NTA Level 4 • Semester 2 • PST04211

Description of Eye, Ear and Nose Preparations

Basic Pharmacology • Source Session/Topic 42

Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability.

Session 42: Description of Eye, Ear and Nose Preparations

Total Session Time: 120 minutes

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• List preparations of the eye, ear and nose and their indications

• List Contraindication of eye, ear and nose preparations

• Describe dose, dosage and course of eye, ear and nose preparations

• List side effects and adverse effects of eye, ear and nose preparations

• Describe interactions and precautions of eye, ear and nose preparations

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

• Overhead projector (OHP) and Computer

SESSION OVERVIEW

Activity/

Step Time Content

Method

1 05 minutes Presentation Introduction, Learning Objectives

Presentation

A List of the Eye, Ear And Nose Preparations

2 40 minutes small Group

and their indications

Discussion

Dose, Dosage and Course of the Eye, Ear and

3 20 minutes Presentation

Nose Preparations

Presentation Side Effects and Adverse Effects of the Eye,

4 20 minutes

Buzzing Ear and Nose Preparations

Presentation Contraindications of the Eye, Ear and Nose

5 10 minutes

Brainstorming Preparations

Presentation Interactions and Precautions of

6 15 minutes

Brainstorming the Eye, Ear and Nose Preparations

7 05 minutes Presentation Key Points

8 05 minutes Presentation Evaluation

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SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Objectives (5 minutes)

READ or ASK students to read the learning objectives and clarify

ASK students if they have any questions before continuing.

STEP 2: List of the Eye, Ear and Nose Preparations and their indications

(40 minutes)

Activity: Small Group Discussion ( 30 minutes)

DIVIDE students into small manageable groups

ASK students to discuss on the following question

• What are the eye,ear and nose preparations that are used in clinical settings?

• What are the indications of the eye, ear and nose preparations?

ALLOW students to discuss for 15 minutes

ALLOW few groups to present and the rest to add points not mentioned

CLARIFY and SUMMARIZE by using the contents below

List of preparations

• Nasal preparations

o Beclomethasone spray

o Ephedrine nasal drops

• Ear preparations

o Chroramphenicol ear drops

o Neomycin + Dexamethasone ear drops

o Ciprofloxacin ear drops

o Aluminium diacetate ear drops

• Eye preparations

o Anti-effective agents

 Acyclovir ointment

 Chloramphenicol drops

 Chloramphenicol ointment

 Gentamycin drops

 Povidone iodine

 Oxytetracycline ointment

 Ciprofloxacin

 Dexamethasone + Chloramphenicol

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 Dexamethasone + Gentamycin

 Natamycin

 Econazole

o Steroidal anti-inflammatory agents

 Dexamethasone

 Prednisolone

 Methylprednisolone

 Triamcinolone cream and injection

o Ant infective and ant inflammatory agents

 Cyclopentolate

 Atropine

 Timolol

 Hydroxypropylmethylcellulose

 Iodoxamine tromethazine

 Sodium cromogylate

 Pilocarpine

 Zinc sulphate

 Latanoprost

 Acetazolamide

Indications

• The eye preparations can be indicated in either of the following:

o Bacteria, fungal and viral infections

o Inflammations like conjunctivitis

o Mydriasis and cycloplegia

o Anaesthesia induction

o Glaucoma

o Lubrication

o Diagnosis

• The ear preparations are usually indicated in microbial infections, inflammations like

otitis media and lubrication in removal of ear wax

• The nose preparations are indicated in microbial infections of the nose, diagnosis of nose

disorders, inflammations of the nose and shrinking of the nasal polyps by corticosteroids

STEP 3: Dose, Dosage and Course of Eye, Ear and Nose Preparations

(20 minutes)

