Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ID PHARM 152 > Otis Media > Flashcards

Otis Media Flashcards

1
Q

What is otitis media?

A

Is inflammation in the middle ear
May be caused by an infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common paediatric diseases for which medical attention is sought?

A

Otitis Media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the functions of Eustachian tube?

A

Equalizing pressure on both sides of the tympanic membrane
Protecting the middle ear from nasopharyngeal secretions
Draining middle ear secretions into nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the dysfunction of Eustachian tube lead to?

A

Impaired the middle ear ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How otitis media happens?

A

Viral URTI —> vasodilation and Edelman of nose and nasopharynx
Occculsion of ET —> edema of ET mucosa
Impaired middle ear ventilation
Accumulation of fluid (effusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk factors for Otitis Media

A

Age >5
Gender (slightly more common in males)
More likely in FN and Inuit populations
Family history - suggests a possible genetic factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Non-modifiable Risk factors for otitis media

A

Other medical conditions (anatomic differences)
Recurrent URTI
Allergies
Reduced Immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Modifiable Risk Factors of Otitis Media

A

DayCare
Exposure to tobacco Smoke
Lack/short period of breast feeding
Extended pacifier use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can daycare be a risk factor for otitis media?

A

Leads to close contact with others potentially sick kids
May be more drug resistant organisms within daycare groups as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can exposure to tobacco smoke be a risk factor for otitis media?

A

May increase inflammation of mucosal surfaces of nose throat and ears which increases chance of infection
May also impair mucociliary clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can lack/short period of breast-feeding be a risk factor for otitis media?

A

Immunoglobulins in breast milk are believed to boost immune system of infant
Should avoid bottle feeding while baby is laying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can extended pacifier use be a risk factor for otitis media?

A

Increased mucus production with prolonged use may cause reflux of flora into middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the definition of recurrent infections of otitis media?

A

At least 3 episodes within 6 months
Or at least 4 episodes within 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is some effects that recurrent infections can causes?

A

Alterations in middle ear mucosa
Damage to tympanic membrane and ossicles
Adhesions
Conductive hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Types of Otitis Media

A

Acute Otitis Media (AOM)
Otitis Media with Effusion (OME)
Persistent otitis media
Recurrent otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the diagnosis requirements for otitis media?

A

Middle ear effusion
Acute onset of symptoms
Significant inflammation of middle ear

Needs all three elements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Symptoms of Acute Otitis Media

A

Inflammation/infection
-pain
May see fever
May see N/V/D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does the pain look like in a otitis media child?

A

May see tugging at the ear, crying, irritability, altered sleep patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are you looking for when looking at the ear?

A

Redness
Loss of anatomical tympanic membrane
Bulging eardrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some intracranial complications of acute otitis media?

A

Meningitis
Subdural or brain abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some extracranial complications of acute otitis media?

A

Hearing loss
TM perforation
Chronic OM
Mastoiditis
Facial paralysis
Tympanosclerosis
Labyrinthititis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some organism that could causes otitis media?

A

S. Pneumoniae
Non-table strains of haemophilus influenzae
Moraxella catarrhalis
Group A strep
Staph. Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Goals of Treatment with Otitis Media

A

Reduction in signs and symptoms
Eradication of infection
Prevention of complications
Avoid unnecessary antibiotic prescribing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is antibiotic selection based on?

A

Spectrum of Activity
Adverse effects
Ability to penetrate the middle ear
Convenience
Cost

25
Q

What is the first line therapy?

A

Amoxicillin

26
Q

What is the amoxicillin dose for acute otitis media?

A

80 mg/kg/day divided into BID or TID
Max 3g/day (USA)
Or
75-90mg/kg/day divided into BID
45-60mg/kg/day divided into TID

27
Q

What is second line therapy for acute otitis media?

A

Amoxicillin/clav

28
Q

What is the dose for amox/clav for acute otitis media?

A

40-80 mg/kg/day divided BID

29
Q

What are some factors that cause second line to be choose instead of first?

