Home' Australian Pharmacist : November 2011 Contents Vol.30–November#11,2011
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
symptoms may include antiemetics
(e.g . metoclopramide) for nausea/
vomiting, vestibular suppressants
(e.g . benzodiazepines) for vertigo,
and corticosteroids for hearing loss.
• Patients with ongoing dizziness
and vertigo may require vestibular
1. Boston ME. Inner Ear Labyrinthitis. Medscape
Reference [online]. Jan 2010. At: http://emedicine.
2. Lee SC. Anatomy of the Vestibular System. Medscape
Reference [online]. Mar 2010. At: http://emedicine.
3. Pillsbury HCI, Rose AS. Ears: Biology of the Ears, Nose,
and Throat. Merck Manual Home Edition [online].
Mar 2006. At: www.merckmanuals.com/home/sec19/
1. What is the MOST COMMON
type of labyrinthitis?
a) Viral labyrinthitis.
b) Bacterial labyrinthitis.
c) Suppurative labyrinthitis.
d) Autoimmune labyrinthitis.
2. Serous labyrinthitis occurs as
a result of:
a) a viral upper respiratory tract
b) direct bacterial invasion of the
c) invasion of the inner ear by
bacterial toxins and host
d) tertiary syphilis.
3. One of the symptoms of
labyrinthitis is hearing loss.
Which ONE of the following
statements regarding hearing
loss in labyrinthitis is
a) Hearing loss in suppurative
labyrinthitis usually resolves within
a few days.
b) Hearing loss due to viral
labyrinthitis is usually profound and
c) Hearing loss is a symptom
common to both viral labyrinthitis
and vestibular neuritis.
d) Hearing loss due to meningitis is
4. Which of the following is the
MOST APPROPRIATE treatment
to recommend for vertigo due
to viral labyrinthitis?
a) Prochlorperazine 5 mg every
b) Prednisone 60 mg daily until
vertigo resolves, then taper off
over five days.
c) Diazepam 5 mg every six hours.
d) Promethazine 25 mg every
A score of 4 out of 5 attracts 1 CPD credit.
5. Which ONE of the following
is an appropriate strategy
to suggest for reducing
symptoms of labyrinthitis?
a) During an attack of vertigo, remain
in a seated position; avoid lying
down as this may worsen the
b) Commence vestibular rehabilitation
therapy, as this has been shown to
improve vertigo and balance.
c) Drink at least three cups of
coffee per day, as caffeine has
been shown to stimulate central
d) Avoid excessive fluid intake, as this
can exacerbate vertigo.
4. National Institute on Deafness and Other
Communication Disorders, National Institutes of
Health. Balance Disorders [online]. Jun 2010. At: www.
5. Isaacson B. Labyrinthitis. Epocrates online [online].
May 2011. At: https://online.epocrates.com
6. Better Health Channel. Labyrinthitis and vestibular
neuritis [online]. Mar 2010. At: www.betterhealth.vic.
7. Brodie HA. Labyrinthitis Ossificans. Medscape
Reference [online]. Sep 2008. At: http://emedicine.
8. Mathur NN. Inner Ear, Autoimmune Disease. Medscape
Reference [online]. Oct 2009. At: http://emedicine.
9. Mudd P. Inner Ear, Ototoxicity. Medscape Reference
[online]. Jul 2010. At: http://emedicine.medscape.com/
10. Roland PS. Inner Ear, Perilymphatic Fistula. Medscape
Reference [online]. Apr 2010. At: http://emedicine.
11. Shohet JA. Skull Base Tumor and Other CPA
Tumors. Medscape Reference [online]. Feb 2009. At:
12. Swartz R, Longwell P. Treatment of Vertigo. Am Fam
Phys. 2005. 15;71(6):1115–22. At: www.aafp.org/
13. Zapanta PE. Vestibular Rehabilitation. Medscape
Reference [online]. Nov 2009. At: http://emedicine.
14. NHS UK. Labyrinthitis. NHS Choices health information
[online]. Apr 2009. At: www.nhs.uk/conditions/
15. Mudd PA. Inner Ear, Ototoxicity Medscape Reference
[online]. Jul 2010. At: http://emedicine.medscape.com/
16. Rossi S, ed. Australian Medicines Handbook. Adelaide:
Australian Medicines Handbook; Jan 2011.
counselling in practice
Allergic rhinitis relief1
Whatever the reason
whatever the season1
Avamys effectively relieves
nasal and ocular symptoms
of allergic rhinitis1,2,3
Avamys (fluticasone furoate) Nasal Spray Minimum Product Information.
PLEASE REVIEW FULL PRODUCT INFORMATION BEFORE PRESCRIBING.
Indications: Seasonal allergic rhinitis and perennial allergic rhinitis in patients aged 2 years and older. Contraindications: Hypersensitivity.
Precautions: Severe liver disease. Infection of nasal airways should be treated and healing from nasal surgery should have occurred before use.
Systemic effects with nasal corticosteroids have been reported, particularly at high doses prescribed for prolonged periods. These effects are much less
likely to occur than with oral corticosteroids and may vary in individual patients and between different corticosteroid preparations. Rare class effects:
glaucoma, increased ocular pressure, nasopharyngeal candidiasis. Patients susceptible to candida infections (e.g. diabetics). Excessive dosing may
cause suppression of the HPAaxis, reduction in bone density and growth retardation. Children receiving prolonged treatment: regular height monitoring.
Pregnancy category B3, lactation. Interactions: No theoretical basis for anticipating interactions between Avamys and CYP450 metabolism of other
compounds. Ritonavir is not recommended because of the potential risk of increased systemic exposure to Avamys. Adverse reactions: Very
common: epistaxis, generally mild to moderate. Common: nasal ulceration. Dosage: Intranasal route only. Regular usage is recommended. Adults/
Adolescents (12 years and over): Starting dosage is 2 sprays in each nostril once daily. Once adequate control of symptoms is achieved, dose reduction
to 1 spray in each nostril once daily may be effective for maintenance. Children (2 to 11 years of age): Starting dosage is 1 spray in each nostril once
daily. Patients not adequately responding may use 2 sprays in each nostril once daily. Once adequate control of symptoms is achieved, dose reduction
to 1 spray in each nostril once daily is recommended. Last updated 10th May 2011, version 3.0. References: 1. Avamys Product Information.
2. Vasar M et al. Allergy Asthma proc 2008; 29(3):313-321. 3. Fokkens et al. Allergy 2007; 62:1078-1084. PC1103029
PBS Information: This product is not listed on the PBS.
For full product information please contact GlaxoSmithKline Australia Pty Ltd. Melbourne,
VIC. ABN 47 100 162 481.
Education for pharmacists and
Counter Connection – A monthly
distance education module for
Facts Behind the Fact Cards – Monthly
detailed clinical and practice education
for pharmacists. CPD points are available.
Self Care Your professional edge
Health information for your customers
Fact Cards – Fact Cards provide
independent, concise and factual
information for the pharmacy team
Health campaigns – Comprehensive
health promotion pharmacy
packages designed to educate and
raise public awareness.
Promotion tools for your pharmacy
John Bell’s Health Column – Self Care
Adviser, John Bell, writes an informative
weekly column that can be personalised
to member pharmacies and used in
local media such as newspapers and
Pharmacy’s leading health information and education program Join now at www.psa.org.au/selfcare or call 1300 369 772
Links Archive December 2011 October 2011 Navigation Previous Page Next Page