Rx
Notes
In emergency
Disease annotations
Rx
- Amoclan 1g tablets 1 x 2 x 10
- Panadol ActiFast 2 tablets up to 4 times daily
- Avamys 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Chlorohistol 4mg tab 4mg 1tab every 4-6 hours
If there is nasal obstruction add :
- Vibrocil nasal spray apply 1 to 2 sprays in each nostril, 3to 4 times a day
Notes
Amoxicillin with clavulanic acid
Dosage Forms & Strengths:
- 375mg tablet, 625mg tablet, 1g tablet, 156mg/5ml suspension, 312mg /5ml suspension, 200mg/5ml suspension, 400mg/5ml suspension, 600mg/5ml suspension, 457 mg /5ml suspension, 62.5mg/5ml drops , 600 vial injection , 1200 vial injection .
Trade names :
- Clavar , Klavox, Moxiclav, Ramoclav, Curam, Julmentin, Augmentin, Clavodar, Amoclan
Therapeutic indication and dose :
Lower Respiratory Tract Infection :
- Mild to moderate: 375mg PO q8hr for 10 days
- Severe: 625 mg PO q8hr or 2000 mg (2 extended-release tabs) PO q12hr for 7-10 days
Chronic Obstructive Pulmonary Disease
- 625 mg PO q8hr
Acute Bacterial Sinusitis
- 2000 mg (2 extended-release tablets) PO q12hr for 10 days
Animal/Human Bite Wounds
- 625mg PO q8hr for 3-5 days
Erysipelas
- 625 mg PO q8hr for 7-10 days
Pyelonephritis
- 625mg PO q8hr
Skin Abscess
- 625 mg PO q12hr
Diabetic Foot
Mild to moderate, localized cellulitis
- 2000 mg (2 extended-release tablets) PO q12hr for 7-14 days
Group A Streptococci, Chronic Carrier
- 40 mg/kg/day PO divided q8hr for 10 days; not to exceed 2000 mg/day
Contraindications:
- Hypersensitivity to penicillin’s
- History of a severe immediate hypersensitivity reaction (e. g. Anaphylaxis) to another beta-lactam agent (e. g. A cephalosporin, carbapenem or monobactam).
- Hepatic and renal impairment
Pregnancy:
- Category B
Breastfeeding :
- Both substances are excreted into breast milk, diarrhea and fungus infection of the mucous membranes are possible in the breast-fed infant, so that breast-feeding might have to be discontinued.
Common side effects:
- Diarrhea, nausea and vomiting.
- Mucocutaneous candidosis
- Skin rash, itching, hives
- Vaginal itching and discharge
Panadol ActiFast Product Description:
- Panadol ActiFast is a fast effective pain and is gentle on the stomach.
- Panadol ActiFast is a pain reliever that is absorbed twice as fast as regular paracetamol.
- Panadol ActiFast is effective for the relief of fever and the treatment of mild to moderate pain including headache, migraine, rheumatic and muscular pain, period pain, pain of osteoarthritis, toothache, pain following dental procedures/tooth extraction, and pain after vaccination.
What is Paracetamol used for :
Paracetamol is a medication that is used for the relief of the following indications:
- Headache
- Period pain
- Backache
- Rheumatic pain (joints pain)
- Cold and flu
- Sore throat
- Mild arthritis pain (joints pain)
- Muscle Pain
- Toothache
- Fever
Contraindication:
- In allergy to Paracetamol, or any of the ingredients in this medicine.
Corticosteroids nasal spray (Fluticasone)
Available forms:
- Flixonase, Rhinase, Dalman, Avamys, Aierxem: 50mcg/dose
Indications:
corticosteroid indicated for the management of thenasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients
aged 4 years and older.
Dose:
For intranasal use only. Recommended starting dosages:
- Adults: 2 sprays per nostril once daily (200 mcg per day).
- Adolescents and children aged 4 years and older: 1 spray per nostril oncedaily (100 mcg per day).
Chlorpheniramine
Available forms:
- Allerfin: 4mg tab, 10mg/ml ampule, 2.5mg/5ml syrup
- Anallerge: 4mg tab 2mg/5ml syrup
- Chlorohistol: 4mg tab
Therapeutic indications:
- symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
- Also indicated for the symptomatic relief of itch associated with chickenpox.
