Content)Questions & Answers
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Excessive cerumen in the ear - ANSWER can lead to conductive hearing loss.
Causes: - ANSWER impactions are often caused by patients pushing excessive cerumen further into
the ear canal while cleaning.
Treatment: - ANSWER Irrigation of the ear canal with warm water or saline is the recommended
intervention.
Debrox an OTC medication of carbide peroxide can also be used to soften ear wax forays removal. It
does not prevent acute otitis external-AOE.
DO NOT REMOVE the cerumen
Otomycosis - ANSWER Fungal infection caused by aspergillum or candida.
symptoms of otomycosis - ANSWER intense pruritus and erythema
treatment of otomycosis - ANSWER thorough cleansing and application of acidifying drops. 2% acetic
acid solution must be applied 3-4 times a day for 7 days.
if this doesn't work, a solution containing an anti fungal drug (1% clotrimazole/Lotrimin) can be
applied twice daily for 7 days. Oral anti fungal medication may then be added such as Itraconazole
and Fluconazole
Acute Otitis Media - ANSWER 2 months-12 years if AOM confirmed:
amoxicillin - 90 mg/kg/day
clavulanate - 6.4 mg/kd/day divided into 2 dose (12 hrs)
Ceftriaxone 50 mg IM for 3 days
, Treatment of rhinitis - ANSWER glucocorticoids (intranasal), antihistamines (oral and intranasal),
sympathomimetics (oral and intranasal)
Monoclonal antibody-drug treatment - ANSWER Omalizumab (Xolair) - directed against IgE, an
immunoglobulin antibody that plays a central role int he allergic release of inflammatory mediators
from mast cells and basophils.
approved only for allergy-mediated asthma.
Glucocorticoids Intranasal - ANSWER therapeutic action in allergic reactions.
prevent inflammatory response to allergens and thus reduce all symptoms. These drugs can prevent
or suppress the major symptoms of allergic rhinitis: congestion, rhinorrhea, sneezing, nasal itching,
and erythema in 90% of patients.
Budesonide
When to prescribe intranasal glucocorticoids - ANSWER Nasal congestion is dominant or with
moderate to severe symptoms.
for the prophylaxis and treatment of perennial and seasonal allergic rhinitis.
How to treat glaucoma in someone with COPD or asthma. - ANSWER Betaxolol - B1 selective.
preferred to other B blockers for patients with asthma or COPD, no beta blockers because of
bronchospasm.
latanoprost side effects - ANSWER harmless heightened brown pigmentation of the iris, which is
most noticeable in patients who iris are green-brown, yellow-brown, or blue/gray-brown.
Topical latanoprost may also increase pigmentation of the eyelid and may increase the length,
thickness, and pigmentation of the eyelashes. Other side effects include blurred vision, burning,
stinging, conjunctival hyperemia, conjunctival edema and punctate kertopathy.
Antihistamines - ANSWER can relieve sneezing, rhinorrhea, and nasal itching; however, they do not
reduce nasal congestion. Antihistamines are less effective than glucocorticoids.
H1 receptor antagonist-block action of histamine, inhibit dilation of arterioles and venues in the skin,
decrease localized flushing, edema, itching and pain, suppress mucus secretion.
< 6 months - ANSWER antibacterial therapy for certain and uncertain diagnosis.