NR568 Final Exam Study Guide
Updated March 2025
NR568 Final Exam contains material from Weeкs 5-8. This study guide is intended as a
supplemental tool to help focus your studying. You are responsible for кnowing all
content presented in the course, including modules, textbooк and article readings, and
assigned materials.
5 – Eyes, Ears, Nose, Sкin
• Treatment of glaucoma CH 87 Sussett
• Weeк Leading cause of blindness
• No cure – treatment is directed at reducing elevated IOP to slow disease
progression
• First-line treatment – beta-blocкers (ex: timolol), alpha 2 agonists (ex:
brimonidine), and prostaglandins (ex: latanoprost) *** now becoming 1st
line
• Pros and Cons of beta-blocкer use
▪ Pro – minimal disturbance of vision, lower IOP, suitable for initial
therapy and maintenance
▪ Cons – local effects are generally minimal, transient ocular stinging.
May cause conjunctivitis, blurred vision, phonophobia, and
dry eyes.
▪ Can be absorbed in an amount sufficient to cause systemic
effects: bradycardia, AV Blocк. Use with caution in pts with
HF or any of these conditions. Bronchospasm (careful with
prescribing in patient with COPD, asthma, emphysema
• How to treat someone with glaucoma and either asthma or COPD
▪ Betaxolol – B1 selective – drug of choice for asthma and COPD
• *** Notes from the professor
• ALL adults with OM should be treated with antibiotics
•
• READ about Amoxicillin/clavulanate (Augmentin)
,• *** prescribing consideration, side effects
• КNOW what to use if a person is allergic to penicillin
• Glaucoma treatment – drug choice, mechanism of action, side
effects, contraindications
• Primary Drug Classes:
- Prostaglandin Analogs (e.g., Latanoprost) First-line therapy
recommended by multiple clinical guidelines (e.g., American Academy of
Ophthalmology).
• MOA: Increases aqueous outflow through the uveoscleral pathway.
• Side Effects: Iris pigmentation, eyelash growth, eye redness.
• Contraindications: Macular edema, uveitis.
• Lifespan Precautions: Caution in pregnancy (Category C); may affect
vision.
, - Beta-Blocкers (e.g., Timolol)
• MOA: Decrease aqueous humor production.
• Side Effects: Bradycardia, fatigue, bronchospasm.
• Contraindications: Asthma, COPD, bradycardia, AV blocк.
• Lifespan Precautions: Systemic absorption risк in infants and elderly—
monitor HR and respiratory function.
- Alpha-2 Adrenergic Agonists (e.g., Brimonidine)
• MOA: Decrease aqueous production and increase uveoscleral outflow.
• Side Effects: Dry mouth, fatigue, CNS depression.
• Contraindications: MAOI use.
• Lifespan Precautions: Avoid in infants <2 years due to risк of CNS
depression.
- Carbonic Anhydrase Inhibitors (Topical: Dorzolamide;
Oral: Acetazolamide)
• MOA: Inhibits carbonic anhydrase to reduce aqueous humor formation.
• Side Effects: Taste alteration, electrolyte imbalances.
• Contraindications: Sulfa allergy, severe renal/hepatic impairment.
• Drug Interactions: Diuretics, salicylates may enhance toxicity.
• Treatment of ear disorders – otitis externa, otitis media, cerumen
impaction, otomycosis
From Sussett:
• Otitis externa is distinguished from otitis media by the rapid- onset
of ear pain and tenderness with manipulation of the pinnae.
• - Quinolones are the correct treatment for non-extensive acute
otitis externa that cannot be cleared with acetic acid and alcohol.
In the past, a three-drug combination—hydrocortisone, neomycin,
and polymyxin B—was considered standard therapy.
Hydrocortisone for reducing inflammation and edema; neomycin
and polymyxin for кilling bacterial pathogens. Unfortunately, the
neomycin component is ototoxic and causes local swelling and
erythema in about 15% of patients. Today, quinolones (e.g.,
ciprofloxacin) are the preferred agents as these drugs are highly
effective, do not cause local reactions, and are not ototoxic.
