DRUGS USED IN DISORDERS OF

EAR, NOSE, THROAT AND EYE

 INTRODUCTION
• Hearing and maintaining equilibrium and
balance are the two basic sensory functions of
the ear.

• Topical medications in the form of eyedrop or

eardrops are the most common therapy for eye
or ear problems.
 ANTI-HISTAMINES

• Antihistamines are a pharmaceutical class of

drugs that act to treat histamine-mediated
conditions.

• Antihistamines are medicines often used

to relieve symptoms of allergies, such as
allergic rhinitis, urticaria, conjunctivitis,
bronchitis, nausea, vomiting and reactions
to insect bites or stings.
 TYPES OF ANTIHISTAMINE

There are two main classes of histamine receptors:

1. H-1 receptors- Antihistamine drugs that bind to

H-1 receptors are generally used to treat
allergies and allergic rhinitis.

2. H-2 receptors- Drugs that bind to H-2 receptors

can treat upper gastrointestinal conditions that
are caused by excessive stomach acid.
 MECHANISM OF ACTION
• Histamine (an endogenous chemical messenger)
induces an increased level of vascular
permeability, which leads to fluid moving from
capillaries into the surrounding tissues.
• The overall outcome of this is increased swelling
and dilation of vessels.
• Antihistamines stop this effect by acting as
antagonists at the H-1 receptors.
• The clinical benefit is a reduction in allergy
symptoms and any related symptoms
ANTIHISTAMINE DRUGS USED IN EYE
DISORDERS
• The ophthalmic antihistamines are used to treat the
allergic disorders of eyes and prevent conjunctivitis.

• It inhibits the histamine-mediated inflammatory

responses.

• Examples- Antazoline sulphate, Olopatadine

Hydrochloride
INDICATIONS-

1. Allergic conjuctivitis
2. Seasonal and perennial conjuctivitis
3. Corneal inflammation
Dose- 1-2 drops twice daily until the cessation of
symptoms.

CONTRAINDICATION- Hypersenstivity to the

drug.
SIDE EFFECTS-

1) Ocular Side Effects- Local irritation and

stinging are possible, visual disturbances,
edema.
2) Systemic Side Effects (Rare)- Headache,
pruritus and skin reactions
 NURSING CONSIDERATION
1. Check the rights of medication before
administering the drug.
2. Ensure proper administration of eye drops and
eye ointment.
3. Evaluate the signs for side effects.
4. Ensure the regular usage of the drugs as
prescribed.
5. Consider oral antihistamines if symptoms are
severe or not limited to the eye.
 Cont..
6. Advise patient regarding safety during home
usage of the drug.
7. Instruct the patient not to drive or use any
machinery while on treatment.
8. Instruct the patient to avoid sharing of the
drug.
9. Teach patient how to instil eyedrops properly.
 ANTIHISTAMINE DRUGS USED IN ENT
DISORDERS

• The antihistamines are used to treat the allergic

disorders of Ear, Nose and Throat i.e. Allergic
rhinitis, Sore throat, sinusitis, ear infections,
otitis media etc.

• Examples- Levocetrizine and Cyproheptadine.

INDICATION-

1. Allergic rhinitis
2. Sinusitis
3. Surgical intervention for ENT
4. Sore throat
5. Otitis media with effusion
 DOSAGE

S.No DRUG NAME DOSAGE FREQUENCY

.

1. LEVOCETRIZINE 5-10 mg/day in night OD

(HS)

2. CYPROHEPTADINE 0.5 mg/kg/day BD/TID

CONTRAINDICATION-

1. Hypersensitivity to the drug

2. End stage renal disease
3. Newborn
4. Pregnancy
5. Lactating mothers
SIDE EFFECTS-

1. Fatigue
2. Drowsiness
3. Headache
4. Dry mouth
5. Urinary retention
6. Tachycardia
 NURSING CONSIDERATION
1. Check the rights of medication before
administering.
2. Check for any contraindications of the drug.
3. Ensure the safe administration of the drug.
4. Observe any side effects if patient is having.
5. Advise the patient to avoid alcohol consumption
during treatment.
6. Instruct the patient not to drive or use any
machinery while on treatment.
7. Keep the medication in cool and dark place.
 TOPICAL APPLICATION FOR
EYE,EAR, NOSE & BUCCAL CAVITY
 TOPICAL APPLICATION FOR EYE
1. CHLORAMPHENICOL
Chloramphenicol is a broad-spectrum antibiotic
used to treat the bacterial eye infection i.e.
Conjuctivitis, Eye stye etc.

Dosage-
1. Eyedrop- 1-2 drop 6-8 hourly for 5 days
2. Ointment- It is used every 3-4 hourly for 5
days.
MODE OF ACTION-

• It inhibits the formation of peptide bond and

protein synthesis in bacteria, which results in
diffusion of bacterial cell membrane.
SIDE EFFECTS-

1. Blurred vision
2. Burning sensation in eyes
3. Stinging
4. Itching
5. Redness in eyes
6. Dizziness
 NURSING CONSIDERATION
1. Check the right of medication before
administering the drug.
2. Check for any contraindications of the drug.
3. Administer the drug properly.
4. Evaluate the signs for any side effects i.e.,
itching, dizziness or dyspnea.
5. Monitor the liver and kidney function test
while the drug is used for long period of time.
 Cont..
6. Advise the patient to avoid the usage of the
contact lenses during treatment.
7. Instruct to clean the hands before
administration of the drugs.
8. Inform patient to avoid prolong usage without
prescription.
9. Keep the medication in cool and dark place.
10.Teach patient how to apply eye ointment
properly.
 2. GENTAMYCIN
Gentamycin is an aminoglycoside antibiotic
used to treat several types of bacterial
infections.

