W11 Routes of administration- EENT Flashcards
Eye, ear, nose and throat
Treatment for Nasal congestion, rhinitis, sinusitis?
Otrivine
Why target the nose?
- Local delivery
- Allergic rhinitis, congestion, infection
- Systemic absorption
- Migraine, diabetes insipidus, prostate cancer, endometriosis,
osteoporosis, nicotine - Nose to brain
- Antipsychotic drugs
The blood supply to the nose has 5 arteries:
Superior labial artery
Greater palatine artery
Sphenopalatine artery
Anterior ethmoidal artery
Posterior ethmoidal artery
What is Kiesselbach’s plexus?
A vascular network formed by five arteries that supply oxygenated blood to the nasal column.
The respiratory epithelium contains:
Which types of cells?
- Columnar cells (ciliated or non-ciliated)
- Goblet cells
- Basal cells
Mucus (for info)
Where is it secreted from?
- From serous glands and goblet cells
- Form viscous gels due to high molecular weight mucins and ability to form disulphide bridges
- Function: clearance and air conditioning (prevent drying out)
Composition:
* Water (90-95%)
* Salts (1-2%)
* Lipids (2-3%)
* Mucins (0.5-5%) – responsible for gel-like structure
How to deliver to the nose? ( 3 dosage forms)
Nasal spray
Nasal drop
Nasal powder
Types of nasal sprays:
- Steroid nasal sprays (fluticasone)
- Decreases inflammation
- Alpha-adrenergic agonist (xylometazoline) / antihistamine (azelastine) / anticholinergic (ipratropium) nasal sprays
- Decongestant
- Saline nasal sprays and rinses
- A more ‘natural’ remedy
- Menthol nasal sprays
- Provide short-term relief from the discomfort
of nasal congestion
*Intranasal peptides (systemic absorption)
* Desmopressin – control increased thirst and too much urination
* Buserelin – treat hormone-responsive cancers (prostate cancer, premenopausal breast cancer)
* Nafarelin – treat symptoms of endometriosis (pelvic pain, menstrual cramps, painful intercourse)
Fate of particles delivered to the nose
- > 10 μm filtered by vibrissae in the nostrils
- 5-10 μm deposit in the nasal passages but are subject to
mucociliary clearance - 2 μm pass through to the lungs
Explain to a patient how you would use a nasal spray.
- Blow your nose to clear up the passageways
- Shake the bottle
- Block one nostril
- Insert the nasal applicator into the other nostril.
- Squeeze the pump and breathe in gently
- Repeat the process for the other nostril
What medications are suitable for a Sore throat, tonsilitis?
What is the active ingredient?
Strepsils
Difflam spray
- Benzydamine exerts an anti-inflammatory and analgesic action by stabilising the cellular membrane and inhibiting prostaglandin synthesis (produced by almost all nucleated cells)
What medication is suitable for oral thrush?
What are the symptoms of oral thrush?
Antifungals e.g Daktarin
- Your mouth is red inside and you have white patches (red/yellow sores)
- When you wipe off the white patches, they leave red spots that can bleed
Where do mouth ulcers occur?
What medication is suitable?
- Usually appear inside the
mouth, on the cheeks or lips - Can also appear on the
tongue
Bonjela
Bonjela Adult contains :
- Cetalkonium chloride, an antiseptic which helps to fight infections
- Choline salicylate, for relief from pain and inflammation
What are the symptoms of excessive ear wax? (wax impaction)
What can improve the hearing?
Hearing loss, Ringing in ears, Ear pain, A sensation of fullness in the ear canal, Itchiness in the ear canal, Discharge or ear drainage, Cough, Dizziness, Odour from the ear canal.
Wax removal
