Otic pharm - otic drugs notes PDF

Preview

Summary

otic drugs notes...

Description

Pharm II Otic Drugs Final Ear Disorders • Bacterial and fungal infections • Inflammatory disorders that cause pain • Earwax accumulation • External ear: physical trauma, dermatitis • Middle ear: otitis media (middle ear infection) has to be treated with systemic drugs (amoxicillin first line) o Most often afflicts children, following a respiratory tract infection do not start ABX until fever is present o In adults usually results from foreign objects or water sports o Symptoms include pain, fever, malaise, pressure, sensation of fullness in the ears, hearing loss o If untreated, tinnitus, nausea, vertigo, mastoiditis may occur o Hearing deficits and hearing loss may result if prompt therapy not started Antibacterial and Antifungal Otic Drugs • Topical formulations applied to the external ear for otitis externa • Often combined with steroids for antiinflammatory, antipruritic, and antiallergic drug effects • Middle ear infections generally require systemically administered antibiotics PO, IV, IM • Antibiotics combination products contain ABX & steroid o neomycin and polymyxin B plus hydrocortisone combination (Cortisporin Otic) o Others containing ciprofloxacin • Antifungals more associated with water o Cortic (combination of antifungal drugs and hydrocortisone) steroids for inflammation and itching* o Giving ear drops with adult: pull back and up o Children: pull down Wax Emulsifiers used for hardened wax • carbamide peroxide leave in for a few mins, want pt to lay on opposite side, breaks down the wax and then can be removed. • Combined with other drugs, such as glycerin, to work together to loosen and help remove cerumen • Debrox Drops, Murine Ear Drops, Auro Ear Drops OTC Nursing Implications **** • Assess baseline hearing or auditory status • Evaluate patient’s symptoms • Assess drug and food allergies • Assess for contraindications • Perforated eardrum(s) may be a contraindication to these drugs do not want to give anything but maybe Cipro • If necessary or if ordered, remove cerumen before instilling ear drops by irrigation • Cleanse outer ear thoroughly • Ear drops should be warmed to approximately body temperature before instillation • Allow refrigerated solutions to warm to room temperature • Drops that are too cold may cause vomiting and dizziness refrigerated drugs need to be warmed to room temp. take out for at least an hr. Cold will cause vomiting • For adults, drops should be given while holding the pinna up and back

Pharm II Otic Drugs Final • For children younger than 3 years, hold the pinna down and back when giving ear drops • Allow the drops time to flow down into the ear canal • Patients should lie on the side opposite to the side of the affected ear for about 5 minutes after instillation of the drug • A small cotton ball may be gently inserted into the ear canal to keep the drug in, but do not force the cotton into the ear canal • Gently massage the tragus of the ear to encourage flow of medication to go into the ear (use gloves)...