Rx
Notes
In emergency
Disease annotations
Rx
- Moxifloxacin 400 mg tablet 1×1 x5-10 days
- Panadol cold and flu 1-2 tablet 2 times daily
- Aierxem 50mcg/dose nasal spray2 spray in each nostril once a day
Notes
Moxifloxacin
Dosage Forms & Strengths
- 400mg tablet, 436.8 mg tab ,400mg/250ml solution for injection, 5mg /ml solution for injection , 1.6mg/ml solution for injection
Trade names :
- Muxava, Avaquin,Avalox, AVORES JPM, Vigamox, Elevemox , Mofloxine , Moxiquin
Therapeutic indication and dose :
Acute Bacterial Sinusitis
- 400 mg PO/IV qDay for 5-10 days
Community-Acquired Pneumonia
- 400 mg PO/IV qDay for 7-14 days
Acute Exacerbation of Chronic Bronchitis
- Indicated for acute exacerbations of chronic bronchitis caused by bacterial infections
- 400 mg PO/IV qDay for 5 days
Skin & Skin Structure Infections
- Uncomplicated: 400 mg PO/IV qDay for 7 days
- Complicated: 400 mg PO/IV qDay for 7-21 days
Intra-abdominal Infections
- Complicated: 400 mg PO/IV qDay for 5-14 days
Pneumonic & Septicemic Plague
- Indicated in adults for the treatment of plague, including pneumonic and septicemic plague, caused by susceptible isolates of Yersinia pestis; it is also indicated for prophylaxis of plague in adults
- 400 mg PO/IV qDay x10-14 days
- Begin administration as soon as possible after suspected or confirmed exposure to Yersinia pestis
Contraindications
- Hypersensitivity to moxifloxacin, other quinolones
- Pregnancy and lactation
- Patients below 18 years of age.
- Patients with a history of tendon disease/disorder related to quinolone treatment.
Side effects:
- Headache
- Dizziness
- Nausea, Vomiting, Diarrhea
- Gastrointestinal and abdominal pains
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 (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).
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