QuestionSBA
QuestionChoice
Paracetamol is available as a flavoured syrup for young children who will not tolerate tablets or are adverse to the bitter taste
34005
a
Paracetamol oral suspension 240mg PO QDS
QuestionChoice
Amoxicillin may be given to treat acute otitis media that has not resolved after 3-4 days or if there is any evidence of complications
34006
b
Amoxicillin 250mg PO TDS
QuestionChoice
Clarithromycin is an acceptable option in treating acute otitis media where antibiotics are required
34008
d
Clarithromycin 250mg PO BD
QuestionChoice
This is a combination medication given topically to treat acute otitis externa, or acute otitis media with grommets present
34007
c
Ciprofloxacin with dexamethasone topical ear drops BD
QuestionChoice
While most cases of acute otitis media are self-limiting and resolve in a few days, the child is clearly in some pain and distress. At the very least, simple oral analgesia should be prescribed
34009
e
No additional treatment is required
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2745
Uncomplicated otitis media
Topic
91
Paediatrics
6812
Case Presentation: A 4 year old girl is brought to GP by her parents as she has been unsettled and complaining of right-sided ear pain for the past 24 hours.


**O/E**

Temperature 37.0°C. HR 84, RR 15, O2 99% RA. Visibly restless and tugging at right pinna. Oropharynx pale pink with moist mucous membranes. Cervical lymph nodes not palpable. Otoscopy – left ear unremarkable, right ear hyperaemic tympanic membrane with loss of light reflex but no visible effusion.

Cardiovascular examination unremarkable. She has no known drug allergies.

Question: Select the most appropriate management at this stage.
a