To guide PCH ED staff with the assessment and management of otitis externa in children who present to the Emergency Department. If you have trouble remembering to use your medicine, ask your pharmacist for some hints. If you use too much Otodex

You should do this even if there are no signs of discomfort or poisoning. 5. What should I know while using Otodex? Things you should do Tell your doctor if you are pregnant or intend to become pregnant. Like most medicines of this kind, Otodex is not recommended to be used during pregnancy. Your doctor or pharmacist will discuss the risks and benefits of using it if you are pregnant. There have been reported cases of ototoxicity with aminoglycosides administered to patients with mitochondrial mutations, particularly the m.1555A > G mutation, which suggests an increased risk of ototoxicity in these patients, including cases where the patient's aminoglycoside serum levels were within the recommended range. Some cases were associated with a maternal history of deafness and/or mitochondrial mutation. Mitochondrial mutations are rare, and the penetrance of this observed effect is unknown. For dogs who have ear infections, a deeper cleanse is required and so liquid solutions which can get further into the ear without damaging them or being abrasive are usually the best choice. They should also boast antifungal and antibacterial properties to help disinfect and clear up the infection. Mites Each mL contains framycetin sulfate 5 mg, gramicidin 50 microgram and dexamethasone (as sodium metasulfobenzoate) 500 microgram.Do not use Otodex if you are pregnant or intend to become pregnant. Like most aminoglycosides, Otodex is not recommended for use during pregnancy.

A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI. 4. How do I use Otodex? Otodex is used to treat infection or inflammation of the ear. 2. What should I know before I use Otodex? Warnings Do not use if you have ever had an allergic reaction to Otodex or any of the ingredients listed at the end of the CMI. Persisting infection which is thought to be fungal can be treated with Locacorten-Viaform ear drops, where as more severe cases may require a topical antifungal such as 1% clotrimazole. Because of their chemical similarity, all aminoglycosides must be considered potentially nephrotoxic and ototoxic to the foetus. It should also be noted that therapeutic blood concentrations in the mother do not equate with safety for the foetus.During therapy with Otodex, a possible increased need for insulin or antidiabetics should be considered in patients with diabetes. The hypoglycaemic reactions can be reduced. A dry powder that only needs a small spoonful to be effective, this is a dry solution which can be applied with a soft brush (make-up brush is best). Unlike liquid solutions, you don’t want this powder to go near your mutt’s ear hole and so it needs to be lightly dusted round the inner ear and then massaged gently! Wipes Mechanism of action. Framycetin sulfate is a bactericidal antibiotic active against a wide variety of Gram-positive and Gram-negative bacteria commonly found in superficial infections; staphylococci (including strains resistant to other antibiotics), Pseudomonas aeruginosa, coliforms and pneumococci.

Do not apply Otodex to open wounds or damaged skin, as this may cause irreversible, partial or total deafness. These effects may be aggravated by kidney or liver problems, or prolonged use. Do not continue treatment after these symptoms have resolved. Yes, like many medications, dog ear cleaner does have a best before date and can eventually become less effective. Do not use Otodex if you have an allergy to Otodex or any of the ingredients listed at the end of this leaflet. Side effectsTell your doctor or pharmacist as soon as possible if you do not feel well while you are using Otodex, even if the problem is not listed below. Otodex helps most people with an infection or inflammation of the ear, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.The organisms involved include Staphylococcus aureus, Pseudomonas and fungi (e.g. Aspergillus )4. Infections with Candida are less common. During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects? Pregnancy and breastfeeding Your doctor may decide to adjust your dosage if necessary or ask you to use Otodex in a different way, according to his or her judgment. Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines. 7. Product details Gentamicin and other aminoglycosides cross the placenta. There is evidence of selective uptake of aminoglycosides by the fetal kidney resulting in damage (probably reversible) to immature nephrons. Eighth cranial nerve damage has also been reported following in utero exposure to some of the aminoglycosides.

Prescriptions must be written on an Authority Prescription Form, and the approval number must be noted on the prescription. Pharmacists cannot dispense the item as a pharmaceutical benefit unless it has been approved by Medicare Australia (indicated by the presence of the approval number). Frequency not known: Hypersensitivity reactions, usually of the delayed type, may occur, leading to irritation, burning, stinging, itching and dermatitis. Framycetin sulfate, gramicidin and dexamethasone (as sodium metasulfobenzoate). 2 Qualitative and Quantitative Composition Oral antibiotics may be required for complicated otitis externa (e.g. with significant cellulitis, or symptoms such as fever or cervical lymphadenopathy). Further management For more information, see Section 1. Why am I using Otodex? in the full CMI. 2. What should I know before I use Otodex?

Otex ear drops contain the active ingredient urea hydrogen peroxide, which helps to soften ear wax. Urea hydrogen peroxide works to soften ear wax by releasing oxygen which breaks up hardened wax, it also has some antiseptic properties.