Rx
Notes
In emergency
Disease annotations
Rx
- Roxithromycin 300mg tablet orally 1 x1
- Advil cold and sinus 1- 2 caplets every 4 to 6 hours
- Nasonex .05% nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Cerin 10mg tab once daily
Notes
Roxithromycin:
Dosage Forms & Strengths:
- 300mg tab, 150mg tab
Trade names :
- Roximac, Roxipharm, Rulid, Roxamed ,Ruxid, Romac
Therapeutic indications:
- Acute pharyngitis, tonsillitis, sinusitis
- Acute bronchitis
- Exacerbation of chronic bronchitis
- Pneumonia
- Skin and soft tissue infections
- Non gonococcal urethritis
- Impetigo
Dose:
- 300mg once a day Or 150mg twice a day
Contraindications:
- Known hypersensitivity to Roxithromycin
Pregnancy: Category B.
Side effects:
- Oral thrush – white, furry, sore tongue and mouth
- Vaginal thrush – sore and itchy vagina and/or discharge
- Nausea, vomiting, stomach pain, diarrhea, flatulence
- Loss of appetite
- Red and/or itchy skin
- Headache, dizziness, ringing in the ears
- Tiredness
- Altered taste.
Advil-Cold&Sinus Capsule
Ingredients: Ibuprofen – Pseudoephedrine
Product Description:
- Advanced formula for cold & sinus relief
Indications:
- Fast, temporary relief of the symptoms of colds including sore throat pain, sinus pain, nasal congestion, headache, fever, body aches and pains.
Dose:
Adults under 65 years and children over 12:
- 1 or 2 caplets every 4 to 6 hours as needed.
- not more six caplets in 24 hours
- not given to children under 12.
- not used longer than 3 days for a fever or 5 days for pain or cold symptoms.
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)
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