Drugs For Eye and Ear Disorders - (Ear Only)
College: First year, College: Second year, College: Third year, College: Fourth year
OTIC
EAR
ANTIINFECTIVES
ARE THE SAME PREPARATIONS USED TO TREAT OTHER AREAS OF THE BODY, BUT ARE ALSO USED TO TREAT EAR DISORDERS.
CONDITIONS REQUIRING ANTIBACTERIAL DRUGS ARE:
ACUTE OTITIS MEDIA (AOM), AND ACUTE OTITS EXTERNA (SWIMMER'S EAR)
COMMON PATHOGENS THAT CAUSE AOM IN CHILDREN ARE:
1. STREPTOCOCCUS PNEUMONIAE (40% TO 50%)
FOLLOWED BY HAEMOPHILUS INFLUENZA AND MORAXELLA CATARRALIS.
VAST MAJORITY OF AOM RESOLVE ____________.
SPONTANEOUSLY.
THE DRUG OF CHOICE (GOLD STANDARD) WHEN A ANTIBIOTIC ARE INDICATED IS ?
amoxicillin (Amoxil, Augmentin)
*(AGE 6 MO AND OLDER WITH DEFINITIVE DIAGNOSIS AND SEVERITY OF DISEASE)
WHAT IS RECOMMENDED IF THE CLIENT;S ALLERGY TO PENICILLIN IS SEVERE (ANAPHYLAXIS, URTICARIA)
1. AZITHROMYCIN
2. CLARITHROMYCIN
WHAT IS RECOMMENDED IF THE ALLERGY IS NOT SEVERE
1. CLARITHROMYCIN
FACTORS FOR THE RISK OF DEVELOPMENT OF RESISTANT AOM INCLUDE? AND WHEN IS THE INCIDENCE OF INFECTIONS MOST HIGHEST?
<2 YEARS OF AGE, DAY CARE, AND RECENT EXPOSURE TO ANTIBIOTICS. INCIDENCE IS THE HIGHEST IN SPRING AND WINTER.
AN INFECTION OF THE EXTERNAL AUDITORY CANAL (EAC) GENERALLY ATTRIBUTED TO EXCESS MOISTURE AND BREAKS IN SKIN IS CALLED?
OTITIS EXTERNA (OE), "SWIMMER'S EAR"
WHAT IS PREFERRED AND WHAT IS THE DRUG OF CHOICE FOR OTITIS EXTERNA (OE), "SWIMMER'S EAR"?
TOPICAL ANTIBACTERIAL IS PREFERRED, AND FLUOROQUINOLONES ARE THE DRUGS OF CHOICE.
ORAL ANTIBIOTICS ARE REQUIRED IF THE OS ?
EXTENDS TO THE PINNA
(CIPROFLOXACIN FOR ADULTS, AND KEFLEX FOR CHILDREN)
SIDE EFFECTS AND ADVERSE REACTIONS
OVERGROWTH OF NONSUSCEPTIBLE ORGANISMS. PRIOR HYPERSENSITIVITY IS A CONTRAINDICATION.
ANTIHISTAMINE-DECONGESTANTS
THOUGHT TO REDUCE NASAL AND MIDDLE EAR CONGESTION IN ACUTE OTITIS MEDIA. REDUCES EDEMA AROUND THE ORIFICE OF THE EUSTACHIAN TUBE PROMOTES DRAINAGE FROM THE MIDDLE EAR.
ANTIHISTAMINE-DECONGESTANTS
NUMEROUS OTC MEDICATIONS ARE AVAILABLE, INCLUDES: ACTIFED, ALLEREST, DIMETAPP, DRIXORAL, NOVAFED, ORNADE, PHENERGAN, AND TRIAMINIC. COMMON SIDE EFFECTS: DROWSINESS, BLURRED VISION, AND DRY MUCOUS MEMBRANES.
ANTIHISTAMINE
THICKENS
DECONGESTANT
LOOSENS
COMBINATION PRODUCTS
SUCH AS CORTISPORIN OTIC ARE NOT HELD IN HIGH REGARD, MANY HEALTH PROFESSIONALS THINK MULTIPLE DRUGS ARE NOT NEEDED IF ONE DRUG CAN TREAT THE DISORDER.
CERUMINOLYTICS
LOOSENS AND REMOVES IMPACTED EARWAX FROM EAR CANAL. CAN USE HYDROGEN PEROXIDE (3% DILUTED TO HALF STRENGTH WITH WATER) FOR CHRONIC IMPACTION, 1 OR 2 DROPS OF OLIVE OIL OR MINERAL OIL SOFTEN THE WAX. SOME MEDICATIONS ARE AVAILABLE BUT COST MORE AND ARE AS EFFECTIVE AS HYDROGEN PEROXIDE.
ADMINISTRATION OF EAR MEDICATIONS (EAR DROPS)
CHILD - EAR LOBE - BACK AND DOWN
ADULTS - EAR LOBE - BACK AND UP
ANTIINFECTIVES - NURSING PROCESS:
(ASSESSMENT, NURSING DIAGNOSES, AND PLANNING)
ASSESSMENT: GET MEDICAL AND DRUG HISTORY, ALLERGIES IF ANY, CHECK VITALS, OBTAIN BASELINE FOR FUTURE FINDINGS.
NURSING DIAGNOSES: SENSORY PERCEPTION, DISTURBED, (AUDITORY) DUE TO DIAGNOSIS, PAIN
PLANNING: CLIENT WILL BE FREE OF EAR INFECTION AFTER COMPLETION OF DRUG REGIMEN.
ANTIINFECTIVES - NURSING PROCESS:
(NURSING INTERVENTIONS, CLIENT TEACHING, AND EVALUATION)
NURSING INTERVENTIONS: COMPLETE C&S TEST, MONITOR I&O, REPORT HEMATURIA OR OLIGURIA (HIGH DOSES OF ANTIBACTERIALS CAN BE NEPHROTOXIC), PROVIDE RELIEF OF PAIN IF NEEDED, MONITOR RENAL FUNCTION, LIVER STUDIES, AND BLOOD STUDIES. STORE MEDICATION IN AIRTIGHT CONTAINER, REPORT DIZZINESS, FATIGUE, FEVER, OR SORE THROAT (COULD INDICATE SUPERIMPOSED INFECTION).
CLIENT TEACHING: COMPLETE ENTIRE COURSE OF MEDICATION, EAT YOGURT OR BUTTERMILK, GIVE INSTRUCTIONS ON HOW TO KEEP CANAL DRY. AND WEAR MEDIC ALERT BRACELET AT ALL TIMES IF ALLERGIC TO MEDS.
EVALUATION: DETERMINE EFFECTIVENESS OF DRUG THERAPY AND PRESENCE OF SIDE EFFECTS.