Eye and Ear Pharmacology Mnemonics in 5 minutes

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A lot of time, eyes and ears get short shrift, but there are a lot of medications that you can readily remember with a few suffixes in this group.

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Welcome to the Memorizing Pharmacology podcast. I'm Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Let's get started with the show.

Hey, welcome to the Memorizing Pharmacology podcast. Today we're going to go over eye and ear infection pharmacology and some mnemonics that can help you. Let's get started here with what is maybe better known as swimmer's ear but external ear infection. So when you have an infection on the outer ear then it actually makes sense to just use drops and put something on it. So you can use something that would be an antibiotic that would take care of the infection but also there's going to be some inflammation so we'll use some kind of steroid.

So the medication that we can use is something like Ciprodex which is a combination of ciprofloxacin and the floxacin ending tells us it's a fluoroquinolone antibiotic. The FL is for fluoro and then the oxygen is for quinolone and then the dexamethasone, we've seen that sewn ending before, that's a steroid for inflammation. Now you do it a little bit differently for a child versus an adult. A child, you'll put the head horizontally, pull the earlobe down and then apply the drops. So the word child ends in d and then use that for d for down whereas an adult has a u in it and we go adult up.

So the head will be again horizontal, we pull the earlobe up and we apply the drop. So child down, adult up. When you have a middle ear infection, the drops aren't going to be able to get to that infection so we need an oral medication. And I remember my daughter had the tubes put in and a physician said okay well you know what this is our week meeting we'll give her amoxicillin like well she's already been on amoxicillin for a whole week. It's like oh all right well what that means is that it is a beta lactamase producing bacteria that is resistant to Amoxicillin.

So beta lactamase is an enzyme that the bacteria secretes and it destroys the beta-lactam ring and makes it ineffective in penicillin. So just to be clear, the amoxicillin didn't work for a week, my daughter still had an infection in her ear and it was because the bacteria made an enzyme that basically broke the amoxicillin ring. So we switched to something a little bit different so we cross off amoxicillin and include amoxicillin with something called clavulanate.

So Augmentin is just that something that augments amoxicillin by itself and what clavulanate does is it kind of has the bacteria attack it instead of the amoxicillin allowing the amoxicillin to do its job. You can do some work with cephalosporins again cephalosporins tend to begin with CEF or ceph so cephachlor which is seclor and cephyroxine which is sinus F those are both second generation or you might see suffixine which is suprax that's third generation.

So what we're really doing with this middle ear infection is it's a resistant infection we're going to give what's quotation figures a stronger antibiotic now why don't you want to give clavulanate why don't you just give that in the first place well you want to reserve it for resistant infections but also it tends to cause a lot of GI upset unlike amoxicillin by itself.

Let's move on to the eyes. There's really three big conjunctivitises that you have to deal with. There's the allergic where we kind of put in an eye drop antihistamine is usually a good way to do it. Something viral, we might have to take an oral medication like oral acyclovir or if it's bacterial, we have lots and lots of eye drop antibiotics. Fluoroquinolones like we talked about with the ear, Amino glycosides Gentamicin Tobramycin, macrolides like erythromycin and then others will see the kind of neomycin type of thing.

Alright, well let's start with the allergy eye drops, the antihistamines. There's just a number of them and there's not really as good a stem as this although if you're familiar with Loratadine which is Claritin, you notice olopatadine which is Pat a day then open which looks a lot like ketoprofen which is a non-steroidal but that's zaditor and then pheneramine. You may remember the chloropheneramine which is color trimeton from a long time ago that was also an antihistamine which is Opticon A or part of afcon A.

So again, if the patient has allergy eyes we're going to try to put an antihistamine drop in there. Usually there's some water, some redness that's how allergic conjunctivitis presents. We talk about bacterial conjunctivitis, you're going to get some crud as it were and you're going to have eye drops and ointments available. You can use the fluoroquinolones again that's the floxacin stem ciprofloxacin levofloxacin, aminoglycosides Tobramycin Gentamicin, the macrolides erythromycin and azithromycin.

So again be careful with that mycin stem, a lot of drugs end in mycin and it just means that the streptomyces bacteria was used to actually make the antibacterial and then the other is like neomycin polymixon B and Bacitracin or polymixon B and trimethoprim. So lots and lots of options when it comes to bacterial conjunctivitis. Viral conjunctivitis actually usually clears up in a week or two maybe three weeks at worst. You'll probably use an oral medication like oral acyclovir if that's something we're going to use.

Well let's talk about actually instilling the drop itself so you want to tilt the head back while looking up that's the first thing and this is kind of a natural thing you kind of look up to the sky you tend not to look down you're going to pull the lower eyelid down and away foreign drops into that pocket then this is kind of the key is that you're going to and you'll probably do this automatically you'll close the eye okay to get those drops in there so kind of four steps here tilt your head back while looking up pull the lower eyelid down and away squeeze the drops into the pocket and then close the eye.

Again this information is informational only if you have a medical condition contact a medical professional. Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes cheat sheets and more at memorizingfarm.com. Again you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile friendly self-paced online pharmacology review course at residency.teachable.com/P/mobile. Thanks again for listening.

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