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Week 8: Discussion: Glaucoma
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Pharmacological management of glaucoma focuses on the reduction of intraocular
pressure by increasing the drainage of aqueous humor, decreasing the production, or
both. What drug classes are used to reduce intraocular pressure? Describe three
nursing interventions to consider with these drug classes.
Glaucoma is a condition where the optic nerve of eye is damaged due to abnormally high
pressure in the optic nerves. Glaucoma does not discriminate, it can occur at any age, however it
is seen more in adults and it is the leading cause of blindness in the elderly. This condition has no
warning signs because it is gradual and it is unnoticeable for the most part when vision change is
in an advanced stage. Vision loss due to glaucoma is not reversible, however, complications can
decrease with early diagnosis and treatment because earlier detection can slowdown or prevent
vision loss.
Medications for glaucoma includes;
Beta blockers are the first-line drug therapy for glaucoma and decrease intraocular
pressure by reducing aqueous humor production.
Pilocarpine ophthalmic solution - these medications work by draining excess fluid from
the eye (medlineplus.gov).
Carbonic anhydrase inhibitors (dorzolamide, acetazolamide, and brinzolamide) work in
similar ways as beta blockers. In the treatment of glaucoma, carbonic anhydrase
inhibitors decrease the secretions of the aqueous humor (drugs.com).
These are available in gels or eyedrop.
Nursing considerations
Patients should be taught how to administer their medications properly to ensure that they get
the full benefits of the therapy.
Instructions on proper administration will be provided to the patient during discharge
teaching. With timolol eyedrop, patients should be made aware of the side effects, such as
dizziness, difficulty breathing, swelling and numbness or tingling.
Patient’s blood pressure should be monitored when on beta blockers.
For patients using carbonic anhydrase inhibitors, patients should be assessed for allergies to
sulfonamides and be observed for signs of hypokalemia (Vallerand, Sanoski & Quiring,
2019). Patients should also be assessed for a decrease in visual acuity.
It is important for the patient to know to keep eyes closed for about 2 minutes after
administering eye drops to be more effective.
As always, medications should not be shared and side effects should be noted.
If severe adverse effects occur, a healthcare provider should be contacted immediately.
Take out contact lenses before using dorzolamide. Lenses may be put back in 15 minutes
after dorzolamide is given. Do not put contacts back in if your eyes are irritated or infected
(drugs.com).
If it is close to the time for your next dose, skip the missed dose and go back to your normal
time.
Do not use 2 doses at the same time or extra doses.
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