pharmacology.docx

- 8-9 questions per unit **Adrenergic Drugs** -------------------- ### **Overview** Adrenergic drugs stimulate the sympathetic nervous system by mimicking the effects of the neurotransmitters norepinephrine, epinephrine, and dopamine. These neurotransmitters are known as...

- 8-9 questions per unit **Adrenergic Drugs** -------------------- ### **Overview** Adrenergic drugs stimulate the sympathetic nervous system by mimicking the effects of the neurotransmitters norepinephrine, epinephrine, and dopamine. These neurotransmitters are known as catecholamines. ### **Receptor Types and Effects** #### **Alpha Receptors** - - - #### **Beta Receptors** - - - - - - - - - - ### **Mechanisms of Action** - - - ### **Indications** #### **Respiratory System** - - #### **Eyes** - - #### **Cardiovascular System** - ### **Contraindications** - ### **Adverse Effects** #### **Central Nervous System (CNS)** - - - - #### **Cardiovascular System (CV)** - - - - - #### **Other** - - - - ### **Toxicity and Management** - - ### **Specific Drugs** #### **Vasoactive Cardioselective Adrenergics** - - - - - - - - - - - - - - - ### **Nursing Implications** - - - - - - **Adrenergic-Blocking Drugs** ----------------------------- ### **Classes** - - - ### **Alpha Blockers** #### **Mechanism of Action** - - #### **Indications** - - - - - - #### **Contraindications** - - - - - #### **Adverse Effects** - - - - - #### **Interactions** - - - - - - #### **Drugs** - - - - ### **Beta Blockers** #### **Mechanism of Action** - - - #### **Indications** - - - - - #### **Contraindications** - - - - - - #### **Adverse Effects** - - - - - #### **Abrupt Withdrawal** - - - - #### **Interactions** - - - - - - #### **Drugs** - - - - - - - ### **Nursing Implications** - - - - - - - **Cholinergic Drugs** --------------------- ### **Overview** Cholinergic drugs stimulate the parasympathetic nervous system (PSNS), mimicking the effects of acetylcholine. They are involved in voluntary muscle movement, memory, cognition, and learning. ### **Receptor Sites** - - ### **Mechanism of Action** - - ### **Effects** - - - - - - - - ### **Indications** #### **Direct-Acting Drugs** - - - #### **Indirect-Acting Drugs** - - - - ### **Contraindications** - - - - - - - - ### **Adverse Effects** #### **Cardiovascular** - - - - #### **Central Nervous System (CNS)** - - - - #### **Gastrointestinal (GI)** - - - #### **Respiratory** - - #### **Other** - - - - ### **Cholinergic Crisis (SLUDGE-M)** - - - - - - - - ### **Interactions** - - - - ### **Antidote** - ### **Nursing Implications** - - - - - This breakdown organizes the key concepts and details of cholinergic drugs, covering their mechanisms of action, indications, contraindications, adverse effects, interactions, specific drugs, and nursing implications. **Cholinergic-Blocking Drugs** ------------------------------ ### **Overview** Cholinergic-blocking drugs, also known as anticholinergics, block the action of acetylcholine (Ach) in the parasympathetic nervous system (PNS). They act as competitive antagonists by competing with Ach to bind at muscarinic receptors, thereby inhibiting nerve transmission and preventing cholinergic effects. ### **Mechanism of Action** - - ### **Effects** #### **Cardiovascular (CV)** - - #### **Central Nervous System (CNS)** - - #### **Eye** - #### **Gastrointestinal (GI)** - - #### **Genitourinary (GU)** - #### **Glandular** - #### **Respiratory** - - ### **Indications** #### **Parkinson\'s Disease** - #### **Cardiovascular** - - - #### **Respiratory** - - - #### **Gastrointestinal** - - #### **Genitourinary** - ### **Contraindications** - - - - - ### **Adverse Effects** #### **Cardiovascular** - - #### **Central Nervous System** - - - #### **Eye** - - #### **Gastrointestinal** - - #### **Genitourinary** - #### **Glandular** - #### **Respiratory** - #### **General Side Effects** - - - - - ### **Overdose/Toxicity Management** - - - - - ### **Nursing