Ear, Nose, Mouth Flashcards
What is otitis externa ?
What are the treatment options?
Inflammatory reaction of the maetal skin - important to exclude any underlying chronic otitis media before treatment.
- Thorough cleansing by suction or dry mopping.
- Dressing/sponge soaked in corticosteroid ear drops with an astringent aluminium acetate solution
Infection present?
1. Topical anti-infective e.g. neomycin or clioquinol - only for 1 week as excessive use can cause fungal infection
- Aluminium acetate ear drops
- Chloramphenicol ear drops version
What can excessive use of neomycin or clioquinol lead to?
fungal infections which are difficult to treat
For ear pain what can be used?
Paracetamol or ibuprofen
In mild cases of otitis externa - which product can be used?
Acetic acid 2% ( Earcalm)
Antifungal and antibacterial properties
What is otitis media?
Self-limiting condition that usually affects children.
characterised by inflammation in the middle ear - with rapid signs and symptoms of infection.
Symptoms of otitis media in children?
ear pain rubbing of ear fever irritability crying poor feeding cough restlessness at night rhinorrhoea
usually resolve within 3 -7 days without drugs
Treatment options for otitis media?
Usually nothing
Oral analgesic for pain and fever
children aged 3 over without perforated eardrum - anaesthetic ear drops in addition to oral analgesic
if more serious/unwell - abx can be given
If severe complications then refer to hosptial
1st line and 2nd line abx treatment for otitis media in children?
- Amoxicillin
- Co-amoxiclav -if worsening despite 2-3 days of 1st line
penicillin allergy/intolerance?
- Clarithromycin or erythromycin
- Consult microbiologist
What can be used for ear wax build up? (3)
Should only be removed if causes hearing loss or interferes with proper view of ear drum
Olive oil
Almond oil
Sodium bicarbonate
Treatments for Nasal allergy/rhinits?
Usually self-limiting
Sodium chloride 0.9% solution - nasal irrigation
Antihistamines topical - azelastine hydrochloride faster than oral
Topical corticosteroids
Nasal decongestants (short term use only- no more than 7 days rebound congestion)
What are Treatments for Nasal allergy/rhinitis in pregnancy ?
Nasal corticosteroids - minimal systemic absorption
e.g. fluticasone (least absorption), beclometasone, budesonide
Sodium cromoglicate
Decongestants NOT recommended
Treatments for Nasal infection - staphylococci? (2)
Frequency?
Chlorhexidine with neomycin cream - Naseptin
QDS a day for 10 days
Mupirocin - also used in MRSA
2-3 day for 5 days
Dry mouth (xerostomia) can be caused by which drugs?
Antimuscarinic/anti-cholinergic drugs e.g.
Antispasmodics
Tricyclic antidepressants (amitriptyline)
Diuretics
Treatments for dry mouth?
Frequent sips of drinks
Sucking on ice or sugar-free pastilles/chewing gum
Artificial saliva (needs to be of neutral pH and contain electrolytes) e.g. Xerotin, Saliveze, Glandosane
Advice for superficial infection of the mouth?
Warm salt water gargle
chlorhexidine mouthwash
