therapy for Bacterial Conjunctivitis |
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Definition
Tx acute episodes w/ broad-spectrum antibiotics (decrease spread, prevents extraocular infection, decrease risk of corneal ulceration, speed recovery);
Empiric antibiotic selection:
1st line - polymixin B/TMP soln, polymyxin B w/ bacitracin ointment, erythromycin;
Alternatives: aminoglycosides (tobramycin, neomycin, gentamicin), fluoroquinolones (ofloxacin, ciprofloxacin, moxifloxacin, levofloxacin);
Hyperacute bacterial conjunctivitis: ceftriaxone 1 g IM in combo w/ topical antibiotics; |
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