Chapter 41
Drugs for the Ears
Common Ear Conditions Treated with Medication
1. Otitis Externa (Swimmer’s Ear)
o Inflammation/infection of the outer ear canal
o Caused by bacteria (e.g., Pseudomonas, Staphylococcus) or fungi
o Symptoms: Pain, itching, discharge, reduced hearing
2. Otitis Media (Middle Ear Infection)
o Common in children; involves fluid behind the eardrum
o Often caused by Streptococcus pneumoniae or Haemophilus influenzae
3. Earwax (Cerumen) Impaction
o Buildup can cause discomfort or hearing loss
o Treated with softening agents or irrigation
Treatment for Otitis Externa
4. Topical Antibiotics (First-line treatment)
o Ciprofloxacin, Ofloxacin, or Ciprofloxacin-hydrocortisone drops
o Effective against common pathogens
o Corticosteroids reduce inflammation and pain
5. Administration Tips
o Warm drops to body temperature before use
o Lie on side, pull pinna to straighten canal
o Remain in position for 2–3 minutes after instillation
6. Analgesics
o NSAIDs or acetaminophen for pain control
o Benzocaine drops may be used short-term, but can cause allergic reactions
Treatment for Otitis Media
7. Antibiotic Therapy
o First-line: Amoxicillin
o Alternatives for penicillin allergy: Cefdinir, Azithromycin
o Observation approach: In select children over 2 years with mild symptoms,
antibiotics may be deferred for 48–72 hours
, 8. Pain Management
o Acetaminophen or ibuprofen recommended even if antibiotics aren’t used
o Decongestants and antihistamines not effective and not recommended
9. Recurrent Otitis Media
o May require tympanostomy tubes
o Consider prophylactic antibiotics only in select cases
Treatment for Earwax Impaction
10. Cerumenolytics
Carbamide peroxide (Debrox): softens wax
Hydrogen peroxide and mineral oil are also used
11. Irrigation
Performed if wax is soft and tympanic membrane is intact
Use warm water to avoid dizziness
Avoid in patients with perforated eardrum
Antifungal Therapy (Otomycosis)
12. Topical Antifungals
Clotrimazole, Acetic acid solution, or Tolnaftate
Used when fungal infection is suspected (itching, thick discharge)
13. Cleaning the Ear Canal
Debridement may be necessary before medication is effective
Performed by clinician under otoscopic guidance
Patient Counseling
14. Ear Drop Instructions
Use only as directed; don’t share medications
Finish full course of treatment, even if symptoms improve
15. Prevention Tips for Otitis Externa
Keep ears dry; use ear plugs while swimming
, Avoid inserting objects like cotton swabs into the ear canal
16. When to Seek Help
If pain persists or worsens
Fever, facial swelling, or drainage from the ear
, Chapter 42
Drugs for the Respiratory
Tract
Overview
1. Common Respiratory Conditions Requiring Drug Therapy
o Asthma, Chronic Obstructive Pulmonary Disease (COPD), Allergic rhinitis,
Cough, Common cold
o Drug treatment focuses on relieving symptoms, reducing inflammation, and
improving airflow
2. Goals of Respiratory Drug Therapy
o Maintain open airways
o Minimize inflammation and secretions
o Prevent and treat bronchospasm and hypersensitivity
Asthma and COPD Medications
1. Bronchodilators
3. Beta2-Adrenergic Agonists
o Short-acting (SABA): Albuterol – used for quick relief
o Long-acting (LABA): Salmeterol, Formoterol – used for maintenance, always
combined with an inhaled steroid in asthma
o Side effects: Tremor, tachycardia, nervousness
4. Anticholinergics
o Short-acting (SAMA): Ipratropium – for acute bronchospasm, mostly in COPD
o Long-acting (LAMA): Tiotropium – for long-term COPD management
o Side effects: Dry mouth, hoarseness
5. Methylxanthines
o Theophylline (oral): less common due to narrow therapeutic index and drug
interactions
o Monitor blood levels; side effects include nausea, arrhythmias, seizures
