Thursday, March 11, 2010

Iritis

Iritis - Acute
Rahul Soman, M. Pharm


 

Definition  

Inflammation of the uveal layer of the anterior chamber of the eye. Sometimes the terms iritis and uveitis are used interchangeably; however, uveitis is a broader term referring to inflammation in the eye (anterior chamber, intermediate, posterior chamber, or panuveitis). More correctly, iritis is the same as acute anterior chamber uveitis . Chronic iritis is the result of recurring episodes of acute iritis.


 

Medical History  

* Injury of globe of eye

* Juvenile rheumatoid arthritis

* Behcet's syndrome

* Genetic predisposition

* Viral disease

* Bacterial infectious disease


 

Findings  

* Decreased intraocular pressure

* Fluorescein staining of cornea

* Light intolerance

* Pain of eye structure

* Raised intraocular pressure

* Anterior chamber finding

* Blurred vision

* Excessive tear production

* Limbal injection

* Miosis

* Reduced visual acuity


 

Tests  


 

Suspected and known iritis  

* Ocular slit lamp examination: Translucence of the aqueous humor (aqueous flare) and the presence of white blood cells in the anterior chamber are the sine qua non of iritis .


 

Differential Diagnosis  

* Glaucoma - Acute

* Corneal abrasion - Acute

* Keratitis

* Conjunctivitis

* Episcleritis

* Retinoblastoma

* Leukemia

* Malignant lymphoma of the eye region

* Retinitis pigmentosa


 

Treatment  


 

Drug Therapy  


 

Pain secondary to iritis  


 

HOMATROPINE HYDROBROMIDE  

Adults: Instill 1 drop of 2% or 5% solution in affected eye


 

CYCLOPENTOLATE HYDROCHLORIDE  

Adults: Instill 1 drop of 1% or 2% solution in affected eye


 

ACETAMINOPHEN/CODEINE PHOSPHATE  

Adults: Codeine 15 to 60 mg/acetaminophen 325 to 1,000 mg orally every 4 hours as needed (maximum 360 mg codeine and 4 g acetaminophen/day)

Pediatrics (3-6 years): 5 mL (12 mg codeine/120 mg acetaminophen per 5 mL) orally every 6 to 8 hours as needed

Pediatrics (7-12 years): 10 mL (12 mg codeine/120 mg acetaminophen per 5 mL) orally every 6 to 8 hours as needed


 

HYDROCODONE BITARTRATE/ACETAMINOPHEN  

Adults: Hydrocodone 5 to 20 mg/acetaminophen 325 to 1,000 mg orally every 4 hours as needed (maximum 4 g acetaminophen/day)

Pediatrics (2-13 years): 0.27 mL/kg (0.135 mg/kg hydrocodone and 9 mg/kg acetaminophen) orally every 4 hours as needed (maximum 6 doses/day)


 

 
 

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SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence