Ear-drops

The human external (outer) ear includes the external auditory canal (ear canal) and the surrounding auricle or pinna (fleshy cartilaginous shell- 

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Special instructions for specific ear preparations are found in the Summary Drug Table Otic Preparations. When instilling ear drops, the nurse has die patient lie on his or her side with the ear toward the ceiling. If the patient wishes to remain in an upright position, the head is tilted toward the untreated side with the ear toward the ceiling (Fig. 57-1). hi the adult, the earlobe is pulled up and back. In children, the earlobe is pulled down and back. The nurse instills die prescribed number of drops into the ear canal. If die primary health... 

FIGURE 57-1. Instilling ear drops. With the head turned toward the unaffected side, the nurse pulls the cartilaginous portion of the outer ear (pinna) up and back in the adult pictured and instills the prescribed number of drops on the side of the auditory canal. 

Wash the hands thoroughly before cleansing die area around the ear (when necessary) and instilling ear drops or ointment. 

Glycerin is used in many skin creams and medicines, such as eye and ear drops, poison ivy creams, suppositories, and contraceptive jellies. It is also used as an emollient (skin softener) in soaps. 

Nasal sprays and ear drops use xylitol to reduce the adhesion of bacteria. 

Camphor is used in acne medications, cough remedies, ear drops, and other medications where its ability to soothe the skin helps it to counter the effects of other ingredients that might otherwise be irritants. 

Stockwell M Gentamicin ear drops and ototoxicity Update. CMAJ 2001 164 93-94. 

For routes of administration in which the chemical is given orally or placed into an orifice other than the mouth, clear instructions about the correct administration of the chemical must be provided. Many cases are known of oral pediatric drops for ear infections being placed into the ear, and vice versa (ear drops being swallowed) in humans. Errors in test-article administration are especially prevalent when a chemical form is being used in a nontraditional manner (e.g., suppositories that are given by the buccal route). 

Molcer ear drops containing sodium docusate is a preparation used to remove ear v/ax. 

Gentamicin is an aminoglycoside. As aminoglycosides are not absorbed from the gastrointestinal tract, gentamicin is only presented for parenteral or topical use (as eye/ear drops). 

Khalil and Sheiver have determined procaine in pharmaceuticals by a high speed liquid chromatography method [128], Maurich et al. reported the determination of procaine in ear drops by an HPLC procedure [129]. 

Brand Name(s) Auro Ear Drops, Debrox, E-R-O Ear, Gly-Oxide, Mollifene Ear Wax Removing, Murine Ear Drops, Orajel Perioseptic, Proxigel OTC (gel, solution)... 

Dose 250-500 mg QID oral, 1-2 g IM injection, 0.5-1.0% topical (eye ointment/ drops/applicap and ear drops). 

Neomycin (as suiphate) 0.3-0.5% topicai (eye/ear drop, ointment/powder)... 

Amphotericin-B (FUNGIZONE) 50-100 mg QID, 200pg to 1.5 mg/kg daily or on alternate days IV infusion, 3% topical (ear drops)... 

It has broad spectrum antifungal and antibacterial activity and is effective against Cryptococcus, Blastomyces, dermatophytes, Microsporum, Coccidioides and Candida. Used topically as ointment, lotion, gel, ear drop and vaginal gel. Adverse effects include fever, chills, allergic reaction and even anaphylaxis. 

A saturated solution of aluminum sulfate is employed as a mild caustic. Solutions containing 5-10% aluminum sulfate have been used as local applications to ulcers and to arrest foul discharges from mucous surfaces. Aluminum sulfate is also used in the preparation of aluminum acetate ear drops (HSDB 1995). With respect to use application, about 65% of the aluminum sulfate produced is used for water and sewage treatment (HSDB 1995). 

Aminoglycoside Ear drops CE Dissolve in 100 mA7 Silica 0.01 M imidazole acetate, 214 nm Resolved dihydrostrepto- [147)... 

B. S. Rutherford and R. H. Bishara, Quantitative determination of antipyrine and benzocaine in ear drops by high-performance liquid chromatography, J. Pharm. Sci., 65 1322 (1976). 

Flumetasone pivalate is a corticosteroid used topically for its glucocorticoid activity in the treatment of various skin disorders. It is usually employed as a cream, ointment, or lotion. Flumetasone pivalate is also used in ear drops. 

Mr RI, a middle-aged man, comes into the pharmacy and asks for your advice. Over the last couple of weeks, he feels that his hearing, particularly in his left ear has become progressively deaf, and the ears feel full up. He has no other symptoms, has not tried anything already and nor does he take any medication. Upon further discussion, Mr RI mentions that he had his ears syringed a couple of years ago by the nurse at the GP s surgery, and thinks he may need to go again, but wonders whether he should use the ear drops advertised on TV last week as it would save him the trip. 

Wax softener ear drops (cerumenolytics) are aqueous- or oil-based products which either directly soften, loosen and partially dissolve excess earwax, or indirectly through mechanisms such as aiding water penetration into the wax, or mechanically dispersing the wax. Generally, cerumenolytic preparations take several days to produce a noticeable effect, and are unlikely to completely dissolve and remove severely compacted wax plugs as a monotherapy. However, if ear syringing is required, drop use would facilitate this process. 

Pharmacists can advise patients on how best to administer ear drops, therefore reducing the risk of treatment failure through incorrect product usage, and general advice regarding the condition itself. 

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