Implications** - - - - - **Thyroid and Antithyroid Drugs** --------------------------------- ### **Overview of Thyroid Function** - - - - ### **Hypothyroidism** - - - - #### **Specific Conditions** - - - - - - #### **Treatment** - - - - - - - ### **Hyperthyroidism** - - - - - - - - - - - - - - - - ### **Antithyroid Drugs** - #### **Specific Treatments** - - - - - - - - - - - - - #### **Administration Considerations** - - ### **Nursing Implications** - - - - - **Antidiabetic Drugs** ---------------------- ### **Overview of Diabetes** - - - - ### **Treatment** - - ### **Types of Insulin** #### **Short-Acting Insulin** - - - - #### **Regular Insulin** - - - - #### **Intermediate-Acting Insulin (NPH)** - - - - #### **Long-Acting Insulin** - - - - #### **Insulin Mixtures** - - #### **Key Points** - - ### **Oral Antidiabetic Drugs** - #### **Biguanides** - - - - - #### **Sulfonylureas** - - - - ### **Glucose-Elevating Drugs** - - - - - - ### **Nursing Implications** - - - - - - - **Adrenal Drugs** ----------------- ### **Overview of the Adrenal Glands** - - - - ### **Types of Adrenal Drugs** #### **Glucocorticoids** - - - - - - - - #### **Mineralocorticoids** - - - - ### **Indications** #### **Glucocorticoids** - - - - - - #### **Mineralocorticoids** - - ### **Contraindications** - - - - - - ### **Adverse Effects** #### **Glucocorticoids** - - - - - - - - #### **Mineralocorticoids** - - - - - ### **Drug Interactions** - - - - - ### **Nursing Implications** - - - - - - - - - - **Women\'s Drugs** ------------------ ### **Overview** Women\'s drugs encompass various categories, including hormone replacement therapies, contraceptives, fertility drugs, and drugs for osteoporosis. ### **Hormone Replacement Therapy (HRT)** - - - - - - - - - - - - - - ### **Contraceptives** - - - - - - - - - ### **Fertility Drugs** - - - - - - - - - - - - ### **Drugs for Osteoporosis** - - - - - - - - - - - - - - - - - - **Men\'s Health Drugs** ----------------------- ### **Overview** Men\'s health drugs include treatments for hormone replacement, erectile dysfunction, benign prostatic hyperplasia (BPH), and conditions related to testosterone deficiency. ### **Androgens (Testosterone)** - - - - - - - - - - - - - ### **Erectile Dysfunction Drugs** - - - - - - - - - - - - - ### **Benign Prostatic Hyperplasia (BPH) Drugs** - - - - - - - - - - - - - - - - ### **Drugs for Male Pattern Baldness** - - **Antihypertensive Drugs** -------------------------- ### **Overview** Antihypertensive drugs are used to manage hypertension (high blood pressure) and prevent complications such as stroke, myocardial infarction, and kidney damage. These drugs are classified into several categories based on their mechanisms of action. ### **Diuretics** - - - - - - - - - - - - - - - - ### **Beta-Blockers** - - - - - - - - - - - ### **ACE Inhibitors** - - - - - - - ### **Angiotensin II Receptor Blockers (ARBs)** - - - - - - - ### **Calcium Channel Blockers** - - - - - - - - - - - ### **Alpha-Blockers** - - - - - - - ### **Centrally Acting Alpha Agonists** - - - - - - - ### **Vasodilators** - **Antianginal Drugs** --------------------- ### **Overview** Antianginal drugs are used to manage angina, a type of chest pain caused by ischemia (poor blood supply) to the heart muscles. Ischemic heart disease, often resulting from atherosclerosis and coronary artery disease (CAD), can lead to myocardial infarction (MI) or heart attack, characterized by the necrosis and death of cardiac tissue. ### **Types of Angina** 1. - - 2. - - 3. - - ### **Drug Classes** - - - These drugs are used to minimize the frequency and intensity of angina attacks. ### **Nitrates and Nitrites** #### **Mechanism of Action** - - - #### **Available Forms** - - #### **Contraindications** - - #### **Adverse Effects** - #### **Specific Drug: Nitroglycerin (NTG)** - - - - #### **Nursing Interventions** - - - - ### **Beta Blockers** #### **Mechanism of Action** - #### **Indications** - #### **Contraindications** - #### **Adverse