Otic Drugs

Question 1

Otits Media

Answer 1

Infection, inflammation and fluid in middle ear. 75% of kids by age 3, 95% by 12.
Most cases are bacteria and self limiting. Viral AOM is rare w/o underlying Bacterial.
Not all get Abx, 80% are self limiting. 48-72 hour observation usually.

Question 2

AOM Treatment

Answer 2

Under 6 months: ABX if we’re certain or uncertain
6-2 years: ABX if certain. ABX if severe when uncertain or if mild, observe
2 and older: ABX if certain and severe. Observation otherwise

Question 3

AOM Drugs

Answer 3

Immediate ABX:
Non-severe: Amoxicillin, 40-45 mg/kg 2x daily
Severe: Amoxicillin 45 mg/kg and clavulanic acid 2x daily

Pts with persistent s/s after 48-72:
Non-severe: Amoxicillin 45mg/kg 2x daily and clavulanic acid 2x daily
Severe: Ceftriaxone 50mg/kg IM for 3 days

Question 4

Amoxicillin

Answer 4

IND: AOM
BOX: NONE
MOA:
ROUTE: 14:1 product ratio Amoxicillin600mg/Clavulanic acid 42.9mg
Normal doses of Amoxicillin: Severe: 45mg/kg 2x daily. Nonsevere: 40-45
ADR: Allergies to peicillin, cdiff, AAD

Question 5

Hydrocortisone/Polymyxin B/Neomycin

Answer 5

IND: Otic infections (EAC infections)
MOA: Neomycin and polymyxin are abx. Hydrocortisone decreases inflammation for pain and swelling relief
Route: Solution and suspension(shake well!)
ADR: Local RXN

Question 6

Ciprofloxacin

Answer 6

IND: AOE
MOA: Cipro is a fluoroquinolone abx. Dexamethasone is a steroid for pain and inflammation reduction

Question 7

Ear Drop Application

Answer 7

COLD solutions may cause dizziness. Roll between hands to warm up for a few minutes.
Wiggle earlobe to facilitate further transit into the ear

Question 8

Isopropyl Alcohol

Answer 8

Helps with evaporation of the water in the ear. Best at preventing AOE
Another product has acetic acid 2%: acidification can control bacteria in addition to the drying.

Question 9

Lipo

Answer 9

Flavonoid
Used for: Tinnitus and Meniere’s syndrome
Natural bioflavonoid product. Really just a supplement.
Worth a shot, no safety warnings