Otitis and Otic Administration

Study Notes

Otitis

Inflammation of the ear
External otitis: Inflammation of the outer ear, often associated with water ("swimmer's ear")
Treated with corticosteroids
Otitis media: Inflammation in the middle ear
Often associated with upper respiratory infections, allergies, auditory tube dysfunction, or irritation
Impacted cerumen (earwax) is a common cause of ear problems

Otic Administration

Used to treat local ear conditions, including infections and blockages of the auditory canal
Includes ear drops and irrigations
Ear drop administration:
- Adults and older children: Pull ear back and up
- Children age 3 and down: Pull ear down and back

Drugs for Ear Disorders

Anti-infective medications are frequently prescribed for ear infections.
- Acute otitis media: Amoxicillin, azithromycin, clarithromycin
- Otitis externa: Neomycin, polymyxin B, hydrocortisone, chloramphenicol, fluoroquinolones
- Common side effects: Burning, stinging, and superinfection

Pharmacotherapy with Otic Medications

Antibiotics: Treat infections
Topical corticosteroids: Used to treat inflammation
Severe or systemic infections: Require more than ear drops for treatment.
- Systemic symptoms include fever, nausea, and diarrhea, often seen in children.

Cerumenolytics

Used to soften cerumen for easier removal
Available in water and oil-based products

Glaucoma Drops

Applied to the eye
Cycloplegics: Paralyze eye muscles to prevent accommodation and dilate the pupil.
Allows for procedures like cataract surgery.
Causes blurred vision and loss of near vision
Mydriatics: Dilate the pupil to allow for viewing of the inner eye structures.
- Causes blurred vision, light sensitivity, and photophobia.
- Avoid driving until vision has returned to normal.
Prostaglandin analogues: Reduce fluid in the eye and lower pressure.
Beta-adrenergic blockers: Decrease pressure in the eye.

Glaucoma Pharmacotherapy

Goal: Prevent optic nerve damage by lowering intraocular pressure (IOP)
Combination therapy: May be necessary to achieve the goal.
Beta-adrenergic blockers:
- Medications typically end in "-olol".
- Used for glaucoma and ocular hypertension.
- Reduce IOP by decreasing the production of aqueous humor.
- Examples include carteolol, levobunolol, and timolol.
- Side effects include eye discomfort, burning/stinging, blurred vision, miosis, bronchoconstriction, bradycardia, AV heart block, and heart failure.
Teaching: Proper administration
- Clients should hold pressure on the inner corner of the eyelid for 1 full minute to prevent systemic absorption.
- Clients require monitoring for blood pressure changes.

Nasal Administration

Used for local and systemic treatment
Nasal mucosa: Provides excellent absorptive surface
Bypasses digestive enzymes: Increases bioavailability of medications.
High safety margin: Relatively safe route for administration
Drops and sprays: Used to shrink swollen nasal membranes.
Proper positioning: Important to avoid nasal septum.
Spray away from the septum

Pharmacotherapy for Nasal Congestion with Decongestants

Intranasal preparations: Decongestants
- Action: Constrict blood vessels, reducing congestion.
- Only use for 3-5 days: To avoid rebound congestion.
- Available OTC: In sprays and drops.
- Local action: Effects are seen within minutes.
- Few systemic effects: Safe for most patients.
Corticosteroids: Stop the immune/inflammatory response.
- Do not spray toward septum
- Not for long-term use
- Takes a few weeks for effectiveness: Consider using before peak allergy season.

Description

This quiz covers the inflammation of the ear, including external otitis and otitis media, along with their treatment. It also discusses the administration of ear medications and common drugs used for ear disorders. Test your knowledge on ear health and treatment protocols!