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25 Cards in this Set
- Front
- Back
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what are general principles of therapy
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thoroughly clean ears
repeat cleaning if needed treatment based on diagnostics treatment for sufficient period ID and control primary factors for long term success |
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Why do ears get filled with debris
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-Infectious agent
-Cutaneous debris (keratinocytes) - Increased turn over when inflamaed |
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What test must you do with all ear disease
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cytology
initial and recheck visit |
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What inherent ingredients are known to be ototoxic
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aminoglycoside ab
chlorhexidine chloramphenicol ethanol iodine / iodophors propylene glycol |
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What can propylene glycol lead to
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Long standing exposure causes increased epithelial turnover - thickens ear wax
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What separates middle ear from inner ear
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Round window/ cochlear
Vestibular / oval window |
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What drug combos can increase ototoxicity
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detergent and chlorhexidine
aminoglycosides and loop diuretics salicylates and gentamicin |
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What types of adverse effects can occur
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-epithelium / dermis
-middle ear -cochlear and vestibular functions (ototoxic) -systemic effects |
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what substances can cause contact allergy / irritation
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Neomycin
carrier ab topical anesthetic alcohol |
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what are signs of contact allergy / irritation from medication
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positive response from product X
relapse - worsening of signs cytology shows inflammation without infecting agents |
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What are advantages of topical therapy
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-delivers medication directly to affected area
-high concentration (AG, FQ) -inexpensive |
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What are disadvantages of topical therapy
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-delivery deep into ear is questionable
-compliance -owners need ed on medicating -poor penetration if middle ear is involved |
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what are keys to topical therapy success
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correct active ingredients
remove hair and wax correct frequency correct volume less viscous formula |
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what are important considerations for topical therapy use
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-integrity of tympanic membrane
-obstructions: hair, exudate, hyperplastic changes -sytemic effects |
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what are indications for systemic therapy
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-recurring or severe infections
-concurrent infection elsewhere -owners cant medicate -patient wont cooperate -hyerplastic lesions preven topical med application -known otitis media -presence gram (-) rods -inflammatory cells on cytology -ulcer -other systemic signs (fever) |
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when is ear culture indicated
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Rod shaped bacteria
failure to respond to SOC |
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What do you do on first occurence of otitis
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history
PE otitic exam data base explain pathogenesis FOLLOW UP exam! ensure resolution of signs |
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What are ingredients and benefit of Panalog
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-Neomycin, thiostrepton, nystatin, triamcinolone
-good broad spectrum -esthetics, ointment base |
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What are ingredients and benefit of Tresaderm
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-Neomycin, dexamethasone, thiabendazole
-mild ab and yeast action -broad spectrum -good first drug -mild activity contain propylene glycol -needs to be refrigerated |
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What are ingredients and action of Otomax / Mometamax
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-gentamicin, clotrimazole, betamethasone / mometasone
-ointment based -gentamicin is ototoxic -potential for systemic absorption of GC |
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What are ingredients and action of Posatex
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-Orbifloxacin, posaconazole, mometasone
-ointment -potential for systemic absorption of GC |
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What are ingredients and action of Baytril otic
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-Enrofloxacin, silver sulfadiazine
-Good activity vs. Pseudomonas -no GC or anti-fungal activity |
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What are ingredients and action of Surolan
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-Polymyxin B, sulfates, miconazole, prednisolone
-Good activity vs. Pseudomonas -questionable activity in presence of pus |
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What are ingredients and action of easOtic
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-Gentamicin, Miconazole, Hydrocortisone aceponate
-bottle only gives 5 days worth dosing |
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What are maintenance principles
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-intermittent use of cleaners / therapeutics
-antiseptics preferred vs ab (resistance development) |
