Rx
Notes
In emergency
Disease annotations
Rx
- Moxifloxacin 400 mg tablet 1×1 x5-10 days
- Panadol Extra 2 tablets up to 4 times daily
- Aierxem 50mcg/dose nasal spray 1 spray in each nostril once a day
If there are excessive secretions and sneezing add:
- Fenistil 4mg tab 1tab every 4-6 hours
If there is nasal obstruction add :
- Otrivin 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily not more than 7 days
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
- Skin: Urticaria, pruritus of various etiology, endogenous eczema with previous medical diagnosis.
- Respiratory system: Seasonal (hay fever) and perennial rhinitis with previous medical diagnosis.
Panadol-Extra
Ingredients:
Each tablet contains:
- 500MG PARACETAMOL, 65MG CAFFEINE.
Product Description
- Panadol Extra is ideal for those who want the benefits of Panadol, plus a little extra relief from mild to moderate pain such as headaches, toothache, and period pain.
- The ingredients in Panadol Extra provide up to 37% more powerful pain relief than standard paracetamol.
- It is also gentle on the stomach when used as prescribed . Panadol Extra is a paracetamol-based analgesic that provides relief from fever and strong pain such as
- Headaches, including migraine, muscular aches and pains, period pain, toothache, and sore throat.
How to use:
- Oral administration only. Adults including the elderly and children aged 12 years and over:
- 2 tablets up to 4 times daily 8 tablets in 24 hours.
- Should not be used with other paracetamol-containing products. Not recommended for children under 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).
Dimetindene
Available forms:
- Fenistil: drop 1mg/1ml, 4mgcaps, 1mgtab
- Pedia fast: drop 0.1g/100ml, 0.01g/100ml syrup
- Alergin: drop 1mg/1ml (1 ml = 20 drops).
- Fencil: drop 1mg/1ml
- 1 ml contains dimetindene maleate 1 mg (1 ml = 20 drops).
Therapeutic indications
- Symptomatic treatment of allergic diseases:
- Relieve of itching associated with infectious diseases (e.g. chickenpox) with previous medical diagnosis or after an insect bite or stings.
Dose:
1mg/1ml oral drops, 0.1g/100ml drop:
- Adults :The recommended daily dose is 3 – 6 mg of dimetindene maleate divided into 3 doses,
- 20 –40 drops 3× a day.
- Paediatric The recommended daily dose for children 1 – 11 years is 0.1 mg dimetindene maleate/kg body
- 2 drops/kg/day divided into 3 doses.
1mg tablet:
- 1 to 2 milligrams three times daily
0.01g/100ml syrup:
- the recommended dose is 1 teaspoonful (5 ml) of a 0.01g/100ml syrup 3-4 times daily
4mg capsule :
- 1capsule once daily
Contraindications :
- Hypersensitivity to the active substance or to any of the excipientsInfants and children under 1 year of age.
pregnancy and lactation :
- Pregnancy There are no data about the use of dimetindene maleate during pregnancy.
- Dimetindene maleate should not be used in pregnant women unless the benefit of treating the mother outweighs the risk for the foetus
Breast-feeding :
- There is a well-founded presumption that dimetindene can be excreted in human milk. So its not recommended.
Side effect :
- Fatigue
- Somnolence, nervousness
Otrivine
Otrivine Nasal Spray contains the active ingredient xylometazoline hydrochloride which helps to open up and clear the nasal passages by reducing the excessive nasal secretions and returning the swollen blood vessels to their normal size.
Used in :
- nasal congestion (blocked nose, including colds)
- allergic rhinitis
- sinusitis.
- Not used>5 days Cause rebound congestion
Pregnancy : not recommended
Available forms:
- Otrivin 0.1% spray/drop , .05% spray /drop
- Decozal 0.1% spray/drop , .05% spray /drop
- Xylomet 0.1% spray
Dose:
Adult
- 0.1% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child>6y
- 0.05% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child 6months-6y
- 0.05% Nasal drop 1drops in each nostrils up to 3 times daily
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