North Staffordshire Joint Formulary: Section 12

North Staffordshire Joint Formulary

SECTION 12. EAR, NOSE & OROPHARYNX

Section Last Updated: October 2018

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12.1 DRUGS ACTING ON THE EAR 12.1.1 Otitis externa 12.1.3 Removal of ear wax 12.2 DRUGS ACTING ON THE NOSE 12.2.1 Drugs used in nasal allergy 12.2.2 Topical nasal decongestants 12.2.3 Nasal preparations for infection 12.3 DRUGS ACTING ON THE OROPHARYNX 12.3.1 Drugs for oral ulceration and inflammation 12.3.2 Oropharyngeal anti-infective drugs 12.3.4 Mouthwashes, gargles, and dentifrices 12.3.5 Treatment of dry mouth

Page 1 of 3 Ratified February 2006 Updated October 2018 North Staffordshire Joint Formulary: Section 12

SECTION 12. EAR, NOSE & OROPHARYNX

12.1 DRUGS ACTING ON THE EAR 

12.1.1 Otitis externa Astringent preparations Aluminium acetate Anti-inflammatory preparations Betamethasone sodium phosphate Prednisolone sodium phosphate Anti-inflammatory with antibacterial preparations Betnesol-N® (Betamethasone sodium phosphate/neomycin sulfate) Otomize®

(Dexamethasone/neomycin) Sofradex® (Dexamethasone/ framycetin/ gramicidin) Locorten-Vioform®

(Flumetasone pivalate/clioquinol) Gentisone®HC

(Hydrocortisone/gentamicin) Anti-infective preparations Gentamicin Clotrimazole

12.1.3 Removal of ear wax Olive oil Sodium bicarbonate

12.2 DRUGS ACTING ON THE NOSE 

12.2.1 Drugs used in nasal allergy Antihistamines Azelastine Corticosteroids Beclometasone 1st line for the treatment and prophylaxis of allergic perennial rhinitis (beclomethasone) Budesonide Recommendation: Licensed for the treatment of nasal polyps Fluticasone furoate (Avamys®) 2nd line for the treatment and prophylaxis of allergic perennial rhinitis 2nd line for the treatment and prophylaxis of allergic perennial rhinitis

Mometasone Recommendation: Licensed for the treatment of nasal polyps Antihistamine with Corticosteroid

Dymista® (Azelastine 2nd line for moderate to severe seasonal and perennial allergic rhinitis if monotherapy Medicines hydrochloride & Fluticasone with either intranasal antihistamine or intranasal glucocorticoid is insufficient. Review propionate) Verdict Sheet Cromoglicate Sodium cromoglicate (sodium cromoglycate) Page 2 of 3 Ratified February 2006 Updated October 2018 North Staffordshire Joint Formulary: Section 12

12.2.2 Topical nasal decongestants Sympathomimetics Ephedrine Xylometazoline Antimuscarinic Ipratropium

12.2.3 Nasal preparations for infection Chlorhexidine hydrochloride Restriction: For eradication or suppression of nasal carriage of staphylococci, if 0.1% & neomycin sulfate 0.5% staphylococcus is resistant to mupirocin or patient allergic to mupirocin nasal cream (Naseptin®) Restriction: For the eradication (in both patients and staff) of nasal carriage of MRSA, in Mupirocin 2% nasal ointment accordance with hospital or local guidelines.

(Bactroban Nasal®) Restriction: For the suppression of S. aureus prior to elective high risk surgery, on request of the consultant surgeon

12.3 DRUGS ACTING ON THE OROPHARYNX 

12.3.1 Drugs for oral ulceration and inflammation Benzydamine Carmellose sodium Hydrocortisone 2.5mg pellets Adcortyl in Orabase®

(triamcinolone) Choline salicylate Dental Gel

12.3.2 Oropharyngeal anti-infective drugs Oropharyngeal fungal infections Nystatin Amphotericin Miconazole

12.3.4 Mouthwashes, gargles, and dentifrices Chlorhexidine gluconate Hydrogen peroxide

12.3.5 Treatment of dry mouth Local treatment Salivix® pastilles Glandosane® spray Systemic treatment Pilocarpine Restriction: Consultant use only following irradiation for head and neck cancer

Page 3 of 3 Ratified February 2006 Updated October 2018