Rx
Notes
In emergency
Disease annotations
Rx
- Azithromycin 500mg capsule 1x1x3
- Panadol cold and flu 1-2 tablet 2 times daily
- Nasonex . 05% nasal spray 2 sprays in each nostril once a day
Notes
Erythromycin
Dosage Forms & Strengths:
250mg tablet , 400mg tablet , ,200mg tablet , 200mg/5ml suspension
Trade names :
Rythromac ,Erythrodar
Therapeutic indication and dose :
General Dosing Recommendations
- 400 mg PO q6hr or
- 250-500 mg PO q6-12hr or 500 mg q12hr or 333 mg PO q8hr
- Severe infections: Up to 4 g/day
Intestinal amebiasis
- 400 mg PO q6hr for 10-14 days
Legionnaire Disease
- 400-1000 mg PO q6hr for 21 days
Pertussis
- 500 mg PO q6hr for 14 days
Streptococcal infections
- 400 mg PO divided q12hr for 10 days
Urethritis
- 800 mg PO q8hr for 7 days or
- 500 mg PO q6hr for 7 days
Lymphogranuloma Venereum
- 500 mg PO q6hr for 21 days
Contraindications:
- Known hypersensitivity to erythromycin.
- Erythromycin is contraindicated in patients taking simvastatin
Pregnancy and lactation:
- Observational studies in humans have reported cardiovascular malformations after exposure to medicinal products containing erythromycin during early pregnancy.
- Erythromycin has been reported to cross the placental barrier in humans, but foetal plasma levels are generally low.
- There have been reports that maternal macrolide antibiotics exposure within 7 weeks of delivery may be associated with a higher risk of infantile hypertrophic pyloric stenosis (IHPS).
- Erythromycin can be excreted into breast-milk. Caution should be exercised when administering erythromycin to lactating mothers
Side effect:
- Upper abdominal discomfort, nausea, vomiting, diarrhea
- Pancreatitis, anorexia, infantile hypertrophic pyloric stenosis.
- Allergic reactions ranging from urticaria and mild skin eruptions to anaphylaxis
- Deafness, tinnitus
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
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.
Cetirizin
Available forms:
- Zyrtic: 10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
- Cerin :10mg tab, 1mg/1ml syrup
- Zertazin : 10mg tab, 5mg/5ml syrup
- Zeran :10mg tab
- Zain :10mg tab
- Siraz : 5mg tab, 5mg/5ml syrup
- Finallerg :10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
- Sezonal :10mg tab
- Omcet : 5mg tab, 5mg/5ml syrup, 10mg/ml syrup
Therapeutic indication:
- for the relief of nasal and ocular symptoms of seasonal and perennial allergic rhinitis
- for the relief of chronic nettle rash (chronic idiopathic urticaria).
Pregnancy and breast-feeding :
- Cetirizin should be avoided in pregnant women. Accidental use of the medicine by a pregnant
- woman should not produce any harmful effects on the foetus. Nevertheless, the medicine should be only administered if necessary and after medical advice.
- Cetirizine passes into breast milk. Therefore, should not taken during breast feeding
How to take Cetirizin Sandoz :
Adults :
- The recommended dose is 10 mg once daily as 1 tablet
Use in children between 6 and 12 years old:
- The recommended dose is 5 mg twice daily as a half tablet twice daily
side effects :
- fatigue
- dry mouth, nausea, diarrhoea
- dizziness, headache
- somnolence (sleepiness)
- pharyngitis (sore throat), rhinitis (swelling and irritation inside the nose)
Sinomarin (sea water)
- 100% natural, clinically proven nasal spray that relieves nasal congestion naturally, thins mucus and cleanses the nasal cavities effectively, helping to protect from infections. It is ideal both for regular nasal hygiene and congestion relief.
Use in cases of
- Infectious rhinitis (common cold & flu)
- Allergic rhinitis (seasonal hay fever or year-long)
- Other causes of rhinitis (e.g. pregnancy
- Sinusitis
- Regular nasal hygiene
- Nasal hydration
Dose:
- 1puffs 4-6 times daily
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