• The dose of respective antimicrobial agent should be given to an individual depending on

the diagnosis, weight and vital body organs functions

• The dosage of respective antimicrobial agent depends on the severity of diagnosis, half

life of an agent and vital organ functions

• One to two drops of eye formulations are given 2-4 times a day depending on their half

lives

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• 2-3 drops of ear formulations is given 3-4 times a day and reducing the frequency as the

day dose

• The course of antibacterial treatment can be up to 14 days, antifungal up to three months

and antiviral up to six weeks

• Lubricants can be used until there is a promising outcome

• The duration of treatment with steroidal ant inflammatory agents should be short

especially in corticosteroids because are immunosuppressants

STEP 4: Side effects of Eye, Ear and Nose Preparations (20 minutes)

Activity: Buzzing (5 minutes)

ASK students to pair up and buzz on the following question

• What are the side effects of the eye, ear and nose preparations listed above?

ALLOW few pairs to respond and let other pairs to add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARIZE by using the content below

• Aplastic anaemia and transient stinging caused by preparations containing

chloramphenicol

• Local burning and itching; lid margin crusting; hyperaemia; taste disturbances; corneal

staining, keratitis, lid oedema, lacrimation, photophobia, corneal infiltrates; nausea and

visual disturbances reported in preparations containing ciprofloxacin and other

quinolones

• Local irritation and inflammation, superficial and punctate keratopathy in products

containing acyclovir

• Aggravation of red eye, steroid cataract and glaucoma and thinning of cornea and sclera

for eye corticosteroids

• Local sensitivity reactions may occur in ear preparations

• Dryness, irritation of nose and throat, and epistaxis in nose corticoid preparations.

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STEP 5: Contraindications of Eye, Ear and Nose Preparations (10 minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the contraindications of the eye, ear and nose preparations?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

• Corticosteroid ear and eye preparations should be avoided in the presence of an untreated

ear infection

• If infection is present, the corticosteroid should be used in combination with a suitable ant

infective

• Avoid prolonged use of chloramphenicol and aminoglycosides like gentamycin

STEP 6: Interactions and Precautions of Eye, Ear and Nose Preparations

(15 minutes)

Activity: Brainstorming (5 minutes)

Ask students to brainstorm on the following question:

• What are the interactions and precautions of the ear, eye and nose preparations?

ALLOW few students to respond

WRITE their responses on the flip chart/ board

CLARIFY and SUMMARISE by using the content below

• Ciprofloxacin and other quinolone containing preparations should be avoided in children

less than one year and pregnancy

• Gentamycin and other aminoglycoside preparations are not recommended in pregnancy

• Prolonged use of topical corticosteroid ear, eye and nose preparations should be avoided

• Long use of chloramphenicol and aminoglycoside preparations should be avoided

• Corticosteroid nasal preparations should be avoided in the presence of untreated nasal

infections, and also after nasal surgery until healing has occurred

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STEP 7: Key Points (5 minutes)

• Most of eye, nose and ear preparations are ant infective and ant inflammatory agents

• The use of antimicrobial eye, ear and nose preparations should be given special attention

to pregnant women and children less than one year

• In order to avoid their possible side effects steroids should be used for as short time as

possible

STEP 8: Evaluation (5 minutes)

• What are the possible side effects of eye preparations containing corticosteroids?

• What measures will you take as Pharmaceutical personnel when a patient has been

prescribed with corticosteroid spray after nasal surgery?

• Why steroids should not be used for a long time?

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References

School of Pharmaceutical sciences. (2011). Tanzania Pharmaceutical Handbook (2nd ed.).

Dar es Salaam, Tanzania: ARDHI University press.

Ministry of Health and Social Welfare. (2013). Standard Treatment Guidelines & National

Essential Medicines List Tanzania Mainland (4th ed.). Dar es salaam, Tanzania:

Government printers.

The Royal Pharmaceutical Society of Great Britain. (2007). Martindale, the Extra

Pharmacopoeia (5TH ed). London, UK: Pharmaceutical press.

The Royal Pharmaceutical Society of Great Britain. (2009). British National Formulary (59th

ed). London, UK: BMJ Group and RPS Publishing.

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