Effects** - #### **Examples** - - #### **Nursing Interventions** - - - ### **Calcium Channel Blockers (CCBs)** #### **Mechanism of Action** - #### **Indications** - #### **Contraindications** - #### **Adverse Effects** - #### **Examples** - - #### **Nursing Interventions** - - - - ### **Chapter 24: Heart Failure Drugs** **Heart Failure (HF)**: Results from functional or structural impairment of the heart, specifically the ejection of blood or ventricular filling. The heart is unable to pump a sufficient amount of blood from the ventricles to meet the body's metabolic needs, leading to reduced ejection fractions. **Symptoms**: Depend on the area of the heart affected. - - - **Drug Classes for Heart Failure**: 1. 2. 3. 4. 5. 6. 7. 8. 9. ### **ACE Inhibitors** - - - - ### **ARBs (Angiotensin II Receptor Blockers)** - - - - ### **Beta Blockers** - - - - ### **Cardiac Glycosides** - - - - - - - - - ### **Diuretic Drugs** - - 1. - - - - - 2. - - - - - 3. - - - - - ### **Heart Failure Drug Implications** - - - - - - - - OTHER DIURETICS ### **Osmotic Diuretics** - - - - - - - - ### **Carbonic Anhydrase Inhibitors** - - - - - - - - - **Antidysrhythmic Drugs** ------------------------- ### **Overview** Antidysrhythmic drugs are used to treat abnormal heart rhythms (dysrhythmias) by restoring a normal heart rhythm and preventing the recurrence of arrhythmias. These drugs are classified into five classes based on their mechanisms of action. ### **Class I: Sodium Channel Blockers** #### **Class IA** - - - - - - - - #### **Class IB** - - - - - - - - #### **Class IC** - - - - - - - - ### **Class II: Beta Blockers** - - - - - - - - ### **Class III: Potassium Channel Blockers** - - - - - - - - ### **Class IV: Calcium Channel Blockers** - - - - - - - - ### **Class V: Miscellaneous** #### **Adenosine** - - - - - - - #### **Digoxin** - - - - - - - - **Coagulation Modifier Drugs** ### **Overview** Coagulation modifier drugs are used to prevent or treat blood clotting disorders. These drugs are classified into anticoagulants, antiplatelets, thrombolytics, and antifibrinolytics, each with specific mechanisms of action and clinical applications. ### **Anticoagulants** Anticoagulants prevent the formation of new clots and the extension of existing clots. They do not dissolve existing clots. #### **Heparin and Low Molecular Weight Heparins (LMWH)** - - - - - - - - - #### **Warfarin (Coumadin)** - - - - - - - - #### **Direct Oral Anticoagulants (DOACs)** - - - - - - - - - ### **Antiplatelets** Antiplatelets prevent platelet aggregation, reducing the risk of arterial thrombosis. #### **Aspirin** - - - - - - - #### **Clopidogrel (Plavix)** - - - - - - - ### **Thrombolytics** Thrombolytics dissolve existing clots, used in acute situations such as myocardial infarction and stroke. #### **Alteplase (tPA)** - - - - - - - - ### **Antifibrinolytics** Antifibrinolytics promote blood clotting by inhibiting the breakdown of fibrin. #### **Tranexamic Acid** - - - - - - - ### **Nursing Implications for All Coagulation Modifier Drugs** - - - - - - - - - - **Antilipemic Drugs** --------------------- ### **Overview** Antilipemic drugs are used to lower lipid levels in the blood, primarily to reduce the risk of cardiovascular diseases such as atherosclerosis, myocardial infarction, and stroke. These drugs target various pathways in lipid metabolism to achieve their effects. ### **HMG-CoA Reductase Inhibitors (Statins)** - - - - - - - - ### **Bile Acid Sequestrants** - - - - - - - - ### **Niacin (Vitamin B3)** - - - - - - - - ### **Fibric Acid Derivatives (Fibrates)** - - - - - - - - ### **Cholesterol Absorption Inhibitors** - - - - - - - - ### **PCSK9 Inhibitors** - **Fluids and Electrolytes** --------------------------- ### **Overview** Fluids and electrolytes are critical for maintaining homeostasis, regulating nerve and muscle function, hydrating the body, balancing blood acidity and pressure, and rebuilding damaged tissue. Disorders of fluid and electrolyte balance can lead to serious health issues. ### **Intravenous (IV) Fluids** IV fluids are used to manage fluid and electrolyte imbalances and provide hydration. They are categorized into crystalloids and colloids. #### **Crystalloids** - - - - - - - - #### **Colloids** - - - - - - - - ### **Electrolyte Supplements** Electrolyte supplements are used to correct electrolyte imbalances. Common electrolytes include potassium, sodium, calcium, magnesium, and phosphate. #### **Potassium** - - - - - - - - #### **Sodium** - - - - - - - - #### **Calcium** - - - - - - - - #### **Magnesium** - - - - - - - - #### **Phosphate** - **Antibiotic Therapy** ---------------------- ### **Types of Therapy** - - - ### **Antibiotic Classes** 1. 2. 3. 4. 5. 6. 7. ### **General Mechanisms** - - ### **Sulfonamides** - - - - - - - ### **Beta-Lactams** #### **Penicillins** - - - - - - - #### **Cephalosporins** - - - - - - ### **Macrolides** - - - - - - - ### **Tetracyclines** - - - - - - - ### **Aminoglycosides** - - - - - - - ### **Quinolones** - - - - - - - ### **Miscellaneous** #### **Vancomycin** - - - - - - ### **General Nursing Implications for Antibiotic Therapy** - - - - - - - - - - - - - **Antiviral Drugs** ------------------- ### **Overview** Antiviral drugs are used to treat infections caused by viruses. These drugs work by inhibiting the replication of viruses, thereby reducing the severity and duration of viral infections. ### **Antiviral Drug Classes** 1. 2. 3. ### **Antiherpesvirus Agents** - - - - - - - - ### **Antiinfluenza Agents** - - - - - - - - ### **Antiretrovirals** - - - - - - - - **Antitubercular Drugs** ------------------------ ### **Overview** Antitubercular drugs are used to treat infections caused by Mycobacterium tuberculosis. These drugs are usually used in combination to prevent resistance and effectively eradicate the bacteria. ### **First-Line Antitubercular Drugs** 1. 2. 3. 4. ### **Isoniazid (INH)** - - - - - - - ### **Rifampin (Rifadin)** - - - - - - - ### **Ethambutol (Myambutol)** - - - - - - - ### **Pyrazinamide (PZA)** - - - - - - - **Antifungal Drugs** -------------------- ### **Overview** Antifungal drugs are used to treat fungal infections. These infections can be systemic or localized to the skin, nails, or mucous membranes. ### **Antifungal Drug Classes** 1. 2. 3. 4. ### **Polyenes** #### **Amphotericin B** - - - - - - - #### **Nystatin** - - - - - - - ### **Azoles** - - - - - - - - ### **Echinocandins** - - - - - - - - ### **Miscellaneous** #### **Terbinafine (Lamisil)** - **Antiinflammatory and Antigout Drugs** --------------------------------------- ### **Overview** Antiinflammatory and antigout drugs are used to reduce inflammation, pain, and manage symptoms associated with gout. These drugs can be classified into several categories based on their mechanisms of action and therapeutic use. ### **Nonsteroidal Antiinflammatory Drugs (NSAIDs)** - - - - - - - - ### **Corticosteroids** - - - - - - - - ### **Antigout Drugs** #### **Allopurinol (Zyloprim)** - - - - - - - #### **Colchicine (Colcrys)** - - - - - - - #### **Probenecid** - - - - - - - ### **General Nursing Implications for Antiinflammatory and Antigout Drugs** - - - - - - - - - - - - - **Upper Respiratory Drugs** --------------------------- ### **Antitussives** - - - - - - - - ### **Expectorants** - - - - ### **Decongestants** - - - - - - - - ### **Antihistamines** - - - - - - **Lower Respiratory Drugs** --------------------------- ### **Classes** - - - - - - - ### **Mucolytics** - - - - - ### **Bronchodilators** - - - - - - - - - - - - - ### **Anticholinergics** - - - - ### **Mast Cell Stabilizers** - - - - ### **Leukotriene Antagonists** - - - - ### **Steroids** - - - - - - - ### **Analeptics** - - - - - - **Upper GI Drugs** ------------------ ### **Indications** - - - - ### **Antacids** - - - - - - - - - - - - - - - ### **Histamine 2 Receptor Antagonists** - - - - - - ### **Proton