EAR PHARMACOLOGY Flashcards
What causes O. Externa?
- pseudomonas
- proteus
- fungi-aspergillus
- *gram neg rods
How do you tx O. Externa (2)?
decrease excessive moisture
- acetic acid (vosol)
- 50/50 isopropyl alcohol and white vinegar-3-5 drops x4-6 hrs
tx abx: fluoroquinolone drops (ciprofloxacin)
Vosol ADE:
transient burning stinging
Fluoroquinolone ADE:
fungal superinfection, pain pruritus
T/F TX with aminoglycosides for O Extrena is appropriate even if you cant see the TM
FALSE! Don’t give aminoglycosides,
Why is aminoglycoside tx inappropriate in perforated TM?
can cause vestibular ototoxicity
What causes infection in O. media?
- Strep pneumo
- H flu
How do you tx O. media (2)?
- high dose amoxicillin 80-90 mg/kg/day every 12 hrs
- augmentin 90 mg/kg/day QID x 12 hrs for 10 days
If patient is allergic to penicillin but did not have an anaphylactic rxn what is the next best tx option?
cefdinir cefpodoxime
What class of drugs are not given for ear infections due to high bacterial resistance?
Macrolides
When is it appropriate to observe pediatric patients with ear infections?
6-12 months:
- unilateral pain
- mild symptoms
2 y/o and older:
-uni or bilateral pain and mild symptoms
When is it abx tx necessary?
**patient is less than 6 months
- *patient is less than 2 y/o with
- severe pain
- fever >102.2
- bilateral AOM
- pain more than 2-3 days
T/F Amoxicillin is tx of choice for initial dx of AOM and Augmentin in tx of choice after 48-72 observation with no improvement
TRUE
What pathogen causes bacterial sinusitis?
S.. pneumo, H flu M. catarrhalis
When would you prescribe abx for bacterial sinusitis?
if symptoms have been persistent for more than 10 days
-if symptoms worsen 5-7 days after visit
What is first line tx for bacterial sinusitis in adults?
Augmentin 500mg/125mg PO QID
What is second line tx for bacterial sinusitis in adults?
3rd gen cephalosporin cefpodoxime 200mg daily
What is tx for bacterial sinusitis if patient has IgE rxn to penicillin?
Doxycycline 100mg QID POP daily
What abx (2) should you not prescribe for bacterial sinusitis?
Macrolides
TMP-SMX
T/F Vaccination against influenza and pneumococcus reduces risk of O. media infection
True
T/F The empiric abx of choice for acute sinusitis and O. media is amoxicillin
True
T/F The empiric drug of choice for acute pharyngitis is penicillin
True
What is first line tx for O media in children? second line txif allergic to mild penicillin allergy?
1st: augmentin 45 mg/kg/day PO QID
2nd: Clindamycin and cefpodoxime
