EENT Administration Flashcards
Give an example of a medication that could be used to treat nasal congestion, rhinitis or sinusitis ?
Nasal spray - Otrivine
Contains : Xylometazoline, hydrochloride/ Ipratropium bromide
What are the three main reasons for targeting the nose during administration ?
1) for local delivery - this could be for congestion, infection or in response to allergic rhinitis
2) for systemic absorption - this could be for migraines, diabetes insipidus, prostate cancer, endometriosis, osteoporosis, nicotine
3) for nose to brain delivery - this could be used for the delivery of antipsychotic drugs
How many arteries does the blood supply to the nose have ?
And what are these arteries ?
5 :
- Anterior ethmoidal artery (superior artery- top of nasal cavity)
- posterior ethmoidal artery (artery inferior to anterior ethmoidal artery - superior to sphenopalatine artery)
- sphenopalatine artery (inferior to both anterior and posterior artery)
- greater palatine artery (inferior to all arteries - bottom of nasal cavity)
-superior labial artery (front of nasal cavity)
What is the Kiesselbach’s plexus found in the nose ?
A vascular network formed by five arteries that supply oxygenated blood to the nasal septum.
What are the three types of respiratory epithelium cells ?
1) Columnar cells (can be ciliated or non-ciliated)
2) Goblet cells
3) Basal cells
Where is mucus secreted from ?
Serous glands and goblet cells
Why does mucus form a viscous gel ?
Due to it containing high molecular weight mucins and its ability to form disulfide bridges.
What is the function of mucus ?
clearance and air conditioning - prevents drying out
What makes up mucus ?
- water
- salts
- lipids
- mucins
What are the 3 types of dosage form used for nasal administration ?
- nasal spray
- nasal drop
- nasal powder
What are the 5 types of nasal sprays ?
1) Steroid nasal sprays - e.g. fluticasone (decreases inflammation)
2) Alpha-adrenergic agonist e.g. xylometazoline / Antihistamine e.g. azelastine / Anticholinergic e.g. ipratropium nasal sprays (decongestant)
3) Saline nasal sprays and rinses (treats blocked noses)
4) menthol nasal sprays (short-term relief from discomfort of nasal congestion)
5) Intranasal peptides (used for systemic absorption)
E.g. Desmospressin, Buserelin, Nafarelin
What size drug particles deposit in the nasal passage so are subject to mucociliary clearance ?
5-10 micrometers
Describe how to use nasal sprays ?
1) Blow nose to clear up passageways
2) shake bottle well
3) block one nostril
4) insert nasal applicator into other nostril
5) Squeeze the pump and breathe in gently
6) repeat process for other nostril
What can be used for the primary treatment of a sore throat or tonsillitis ?
Difflam spray
Strepsils
How does the active ingredient found in Difflam spray (Benzydamine) exert an effect ?
Benzydamine exerts an anti-inflammatory and analgesic action by stabilising the cellular membrane and inhibiting prostaglandin synthesis (produced by almost all nucleated cells)
What can be used for the treatment of mouth thrush ?
Daktarin oral gel
What are symptoms of oral thrush ?
- inside mouth is red and there are white patches
- the white patches are irritated or wiped off they leave red patches which are susceptible to bleeding.
What can be used for the treatment of a mouth ulcer ?
Bonjela
What components in Bonjela adult are resistible for paint relief and antiseptic ?
- for relief from pain and inflammation = Choline salicylate
- antiseptic which helps infection control = Cetalkonium chloride
What can be used fro the treatment of blocked ears, infections, otitis externa/ media, tinnitus ?
- sodium bicarbonate ear drops
- olive oil ear drops
What could be some symptoms of excessive ear wax ?
- hearing loss
- ringing in the ears
- ear pain
- itchiness in ear canal
- sensation of fullness in ear canal
- odor from ear canal
-dizziness - cough
- discharge or ear drainage
What is the initial recommended dosage advice to give to a patient for the administration/ use of ear drops ?
Drops 3-4 times daily for 3-5 days initially
When do you refer to the routine ENT clinic for a patient with excessive ear wax ?
- If there is difficulty removing the wax despite olive oil
- If a child is uncooperative or there is uncertainty about the condition of the tympanic membrane (eardrum)
What are the 4 main types of ear drops and are these OTC, P OR POM drugs ?
1) Alcohol and Acetic acid solutions (prevention of swimmers ear) - OTC
2) Antibiotics (treatment of bacterial infections) - POM
3) Anesthetics (to help numb ear pain) - POM
4) Corticosteroid drops (reduce ear inflammation) - POM
List how to correctly use ear drops ?
1) Lay on folded towel on counter.
2) Make sure affected ear is facing up.
3) Gently pull earlobe out and up to straighten auditory tube
4) Administer recommended number of drops into ear canal
5) Gently push on ear flap to encourage liquid into ear
6) stay in position for at least 2 mins
What can be used to treat dry eyes or conjunctivitis ?
- optrex eye drops
- chloramphenicol antibiotic eye ointment
What are 4 serious eye conditions ?
- Glaucoma
- Cataracts
- Macular degeneration
- Vision Loss
What are 2 mild eye conditions ?
- dry eyes
- conjunctivitis
What are the 4 types of eye drops ?
- Artificial tears
- Antibiotic eye drops/ ointments
- Corticosteroid eye drops/ ointments
- Glaucoma eye drops
