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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 70-year-old woman had been treated for some time with eardrops for seborrheic dermatitis in the right ear canal, when she developed worsening of itchy erythematous, edematous and vesicular dermatitis in the ear canal and on the right ear. She stopped the use of the eardrops, with clearance of the lesions within a week. Patch tests with the eardrops and all its ingredients showed positive (++) patch test reactions at 2 and 4 days to the eardrops and its active ingredients furaltadone hydrochloride 1% pet. and neomycin sulfate 20% pet. Twenty controls were negative to furaltadone HCl 1% pet. (2).
Ears
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
The treatment of otitis externa is topical. As much debris as possible should be cleaned out under the microscope. Take a swab and remember to ask for a fungal culture, especially if the GP has already used drops. If the ear canal is open, give eardrops (Sofradex or Gentisone) and review the patient in the clinic in a week or so. If the ear canal is very narrow or closed, insert a wick. Either use a pope wick (which, like a tampon, expands lengthways and widthways to open up the ear canal) to give the drops, or else use ribbon gauze soaked in bismuth iodoform paraffin paste (BIPP) or Tri-Adcortyl ointment. There is no need for eardrops with a BIPP or Tri-Adcortyl wick. We tend to prefer a pope wick (seeFigure 1.12) because it expands and can also be placed in a single motion (never underestimate exactly how painful this condition is!). The patient must keep their ear meticulously dry, especially when washing their hair. Tell them to put cotton wool covered in Vaseline into the concha before showering. They need to be reviewed in two to three days for removal and replacement of the wick if necessary. Warn the patient that insertion of the wick is painful but that the pain should ease once the wick is in place.
Acute otitis externa
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Patients should be shown how to effectively insert ear drops. If possible, an assistant should administer the drops while the patient is lying on their side. The patient should remain in this position for 5 minutes. The anti-tragus can be gently massaged to encourage drops deeper into the canal. Topical acetic acid 2 per cent spray is often used as first line treatment in a primary care setting, as it has both antifungal and antibacterial action. It can be bought without prescription in the UK.
Haemophilus influenzae purulent pericarditis in an immunocompetent individual
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Smit Shah, Pooja Shah, Jared Green
Further history was obtained from the patient by an Infectious Disease specialist, which revealed that over 2 months before his admission, the patient recalled eating ice cream from an ice cream truck in Philadelphia where he noted that hygiene of the ice cream machine was questionable. Due to upper respiratory infection symptoms, he visited his primary care physician who prescribed the patient doxycycline for 10 days duration for acute pansinusitis. Due to recurrent symptoms 6 weeks later, the patient was prescribed azithromycin (Z-pak) for recurrent pansinusitis. The patient saw an ENT-Otolaryngologist and was informed that he had a left ear infection, for which he was started on topical ear drops (name unknown). Temporal bone CT was performed that revealed findings suggestive of left otomastoiditis without bony destructive change, and also fluid and thickening in the right external auditory canal related to otitis externa. The patient stated that ENT-Otolaryngologist prescribed alternative ear drops (name unknown), but the patient had not started using the drops.
Dose- and starting time-dependent effect of the application of EGF to the regeneration of traumatic eardrum
Published in Acta Oto-Laryngologica, 2019
The first EGF application was performed by the physician in both EGF groups, and thereafter the EGF ear drops were administered as a single dose each day by the patients themselves at home, as instructed. Patients lay in the lateral position with the perforated ear upwards for at least 30 min after application of the eardrops. All patients received oral amoxicillin for 1 week. Follow-up was scheduled twice per week within 1 month following treatment, and once per week thereafter until either the perforation had completely closed or up to a maximum of 6 months following treatment. The physician determined whether the self-application of EGF by patients at home was correct, and whether purulent otorrhea developed during the 2–3 days following treatment commencement. Patients were advised to discontinue the application of EGF if purulent otorrhea of the middle ear occurred. The tympanic membrane was repeatedly examined endoscopically and color photographs were taken by an independent clinician blinded to the group assignments at all follow-up visits. To reduce clinician bias, closure of the tympanic membrane and the occurrence of otorrhea were photo-documented using color slides.
Otic drug delivery systems: formulation principles and recent developments
Published in Drug Development and Industrial Pharmacy, 2018
Xu Liu, Mingshuang Li, Hugh Smyth, Feng Zhang
Based on the latest clinical guidelines on the diagnosis and management of acute otitis externa published by The American Academy of Otolaryngology-Head and Neck Surgery Foundation, the primary treatment of otitis externa includes management of pain, administration of topical medications to control edema and infection, removal of debris from the external auditory canal, and avoidance of contributing factors [63]. Most acute otitis externa can be successfully treated with over-the-counter analgesics and topical eardrops. Commonly used eardrops include acetic acid drops, which lower the pH of the ear canal; antibacterial or antifungal preparations, which control bacterial or fungal growth. In severe cases, treatment may require oral or intravenous antibiotic therapy and narcotic analgesics [63].