Dermatologic, Ophthalmic & Otic Medication

Dermatologic Drugs

-skin is the largest organ of the body -protection -sensations -temperature regulation -excretion -absorption

Antimicrobial; sulfonamides

-sulfacetamide (Bleph-10) -Use w/ conjuivtis

Antimicrobials - Antiacne Drugs; clindamycin (clecoin T) lotion

-topical antibiotic -applied once or twice a day

When administering eye drops for glaucoma, the nurse understands the desired drug effect causes

decreased IOP

Mydriatics (apraclonide)

dilate the pupil D= dilate

Antimicrobials; Neomycin & polymyxin B

-neosporin -both aerobic and anaerobic

Topical anesthetic Drugs

-numbs the skin -reduces pain and itching •EMLA cream (1hr before procedure) •Lidocaine (Ela-max) (starts w/in 30 minutes)

Tetrahydrozoline

-ocular decongestion -vaso constrict blood vessels around the eye *Decongestant

Topical Dermatologic Drugs

drugs that are administered directly to a skin site -ointments, cream, gels and lotion

Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants take the drug more frequently so the acne will go away quickly. What information will the nurse provide to Jane?

"Overuse of this drug can result in painful, reddened skin."

Direct-Acting Miotic; stimulate

*acetylcholine (Miochol-E) -Used in surgery to produce miosis *pilocarpine (Pilocar) -Used for tx. Of glaucoma -Applied one a week

Topical dermatologic Drugs; Therapeutic Categories

-Antibacterial -Antifungal -Antiinflammatory - Burnsn -Plus many more

Implementation; eyes

-Assess for clarity; shake well if needed -Tilt patients head back and have them look -Avoid touching the eye with the dropper -Apply pressure to the inner canthus for ONE minute -5 minute intervals; when giving more than one eye med

Osmotic Diuretics

-Can be given IV, PO, or Topically -Used to decrease Intraocular pressure *Glycerin or Mannitol

Antimicrobials

-Culprits of bacterial infections of the skin -streptococcus & staphylococcus

Assessment; ears

-Hearing assessment -Symptom Questions -When did it start? -What medications are you taking -Allergies

Glaucoma

-Increased intraocular pressure d/t aqueous humor not draining in the canal of Schlemm. -Angle-Closure Glaucoma -Open-Angle Glaucoma

Carbonic Anhydrase Inhibitors

-Inhibit carbonic anhydrase = decreased Intraocular pressure by reducing formation of aqueous humor -Used for both types of glaucoma

Antiglaucoma drugs; Cholinergic Drugs (Miotics)

-Mimics acetylcholine -Mitosis = reduces IOP caused by increased outflow of aqueous humor -Vasodilation -Contraction of ciliary muscles -Treat both open and closed

cycloplegics (atropine, cyclopentolate)

-Paralyze the ciliary body -Have mydriatic properties -Cycloplegia: paralysis of accommodation

Antimicrobials; silver sulfadiazine (silvadene)

-Prevention and treatment of infections from burns. -Do not give if patient is allergic to sulfonamide drugs -Apply twice a day

three layers to the anterior portion of the eye

-Protective external layer: cornea and sclera -Vascular middle layer: Uvea *Choroid *Iris *Ciliary body -Internal layer: retina and vitreous humor

6 muscles controlled by cranial nerves

-Rectus (4 total) -Oblique (2 total)

Antiglaucoma drugs

-Reduce intraocular pressure -Increase drainage Decrease production of fluid

Beta-Adrenergic Blockers

-Reduce intraocular pressure by reducing aqueous humor formation -Used in Chronic Open-Angle glaucoma

Opthalmic Drugs

-Responsible for sense of sight -Recessed into frontal skull cavity: Orbit

Implementation; ears

-Store eardrops, solutions, and ointments at room temperature -Adults: Hold pinna up and back -Children (younger than 3): Hold pinna down and back -Gently massage the tragus area Of the ear

Antimicrobials; Bacitracin

-Treatment of local skin infections -Treats arobic or anaerobic organisms -Apply 1-3 times a day -both aerobic and anaerobic

Sympathomimetics (Mydriatics)

-Used for glaucoma and ocular hypertension -Causes mydriasis (pupil dilation) and enhances aqueous humor outflow and decreases production of aqueous humor

Antimicrobials; Mupirocin (Bactroban)

-Used for treatment impetigo -Prescription only -Treats Staph and Strep - Nasal colonization of MRSA

Antimicrobial Drugs; polypeptides

-bicitracin

Antimicrobial; Quinolones

-ciprofloxacin (Ciloxan)

atropine sulfate; dialation, exam

-dilates the eye -used during exams Cycloplegic Mydriatics

Topical Antipruritic and Anti inflammatory Drugs

-help with inflammation & usually combined with topical anesthetics •Topical antihistamines •Corticosteroids

Antimicrobial Drugs; Macrolides

-interfear with protein synthesis, they kill the cell *Erythromycin

otic drugs

4 parts to the ear -External -Outer -Middle -Inner Most common infections -Otitis externa; infection of ear conal -Otitis media (OM); infection in middle ear

Which antiglaucoma drug works by increasing the outflow of aqueous humor between the uvea and sclera as well as via the usual exit through the trabecular meshwork?

