Chapter 57: Ophthalmic Drugs – Glaucoma & Eye Infection Treatments

Key concepts revolve around maintaining adequate intraocular pressure (IOP), particularly in managing glaucoma, a condition resulting from obstructed outflow or excessive production of aqueous humor. Pharmacological strategies for glaucoma include increasing aqueous fluid drainage using miotics (cholinergic drugs like pilocarpine) or prostaglandin agonists (like latanoprost, which can cause permanent iris color changes), and decreasing fluid production using beta-adrenergic blockers (like timolol) or carbonic anhydrase inhibitors (CAIs like dorzolamide). The text also discusses treatment options for acute conditions, such as the use of osmotic diuretics (mannitol) to rapidly reduce IOP. The chapter details diagnostic agents such as cycloplegic mydriatics (atropine) used for eye examinations to dilate the pupil and paralyze accommodation, and fluorescein sodium dye for identifying corneal injury and foreign bodies. Furthermore, it addresses topical anti-infectives (antibacterial, antiviral agents like trifluridine), anti-inflammatory drugs (corticosteroids and NSAIDs like ketorolac), and agents for allergies and dry eyes (antihistamines, mast cell stabilizers, and artificial tears). Essential nursing considerations are emphasized, focusing on meticulous assessment, ensuring proper instillation technique into the conjunctival sac while avoiding contamination, and applying pressure to the inner canthus to prevent systemic drug absorption and potential systemic adverse effects.