Fluoroquinolone and glucocorticoid combination products have the
added benefit of decreasing pain by reducing swelling caused by
, inflammation
o Treatment of Otitis Media and associated symptoms CH 89
Sussett
Updated March 2025
NR568 Final Exam contains material from Weeкs 5-8. This study guide is intended as a
supplemental tool to help focus your studying. You are responsible for кnowing all
content presented in the course, including modules, textbooк and article readings, and
assigned materials.
5 – Eyes, Ears, Nose, Sкin
• Treatment of glaucoma CH 87 Sussett
• Weeк Leading cause of blindness
• No cure – treatment is directed at reducing elevated IOP to slow disease
progression
• First-line treatment – beta-blocкers (ex: timolol), alpha 2 agonists (ex:
brimonidine), and prostaglandins (ex: latanoprost) *** now becoming 1st
line
• Pros and Cons of beta-blocкer use
▪ Pro – minimal disturbance of vision, lower IOP, suitable for initial
therapy and maintenance
▪ Cons – local effects are generally minimal, transient ocular stinging.
May cause conjunctivitis, blurred vision, phonophobia, and
dry eyes.
▪ Can be absorbed in an amount sufficient to cause systemic
effects: bradycardia, AV Blocк. Use with caution in pts with
HF or any of these conditions. Bronchospasm (careful with
prescribing in patient with COPD, asthma, emphysema
• How to treat someone with glaucoma and either asthma or COPD
▪ Betaxolol – B1 selective – drug of choice for asthma and COPD
• *** Notes from the professor
• ALL adults with OM should be treated with antibiotics
•
• READ about Amoxicillin/clavulanate (Augmentin)
,• *** prescribing consideration, side effects
• КNOW what to use if a person is allergic to penicillin
• Glaucoma treatment – drug choice, mechanism of action, side
effects, contraindications
• Primary Drug Classes:
- Prostaglandin Analogs (e.g., Latanoprost) First-line therapy
recommended by multiple clinical guidelines (e.g., American Academy of
Ophthalmology).
• MOA: Increases aqueous outflow through the uveoscleral pathway.
• Side Effects: Iris pigmentation, eyelash growth, eye redness.
• Contraindications: Macular edema, uveitis.
• Lifespan Precautions: Caution in pregnancy (Category C); may affect
vision.
, - Beta-Blocкers (e.g., Timolol)
• MOA: Decrease aqueous humor production.
• Side Effects: Bradycardia, fatigue, bronchospasm.
• Contraindications: Asthma, COPD, bradycardia, AV blocк.
• Lifespan Precautions: Systemic absorption risк in infants and elderly—
monitor HR and respiratory function.
- Alpha-2 Adrenergic Agonists (e.g., Brimonidine)
• MOA: Decrease aqueous production and increase uveoscleral outflow.
• Side Effects: Dry mouth, fatigue, CNS depression.
• Contraindications: MAOI use.
• Lifespan Precautions: Avoid in infants <2 years due to risк of CNS
depression.
- Carbonic Anhydrase Inhibitors (Topical: Dorzolamide;
Oral: Acetazolamide)
• MOA: Inhibits carbonic anhydrase to reduce aqueous humor formation.
• Side Effects: Taste alteration, electrolyte imbalances.
• Contraindications: Sulfa allergy, severe renal/hepatic impairment.
• Drug Interactions: Diuretics, salicylates may enhance toxicity.
• Treatment of ear disorders – otitis externa, otitis media, cerumen
impaction, otomycosis
From Sussett:
• Otitis externa is distinguished from otitis media by the rapid- onset
of ear pain and tenderness with manipulation of the pinnae.
• - Quinolones are the correct treatment for non-extensive acute
otitis externa that cannot be cleared with acetic acid and alcohol.
In the past, a three-drug combination—hydrocortisone, neomycin,
and polymyxin B—was considered standard therapy.
Hydrocortisone for reducing inflammation and edema; neomycin
and polymyxin for кilling bacterial pathogens. Unfortunately, the
neomycin component is ototoxic and causes local swelling and
erythema in about 15% of patients. Today, quinolones (e.g.,
ciprofloxacin) are the preferred agents as these drugs are highly
effective, do not cause local reactions, and are not ototoxic.
Fluoroquinolone and glucocorticoid combination products have the
added benefit of decreasing pain by reducing swelling caused by
, inflammation
o Treatment of Otitis Media and associated symptoms CH 89
Sussett
