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