- Amoxicillin 500 mg capsule 1x2x10-14 or 250 mg capsule 1x3x10-14
- Panadol sinus 2 caplets every 4-6 hours as required
- Flixonase 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- clara 10mg orally once a day
Amoxicillin :
Dosage Forms & Strengths
1000mg, 1g, 500mg, 750mg 625mg tablets, 500mg, 250mg capsules, 375mg/5ml suspension ,250mg/5ml suspension, 125mg/5ml suspension
Trade names : Amoxil,Moxiram,Penamox,Ultramox,Moxilen,Hymox,Amoxapen,
Julphamox,Ospamox,Amoxydar,Amoxibel
Therapeutic indication and dose :
Ear, Nose, & Throat Infections
Mild to moderate infections
- 500 mg PO q12hr or 250 mg PO q8hr for 10-14 days
Severe infections
- 500 mg PO q8hr for 10-14 days
Genitourinary Tract Infections
Mild to moderate infections
- 500 mg PO q12hr or 250 mg PO q8hr
Severe infections
- 500 mg PO q8hr
Skin & Skin Structure Infections
Mild to moderate infections
- 500 mg PO q12hr or 250 mg PO q8hr
Severe infections
- 500 mg PO q8hr
Lower Respiratory Tract Infections
- 500 mg PO q8hr for 10-14 days
Helicobacter Pylori
H pylori infection and active or 1-year history of duodenal ulcer
Triple therapy
- 1 g PO q12hr for 14 days with lansoprazole (30 mg) and clarithromycin (500 mg)
Dual therapy
- 1 g PO q8hr for 14 days with lansoprazole (30 mg) in patients intolerant of, or resistant to, clarithromycin
Infective Endocarditis
Prophylaxis
- 2 g PO 30-60 min before procedure
Chlamydial Infection in Pregnant Women
- First trimester: 500 mg PO q8hr for 7 days
Contraindications:
- Hypersensitivity to penicillin’s, semi-synthetic penicillin’s or cephalosporin.
- Liver problems
- Renal impairment
Pregnancy:
- Category B
Breastfeeding :
- Amoxicillin is excreted into breast milk in small quantities
- Diarrhea and fungus infection of the mucous membranes are possible in the breast-fed infant, so that breast-feeding might have to be discontinued.
Common side effects:
- Anaphylaxis
- Anemia
- AST/ALT elevation
- Mucocutaneous candidiasis
- Diarrhea
- Headache
- Nausea
- Vomiting
- Rash
- Pseudomembranous colitis
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 (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).
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.
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