Routes of Administration: eye, ear, nose and throat Flashcards
Why target the nose?
- Local delivery
- Allergic rhinitis, congestion, infection
- Systemic absorption
- Migraine, diabetes insipidus, prostate cancer, endometriosis, osteoporosis,
nicotine - Nose to brain
- Antipsychotic drugs?
How many blood supplies does the nose have + whats it called?
*the blood supply to the nose has five arteries
*kiesselbach’s plexus
What is the respiratory epithelium made of?
- Columnar cells (ciliated or non-ciliated)
- Goblet cells
- Basal cells
Where is mucus from? What does it do?
- From serous glands and goblet cells
- Form viscous gels due to high molecular weight mucins and ability to
form disulphide bridges - Function: clearance and air conditioning (prevent drying out)
What is the composition of mucus?
- Composition:
- Water (90-95%)
- Salts (1-2%)
- Lipids (2-3%)
- Mucins (0.5-5%) – responsible for gel-like structure
What are the ways to deliver to the nose?
*nasal spray
*nasal drop
*nasal powder
What are the types of nasal sprays?
- Steroid nasal sprays (fluticasone)
- Decreases inflammation
- Alpha-adrenergic agonist (xylometazoline) / antihistamine (azelastine) /
anticholinergic (ipratropium) nasal sprays - Decongestant
- Saline nasal sprays and rinses
- A more ‘natural’ remedy to treat blocked noses
- Menthol nasal sprays
- Provide short-term relief from the discomfort of nasal congestion
- Intranasal peptides (systemic absorption)
- Desmopressin – control increased thirst and too much urination
- Buserelin – treat hormone-responsive cancers (prostate cancer, premenopausal breast cancer)
- Nafarelin – treat symptoms of endometriosis (pelvic pain, menstrual cramps, painful intercourse)
What happens to particles delivered to the nose?
- > 10 μm filtered by vibrissae in the nostrils
- 5-10 μm deposit in the nasal passages but are subject to mucociliary
clearance - 2 μm pass through to the lungs
How to use nasal sprays?
*blow your nose to clear up the passageways
*shake the bottle
*block one nostril
*insert the nasal applicator into the other nostril
*squeeze the pump and breathe in gently
*repeat the process for the other nostril
What is used to treat a sore throat and tonsillitis?
- Benzydamine exerts an anti-inflammatory and analgesic action by
stabilising the cellular membrane and inhibiting prostaglandin synthesis
(produced by almost all nucleated cells)
What is used to treat oral thrush?
Daktarin
What is used to treat mouth ulcers?
bonjela
What does bonjela contain to treat mouth ulcers?
- Bonjela Adult contains
- Cetalkonium chloride, an antiseptic which helps to fight infections
- Choline salicylate, for relief from pain and inflammation
What is used to treat blocked ear, infections, otitis externa/media, tinnitus?
sodium bicarbonate ear drops
olive oil ear drops
What are the symptoms to excessive ear wax?
- 30% of people over the age of 64 years will suffer wax impaction
and wax removal can improve the hearing
What are the types of ear drops?
- Alcohol and acetic acid solutions
to prevent swimmer’s ears (OTC) - Antibiotics to treat bacterial
infections (POM) - Anaesthetics to help numb ear
pain (POM) - Corticosteroid drops to reduce
ear inflammation (POM)
What is used to treat dry eyes, conjunctivitis?
chloramphenicol 1.0w/w antibiotic eye ointment
What are some mild eye conditions?
- Dry eyes
- Conjunctivitis
What are some serious eye conditions?
- Glaucoma
- Cataracts
- Macular degeneration
- Vision Loss
What are the types of eye drops?
- Artificial tears
- carboxymethylcellulose (CMC)/hydroxypropyl methylcellulose (HPMC), castor
oil/mineral oil - Antibiotic eye drops/ointments
- Chloramphenicol, Fusidic acid, Levofloxacin
- Corticosteroid eye drops/ointments
- Atropine, Cyclopentolate, Homatropine, Tropicamide, Phenylephrine
- Glaucoma eye drops
- Prostaglandins – Latanoprost, Beta-blockers – timolol, Alpha-adrenergic
agonists – Brimonidine, Carbonic anhydrase inhibitors – Brinzolamide
How to administer eye drops?
*check the expiry date on the eye drop bottle and shake if required
*wash your hands before opening the bottle
*lying down or in a seated position, tilt your head back
*make a fist with one hand and use your knuckles to pull your lower eyelid downwards. Place your other hand with the eye drop bottle onto your knuckles
*look up and squeeze one drop into your lower eyelid making sure the nozzle doesn’t touch your eye, lashes or lid
*close your eye and press gently on the inner corner of your eye for 30-60 seconds to ensure the drop is fully absorbed
How to administer eye ointment?
*if you need to use eye drops and ointment use drops first then wait 5 mins
*check expiry date and wash hands before opening tube
*lie down or sit down and tilt your head back
*make a fist with one hand and use your knuckles to pull your lower eyelid downwards. Place your other hand with the eye ointment tube onto your knuckles
*look up and squeeze about 1cm ointment into your lower eyelid making sure the nozzle doesn’t touch your eye, lashes or lid
*close your eye for a moment, then click a few times to spread the ointment around the inside of the eye.
