Ophthalmic/Otic/Orofacial Discomfort

Hypromellose, Naphazoline, hydrochloride - Bausch + Lomb Advanced Eye Relief

• Time to therapeutic effect: a few minutes

• What this medication used for: relieve dry eyes and local vasoconstrictor to reduce eye redness

• Starting dose and schedule: Instill 1-2 drops in the affected eye up to 4x a day

• Consulting points:

1. Wash hands thoroughly with soap and water

2. Check dropper tip to make sure it is not cracked

3. Avoid touching dropper tip to eye

4. Tilt eye back pull down lower lid to form a pocket

5. While looking up, squeeze dropped so that a single drop falls into the pocket of your lower eye lid

6. Close eyes for 2-3 mins, try not to blink or squeeze your eyelids

7. Place a finger on the tear duct and apply gently pressure, wipe any excess liquid from your face with a tissue

8. Avoid in patients with underlying CVD, DM, hyperthyroidism, and pregnancy, because they are local vasoconstrictors and have the risk of increasing HR and BP

• Side effects and how to alleviate them: slight stinging (avoid rubbing eyes), increased light sensitivity (avoid bright light; wear sunglasses outdoors)

• Non-pharm recs: avoidance of dry, dusty places

Ketotifen - Zaditor

• Time to therapeutic effect: relief after a few minutes

• What this medication is used for: antihistamine, relief itchy eyes

• Starting dose and schedule: Put 1 drop in the affect eye(s) 2x a day, every 8-12 hours, not more than 2x a day

• Consulting points:

1. Wash hands thoroughly with soap and water

2. Check dropper tip to make sure it is not cracked

3. Avoid touching dropper tip to eye

4. Tilt eye back pull down lower lid to form a pocket

5. While looking up, squeeze dropped so that a single drop falls into the pocket of your lower eye lid

6. Close eyes for 2-3 mins, try not to blink or squeeze your eyelids

7. Place a finger on the tear duct and apply gently pressure, wipe any excess liquid from your face with a tissue

• Side effects: increased light sensitivity, fairly safe, contact doctor for vision changes, if it’s a little uncomfortable, avoid rubbing eye

• Non-pharm recs: avoidance of dry, dusty places

Olopatadine - Pataday

• Time to therapeutic effect: relief after a few minutes

• What this medication is used for: antihistamine, relief itchy eyes

• Starting dose and schedule: Put 1 drop in the affect eye(s) 2x a day, every 8-12 hours, not more than 2x a day

• Consulting points:

1. Wash hands thoroughly with soap and water

2. Check dropper tip to make sure it is not cracked

3. Avoid touching dropper tip to eye

4. Tilt eye back pull down lower lid to form a pocket

5. While looking up, squeeze dropped so that a single drop falls into the pocket of your lower eye lid

6. Close eyes for 2-3 mins, try not to blink or squeeze your eyelids

7. Place a finger on the tear duct and apply gently pressure, wipe any excess liquid from your face with a tissue

• Side effects and how to alleviate them: slight stinging (avoid rubbing eyes), increased light sensitivity (avoid bright light; wear sunglasses outdoors)

• Non-pharm recs: avoidance of dry, dusty places

Isopropyl alcohol 95% in an anhydrous glycerin 5% base - Auro Dri

• Time to therapeutic effect: relief after a few minutes

• What this medication is used for: dries the ears

• Starting dose and schedule: Tilt head sideway, place 4-5 drops into ear, make sure tip of applicator doesn’t enter ear canal. Keep drops in ear for several minutes by keeping head tilted, use 2x a day, up to 4 days if needed

• Consulting points:

1. Instill 4-5 drops to affected ear for 1-2 minutes

2. Flammable

3. Do not use in eye

4. If stinging → discontinue and refer to PCP

• Side effects and how to alleviate them: dizziness (war the bottle in your hands), discomfort (lie with affect ear up for 1-2 minutes)

• Non-pharm recs: low heat hair dryer to dry the ear canal

Carbamide Peroxide 6.5% - Earwax removal kit

• Time to therapeutic effect: 15 mins

• What this medication is used for: loosen earwax

• Starting dose and schedule: Tilt head sideway, place 5-10 drops into ear, make sure tip of applicator doesn’t enter ear canal. Keep drops in ear for several minutes by keeping head tilted, use 2x a day, up to 4 days if needed

• Consulting points:

1. Do not allow applicator tip into EAC (due to antibacterial issues)

2. Leave carbamide in ear up to 15 minutes

3. Irrigate remaining loosened cerumen with warm water with rubbed otic bulb syringe (don’t use water jet or water floss!)

4. May use BID, up to 4 days max

• Side effects and how to alleviate them: mild ear itching (warm the bottle in your hands), mild dizziness (do not overuse, do not use longer than 4 days)

• Non-pharm recs: Safely remove earwax from EAC with curette through a medical professional

Docosanol - Abreva

• Time to therapeutic effect: 4-10 days

• What this medication is used for: prevents viral replication of the virus

• Starting dose and schedule: a small dot each time

• Consulting points:

1. Wash hands before and after applying cream. Apply to affect area on the face or lips at the first sign of cold sore/fever blister. Rub in gently but completely. Use 5x a day until healed

• Side effects and how to alleviate them: redness (apply a thin layer), dryness (use a cotton swab)

• Non-pharm recs: Clean lesions by washing with mild soap solutions