ENT Pharm Flashcards
What bacteria cause 75% of bacterial sinusitis?
s.pneumo and h. flu
Abx used as first line tx for bacterial sinusitis in the past
Amoxicillin 500 mg po tid (appropriate sinus penetration) x 7-10 days. Ermergence of resistance
What should you also prescribe to a patient who needs abx but has tendency to get yeast infections?
diflucan one time PO med
What abx is recommended as initial empiric therapy in non PCN allergic patients with bacterial sinusitis?
Augmentin (Amoxicillin-clavulanate): 500mg/125mg
or 875mg/125mg bid x 7 days
CI to augmentin
severe renal impairment
CI to doxycycline
Pediatrics: tooth enamel hypoplasia or permanent tooth discoloration. Do not use during pregnancy a/w reduced bone growth
Abx that can be used for bacterial sinusitis in patients allergic to PCN despite emerging resistance
Azithromycin (Zithromax): 500mg every day x 3 days
Patient popn who should never be prescribed macrolide due to potentially fatal cardiac arrhythmias
pt with QT prolongation
Maximum does of pseudophedrine (Sudafed)
4 doses/24hr
Fancy name for Afrin and dosage
Oxymetazoline 0.05% two sprays each nostril q8 hours for 3 days only
Second line tx for bacterial sinusitis if patient has had abx tx in past 30 days or if patient doesn’t improve in 3-5 days
Amoxicillin/clavulanate 2000mg/125mg po bid
Levoflox 500mg 1 po every day
Moxifloxacin 400mg po every day
What is most common diagnosis in kids between age 1-3?
acute otitis media
T/F abx should be administered to any child younger than 6 months, regardless of the degree of diagnostic certainty
true
First line therapy of AOM if low risk for resistance
Peds: Amoxicillin 90mg/kg/d in divided doses BID x 10 day. Adults: 500 mg PO BID for 5-7 days
Therapy of AOM for patients allergic to PCN
Azithromycin (Zithromax) 10mg/kg/d. Max 500mg/day as day one dose. Max 250mg/day for days two through five
(dosing is for ped patients)
Recommended duration of treatment for otitis media
younger than 2: 10 days. older than 6: 5-7 days
Indications for Auralgan (Antipyrine) drops in otitis media
reduce pain and swelling or to remove/soften cerumen
Abx tx for malignant otitis externa/necrotizing external otitis
antipseudomonal antimicrobials- Ciprofloxin 750mg PO BID (first line), Levofloxin can be used 750mg po or IV every day
Why are otic drops different in pH?
they are acidic because normal environment of EAC is acidic. these drops are painful if penetrate to middle ear because this environment is neutral
First step in tx of otitis externa
Remove Cerumen, desquamated skin, and purulent material from ear canal
What organisms do fluoroquinolones have no activity against?
anaerobes
What drops shouldn’t be used in children < 1 yr?
Cipro HC Otic Suspension, Ciloxan (Ciprofloxin 0.2%/Hydrocrotisone 1%)
What otic soln has been shown to have birth defects in animal studies and is not recommended during breastfeeding?
Ofloxin 0.3% solution (Floxin Otic Solution)
What is the drug of choice when a perforated tympanic membrane cannot be ruled out?
Ofloxacin 0.3% Solution (Floxin Otic Solution)