Drugs for the Ears
Common Ear Conditions Treated with Medication
1. Otitis Externa (Swimmer’s Ear)
o Inflammation/infection of the outer ear canal
o Caused by bacteria (e.g., Pseudomonas, Staphylococcus) or fungi
o Symptoms: Pain, itching, discharge, reduced hearing
2. Otitis Media (Middle Ear Infection)
o Common in children; involves fluid behind the eardrum
o Often caused by Streptococcus pneumoniae or Haemophilus influenzae
3. Earwax (Cerumen) Impaction
o Buildup can cause discomfort or hearing loss
o Treated with softening agents or irrigation
Treatment for Otitis Externa
4. Topical Antibiotics (First-line treatment)
o Ciprofloxacin, Ofloxacin, or Ciprofloxacin-hydrocortisone drops
o Effective against common pathogens
o Corticosteroids reduce inflammation and pain
5. Administration Tips
o Warm drops to body temperature before use
o Lie on side, pull pinna to straighten canal
o Remain in position for 2–3 minutes after instillation
6. Analgesics
o NSAIDs or acetaminophen for pain control
o Benzocaine drops may be used short-term, but can cause allergic reactions
Treatment for Otitis Media
7. Antibiotic Therapy
o First-line: Amoxicillin
o Alternatives for penicillin allergy: Cefdinir, Azithromycin
o Observation approach: In select children over 2 years with mild symptoms,
antibiotics may be deferred for 48–72 hours
, 8. Pain Management
o Acetaminophen or ibuprofen recommended even if antibiotics aren’t used
o Decongestants and antihistamines not effective and not recommended
9. Recurrent Otitis Media
o May require tympanostomy tubes
o Consider prophylactic antibiotics only in select cases
Treatment for Earwax Impaction
10. Cerumenolytics
Carbamide peroxide (Debrox): softens wax
Hydrogen peroxide and mineral oil are also used
11. Irrigation
Performed if wax is soft and tympanic membrane is intact
Use warm water to avoid dizziness
Avoid in patients with perforated eardrum
Antifungal Therapy (Otomycosis)
12. Topical Antifungals
Clotrimazole, Acetic acid solution, or Tolnaftate
Used when fungal infection is suspected (itching, thick discharge)
13. Cleaning the Ear Canal
Debridement may be necessary before medication is effective
Performed by clinician under otoscopic guidance
Patient Counseling
14. Ear Drop Instructions
Use only as directed; don’t share medications
Finish full course of treatment, even if symptoms improve
15. Prevention Tips for Otitis Externa
Keep ears dry; use ear plugs while swimming
, Avoid inserting objects like cotton swabs into the ear canal
16. When to Seek Help
If pain persists or worsens
Fever, facial swelling, or drainage from the ear
, Chapter 42
Drugs for the Respiratory
Tract
Overview
1. Common Respiratory Conditions Requiring Drug Therapy
o Asthma, Chronic Obstructive Pulmonary Disease (COPD), Allergic rhinitis,
Cough, Common cold
o Drug treatment focuses on relieving symptoms, reducing inflammation, and
improving airflow
2. Goals of Respiratory Drug Therapy
o Maintain open airways
o Minimize inflammation and secretions
o Prevent and treat bronchospasm and hypersensitivity
Asthma and COPD Medications
1. Bronchodilators
3. Beta2-Adrenergic Agonists
o Short-acting (SABA): Albuterol – used for quick relief
o Long-acting (LABA): Salmeterol, Formoterol – used for maintenance, always
combined with an inhaled steroid in asthma
o Side effects: Tremor, tachycardia, nervousness
4. Anticholinergics
o Short-acting (SAMA): Ipratropium – for acute bronchospasm, mostly in COPD
o Long-acting (LAMA): Tiotropium – for long-term COPD management
o Side effects: Dry mouth, hoarseness
5. Methylxanthines
o Theophylline (oral): less common due to narrow therapeutic index and drug
interactions
o Monitor blood levels; side effects include nausea, arrhythmias, seizures
