Rx
Notes
In emergency
Disease annotations
Rx
- Azithromycin 500mg capsule 1x1x3
- Panadol ActiFast 2 tablets up to 4 times daily
- Rhinocort 32mcg/dose nasal spray one spray in each nostril once a day
If there are excessive secretions and sneezing add:
- Hydroxyzine 25mg 1 tab every 8-6 hours
If there is nasal obstruction add :
- Sterimar Isotonic sea water spray 1puff 4-6 times
Notes
Azithromycin
Dosage Forms & Strengths:
- 250mg ,500mg capsule and tablet, 500mg vial, 200mg/5ml suspension, 300mg /7.5ml suspension
Trade names :
Zocin, Zimax , Zomax, Azomycin, Azi_once, Zithromax, Azitam, Zithrova, Zaha, Zilacid, Azicure, Azomyne , Azox
Therapeutic indication and dose :
Community-acquired Pneumonia
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Pharyngitis or Tonsillitis
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Uncomplicated skin/skin structure
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Acute bacterial exacerbations of chronic obstructive pulmonary disease
- 500 mg PO qDay for 3 days OR
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Acute bacterial sinusitis
- 500 mg PO qDay x 3 days
Genital Ulcer Disease (Chancroid)
- 1000 mg PO x 1 dose
Nongonococcal or Gonococcal Urethritis and Cervicitis
- 1000 mg PO x 1 dose
Cat Scratch Disease (Off-label)
- >45.5 kg: 500 mg PO once, then 250 mg once daily for 4 days
Pertussis (Off-label)
- 500 mg PO once, then 250 mg once daily for 4 days
Endocarditis (Off-label)
Prophylaxis
- 500 mg PO 30-60 min before procedure
Contraindications:
- Hypersensitivity to azithromycin, erythromycin, any macrolide
Pregnancy:
- The safety of azithromycin has not been confirmed with regard to the use of the active substance during pregnancy. Therefore, Azithromycin should only be used during pregnancy if the benefit outweighs the risk
Breastfeeding :
- Azithromycin has been reported to be secreted into human breast milk
- Because it is not known whether azithromycin may have adverse effects on the breast-fed infant, nursing should be discontinued during treatment with Azithromycin. Among other things diarrhea, fungus infection of the mucous membrane is possible in the nursed infant. It is recommended to discard the milk during treatment and up until 2 days after discontinuation of treatment. Nursing may be resumed thereafter.
Common side effects:
- Anorexia
- Dizziness, headache, paranesthesia, dysgeusia
- Visual impairment, Deafness
- Vomiting, dyspepsia
- Rash, pruritus
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 (Budesonide)
Available forms:
- Rhinocort :32mcg/dose,64mcg/dose
Indications:
- corticosteroid indicated for the management of thenasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients aged 6years and older.
Dose:
- Rhinocort :32mcg/dose For intranasal use only.
Starting dosage:
Adult and children >6 years:
- 64 mcg (one spray per nostril ) once daily.
Maximum dosages:
- Adults: 256 mcg (four sprays per nostril of Rhinocort :32mcg/dose) once daily.
- Pediatric patients (6 to <12 years of age): 128 mcg (two sprays per nostril Rhinocort :32mcg/dose) once daily.
Hydroxyzine
Available forms:
- Atarax :25mg tab, 10mg/5ml syrup
- Newrax :10mg/5ml syrup
Therapeutic indications:
- Anxiety in adults
- Itching (pruritus) caused by allergic reactions in adults and children.
Dose :
- In adults the maximum daily dose is 100 mg (4 tablets) per day
Adults
For anxiety:
- The usual dose is ½ tablet at breakfast, ½ tablet at lunch and 1 tablet in the evening
- doctor may increase this to a maximum of 4 tablets taken three times a day.
For pruritis (itchiness of the skin):
- The usual dose is 1 tablet before going to bed
- doctor may increase this to 1 tablet three or four times a day
Children
- In children up to 40 kg, the maximum daily dose is 2 mg/kg/day.
For pruritis :
- The usual dose is 0.5 mg per kg of body weight twice a day
- doctor may increase this to a maximum of 1 mg per kg of body weight twice a day
The elderly
- In the elderly, the maximum daily dose is 50 mg (2 tablets) per day.
- The usual starting dose is 25 mg (1 tablet) a day
Contraindication :
- allergy to hydroxyzine hydrochloride or any of the other ingredients
- allergy to cetirizine, other piperazine derivatives, aminophylline or ethylenediamine
- pregnancy or breastfeeding
- porphyria.(A blood disease that can cause stomach pain, vomitingand mental disturbances such as depression
- ECG (electrocardiogram) shows a heart rhythm problem called “QT interval prolongation”
Pregnancy and breastfeeding :
- Not recommended in pregnancy or breastfeeding
Side effect:
- feeling sleepy
- dry mouth, feeling tired, headache
Sterimar Isotonic sea water spray
- Is a natural nasal decongestant spray
- Is an isotonic filtered sea water solution, 100% natural and free from preservatives
- Restores natural moisture of the nose (air conditioning, heating, travel). To assist when ENT disorders (sinusitis, colds, hayfever, allergies, dry & stuffy noses).
Dose:
- 1puffs 2 to 6 times a day in each nostril as required or as needed.
Pregnancy and lactation:
- Save
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