Rx
Notes
In emergency
Disease annotations
Rx
- Clarithromycin 125mg/5ml suspension (Wx0.3) x2x10
- Brufen 100mg/5ml syrup (Wx0.375) every 6-8 hours until fever subside
In excessive nasal secretions (Rinorrhea,sneezing),congestion :
- Histal 5mg/5ml syrup one teaspoon (5 ml), once a day
- Sterimar nasal spray 2 to 6 times a day in each nostril as required
Notes
Clarithromycin
Otitis Media
- <6 months: Safety and efficacy not established
- ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose
Community-Acquired Pneumonia
- <3 months: Safety and efficacy not established
- ≥3 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose
Sinusitis
- <6 months: Safety and efficacy not established
- ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose
Bronchitis
- <6 months: Safety and efficacy not established
- ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/dose
Skin Infections
- <6 months: Safety and efficacy not established
- ≥6 months: 15 mg/kg/day PO divided q12hr for 10 days; not to exceed 250 mg/dose
Streptococcal Pharyngitis
- <6 months: Safety and efficacy not established
- ≥6 months: 7.5 mg/kg q12hr for 10 days; individual dose not to exceed 250 mg
Endocarditis (Off-label)
- 15 mg/kg PO 30-60 minutes before procedure; individual dose not to exceed 500 mg
Pertussis (Off-label)
- <1 month: Safety and efficacy not established
- 1-6 months: 7.5 mg/kg/dose PO q12hr for 7 days
- >6 months: 7.5 mg/kg/dose PO q12hr for 7 days
Brufen
- Analgesic and antipyretics
- Has anti-inflammatory effect
- Suitable for Temperature( 38-38.5) C
- Not save under 6 months
- Taken After meal
- 200mg every 6-8 hours, May increase to 400mg every 6-8hours
Trade names : brufen (Taskine , Doloraz, Iburam,Remofen ,Ibugesic,Sapofen,Perofen,Rupan,Bulkaprofen,Advil liquid-gel , Profast, Nashat ,Midofen,Ibusoft).
Other concentration: 800mg and 400mg tablet 600mg tablet, 100mg/5ml syrup
Dose:
Tablets :
Syrup, suspension :
- 100mg/5ml Syrup(Wx0.375) every 6-8hours
Oral drops :
40mg/1ml
- 6-11 months : 1.25ml every 8 hours
- 12-23months : 1.8ml every 8 hours
Maximum dose : 3200 mg per day
Contraindication:
- History of hypersensitivity to aspirin or other NSAIDs
- current or recent stomach ulcer
- severe heart failure.
- severe liver disease
Pregnancy : not usually recommended in pregnancy
Loratadine
Available forms:
- Loratan, clara, histal, Klarihist, Loreen, Lorine Lohist, Ramitin:10mg tab, 5mg/5ml syrup
- Tidilor, Claritine, Lorax :10mg tab, 1mg/1ml syrup
- Loratin, Restamine:10mg tab
- Lostamin: 5mg/5ml syrup
Indications:
- Relief of symptoms associated with allergic rhinitis, such as sneezing, nasal discharge (rhinorrhea) as well as ocular itching and burning.
- indicated for the relief of symptoms and signs of chronic urticaria and other allergic dermatologic disorders.
Dose:
- Adults and children 6 years and older who weigh more than 30kg : 1 x tablet once daily
- Adults and children over 12 years of age: 2 teaspoons (10 ml), once a day, with or without food.
- The dosage for children aged 2-12 is by weight:
- Body weight over 30 kg: 2 teaspoons (10 ml), once a day, with or without food.
- Body weight of 30 kg or less: one teaspoon (5 ml), once a day, with or without food.
Pregnancy and breast-feeding :
As a precautionary measure, it is preferable to avoid the use of Loratadine Tablets during pregnancy. Loratadine is excreted in breast milk so preferable to avoid the use in lactation
side effect:
- drowsiness
- headache
- increased appetite
- difficulty sleeping.
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