TY  - CHAP
M1  - Book, Section
TI  - Glaucoma
A1  - Fiscella, Richard G.
A1  - Lesar, Timothy S.
A1  - Owaidhah, Ohoud A.
A1  - Edward, Deepak P.
A2  - DiPiro, Joseph T.
A2  - Talbert, Robert L.
A2  - Yee, Gary C.
A2  - Matzke, Gary R.
A2  - Wells, Barbara G.
A2  - Posey, L. Michael
Y1  - 2017
N1  - 
T2  - Pharmacotherapy: A Pathophysiologic Approach, 10e
AB  - Patient  Care  Process  for  the  Management  of  GlaucomaCollectPatient  characteristics  (e.g.,  age,  race,  sex,  pregnant)Patient  history  (past  medical,  family  history  of  glaucoma,  social;  date  and  results  of  past  eye  examinations)Changes  in  vision  (see  Figure  94-4)Current  medications,  including  nonprescription  agents  and  topically  applied  products,  including  eye  drops  (see  Table  94-3  for  agents  that  affect  intraocular  pressure  (IOP)Objective  data  (see  Box  94-1)IOP  measurementsDisc  changes  and  abnormalities—bilateral,  symmetrical?Visual  field  changes  and  lossesAssessIf  primary  angle  closure  glaucoma  is  suspected,  manage  or  refer  as  ophthalmologic  emergencyPresence  of  conditions  that  can  produce  secondary  cases  of  open-angle  glaucoma  (e.g.,  exfoliation  syndrome,  pigmentary  glaucoma,  systemic  diseases,  trauma,  surgery,  ocular  inflammatory  diseases,  and  medications  [see  Table  94-3])Current  medications  that  may  contribute  to  or  worsen  glaucoma  (see  Table  94-3)Past  history  of  adverse  effects  to  agents  used  in  treatment  of  glaucomaIdentify  target  IOP  goal  based  on  past  history  and  current  situationPlan*Drug  therapy  regimen  designed  to  achieve  target  IOP,  including  specific  agent(s),  dose,  route,  frequency,  and  duration;  specify  the  continuation  and  discontinuation  of  existing  therapies  (see  Figure  94-5  and  Table  94-4)Monitor  IOP  for  target  reductions  (usually  at  least  20%  reduction  from  baseline  IOP,  if  not  a  reduction  of  25%  to  30%,  at  4–6  weeks  after  therapy  begins,  and  for  adverse  effects  (e.g.,  local  intolerance  or  reactions,  altered  iris  pigmentation  within  2  years  of  treatment  initiation,  hypertrichosis,  hyperpigmentation  of  lids  or  lashes)Referrals  to  other  providers  when  appropriate  (e.g.,  ophthalmologist)Implement*Provide  patient  education  regarding  all  elements  of  treatment  plan  Provide  extensive  education  about  administration  of  eye  drops,  separation  of  doses,  and  reinforcement  of  importance  of  adherence  to  preservation  of  visionUse  motivational  interviewing  and  coaching  strategies  to  maximize  adherenceSchedule  follow-up,  usually  4–6  weeks  after  therapy  starts  and  every  3–4  months  once  target  IOPs  are  achievedFollow-up:  Monitor  and  EvaluateMeasure  Intraocular  pressureOptic  disc  and  visual  fieldsAdverse  effects  to  medicationsAdherence  to  treatment  and  drug  administration  technique*Collaborate  with  patient,  caregivers,  and  other  health  professionals  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1152137201
ER  -