A

If the initial therapy fails
AOM with purulent conjunctivitis
Recent treatment with amoxicillin
Relapse of recent infection

30
Q

What is given acute otitis media for penicillin allergic pt?

A

Cefprozil
Cefuroxime
Clarithromycin
Azithromycin
Use of macro like is discouraged

31
Q

What is the dose for cefprozil?

A

30mg/kg/day divided BID

32
Q

What is the dose for cefuroxime axetil?

A

30-40 mg/kg/day divided BID

33
Q

What is the dose for azithromycin?

A

10mg/kg/day day 1
Then 5 mg/kg/day for 4 days
Or
10 mg/kg/day once daily for 3 days
Or
30 mg/kg single dose

34
Q

Things to check with antibiotic therapy for AOM

A

Check dosing
For all drugs mentioned
What are common side effects
Are there important drug interactions
What should you tell parent/caregivers?

35
Q

What is the criteria for watchful waiting?

A

Age > 6 months
Not bilateral (6 months - 23 months)
No cranofacial abnormalities, immune deficiency, tympanovstomy tubes or recurrent AOM
Access to timely reassessment or antibiotic Rx
Reliable caregiver

36
Q

What is the duration of antibiotic treatment?

A

Normally 10 day
5 days may be enough for some
Uncomplicated AOM
>24 months old
No perforation of the eardrum

37
Q

When should you see improvement?

A

Within 2 to 3 days

38
Q

What happens if the symptoms persist, worsen or reappear?

A

Should go back to doctor

39
Q

What are some nonpharamacolgic treatments?

A

Heating pad or warm wash cloth
- soothing

40
Q

What are some other pharmacologic treatments?

A

Glycerin or vegetable oil
Auralgan
Pain relief (acetaminophen and ibuprofen

41
Q

How to use glycerin?

A

-heat to body temp
-soothing
-Cl with rupture tympanic membrane

42
Q

How to use auralgan?

A

It is an antipyretic
Warm oil in the ear

43
Q

Should you use decongestants/antihistamine on otitis media?

A
44
Q

What is the biggest side effect with clavulanate?

A

Diarrhea

45
Q

Causes of Otitis Media with Effusion

A

Recent AOM
Allergic rhinitis
Anatomic problems

46
Q

What is OME?

A

Otitis media with effusion
Presence of middle ear effusion without any signs of infections

47
Q

What is the classification of OME?

A

Acute (<3 wks)
Subacute (3 wks - 3 months)
Chronic (>3 months)

48
Q

What are some symptoms of OME?

A

Decreasing hearing which can impair language development over time
Cause scarring of tympanic membrane

49
Q

What are the opinions of treatment for OME?

A

Waite and see (resolve in 2-3 months)
Second trial of antibiotics
Decongestants/antihistamines
Corticosteroids
Surgical procedures

50
Q

How are corticosteroids used for OME?

A

PO not drops
Some studies show benefits
Shortest course should be used
Risk vs benefits

51
Q

What surgical procedures can be used for OME?

A

Myringotomy
Tympanostomy tubes
Tends to be reserved for recurrent cases

52
Q

What are some treatment of recurrent AOM?

A

Antibiotics
Prophylaxis
Surgery
Vaccines

53
Q

What can be used for prophylaxis for recurrent AOM?

A

Sulfisoxazole
Amoxicillin
Cotrimoxazole

54
Q

What is the dose for sulfisoxazole for prophylaxis recurrent AOM?

A

75mg/kg/d HS

55
Q

What is the dosing for amoxicillin for prophylaxis recurrent AOM?

A

20mg/kg/d HS

56
Q

What is the dosing for cotrimoxazole for prophylaxis recurrent AOM?

A

0.5mg/kg/d of TMP

57
Q

Goal of treatment of recurrent AOM?

A

To decrease frequency of AOM by at least 1 episode a year

58
Q

What is pharmacists role in Otitis media?

A

Support/education of non-antibiotic choices
Recommendation regarding OTC
Instruction regarding proper antibiotic use
Follow up for response
Compliance - how to improve taste

ID PHARM 152 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions