L41 Drugs in the treatment of Ear, Nose and Throat diseases

Question 1

Treatment of Earwax →↑↓

Answer 1

Softeners
→ Olive oil
→ Urea-hydrogen peroxide (6.5%) and
glycerine
→A solution of sodium bicarbonate in water

Question 2

Treatment of Inflammation of external ear canal-otitis externa

Answer 2

Antibiotic ear drops,
→ ofloxacin (antibacterial),
→ acetic acid (antibacterial)
→ clotrimazole (antifungal)

Corticosteroid ear drops, such
→ hydrocortisone (for allergies and autoimmune disorders)

Combination of antibiotics
and corticosteroid

Pain medications
→ ibuprofen may be used

Question 3

Treatment of Middle ear infection-acute otitis

media and chronic otitis media

Answer 3

Viral infection
→ control pain
(e.g. paracetamol or ibuprofen)

→Bacterial infection- systemic
antibiotic, (e.g. amoxicillin)

 Many children who have a
middle ear infection also have
a stuffy nose at the same time.
→Use nose drops and nasal sprays
containing decongestant
→→can reduce swelling in the
mucous membranes. Keep Eustachian tube (the passages leading to the middle ear) clear, better drainage and reduction
of pressure

Question 4

Treatment of Nasal allergy

Answer 4

Presence of allergens
→ ↑ release of chemical mediators
→→ inflammatory process and symptoms

Cromolyn sodium (prophylactic use)
→ mast cell stabilizer
→→ ↓release of
chemical mediators

Antihistamines (e.g. chlorpheniramine
or loratadine) → ↓ effect of histamine
(a major chemical mediator of allergy)

Anti-inflammatory agent (for severe

situation) : corticosteroids nasal spray
(e. g. beclomethasone or budesonide)-
- ↓ Inflammation

Decongestants → activate α
receptors in blood vessels →
constriction of blood vessels →
↓ swelling → improve airflow

Decongestants (nasal spray and
drops): xylometazoline, oxymetazoline,
pseudoephedrine andphenylephrine

Ephedrine:

Side effects and precautions
Antihistamine (e.g. chlorpheniramine): drowsiness
→ May use non-sedative antihistamine (e.g. loratadine)

Decongestant: absorbed into blood vessels → activation of α
receptors in all blood vessels (systemic effect) → constriction
of blood vessel → increase blood pressure
→Caution in patient with hypertension and heart disease
→Caution in patients with prostate problem (because they tighten
muscles in the prostate and bladder neck)

Corticosteroid
→ Cushing’s syndrome, hypertension, hyperglycemia, increased susceptibility to infection, reduced
growth, etc.

Cromolyn sodium:
→headache, muscle aches, and diarrhea

Question 5

Nasal Infection

•

Answer 5

→ Treatment with appropriate

antibiotics (e.g. amoxicillin)

Question 6

Treatment of Oral ulceration and inflammation

Answer 6

→Disease based ulceration –
infection, nutritional deficiency
→ Drug-induced- cancer
chemotherapy

→ Treatment: understand
underlying problems
→ Supportive treatments: relief
symptoms, enhance recovery
and prevent recurrence
Antiseptic mouthwash 
→hexetidine solution
Relief of pain and discomfort
→lozenge

Question 7

Treatment of Oral infection

Answer 7

Treatment with
appropriate antibiotics
(e.g. nystatin, amoxicillin)
• Control of ulceration and
inflammation (see
supportive treatment
mentioned above)

Question 8

Treatment of Dry mouth

Answer 8

Treatment- salivary substitutes, spray or solution

sodium, potassium, calcium and magnesium salts plus sorbitol and carboxymethylcellulose