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Sensory Organs

EO 003.01 Part 29

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Overview of Lesson(Insert Dari)

Opthamologicals

- Eye anti-infectives- Eye anti-inflammatories- Anti-glaucoma preparations and

miotics- Mydriatics and cycloplegics- Eye decongestants and anti-allergics

Otologicals

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What I need to know as a pharmacy technician(Insert Dari)

In this lecture we will cover the drugs listed in the ANA Formulary which are classified according to the ATC system under

(S) Sensory Organs

For each of these medications/classes students must obtain an understanding of:

(1) Mechanism of Action

(2) Indications (Uses)

(3) Efficacy

(4) Side Effects

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Opthalmologicals(Insert Dari)

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Disorders of the Eye (Insert Dari)

• Conjunctivitis (Pink Eye) – Infection of the conjunctiva (very outer layer of the eye) caused by bacteria, viruses or in rare cases fungi.

• Blepharitis - inflammation of the eyelid, can be caused by bacteria.

• Hordeolum (sty) - infection of an eyelash gland.

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Eye Anti-infectives(Insert Dari)Mechanism of Action

Stops bacterial infections in the same manner as when taken orally.

Fluoroquinolones:Moxifloxacin/Ciprofloxacin Interfere with DNA synthesis

Aminoglycosides: GentamicinInterfere with protein synthesis.

Sulfacetamide – interferes with folic acid synthesis

Polymixin/Bacitracin – damages cell membrane/ inhibits cell wall synthesis

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Povidine and Polyvinyl alcoholPovidone is known to be a powerful germicidal agent effective against a wide range of bacteria, viruses, fungi, protozoa, and spores.

Indications (Use) • Conjunctivitis (infection of the

outer layer of they eye). • Generally less serious infections

(pink eye) are treated with polymixin/gramacidin .

• Depending on the infective agent suspected more serious infections will be treated as appropriate with the other antibiotics.

Eye Anti-infectives(Insert Dari)

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Side Effects• Change in eyesight (blurry

vision for a few moments after instilling the eyedrops).

• Eye pain• Irritation• Burning• Stinging

Eye Anti-infectives(Insert Dari)

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Important Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• If infection doesn’t clear up in 48 to 72 hrs the patient should see a physician as they may require a different antibiotic.

• Can be stored at room temperature.

Eye Anti-infectives(Insert Dari)

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Steroid Eye Drops : Prednisolone (Insert Dari)

Mechanism of action Decreases inflammation and irritation.

Indications (Use)• Conjunctivitis• Corneal injuries• Eye Swelling

Side Effects

• Short-term pain after use.

• Cataracts or glaucoma with long-term use.

• May feel a burning or stinging sensation after instilling the eye drops.

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Prednisolone (Eye drops)(Insert Dari)

Important Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• Can be stored at room temperature.

• Patient should start to feel some benefit with a few hours of using the drops.

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Combination Eye Drops (Anti-infective and Steroid)(Insert Dari)

Mechanism of ActionKills bacteria that are causing an eye infection the steroid acts as an anti-inflammatory helping to reduce irritation and discomfort.

IndicationTo treat an eye infection.

Side Effects• Short-term pain after use.

• Cataracts or glaucoma with long-term use.

• May feel a burning or stinging sensation after instilling the eye drops

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Combination Eye Drops (Anti-infective and Steroid)(Insert Dari)

Important Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• If infection doesn’t clear up in 48 to 72 hrs the patient should see a physician as they may require a different antibiotic.

• Can be stored at room temperature.

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Disorders of the Eye (Insert Dari)

• Glaucoma – increased intraocular pressure. This can permanently damage vision in the affected eye(s) and lead to blindness if left untreated.

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Anti-glaucoma Preparations(Insert Dari)

Mechanism of Action • Decreased internal eye

pressure• Contracts eyeball iris

Indication

To treat glaucoma.

Side Effects

Pilocarpine:• Eye irritation• Blurred eyesight• Lowered night vision• May cause eyelashes to

grow.

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Side Effects

Timolol:• Eye irritaiton• Change in vision

Important Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• Can be stored at room temperature.

