- Cefixime 400 mg capsules orally 1 x1
- Panadol cold and flu 1-2 tablet 2 times daily
- 05% nasal spray 2 sprays in each nostril once a day
Cefixime
Dosage Forms & Strengths:
- 200mg capsules, 400mg capsule and tablets, 100mg/5ml suspension
Trade names :
- Suprax , Cefix, Magnacif, Mixif, Betixim, Winex , Pancef , Apex, Cefim , Macrocef Suraxim.
Therapeutic indication and dose :
Acute Exacerbations of Chronic Bronchitis
- 400 mg/day PO in single daily dose or divided q12hr
Otitis Media
- 400 mg/day PO in single daily dose or divided q12hr
Pharyngitis/Tonsillitis
- 400 mg/day PO in single daily dose or divided q12hr
Uncomplicated Gonorrhea
- 400 mg PO once plus azithromycin 1 g PO once (preferred) or alternatively doxycycline 100 mg PO q12hr for 7 days
Uncomplicated Urinary Tract Infections
- 400 mg/day PO in single daily dose or divided q12hr
Typhoid Fever (Off-label)
- 15-20 mg/kg/day; not to exceed 100-200 mg BID x 7-14 days
Contraindications:
- Hypersensitivity to cephalosporin
Pregnancy and lactation:
- Cefixime should not be used in pregnancy or in nursing mothers unless considered essential by the physician.
Side effects:
- Abdominal pain
- Diarrhea, Dyspepsia, Nausea, Vomiting, Flatulence
Panadol cold and flu
Ingredients:
- Active Ingredients: Paracetamol 500 mg, Pseudoephedrine Hydrochloride 30 mg, Chlorphenamine Maleate 2 mg.
- Other non-active ingredients: Silicon dioxide, Stearic acid, Sodium benzoate, Povidone, Pregelatinised starch, Maize starch, Talc.
used for:
- This product consists of three active ingredients: paracetamol, chlorpheniramine and pseudoephedrine hydrochloride.
- Paracetamol is a medication that belongs to a class of medications known as analgesics (pain relievers) and antipyretics (fever reducers).
- Chlorpheniramine is an antihistamine that acts by decreasing the effects of histamine in your body and therefore helps in relieving allergy signs and symptoms, like, sneezing, watery eyes, itching, and runny nose.
- Pseudoephedrine is a medication that belongs to a class of medicines known as “decongestants” and acts by decreasing nasal stuffiness that you may experience during cold and flu.
- It is used for the night time relief from cold and flu symptoms.
It is used for the relief of the following indications:
- Headache
- Congestion and sinus pain
- Sneezing
- Body aches
- Itchy and watery eyes
- Blocked and runny nose
- Fever
Contraindication:
- In allergy to Paracetamol, or Chlorpheniramine, or Pseudoephedrine Hydrochloride, other antihistamines or any of the ingredients in this medicine.
- In taking other paracetamol containing products or other antihistamines or cough or cold and flu medications or decongestants. Make sure not to exceed the dose.
- In high blood pressure or severe kidney or heart problems.
Possible side effects:
- allergic reaction, like rash and itching, signs of breathing problems like difficulty breathing.
- Other side effects include drowsiness or sleepiness, difficulty sleeping, fatigue, headache, hallucinations, twitching or jerking muscles, nervousness, blurred vision, difficulty concentrating, excitability, dizziness, nausea, indigestion or vomiting, restlessness, dry mouth nose and throat, rapid heart rate, loss of coordination, nervousness and irritability.
Dose:
Adults and children aged 12 years and over:
- 1 to 2 tablets every 4 to 6 hours as needed. not to exceed 8 tablets within 24 hours.
- not more than 4 doses in 24 hours. Doses should be spaced by at least 4 hours.
Children under 12 years:
- not given to children below 12 years of age.
Corticosteroids nasal spray (Mometasone)
- help to relieve inflammation(swelling and irritation of the nose), sneezing, itching and a blocked up or runny nose.
Available forms:
- Nasonex, Tabunex, Sinocort: 05% nasal spray
Indications:
- to treat the symptoms of seasonal allergic rhinitis (also called hayfever) and perennial (long lasting) rhinitis in adults and children aged 3 and older;
- to treat nasal polyps in adults aged 18 and over
Dose:
Adult:
- recommended dose is two sprays in each nostril once a day.
- Once symptoms are controlled, dose reduction to one spray in each nostril may be effective for maintenance.
- may increase to the dose; the maximum daily dose is four sprays into each nostril once a day.
Children aged 3 to 11 years :
- the usual dose is one spray into each nostril once daily.
- May used some days before the start of the allergy season, as this will help to prevent allergic rhinitis symptoms from occurring.
- Prophylaxis must be initiated up to 2-4 weeks prior to the anticipated start of the allergy season.
- Benefit of treatment may be achieved in the first two days.
- Maximum benefit is achieved within 1-2 weeks following initiation of treatment. Therefore, patients should continue regular use to achieve full therapeutic benefit.
For patients who use MOMEX® at regular intervals for treatment of allergic rhinitis,:
- recommended dose is a spray into each nostril once a day. For children between the ages of 2 and 11 years the usual recommended dose is one spray in each nostril once a day.
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 )
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