The main drugs commonly used in the ear are the following and several others.
(a) 5% sodium bicarbonate ear drops, also known as cerumen water or soda water.
1. Pharmacological action: Softening cerumen and scabs.
2. Use: For external ear canal cerumen embolism.
3.How to use: Put the drops into the external ear canal 5~6 times a day, a few drops each time, and perform external ear canal rinsing after 2~3 days.
(B) 3% hydrogen peroxide solution ear drops
1. Pharmacological effect: The primary ecological oxygen of hydrogen peroxide solution forms foam with organic matter such as pus, which has disinfection, cleaning and deodorization effects.
2.Use: It is used for patients with more pus in the tympanic chamber after otitis externa or tympanic membrane perforation.
3.How to use: Put a few drops into the ear, then wipe the foam away with an ear swab, and then put in anti-inflammatory ear medicine.
(C) 2% phenol glycerin ear drops
1.Pharmacological effects denature the protein of the bacteria, sterilize, relieve pain and reduce swelling.
2.Used for patients with otitis externa, external ear canal boils, acute tympanitis, acute otitis media with unperforated eardrum.
3.How to use: 2~3 drops in the ear, 3 times a day.
4. Precautions: Patients with perforated tympanic membrane and pus are prohibited because phenol glycerin will release carbolic acid when it meets pus, which will corrode the tympanic membrane and middle ear mucosa.
(D) 0.25% Chloramphenicol Ear Drops
1. Pharmacological action: broad-spectrum antibiotic.
2.Use: Acute and chronic purulent otitis media.
3. Use: Ear drops 2~3 drops each time, 3 times a day.
4. Precautions: Do not overdose when giving drops to young children with perforated eardrums, as it can flow into the pharynx through the eustachian tube and may affect the hematopoietic function.
(E) 0.3% Ofloxacin Ear Drops
1. Pharmacological action: quinolone broad-spectrum antibacterial agent to kill Staphylococcus aureus, S. pneumoniae, H. influenzae, C. catarrhalis, Pseudomonas aeruginosa.
2.Use: It is used for acute and chronic purulent otitis media, infection after mastoid surgery, otitis externa, boils and tympanitis. It has better effect on otitis media in children.
3.How to use: Ear drops, 5~10 drops each time, 2~3 times a day.
4. Precautions: The dosage should be used with caution or reduced in children with tympanic membrane perforation to prevent possible joint site side effects from quinolones.
(F) 4% glycerol borate
1.Pharmacological action: antibacterial, disinfection, astringent, antipruritic, softening cerumen.
2.Use: For external ear canal cholesteatoma, ear canal skin infection, etc.
3.How to use: Ear drops, 3 times a day.
4. Precautions: Review after 3 days.
(VII) 2% muscimol alcohol ear drops
1. Pharmacological action: antifungal, anti-inflammatory, antipruritic.
2.Use: For external ear canal fungal disease.
3.How to use: Ear drops, 3 times a day.
4. Precautions: Forbidden for perforated eardrum.
(H) 2% ethanol salicylate
1. Pharmacological action: Inhibit bacteria and fungi, stop itching.
2.Use: For external ear canal fungal disease.
3.How to use: Ear drops or rubbing, 3 times a day.
4. Precautions: Forbidden for perforated tympanic membrane.
(ix) 1%~2% bupivacaine
1. Pharmacological action: Local anesthetic, with good penetration of the mucous membrane and rapid action, lasting 60~90 minutes.
2.Use: For tympanic membrane puncture.
3.How to use: Ear drops, 2~3 drops each time, 1 time every 2~3 minutes, 1~3 times.
4.Cautions.
(1) The dosage should not be too large to prevent acute poisoning.
(2) A small number of patients may be allergic, ask the patient’s allergy history before use, and pay attention to observe and ask the patient if there is any discomfort after use.
(X) 10%~50% silver nitrate solution
1. Pharmacological effect: Silver nitrate in low concentration has astringent effect, while silver nitrate above 10% has cauterizing effect.
2.Use: cauterizing the pus head after maturation of external ear canal boils, chronic granulomatous tympanitis, external ear canal granuloma, etc.
3.Use: Apply to the affected area and cauterize directly.
4.Caution
(1) Do not touch the tympanic membrane when applying the solution, so as not to erode the tympanic membrane.
(2) Because silver nitrate will decompose when it sees light, it should be stored away from light.
(xi) 10% fish glycerol
1.Pharmacological effect: antibacterial, anti-inflammatory, inhibition of secretion, swelling and pain relief.
2.Use: When external ear canal boils are immature and otitis media with suppuration of the auricle.
3. Usage: Apply to the affected area or apply externally 1~2 times a day, or make gauze strips to fill the external ear canal.
Medication principles
1.Before local application, clean the external ear canal, remove cerumen and wipe away secretions from the external ear canal.
2.Drugs with corrosive effect should not be used freely.
3.Ear drops should be warmed properly before use to avoid inducing vagus irritation due to the cold drops into the ear.
4.People with tympanic membrane perforation are prohibited from using preparations that can damage the middle ear mucosa.
5. Under normal circumstances, powder should not be used. Because of the poor solubility of the powder drops into the ear, not only the anti-inflammatory effect is poor, but also will be glued with the ear secretions into a mass, preventing drainage and continued treatment, and in serious cases may cause intracranial and extracranial complications.
6. Ototoxic drugs that can easily cause inner ear damage, such as streptomycin and gentamicin, should be used with caution and a good choice of indications, and should not be used for a long time.