Ear Therapeutics Flashcards
What are the main conditions affecting the ear?
Ear wax
Otitis externa
Otitis media
Labyrinthitis/vestibular neuritis
What can be used to treat ear wax?
Cerumenolytic products to soften the ear wax e.g. Olive or almond oil 3-4 times a day for 3-5 days.
- sodium bicarbonate. 5%
- Sodium chloride 0.9% drops
What. is otitis externa and what organisms cause it?
Inflammatory disease of the external ear canal.
Bacteria e.g. pseudomonas, aueriginosa, P.mirabilus, s.aureus
Fungal e.g. candida, aspergillus
What are the symptoms of otitis externa?
pain itching irritation swelling pressure hearing loss scaly skin discharge
What is the treatment for mild otitis externa?
Usually self limiting, simple analgesia and local heat
- removing ear wax and self care
What are treatments for acute diffuse otitis externa?
Analgesia, anti-inflammatory CCS ear drops e.g. 5% prednisolone, 0.1% betamethasone.
- Can also use astringent. e.g. 2%. acetic acid (earcalm) antifungal & antibacterial
Antibiotics e.g. 7-14 day topical with or without topical CCS e.g. Neomycin +/=- dexamethasone - otomize
antifungals e.g. 1% clotrimazole drops canesten
If there is systemic acute diffuse otitis externa - what is used to treat it?
Spread beyond ear canal/cellulitis - 7 days
Flucloxacillin PO or clarithromycin if allergy
What is a BNF caution surrounding when otitis externa is accompanied by a perforated ear drum?
That aminoglycosides such as gentamicin and neomycin are contra-indicated as they may cause ototoxicity - could go into ear more and cause hearing loss.
Name 6 classes of ototoxic drugs
Analgesics/antipyretics e.g. high dose salicylates Aminoglycosides Glycopeptide Abs Macrolides Antineoplastics Loop diuretics esp high dose, parenteral
What is otitis media?
When the eustachian tube becomes swollen, inflamed or blocked. Get trapped fluid in the middle ear which can become infected
Why is otitis media more common in children?
Less development of their eustachian tube so increased spread of infection as it is shorter
What are the main symptoms of otitis media?
Earache, slight hearing loss, discharge.
Younger children may show signs of pulling at their ear, restless.
What symptom indicates more severe otitis media?
Fever, systemic symptoms
High pressure/ear feels full
What are the causative organisms in otitis media?
Inflammation likely caused by viruses but more often than not it is a combination of viral and bacterial pathogens.
Viral e.g. Influenza A, RSV, human rhinovirus, adenovirus
Bacterial e.g. s.pneumoniae, h.influenzae, s.pyogenes, m.catarrhalis
What does otitis media commonly follow?
An upper respiratory tract infection which leads to increased likelihood of colonisation with bacteria e.g. vomiting, discharge, diarrhoea, pressure in ear
