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# TUSQ-QD
## Overview
TUSQ-QD is a combination product containing **ciprofloxacin** (a fluoroquinolone antibiotic) and **dexamethasone** (a corticosteroid).
## Primary Indications
* Treatment of acute otitis media with tympanostomy tubes in pediatric patients.
* Prophylaxis and treatment of postoperative inflammation and infection following cataract surgery.
## Adult Dosing
* **Otic Solution:** 3-4 drops in the affected ear(s) twice daily for 7 days.
* **Ophthalmic Solution:** 1 drop in the affected eye(s) 4 times daily for 7 days post-operatively.
## Pediatric Dosing
* **Otic Solution (for otitis media with tympanostomy tubes):**
* 3 drops in the affected ear twice daily for 7 days for patients 6 months of age and older.
## Dose Adjustments
No specific dose adjustments are typically required for renal or hepatic impairment, but caution is advised, especially with systemic absorption.
## Contraindications
* Hypersensitivity to ciprofloxacin, dexamethasone, or any component of the formulation.
* Viral infections of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic ulcer), vaccinia, and varicella.
* Fungal infections of ocular structures.
* Untreated purulent bacterial or fungal infections of the ear.
## Adverse Effects
* **Otic:** Ear discomfort, taste perversion.
* **Ophthalmic:** Ocular irritation, conjunctival redness, decreased visual acuity, foreign body sensation. Prolonged use of ophthalmic corticosteroids can lead to increased intraocular pressure, glaucoma with optic nerve damage, visual field defects, posterior subcapsular cataract formation, and delayed wound healing. Systemic absorption of dexamethasone can occur, although rare.
## Key Drug Interactions
* **Ophthalmic:** Concurrent use with other ophthalmic corticosteroids may increase intraocular pressure.
* **Otic:** Limited clinically significant interactions reported when used as directed.
## Monitoring
* **Ophthalmic:** Monitor intraocular pressure with prolonged use.
* **Otic:** Assess for signs of infection resolution and symptom improvement.
## Clinical Pearls
* Ciprofloxacin provides antibacterial coverage, while dexamethasone reduces inflammation.
* Ensure proper administration technique to maximize efficacy and minimize systemic absorption.
* Do not touch the dropper tip to any surface or the eye/ear to prevent contamination.
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*This information is intended for clinical decision-making and does not replace a thorough review of the current prescribing information. Always verify with the most up-to-date drug monograph.*