Prostaglandins

A 2-year-old child is seen in the pediatrician's office with a bacterial middle ear infection. Which medication does the nurse anticipate being prescribed for the child?

Amoxicillin

Olopatadine

Antihistamine

Prostaglandin Agonist

Works by increasing the outflow of aqueous humor -Pressure Is lowered for 20 to 24 hours -Can feel like there is a foreign body in eye -Can turn eye color permanently brown

Topical Anesthetics

Decreased the sensation to the nerve ending of the eye causing a local anesthetizing effect -proparcaine -tetracaine Work in 20-30 seconds Lasts 15-20 minutes

Antimicrobial Drugs; Aminoglycosides

Interfere with protein synthesis of the bacterial cells -gentamicin

Assessment; eyes

Need a baseline assessment -What are we looking for? -Document visual acuity; before during & after -Assess before and after instillation

A woman who is taking isotretinoin calls the office to say that she thinks she may be pregnant. What will the nurse instruct the patient to do first?

Stop the isotretinoin immediately.

Antiinflammatory Drugs

Treatment of inflammation and pain Also used before and after ocular surgery -Corticosteroids; -Dexamethasone

Antibacterial and Antifungal Otic Drugs

Used to treat antifungal and antibacterial ear infections -Cortisporin; 3 drug combo, steroid & 2 others -carbamide peroxide (Debrox); helps with accumulation of ear wax

angle-closure glaucoma

also known as narrow-angle glaucoma, is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure

mitotics (acetylcholine, pilocarpine)

constrict the pupil T= tiny pupil

Layers of the skin

epidermis, dermis, hypodermis

Indirect-Acting Miotic; indirectly

help by decreasing the pressure -echothiophate (Phospholine Iodide)

Fluorescein

look for abrasions and foreign bodies -opthalmic dye

Artificial tears

lubricant & moisturizers

open-angle glaucoma

the angle in your eye where the iris meets the cornea is as wide and open as it should be, but the eye's drainage canals become clogged over time, causing an increase in internal eye pressure and subsequent damage to the optic nerve

Nonsteroidal Antiinflammatory drugs

they delay eye wound healing -flurbiprofen -ketorolac

Antiviral Drugs; acyclovir (zovirax) & penciclovir (denavir)

•Apply with gloves or finger cot •Applied every 2-3 hours depending on what medication given.

Antifungal Drugs; Dermatophytes

•Feed on keratin •Tinea pedis (foot) •Tinea cruris (groin) •Tinea corporis (body) •Tinea capitis (scalp)

Dermatologic Drugs; skin preparation drugs

•Isopropyl alcohol; used for injection •Chlorhexidine (Hibiclens); clean skin •Providone-iodine (Betadine); more for foley catheter

Antifungal Drugs; miconazole (monistat)

•OTC or prescription •Inhibits growth of fungi Used for: •Athlete's foot •Jock itch •Ring worm •Yeast infection

Antifungal Drugs; clotrimazole (Lotrimin, mycelex-G)

•OTC or prescription •Treatment of dermatophytoses and yeast infections

Antimicrobials - Antiacne Drugs; isotretinoin (amnesteem, claravis, sortret)

•PO Medication •Severe resistant systic acne •Pregnancy category X •2 reliable contraceptive measures needed •iPLEDGE *pregnancy category X (causes severe defects)

Antimicrobials- Antiacne Drugs; benzoyl peroxide

•Puts active oxygen in the skin •Effects are: Antibacterial, antiseptic, drying, and keratolic (shedding of the skin) actions •Works in 4-6 weeks -adverse effects; red dry skin, pealing (usually due to using it to often) -if blisters or swelling happen need to stop immediately

Antipsoriatic Drugs

•Tazarotene; are pregnancy age must do ipledge pregnancy category X •Tar-containing products -do not use on large areas of the body

Antiviral Drugs

•Used for acute outbreaks of viral skin infections •Products best used early in the viral skin infection

Dermatologic Drugs; wound care drugs

•Vitamin C •Zinc *Both promote wound healing*

Antifungal Drugs; Candida albicans

•Yeast like fungal infection Causes: •Broad spectrum antibiotic •Immunodeficiency's