- Cefixime 400 mg capsules orally 1 x1
- Panadol sinus 2 caplets every 4-6 hours as required
- Tabunex .05% nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Telfast 180mg orally 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 sinus:
Ingredients:
Each Panadol Sinus caplet contains:
- Paracetamol 500mg
- Pseudoephedrine Hydrochloride 30mg.
Panadol Sinus is for fast effective relief from:
- Sinus Pain, Nasal Congestion, and Headache.
- Panadol Sinus provides powerful relief from sinus pain and congestion. .
How to Use:
Adults and children over 12 years:
- Take 2 caplets every 4-6 hours as required.
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.
Fexofenadine
Available forms:
- Telfast, Exofen, Fexofast, Fexodex, Fenadex, Feskine, Fexadine:
- 120mg, 180mg tab
Theraputic indication:
for symptoms that occur with hay fever (seasonal allerigic rhinitis) such as sneezing, itchy, running or blocked nose and itchy, red an watery eye ).
Dose:
For adults and children aged 12 years and over:
- 120 mg Tablets: The recommended dose is one tablet (120mg) daily. Taken with water before a meal.
- 180 mg Tablets: The recommended dose is one tablet (180mg) daily. Taken with water before a meal.
Pregnancy and breast-feeding
- Fexofenadine hydrochloride is not recommended duing pregnancy breast-feeding.
Common side effects
- headache
- Drowsiness
- feeling sick (nausea)
- dizziness
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