Pump Inhibitors (PPIs)** - - - - ### **Promotility Agents** - - - - - ### **Anticholinergics/Antispasmodics** - - - - - - ### **Antiemetics** - - - - - - - - - - **Lower GI Drugs** ------------------ ### **Indications** - ### **Local Acting** - - - - - ### **Antidiarrheals** - - - - - - - ### **Laxatives** - - - - - - - - - - - - - - 24 questions worth together - **Opioid Analgesics** --------------------- ### **Main Use** - ### **Other Uses** - - - ### **Contraindications** - ### **Use with Extreme Caution in Patients with:** - - - - - ### **Adverse Effects** - - ### **Opioid Tolerance and Dependence** - - ### **Toxicity and Management of Overdose** - - ### **Opioid Withdrawal (Opioid Abstinence Syndrome)** - ### **Interactions** - ### **Selected Opioids** #### **Codeine Sulfate** - - - - - #### **Fentanyl** - - - - #### **Hydromorphone (Dilaudid)** - - #### **Morphine Sulfate** - - - - - ### **Nursing Implications** - - - - - Chapter 12 Central Nervous System Depressants and Muscle Relaxants **Central Nervous System (CNS) Depressants and Muscle Relaxants** ----------------------------------------------------------------- ### **CNS Depressants** #### **Main Uses** - - - #### **Classes** 1. 2. 3. ### **Barbiturates** - - - - - - - - ### **Benzodiazepines** - - - - - - - - - ### **Miscellaneous Sedatives/Hypnotics** - - - - - - - - ### **Muscle Relaxants** #### **Main Uses** - - #### **Types** 1. 2. ### **Central Acting Muscle Relaxants** - - - - - - - - ### **Direct Acting Muscle Relaxants** - **Central Nervous System (CNS) Stimulants and Related Drugs** ------------------------------------------------------------- ### **Main Uses** - - - - ### **Classes** 1. 2. 3. 4. ### **Amphetamines** - - - - - - - - ### **Non-amphetamine Stimulants** - - - - - - - - ### **Anorexiants** - - - - - - - - ### **Antimigraine Drugs** - **Antiepileptic Drugs (AEDs)** ------------------------------ ### **Main Uses** - - ### **Classes** 1. 2. 3. 4. ### **Barbiturates** - - - - - - - - ### **Hydantoins** - - - - - - - - ### **Iminostilbenes** - - - - - - - - ### **Miscellaneous AEDs** - - - - - - - - **Antiparkinson Drugs** ----------------------- ### **Main Uses** - - ### **Classes** 1. 2. 3. 4. 5. ### **Dopaminergic Drugs** - - - - - - - - ### **Dopamine Agonists** - - - - - - - - ### **MAO-B Inhibitors** - - - - - - - - ### **COMT Inhibitors** - - - - - - - - ### **Anticholinergics** - Antidepressants and antipsychotics Antidepressant Indications - mdd, eating disorder, personality disorder Moa- increase the levels of neurotransmitter concentrations in CNS Class - tricyclic antidepressants (tca's), monoamine oxidse inhibitors (maoi's) and selective serotonin reuptake inhibitors (ssri's) Tricyclic antidepressant Moa- block reuptake of neurotransmitters, causing accumulation at nerve ending Indications- depression, ocd (clomipramine), adjunctive analgesics for chronic pain conditions, such as trigeminal neuralgia drug to know: amitriptyline Adverse- sedation, impotence, orthostatic hypotension Overdose - lethal 70-80% die before reaching hospital Cns and cardiovascular systems are mainly affected No specific antidote Death from seizure of dysrthmia Maoi's - rarely used for depression, used for parkinsons, disadvtage is potential hypertensive crisis when taken with tyramine Ingestion of foods or drink with tyramine leads to hypertensive crisis which may lead to cerebral hemorrhage, stroke, coma or death Avoid foods withtyramine - aged/ mature cheese, smoked, pickled and aged meats, yeast extracts, italian broad beans Ex- nardil, parnate, marplan (no popular meds) causes sweating, tremors, elevated temp, bounding heart, raised bp, no barbituates, tricyclic antidepressants, antihystamines, cns depressants, antihypertensives, otc cold meds Ssri's Fewer adverse effects than tcas and maois, very few drug-drug or drug-food interactions, still take about 4-6 weeks to reach effectiveness, 1st line drug for depressions