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Anti-glaucoma Preparations(Insert Dari)

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Atropine Eye Drops(Insert Dari)

Insert DariMechanism of Action • Stops contraction of

eyeball iris (dilation)

Indication

To treat swelling of the eye.

To widen the pupil prior to an eye examination.

Side Effects

•Burning.

•Stinging.

•Eye irritation.

•Blurred eyesight.

•Bright lights may be bothersome.

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Atropine Eye Drops(Insert Dari)

Insert DariImportant Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• Can be stored at room temperature.

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Cromolyn Eye Drops(Insert Dari)

Insert DariMechanism of ActionDecreases inflammation and irritation.

IndicationAllergies causing eye irritation.

Side Effects• Can cause irritation of the eye.• Burning stinging sensation.

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Cromolyn Eye Drops(Insert Dari)

Insert DariImportant Points• How to properly instill eye

drops will be covered in detail during EO 003.03.

• Important for patients to wash hands before and after use.

• Also important to not touch the tip of the eyedropper as you may contaminate the bottle.

• Can be stored at room temperature.

• Should start to see an improvement in symptoms within 48-72 hrs.

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Otologicals(Insert Dari)

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Otitis Externa(Insert Dari)

Otitis Externa - inflammation of the outer ear and ear canal (often occurs in swimmers).

Treatment of inflammation and infection primarily involves use of topical agents.

Otitis Media – inflammation of the middle ear should never be treated with topical agents.

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Treatments for Otitis Externa(Insert Dari)

Insert DariMechanism of Action

Antibiotics- kill the bacteria/inhibit growth through various mechanisms.

Boric Acid – increases the acidity of the inner ear preventing the bacteria from growing.

Indications

Otitis externa (infection of the outer ear and ear canal).

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Treatments for Otitis Externa(Insert Dari)

Insert DariSide Effects• Can cause irritation of the

ear. • Can cause dizziness

Important Points• Proper instillation of ear

drops will be covered in EO 003.03.

• If symptoms do not improve within 48-72 hrs the patient should see their physician.

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Questions? (Insert Dari)

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In-class Assignment (Insert Dari)

This assignment will consist of 3 questions which are to be completed individually. Once complete the instructor will review the answers with the class.

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1. Match the following ophthalmologic agents with their indication (use).

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A) Atropine

B) Timolol

C) Polymixin/bacitracin eye drops

D) Prednisolone

1) Reduce inflammation and irritation

2) Reduce eye pressure and can be used before an eye exam

3) To treat an eye infection

4) Glaucoma

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1. Match the following ophthalmologic agents with their indication (use).

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A) Atropine (2) reduce eye pressure and can be used before an eye exam

B) Timolol (4) glaucoma

C) Polymixin/bacitracin eye drops (3) to treat an eye infection

D) Prednisolone (1) reduce inflammation and irritation

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2. When speaking to a patient regarding their eye drops all of the following information is important to tell them

EXCEPT for? (Insert Dari)

A) Wash your hands before an after using the eyedrops

B) Do not touch the tip of the eyedropper to avoid contaminating the bottle.

C) Be sure to store the eyedrops in the fridge.

D) For antibacterial eye drops patients should begin to see improvement within 48 – 72 hrs.

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2. Answer: When speaking to a patient regarding their eye drops all of the following information is important to tell

them EXCEPT for? (Insert Dari)

A) Wash your hands before an after using the eyedrops

B) Do not touch the tip of the eyedropper to avoid contaminating the bottle.

C) Be sure to store the eyedrops in the fridge.

D) For antibacterial eye drops patients should begin to see improvement within 48 – 72 hrs.

Insert DariThe majority of eye drops are NOT stored in the fridge be sure to check manufacture’s information prior to speaking with a patient.

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3. True or False: Topical ear drops are a great option for treating otitis media.

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3. True or False: Topical ear drops are a great option for treating otitis media (inner ear infections).

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Answer: False, topical ear drops are primarily used to treat infection of the outer ear and ear canal (otitis

externa). They do not penetrate the inner ear well enough to treat otitis media.