Articles Index - Hydrolats
 
ENT Drugs
 
Removal of ear wax
Wax is a normal bodily secretion and need only be removed if it causes deafness or interferes with a proper view of the ear drum. So, it is the inconvenience to the doctor that is a good reason for having your ears syringed! The other reason is the assumption that impacted or an 'increased' amount of ear wax causes hearing problems. This is by no means a foregone conclusion.
 
Ear wax softeners are oil based and experience tells us that the best results are achieved by using plain oil as supposed to the pharmaceutical preparations. It is recommended to use a lot of oil and to leave it in the outer ear canal overnight.
 
Anti-inflammatory preparations
The anti-inflammatory preparations for the outer ear, the inner ear, the nose and the mouth are steroid based. They all come with the warning to avoid long-term use, but as they are the only recommended treatment there is no other option but to use them continuously with recurrent inflammations. Observations show us that as a result of not dealing with the underlying causes of persistent inflammations and the use of corticosteroids as a treatment, inflammations become chronic and resistant to treatment. Understanding the reasons behind the inflammatory processes and supporting the body in its effort to clean up, results in the permanent disappearance of the chronic inflammation. Long-term use of locally-applied steroids results in a weakening and thinning of the membranes, a lowering of the resistance (including sensitivity reactions) and an increase in membrane secretions.
 
Anti-infective preparations
Local application of antibiotics has always been known to be extremely ineffective in treating infectious processes. The used preparations have a high incidence of sensitivity reactions. Prolonged use is seriously discouraged but as the treatment is ineffective and local infections keep reoccurring the use of long-term antibiotic preparations keeps rising. A number of preparations combine corticosteroids and antibiotics in a feeble effort to increase the effectiveness of the treatment. Also, by mixing antibiotics in with the steroids they avoid the tricky caution not to use steroids in case of infections, as that will stimulate the infectious process. There is no study that proves any advantage of the combination treatment over the singular.
 
Drugs used in nasal allergy
Mild cases of allergic rhinitis are treated by topical corticosteroids or oral antihistamines. More persistent symptoms and nasal congestion can be relieved by topical corticosteroids and cromoglicate. In seasonal allergic rhinitis treatment should start two to three weeks before the season commences and may have to be continued several months afterwards. Treatment may be required for years in perennial rhinitis; perhaps a sign of inefficiency?

Antihistamines: Azelastine Hydrochloride, Levocabastine. The side-effects include irritation of the nasal mucous membranes, taste disturbances, hypersensitivity reactions, headache, fatigue, and drowsiness. Sodium Cromoglicate causes local irritation and bronchospasm.
 
Topical nasal decongestants
These all contain sympathomimetic drugs which exert their effect by vasoconstriction of the mucosal blood vessels, which in turn reduces oedema of the nasal mucosa. They are of limited value because they can give rise to a rebound congestion on withdrawal due to a secondary vasodilation, with a subsequent increase in nasal congestion. This in turn tempts the further use of the decongestant, leading to a vicious cycle of events. All of these preparations may cause a hypersensitive crisis if used during treatment with a monoamineoxidase inhibitor (antidepressants). Ephedrine hydrochloride, Xylometazoline hydrochloride should be avoided in prolonged use and in infants under three months old. They cause irritation, diminished tolerance, and rebound congestion.

Antimuscarine: Ipratropium bromide also causes nasal dryness and nose bleeds.
 
Antifungal preparations
Fungal infections are associated with the use of antibiotics and cytotoxic drugs. Local applications of antifungal preparations are used which cause gastrointestinal disturbances, liver impairment, nausea, and vomiting.
 
Lozenges and sprays
There is no evidence that antiseptic lozenges and sprays have any beneficial action and they sometimes irritate and cause sore tongue and lips. Some of these preparations also contain local anaesthetics which relieve pain but may cause sensitisation.
 
© By Patrick Quanten MD
 
Jul Aug 07
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