Moa- inhibit of serotonin reuptake and effect on norepinephrine and dopamine reuptake Adverse effects- insomnia, weight gain, sexual dysfunctino Serotonin syndrome Common symptoms - delirium, agitation, tachyc, sweating, myoclonus (muscle spasms) shivering, course tremors Late symptoms- seizures, rhabdo, renal failure and death Common used ssri - citalopram, duloxetine, fluoxetine, mirtazaoine (sedation occurs dose at bedtime) Antipsychotics Moa- block dopamine receptors in brain, areas associated with emotion, cognitive function, motor function Dopamine levels in the CNS are decreased Result- tranqulizing effect in psychotic patients Drugs used to treat serious mental illness - drug induced psychoses, schizophrenia, autism and can also treat mania Adverse effects Cns effect - drowsiness, neuroleptic malignant syndrome (potentionally life threatening, high fever, unstable bp, myoglobinemia) k, extrapyramidal symptoms: pseudoparkinsonism-akathsia, tardive dyskineasia, weight gain, metabolic syndrome Haloperidol (haldol) Indications- long term treatment of psychosis Contraindications- hypersensitivity, parkinsons diseases and in patients taking large amount of cns depressants Can be given oral, intramusclar, intravenous Useful in treating patients with schizophrenia who wee nonadherant with drug regimen Risperidone Idication - schizophrenia, including negtive symptoms Adverse effects- minimal eps at therapeutic dosages 1 to 6mg/day Resperdal consta- long acting injectable form last approximately 2 weeks - **Antidepressants** ------------------- ### **Indications** - - - ### **Mechanism of Action** - ### **Classes** 1. 2. 3. ### **Tricyclic Antidepressants (TCAs)** - - - - - - ### **Monoamine Oxidase Inhibitors (MAOIs)** - - - - - - ### **Selective Serotonin Reuptake Inhibitors (SSRIs)** - - - - - - **Antipsychotics** ------------------ ### **Mechanism of Action** - ### **Indications** - - ### **Adverse Effects** - - - ### **Haloperidol (Haldol)** - - - - ### **Risperidone (Risperdal)** - **Cancer Treatment** -------------------- ### **Overview** - - - ### **Cancer Drug Nomenclature** - - - ### **Chemotherapy** #### **Classification** - - #### **General Characteristics** - - - - - - - - - - - ### **Chemotherapy Considerations** - - - - - - ### **Nursing Implications for Chemotherapy** - - - - - **Dermatologic Drugs** ---------------------- ### **Main Uses** - ### **Classes** 1. 2. 3. 4. 5. 6. 7. ### **Antibacterial Drugs** - - - - - ### **Antifungal Drugs** - - - - - ### **Antiviral Drugs** - - - - - ### **Anti-inflammatory Drugs** - - - - - ### **Antipsoriatic Drugs** - - - - - ### **Acne Drugs** #### **Topical** - - - - - #### **Oral** - - - - - ### **Miscellaneous Dermatologic Drugs** - - - - - - - **Ophthalmic Drugs** -------------------- ### **Main Uses** - ### **Classes** 1. 2. 3. 4. 5. 6. 7. ### **Antibacterial Drugs** - - - - - ### **Antifungal Drugs** - - - - - ### **Antiviral Drugs** - - - - - ### **Anti-inflammatory Drugs** #### **Corticosteroids** - - - - - #### **Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)** - - - - - ### **Antiglaucoma Drugs** #### **Beta-Adrenergic Blockers** - - - - - #### **Prostaglandin Analogs** - - - - - #### **Alpha Agonists** - - - - - #### **Carbonic Anhydrase Inhibitors** - - - - - ### **Mydriatics and Cycloplegics** - - - - - ### **Lubricants and Moisturizers** - - - - - - **Otic Drugs** -------------- ### **Main Uses** - ### **Classes** 1. 2. 3. 4. ### **Antibacterial and Antifungal Drugs** - - - - - - - - - ### **Anti-inflammatory Drugs** - - - - - ### **Local Anesthetics** - - - - - ### **Cerumenolytics** - - - - - ### **General Nursing Implications for Otic Drugs** - - - - - - - - - - - ### **Specific Drug Information** #### **Ciprofloxacin (Otic Solution)** - - - #### **Clotrimazole (Otic Solution)** - - - #### **Hydrocortisone (Otic Solution)** - - - #### **Benzocaine (Otic Solution)** - - - #### **Carbamide Peroxide (Otic Solution)** - - -