Method of administration:
- Adults: 4 mg (1 tablet or 10 ml) every 4-6 hours. Not more than six doses (24 mg) a day if under 65 years of age, or more than a total of three doses (12 mg) a day if over 65 years.
- Children aged 6-11 years: 2 mg (5 ml) every 4-6 hours. Not more than a total of six doses (12 mg) a day.
- Children aged 2-5 years: 1 mg (2.5 ml liquid medicine) every 4-6 hours. Not more than a total of six doses (6 mg) a day.
- Children 1 year-23 months: 1 mg (2.5 ml liquid medicine) twice daily, preferably morning and evening
Contraindications
- contra-indicated in patients who are hypersensitive to antihistamines or to any of the tablet ingredients.
Pregnancy
- There are no adequate data from the use of chlorphenamine maleate in pregnant women. The potential risk for humans is unknown. Use during the third trimester may result in reactions in the newborn or premature neonates. Not to be used during pregnancy unless considered essentially by a physician.
Lactation
- Chlorphenamine maleate and other antihistamine may inhibit lactation and may be secreted in breast milk. Not to be used during lactation unless considered essential by a physician
Side effects :
- Sedation
- drowsiness, dizziness, blurred vision and psychomotor impairment
- Nausea, dry mouth
- Disturbance in attention
Vibrocil
Composition :Nasal drops, nasal spray: Dimetindeni maleas 0.25 mg, Phenylephrinum 2.5 mg
Indications Therapeutic use :
- Common colds, acute and chronic rhinitis, seasonal (hay fever) and non-seasonal allergic rhinitis, acute and
- chronic sinusitis, pre- and postoperative care, adjuvant in cases of acute otitis media.
Dosage:
Nasal drops
- Children from 1to 6 years: 1 to 2 drops 3 to 4 times a day in each nostril.
- Children over 6 years and adults: 3to 4 drops 3 to 4 times a day in each nostril.
Nasal spray
- Adult: apply 1 to 2 sprays in each nostril, 3to 4 times a day.
pregnancy and breast-feeding :
- Vibrocil should not be used as a precaution because too little experience is available
In emergency
In Emergency room:
- Give antipyretic:
- Perflgan 1g/100ml intravenous injection :
Dose:
Pediatrics:
- <10kg : 0 .75ml/kg
- >10kg , <50kg : 1.5ml/kg
- >50kg : 100ml Slowly over 15 minute
Adult:
- 100ml Slowly over 15 minute
OR
- Diclofenac sodium injection 75 mg/3ml intramuscular injection :
Dose:
Pediatrics:
- > 1year : 1ml/20kg every 12 hour .
Adult:
- 25 to 75 mg(1-3ml) depending on the severity pain.
- If the pain still severe, you may decide to give a second injection after 6 hours.
- Give Antibiotic:
- Lincomycin 600mg/2ml
Dose:
Pediatrics:
- IV: 10-20 mg/kg/day divided q8-12hr
- IM: 10 mg/kg q12-24hr
Adult:
- IM: 600 mg q12-24hr
- IV: 600-1000 mg q8-12hr; not to exceed 8 g/day
OR
- Ceftriaxone injection
Dose:
Pediatrics:
- 50 mg/kg IM in single dose; not to exceed 1 g
Adult:
- 50 mg/kg IM once
- Persistent or treatment failures: 50 mg/kg IV/IM for 3 days
- Give Antihistamine In sneezing and rhinorrhea :
- Allerfin 10mg/ml IM injection :
Dose:
- 1-5 year : 25-5mg (½ ml )
- 6-12 year: 5-10mg (1ml )
- Adult : 10-20 mg (1-2 ml )
Disease annotations
Acute sinusitis
Presentation :
- Purulent nasal discharge
- Nasal congestion or obstruction
- Facial congestion or fullness
- Facial pain or pressure
- Decreased sense of smell
- Fever
- Headache
- Ear pain
- fullness; halitosis; dental pain; cough; fatigue
Examination:
- Purulent nasal secretions
- Purulent posterior pharyngeal secretions
- Mucosal erythema
- Tenderness overlying sinuses
Lines of management :
- Antipyretics
- Antibiotics
- Symptomatic treatment:
- In nasal obstruction : use nasal decongestant
- In excessive secretions and sneezing : use antihistamine
- If not respond : Intranasal Corticosteroids :
- Helpful in reducing mucosal swelling of inflamed tissue and facilitating sinus drainage because of an anti-inflammatory effect