ENT Formulations

Question 1

What is the function of er wax and When should it (cerumen) be removed?

Answer 1

Natural body secretion providing protection and helps with removal of stratum corneum cells during turn over

Only removed if causes deafness or interferes with a proper view of the ear drum

Question 2

What is ear wax composed of?

Answer 2

Composition:
Desquamated sheets of corneocytes;
Keratin;
Lipids and peptides;
Saturated and unsaturated fatty acids;
Alcohols;
Squalene;
Cholesterol.

Question 3

How do cerumenolytics products work?

Answer 3

act by softening the cerumen and lubricating the canal, thus facilitating cerumen removal from the ear canal or by disintegrating the cerumen

Question 4

Name some common cerumenolytics

Answer 4

Water
Olive or almond oil ear drops
Sodium bicarbonate ear drops (NaHCO3)
Exterol® (urea-hydrogen peroxide-glycerol)
Cerumol® (chlorobutanol 5%, peanut oil 57.3 %)
Waxsol® (docusate sodium or dioctyl sodium sulphosuccinate)

Question 5

Why can otitis externa occur?

Answer 5

Water in the ear canal;
The skin of the ear canal gets damaged;
Skin conditions in the ear (e.g. eczema)

Question 6

What is an astringent?

Answer 6

a substance that causes shrinking or constriction of body tissues

Question 7

Give examples of astringent ear products?

Answer 7

Aluminium acetate ear drops (13 %) containing:
Al2(SO4)3 2.25 g; CaCO3 1 g; tartaric acid 450 mg;
acetic acid (33 %) 2.5 mL and purified water 2.5 mL

Aluminium acetate ear drops (8 %)
8 parts of Al(CH3COO)3 + 5 parts of purified water

Question 8

Give example sof anti-inflammatory preparations (corticosteroids)

Answer 8

Dexamethasone

Flumetasone puvalate

Hydrocortisone

Prednisolone sodium phosphate

Question 9

What is the composition of Otomize ear spray?

Answer 9

Contains three APIs:
Dexamethasone 0.1 % (corticosteroid)
Nyomicin sulphate 0.6 % (antibiotic)
Acetic acid 2 % (bactericide & fungicide)
Water (solvent)  
Methyl hydroxybenzoate (preservative)  
Propyl hydroxybenzoate (preservative)  
Stearyl alcohol

Question 10

Describe the nasal environment/factors that may affect administration

Answer 10

1. mucociliary clearance
2. nasal pH - approx 5.5-6.5
   rises to 7.2-8.3 in rhinitis
3. Sensitivity of the nasal mucosa - need for isotonic solutions

Question 11

What does a typical liquid nasal formulation consist of?

Answer 11

API
Antimicrobial preservatives (e.g. benzalkonium chloride)
Antioxidants (e.g. butylated hydroxytoluene)
Solubilising agents or co-solvents (e.g. glycol derivatives)
Salts for adjusting pH and tonicity
Humectants, to minimize irritation to the nose (e.g. glycerol)
Viscosity-enhancing agents (e.g. methylcellulose)
Absorption enhancers (if necessary)

Question 12

What is the function of a decongestant and give some examples?

Answer 12

reduce swelling of the blood vessels inside the nasal cavity

e.g.
Xylometazoline
Oxymetazoline
Phenylephrine
Pseudoephedrine

Question 13

What does Otrivine adult nasal spray consist of?

Answer 13

Xylometazoline Hydrochloride 0.1% w/v
Benzalkonium chloride 
Disodium phosphate dodecahydrate (Sodium phosphate)
Sodium dihydrogen phosphate 	dihydrate 
Disodium edetate
Sodium chloride
Purified water

Question 14

What is OptiNose?

Answer 14

Novel nasal drug delivery device - multiuse intranasal delivery device for liquid and powder formulations

Question 15

What is Naseptin nasal cream used for?

Answer 15

treatment of nasal staphylococcal infections

Question 16

What does Naseptin nasal cream consist of?

Answer 16

Chlorhexidine hydrochloride (API, antiseptic effect against a wide range of bacteria, yeasts, and some fungi and viruses)
Neomycin sulphate (API, antibiotic)
Arachis oil (oil-phase solvent)
Purified water (aqueous phase solvent)
Cetostearyl alcohol (emulsion stabiliser)
Cetostearyl alcohol/ethylene oxide condensate (emulsion stabiliser)

Question 17

What formulations are there for delivery via the oral mucosa?

Answer 17

Lozenges
Oral Sprays
Buccal tablets
Sublingual tabs
Mouthwashes
Gargles
Oral gels
Films
Linctuses
Medicated chewing gum/toothpastes

Question 18

What are lozenges?

Answer 18

are tablets that dissolve slowly in the mouth and release the drug dissolved in the saliva