Lecture 2 Flashcards

Question

Should I do a bacterial culture and susceptibility?

Answer 1

Not necessary in most cases. Indications: - Known resistant organisms - Failure to respond to standard of care therapy - Previous administration of several antibiotics - Single population of rods on cytology ==> probably PSEUDOMONAS - concurrent systemic signs

Answer 2

1. removes debris that causes irritation 2. removes debris that blocks movement of medication into horizontal canal 3. removes debris that interferes with "self-cleaning" 4. removes debris (ie. pus) that can interfere w/ activity of active ingredients - Many otic meds are inactive in the presence of abscesses 5. reduces burden of microogranisms

Answer 3

Once otitis is present, hair should be removed - prevents evaluation of entire ear canal and tympanum - predisposing factor - BLOCKS PENETRATION OF MEDICATION INTO EAR

Answer 4

Indicated when you cannot clearly see the tympanic membrane - cleaning the ear may be done through otoscope or video otoscope - Techniques: special catheters, teflon-coated catheters, pump-suction instruments ESPECIALLY IMPORTANT TO DEEP CLEAN IF PSEUDOMONAS IS PRESENT - crystal clear clean!!

Answer 5

Ceruminolytic agents are usually softening agents - Squalene, DSS, urea - Foaming agents: carbamine peroxide

Answer 6

Advantages - delivers medication directly to affected area - get high [ ] ===> can over-ride the defense mechanisms of some organisms by increasing [ ] of the antibiotic Disadvantages - delivery deep into ear may be questionable if done by owner - poor penetration if middle ear is involved

Answer 7

1. Active ingredients: efficacy 2. Removal of obstructions: wax, hair 3. evaluate the integrity of the tympanum (CRITICAL if you are going to use ototoxic drugs, like aminoglycosides!!) 4. the formulation must facilitate distribution of medication DOWN the ear canal 5. Technique, frequency, and duration of administration (he does otic meds 1x/day!!!) 6. Volume per application (drug in ear could be shaken out, could be absorbed, could evaporate, could bind to something) 7. treatment times must be sufficient to clear infections

Answer 8

<10 kg = 0.4 - 0.5 ml 10 - 20 kg = 0.5 - 0.7 ml >20 kg = 1.0 ml Negatives: increased cost due to increased volumes administered compared to the label; may be increased systemic effects

Answer 9

Applied by the vet every 7-30 days - carriers may include lanolin (messy, problematic), gel polymers, or lightweight oils - generally, require clean prior to application

Answer 10

Folliculitis needs to be treated for 3-4 weeks!!!

Answer 11

1. recurring or severe infections 2. concurrent infectinos elsewhere (ie. skin) 3. owners are incapable of medicating the patient 4. patients refuse to cooperate 5. when hyperplastic lesions prevent topical application of medications 6. known OTITIS MEDIA

Answer 12

1. presence of inflammatory cells in cytology 2. ulcers present on otoscopic exam 3. single population of gram (-) rods in a recurring infection 4. systemic signs (ie. fever) 5. known OTITIS MEDIA

Answer 13

1. Will be absorbed systemically and can result in systemic effects 2. Best practice is to use aggressively INITIALLY, then back off asap 3. If possible, use antiseptics... vs. antibiotics for long-term management 4. Almost always are good, if used EARLY!

Answer 14

Rechecks are necessary to monitor therapy | - will determine if treatment reduced infection (relapse) or cleared infection (BIG difference!)

Answer 15

1. intermittent cleaning (w/ products w/ antimicrobial activity) 2. Use of antiseptics or astringents ie. Vinegar and water 3. Intermittent use of mild glucocorticoids - switch from potent agents to glucocorticoids that have fewer systemic effects (hydrocortisone, mometasone) for maintenance

Answer 16

Don't forget to remind clients: there is an underlying cause! - Terminology varies - Includes parasites, foreign bodies, hypersensitivities, keratinization disorders, irritant reactinos - Must prevent relapse or recurrence while searching for the underlying cause