Ear, Nose, and Throat Diseases: Unraveling the Best Ear Drops, Nasal Sprays, and Gargles

Using Ear Drops

EAR DROPS

Commonly used ear drops are:

  • Antibiotics,
  • Antifungal, and
  • Combinations of antibiotics and steroids.

Ear drops are used as a short-term treatment to treat ear infections or soften earwax.

It is important to put ear drops correctly so that the ear enters into the canal and treats ear disease.

Along with your ear drops, you will need to sanitize your hand with soap, water, or hand sanitizer to clean your hands.

You will also need tissues or a towel to wipe away excess drops that drain out of your ear after applying the ear drops.

TECHNIQUE AND PRECAUTIONS

  • Procure the bottle of ear drops and tissue paper to wipe away any drips.
  • Wash your hands with soap and water.
  • If the ear drops were kept in the refrigerator, warm them by holding the bottle in hand for a few minutes. Cold drops can cause discomfort or even giddiness (vertigo).
  • Cleanse the ear canal from outside any discharge with clean tissue paper.
  • Remove the bottle cap and put it on a clean and dry surface.
  • If the bottle has a dropper with it, ensure that the dropper is clean and not chipped.
  • Position the head so that the diseased ear faces upward. The patient can either tilt his head or lies down on his side.
  • Turn the ear drops bottle upside down. The dropper tip should not touch the ear.
  • For adult patients, gently pull the ear UPWARDS, BACKWARDS, AND OUTWARDS
  • For children, pull the ear DOWNWARDS AND BACKWARDS.
  • Squeeze the bottle and instill 2-3 drops into the ear.
  • Remain in that position for 5 minutes and press the tragus occluding the EAC several times so drops go deep into the canal.
  • Follow the doctor’s instructions if given any.
  • Gently pull the pinna up and down, so drops go into the ear. Keep the head tilted for a couple of minutes that will allow the drops to spread into the ear.
  • Put a cotton ball loosely in the EAC.
  • Wipe away any extra solution with tissue paper or clean with a cloth.

The most commonly used EAR DROPS are –

  1. Ciprofloxacin ear drops An antibiotic ear drop.
  2. Ciprofloxacin + Dexamethasone ear drops An antibiotic + Steroid ear drop. Eg. Ciplox-D ear drops
  3. Moxifloxacin ear drops An antibiotic ear drop.
  4. Clotrimazole ear drops An Antifungal ear drop. eg. Candida ear drops
  5. Combination Ear drops: Ear drops that contain Antibiotic + Steroid + Local anesthetic + Antifungal. eg. Candibiotic plus, Neosporin-H ear drops, etc

NASAL MEDICINES

These are available in the form of –

  • Nasal sprays,
  • Nasal drops and
  • Nasal irrigation/lavage.

The nasal sprays are available in two types of containers: –

  • Pressurized canisters and
  • Pump bottles.

The commonly used sprays and nasal drops/sprays are: –

  • Decongestant nasal drops : Used to decongest nasal mucosa. eg. Xylometazoline, Oxymetazoline etc.
  • Steroids nasal sprays : Very useful in Allergic rhinitis, and Sinusitis. Eg. Mometasone, Fluticasone furoate, Fluticasone proipionate, Budesonide etc.
  • Isotonic Saline nasal sprays. For eg. Otrivin-S, Nasoclear
  • Hypertonic Saline nasal sprays. For eg. Nasoclear HD, Physiomer
  • Nasal rinsing and irrigation. for eg. Nasoclear Nasowash etc.

TECHNIQUE AND PRECAUTIONS

  • Gently blow the nose to clear it of mucus, secretions, and discharge before using the nasal spray/drops/irrigations.
  • Shake it well before using it.
  • Keep the head upright and breathe out slowly.
  • Hold the bottle in hand so the thumb remains at the bottom and the index and middle fingers are on the top.
  • Insert the tip in the nose so that the tip should be directed toward the back of the head. Close the opposite side nostril with the finger.
  • Squeeze the canister/bottle and breathe in slowly through the nose.
  • Repeat these steps for the other side of the nostril.
  • Avoid sneezing or blowing out the nose immediately after using topical nasal medications.
  • Overusing nasal decongestants, drops, and sprays can lead to the side effects such as RHINITIS MEDICAMENTOSA.

ORAL AND THROAT MEDICINES

MOUTH RINSES AND GARGLES

POVIDONE IODINE GARGLES such as Betadine 2% gargles
BENZYDAMINE mouth rinses and gargles such as Listerine

One of the most commonly used medicines prescribed for gargling in patients with Sore throat or orodental ailment.

TOPICAL LIDOCAINE

Broad indications: Lidocaine is a local anesthetic and is used to treat mouth ulcers, sore throats, teething, and soreness caused by dentures.

Preparations: It is available in the form of gel, ointments, liquids, and sprays. Most Lidocaine preparations contain antiseptics.

TECHNIQUE AND PREACUTIONS

  • Lidocaine numbs the pain and is usually a safe medicine, and side effects are rare.
  • Avoid hot food and drinks after the use of topical lidocaine because the numbing effect can burn the mouth as the patient will not have a hot sensation.
  • Avoid in children <16 years if it contains choline salicylate as it can cause a rare fatal condition called Reye’s syndrome.
  • Never use if the patient is allergic to lidocaine.
  • Wash your hands before and after applying the ointment, gel, or liquid.
  • Put a small amount of lidocaine onto the fingertip or a cotton bud and rub it across the lesion site.
  • Aim the spray toward the sore parts of the throat.

BENZOCAINE AEROSOL/SPRAY

It is a local anesthetic that starts working within 15-30 seconds, and the action lasts for about 15 minutes.

Indications:

  • To numb the lining of the mouth and throat before laryngoscopy and endotracheal intubation, and dental procedures.
  • To relieve pain from painful disorders of the oral cavity, teeth, and throat.

Contraindications:

Children younger than 2 years and patients allergic to lidocaine.

TECHNIQUE AND PRECAUTIONS

  • It is sprayed within the mouth and throat immediately before the procedure.
  • Repeat the spray if needed but usually not for more than 2 sprays or more than 4 times daily.
  • Avoid spraying near the eyes and breathing in the spray.
  • Avoid large amounts as they cause serious side effects like fatal methemoglobinemia.
  • Avoid chewing gum and swallowing food for 1 hour.
  • Avoid in cases of severe throat infections, fever, nausea or vomiting, headache, rash, or swelling.

ADDITIONAL IMPORTANT POINTS

  • Chlorhexidine is an antiseptic used as a mouthwash and rinse.
  • Gentamycin and neomycin eardrops are not used in patients with tympanic membrane perforations.
  • Diluent ear drops promote acidic pH, which inhibits bacterial growth.

THANK YOU

MEDICAL ADVICE DISCLAIMER:
This blog including information, content, references, and opinions is for informational purposes only.

The Author does not provide any medical advice on this platform.

Viewing, accessing, or reading this blog does not establish any doctor-patient relationship.

The information provided in this blog does not replace the services and opinions of a qualified medical professional who examines you and then prescribes medicines.

And if you have any questions of medical nature, please refer to your doctor or qualified medical personnel for evaluation and management at a clinic/hospital near you.

The content provided in this blog represents the Author’s own interpretation of research articles.

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