Medicines
used in Voice Care Several
medicines are commonly used to treat voice disorders. Many of
these can be exceptionally helpful and even essential to restoring
an effective,
healthy voice. Some of these are less so, and may even be harmful when
used inappropriately. In view of this, caution is needed on the parts of
both the physician and the person with the voice problem in using medicine.
No medication should be prescribed without a clear reason. It is reasonable
for a person with a voice problem to seek to understand:
why
each medication is prescribed.
what
the anticipated effect will be and how long
it will take.
what
the side effects are. |
Antibiotics treat
infections caused by bacteria. They are used to treat hoarseness
when it is believed to be due
to bacterial infection. In fact, bacterial infection rarely causes
hoarseness that lasts more than a week in adults. In such cases,
treatment with successive rounds of antibiotics may only serves
to ‘mask’ illness and delay effective treatment. It
is a good idea to re-examine the larynx if a round of antibiotics
is ineffective.
Anti-Reflux medicine: Laryngopharyngeal
reflux can be a problem on its own or contribute to a number of other vocal
fold disorders. There are three categories
of medicine that all act to diminish the acidity of stomach juices.
Over the counter antacids like Maalox™ and various bicarbonate
preparations use a basic substance to counteract acid. H2
blockers
(examples:
Zantac™, Tagamet™), also available over
the counter, decrease the production of acid in the lining of
the stomach. Proton Pump inhibitors (Aciphex™, Nexium™,
Protonix™, Prilosec™) also act to decrease acid production
and are the strongest of the anti-reflux medications.
Reflux is a chronic problem that often requires diligent long-term treatment,
extending over months. It is important to understand that changes in dietary
patterns are at least as important as medicine in treating reflux, and probably
more so over the long term. These should be discussed with your physician.
Mucus thinner (guaifenesin) preparations
are available with or without a prescription under a variety of brand names.
These are occasionally used for control of throat discomfort. While safe, their
efficacy in each individual case is uneven. Contrary to popular belief, “thick
mucus” is not a well-recognized factor in any voice problem, and may actually
represent other types of laryngeal irritation that should be treated appropriately.
In general, if mucus thinner preparations are not helpful within a week, there
is little reason to continue to use them. Equally important and possibly just
as effective in managing this problem is staying well-hydrated.
Steroid
pills and injections (examples: prednisone, Medrol™) are
meant to simulate substances the body naturally makes in response to stress and
illness, and which reduce inflammation. Steroids are used to reduce swelling
in the vocal folds. Like voice
rest,
they are effective for temporary irritation, but they do not solve any underlying
problems. Steroids have many other effects
throughout the body, like weight gain, stomach ulcers and osteoporosis. They
should be used cautiously, and should not be used over the long term in voice
problems.
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