Ear

Which ONE of the following is the MOST APPROPRIATE recommendation for a patient with water-clogged ears, assuming that the skin around the ears appears normal and there is no pain or hearing loss?

A. See a physician for antibiotic treatment.

B. Self-care using acetic acid in anhydrous glycerin.

C. Self-care using carbamide peroxide in anhydrous glycerin.

D. Self-care using isopropyl alcohol in anhydrous glycerin.

D - Only FDA product for water clogged ears

• A - No exclusions to self tx

• B - Household white vinegar in isopropyl alcohol- not FDA approved

• C - For impacted cerumen

Which ONE of the following statements is the MOST APPROPRIATE for a pharmacist to provide to a parent who is learning to administer ear drops for a 2-year-old child?

A. Lie the child down for 15 minutes after administration.

B. Pull the upper part of the child's ear up and back.

C. Warm ear drops in your hands before administration.

D. You must lie down for safe and effective administration.

C - minimizes dizziness and nausea

• A - lie down for 5 mins

• B - < 3 yo: pull ear down and back

• D - lie down or site down, with affected ear tilting up

What are non-pharm treatments for excessive/impacted cerumen?

• ear cleaning tools

• irrigation method

Carbamide Peroxide 6.5% in Anhydrous Glycerin Class:

• carbamide peroxide: antibacterial (weak)

• glycerin: emollient

Carbamide Peroxide 6.5% in Anhydrous glycerin Indication:

impacted cerumen

Usual dosage for Carbamide Peroxide 6.5% in Anhydrous Glycerin:

5-10 drops, leave in for at least 15 mins

• use up to BID, MAX 4 days

Ear Drop administration for patients < 3 y.o:

gently pull ear lobe down and back

Ear Drop administration for patients 3 y.o. or older:

gently pull upper part of ear up and back

Key counseling points for ear drop administration:

• warm ear drops with hands before administration

  • prevents dizziness and nausea from cold drops

• tilt head/lie down for 5 mins after

Exclusions to self-care for impacted cerumen tx:

• < 12 yrs

• infection

• pain w/ discharge

• bleeding/signs of trauma

• ear surgery within past 6 wks

• ruptured tympanic membrane

• tympanostomy tubes present

When to seek medical attention after self-care for impacted cerumen?

worsening/lack of improvement after 4 days