The eyes, ears, nose, and throat (EENT) are crucial for sensory perception and are common sites for infections and inflammation. Medications are frequently applied directly to the affected area, requiring specific administration techniques and careful monitoring.

This lesson provides a guide to common medications used for EENT conditions, highlighting their uses and key nursing considerations for safe and effective care.

Eye Medications (Ophthalmic)

Used for infections, inflammation, allergies, and conditions like glaucoma. Often given as drops or ointments.

• Treating Eye Infections:

  • Medications: Antibiotic drops/ointments (e.g., Gentamicin, Tobramycin, Erythromycin, Ciprofloxacin), Antiviral drops/ointments (e.g., Ganciclovir).

  • Uses: Bacterial or viral conjunctivitis (“pink eye”), corneal infections.

  • Nursing Focus:

    • Administration: Verify correct eye. Hand hygiene, gloves. Cleanse eye inner-to-outer. Pull down lower lid, drop into conjunctival sac (not on cornea). Close eye gently, press inner corner (nasolacrimal duct) 1-2 min to reduce systemic absorption. Ointment: thin ribbon in lower sac. Wait 5-10 min between different drops.

    • Monitoring: Watch for reduced redness, swelling, discharge. Monitor for local irritation, burning, stinging.

    • Education: Complete full course. Avoid touching dropper/tube tip to eye. Proper technique.

• Reducing Eye Inflammation & Allergy:

  • Medications: Corticosteroid drops/ointments (e.g., Dexamethasone), NSAID drops (e.g., Ketorolac), Antihistamine/Mast Cell Stabilizer drops (e.g., Olopatadine, Cromolyn).

  • Uses: Allergic conjunctivitis, inflammation from injury or surgery.

  • Nursing Focus:

    • Administration: Correct technique. Corticosteroids used cautiously.

    • Monitoring: Watch for reduced redness, swelling, itching. Corticosteroids: Monitor for increased intraocular pressure (IOP) with prolonged use (less common with short-term).

    • Education: Use as prescribed. Corticosteroids can increase infection risk or delay healing.

• Managing Glaucoma (Reducing IOP):

  • Medications: Beta-blocker drops (e.g., Timolol), Prostaglandin analog drops (e.g., Latanoprost), Alpha-adrenergic agonist drops (e.g., Brimonidine), Carbonic anhydrase inhibitor drops (e.g., Dorzolamide).

  • Uses: Lower elevated IOP to prevent optic nerve damage.

  • Nursing Focus:

    • Administration: Correct technique, press nasolacrimal duct.

    • Monitoring: Monitor for reduced IOP (measured by provider). Watch for systemic side effects (Beta-blockers: bradycardia, hypotension; Alpha-agonists: dry mouth, fatigue). Prostaglandin analogs can change iris color/eyelash growth.

    • Education: Crucial: Lifelong, consistent use is essential. Do not miss doses. Report systemic side effects.

Ear Medications (Otic)

Used for infections, inflammation, and wax buildup in the ear canal. Given as drops.

• Treating Ear Canal Infections (Otitis Externa):

  • Medications: Antibiotic drops (often with corticosteroids, e.g., Ciprofloxacin/Dexamethasone), Antifungal drops (e.g., Clotrimazole).

  • Uses: “Swimmer’s ear” (bacterial or fungal).

  • Nursing Focus:

    • Administration: Verify correct ear. Hand hygiene, gloves. Warm drops to body temp (hold in hand). Clean outer ear. Tilt head. Adults: pull auricle up and back. Children (<3): pull auricle down and back. Drop into canal. Stay tilted a few minutes.

    • Monitoring: Watch for reduced pain, redness, swelling, discharge. Monitor for local irritation.

    • Education: Complete full course. Proper technique.

• Removing Earwax:

  • Medications: Cerumenolytic drops (e.g., Carbamide peroxide).

  • Uses: Soften and loosen earwax.

  • Nursing Focus:

    • Administration: Proper technique. Expect bubbling sensation.

    • Education: May need ear irrigation after use to remove loosened wax.

Nose Medications (Nasal)

Used for congestion, allergies, and sinus issues. Given as sprays or drops.

• Relieving Nasal Congestion:

  • Medications: Decongestant sprays/drops (e.g., Oxymetazoline) or oral (e.g., Pseudoephedrine).

  • Uses: Short-term relief of stuffy nose.

  • Nursing Focus:

    • Administration: Sprays: Blow nose gently, tilt head slightly forward, insert tip, aim away from septum, squeeze while inhaling gently. Drops: Tilt head back.

    • Monitoring: Watch for reduced congestion. Topical: Watch for rebound congestion with overuse (>3-5 days). Oral: Monitor BP/HR (caution in hypertension/heart disease).

    • Education: Topical: Use for short duration only to avoid rebound congestion. Oral: Advise caution in cardiac conditions. Proper technique.

• Treating Nasal Inflammation & Allergy:

  • Medications: Intranasal Corticosteroid sprays (e.g., Fluticasone), Nasal Antihistamine sprays (e.g., Azelastine).

  • Uses: Allergic rhinitis (hay fever), nasal polyps.

  • Nursing Focus:

    • Administration: Proper technique (aim away from septum for steroids).

    • Monitoring: Watch for reduced sneezing, itching, runny nose, congestion. Corticosteroids take several days for full effect. Watch for local irritation, dryness, nosebleeds.

    • Education: Use regularly for best results (corticosteroids). Proper technique.

Throat & Mouth Medications (Oropharyngeal)

Used for sore throat, oral infections, and pain. Given as lozenges, sprays, rinses, or suspensions.

• Relieving Sore Throat/Mouth Pain:

  • Medications: Local Anesthetics (e.g., Benzocaine – lozenges, sprays).

  • Uses: Temporary pain relief.

  • Nursing Focus:

    • Administration: Use as directed (dissolve lozenges slowly).

    • Education: Do not eat/drink immediately after use to prevent choking due to numbness. Temporary relief.

• Treating Oral Infections (e.g., Thrush):

  • Medications: Antifungal suspensions/troches (e.g., Nystatin, Clotrimazole), Antiseptic rinses (e.g., Chlorhexidine).

  • Uses: Oral candidiasis (thrush).

  • Nursing Focus:

    • Administration: Suspension: Swish in mouth as long as possible before swallowing (or spitting, as directed). Troches: Dissolve slowly. Rinses: Swish/gargle, then spit.

    • Monitoring: Watch for reduced white patches/soreness.

    • Education: Complete full course. Proper technique.

Key Nursing Responsibilities

• Assessment: Examine the affected area, assess symptoms (pain, discharge, vision/hearing changes, congestion), and patient’s ability to administer.

• Accurate Administration: Technique is paramount for topical EENT meds. Demonstrate and verify patient understanding/ability.

• Monitoring: Watch for desired effect and local side effects (irritation, burning). Be aware of potential systemic effects (less common but possible).

• Patient Education: Clear, step-by-step instructions on technique, dose, timing, duration, side effects (including expected ones like urine color or temporary blurring), and hygiene.

• Hygiene: Emphasize handwashing and not sharing applicators/towels, especially with infections.