INDICATIONS-

1. Bacterial conjuctivitis
2. Blepharitis
 Cont..
MODE OF ACTION-

• Gentamicin, an aminoglycoside, binds to the

prokaryotic ribosome, inhibiting protein
synthesis in susceptible bacteria.

• It is bactericidal in vitro against Gram-positive

and Gram-negative bacteria. Bacterial
resistance to gentamicin is generally developed
slowly.
 DOSAGE

1. Ointment- 0.3% conc: 1 cm of ointment every

3-4 hourly for 5 days.

2. Eye Drops- 2 drops in affected eye 6 hourly till

cessation of symptoms.
SIDE EFFECTS-

1. Eye irritation
2. Burning sensation
3. Stinging.
4. Swelling of the eye.
5. Blurred vision
 NURSING CONSIDERATIONS
1. Advise the patient to avoid usage of the
contact lenses during treatment.
2. Instruct to clean the hands before
administering the drugs.
3. Keep the medication in cool and dark place.
4. Do not let anyone else to use the medication.
5. Inform immediately in case of any side effects
of the drug.
6. Teach patient how to instil eyedrops properly.
 TOPICAL APPLICATION FOR EAR
1. SODA GLYCERINE EAR DROP
• It is also known as glycerol. Soda bicarb
glycerine is used in ear infection to soften the
dry ear wax.
• It is the safest drug.
MODE OF ACTION

• Soda Bicarb Glycerin Ear Drop is an ear wax

softener.
• It works by softening the dry and hardened ear
wax.
• This eases wax removal and reduces discomfort
inside the ear which further prevents infection.
INDICATION
1. Softened the ear wax
2. Ear irritation.
3. Temporary hearing loss due to excessive wax

DOSAGE
• Ear Drops: 3-4 drops in impacted ear twice
daily for 3- 5 days.
SIDE EFFECTS-

1. Irritation of ear
2. Stinging
3. Burning sensation in ear
4. Erythema (skin redness)
5. Dryness in the ear
6. Rashes in the ear
 NURSING CONSIDERATIONS
1. Instruct patient to clean the hands before
administering the drug.
2. Keep the medication in cool and dark place.
3. Teach patient how to instil ear drops properly.
4. After instillation of drops patient should lie on
unaffected side for few minutes.
5. Inform patient to stop the medicine and report
immediately in case of side effects.
6. Instruct patient to don’t try to remove the wax with
ear buds (to avoid penetration of tympanic
membrane).
 2. BORIC- SPIRIT EAR DROP
• Boric spirit contains Boric Acid 3% w/v and
Alcohol.
• It is an antiseptic agent for external use which is
used for a variety of infectious diseases of the
ear.
INDICATION
1. Bacterial or fungal ear infection
2. Chronic suppurative otitis media

DOSAGE-
Ear Drops- 3% w/v :- 2 drops in affected ear 6
hourly for 10 days.
MODE OF ACTION-

• Boric acid is a powerful antiseptic. It kills

bacteria by various processes of coagulation
and denaturation (violation of the tertiary
structure of a protein molecule) of the
intracellular proteins.

• Boric acid is active against a variety of bacteria,

viruses, fungi and ectoparasites (lice, mites).
CONTRAINDICATIONS-

1. Violation of the integrity of the skin or mucous

membranes (including the eardrum) in the
area of drug application.
2. Individual intolerance or hypersensitivity
reaction to the boric acid.
3. Pregnancy at any stage and breast feeding.
SIDE EFFECTS-

1. Abdominal Pain
2. Allergic Reactions
3. Acute Gastritis
4. Ataxia
 NURSING CONSIDERATIONS
1. Instruct to clean the hands before
administering the drug.
2. Keep the drug at temperature between 2°C
and 8°C.
3. Protect from light.
4. Teach patient how to instil ear drops properly.
5. Keep this medicine out of the sight and reach
of children.
6. Inform patient to stop the medicine and
report immediately in case of side effects.
 TOPICAL APPLICATION FOR NOSE AND
BUCCAL CAVITY
CHLORHEXIDINE MOUTHWASH-

• Chlorhexidine gluconate is a prescription

germicidal mouthwash that decreases bacteria
in the mouth.
• It is an antiseptic agent with topical antibacterial
properties which helps in management of the
gingival inflammation and bleeding.
DOSAGE-

Mouthwash- ½
ounce (15mL)
undiluted for 30 sec
twice a day
MODE OF ACTION-

• It is a broad spectrum bactericidal agent.

• It binds to oral tissues and released in active
form for about 5 hours.
• Ruptures bacterial cell membrane and
releases cytoplasm content.
INDICATION-
1. Gingivitis
2. Halitosis
3. Oral rinse before dental work
4. Sore throat

CONTRAINDICATION-
5. Hypersensitivity to the drug.
6. Pregnancy
7. Breastfeeding
SIDE EFFECTS-

1. Allergic reactions—skin rash, itching, hives,

swelling of the face, lips, tongue, or throat
2. Pain, irritation, or ulcers in the mouth at
application site
3. Staining on tooth or tongue surface
4. Alter taste
5. Throat irritation
6. Dry mouth
 NURSING CONSIDERATIONS-
1. Instruct patient to clean the hands before
administering the drug.
2. Keep the medication in cool and dark place.
3. Teach patient how to use mouthwash.
4. Educate patient not to eat anything just after using
chlorhexidine mouthwash.
5. Teach patient to don’t replace toothpaste with
mouthwash.
6. Inform patient to stop the mouthwash and report
immediately in case of side effects or allergic
reactions .
7. Mouthwash should not be used for children.