- Azithromycin 500mg capsule orally 1x1x3 days
- Panadol Advance 2 tablets up to 4 times daily
If there are excessive secretions and sneezing add:
- Atarax 25mg tab 1tab every 8-6 hours
If there is nasal obstruction add :
- Sterimar Isotonic sea water spray 1puff 4-6 times daily
Azithromycin
Dosage Forms & Strengths:
- 250mg ,500mg capsule and tablet, 500mg vial, 200mg/5ml suspension, 300mg /7.5ml suspension
Trade names :
Zocin, Zimax , Zomax, Azomycin, Azi_once, Zithromax, Azitam, Zithrova, Zaha, Zilacid, Azicure, Azomyne , Azox
Therapeutic indication and dose :
Community-acquired Pneumonia
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Pharyngitis or Tonsillitis
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Uncomplicated skin/skin structure
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Acute bacterial exacerbations of chronic obstructive pulmonary disease
- 500 mg PO qDay for 3 days OR
- 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5
Acute bacterial sinusitis
- 500 mg PO qDay x 3 days
Genital Ulcer Disease (Chancroid)
- 1000 mg PO x 1 dose
Nongonococcal or Gonococcal Urethritis and Cervicitis
- 1000 mg PO x 1 dose
Cat Scratch Disease (Off-label)
- >45.5 kg: 500 mg PO once, then 250 mg once daily for 4 days
Pertussis (Off-label)
- 500 mg PO once, then 250 mg once daily for 4 days
Endocarditis (Off-label)
Prophylaxis
- 500 mg PO 30-60 min before procedure
Contraindications:
- Hypersensitivity to azithromycin, erythromycin, any macrolide
Pregnancy:
- The safety of azithromycin has not been confirmed with regard to the use of the active substance during pregnancy. Therefore, Azithromycin should only be used during pregnancy if the benefit outweighs the risk
Breastfeeding :
- Azithromycin has been reported to be secreted into human breast milk
- Because it is not known whether azithromycin may have adverse effects on the breast-fed infant, nursing should be discontinued during treatment with Azithromycin. Among other things diarrhea, fungus infection of the mucous membrane is possible in the nursed infant. It is recommended to discard the milk during treatment and up until 2 days after discontinuation of treatment. Nursing may be resumed thereafter.
Common side effects:
- Anorexia
- Dizziness, headache, paranesthesia, dysgeusia
- Visual impairment, Deafness
- Vomiting, dyspepsia
- Rash, pruritus
Panadol Advance
Ingredients:
Each film-coated tablet contains:
- Paracetamol 500mg.
Panadol Advance:
Is effective for:
- Muscle Pain.
- Colds & Influenza.
- Period Pain.
- Rheumatic Pain.
- Pain of Osteoarthritis.
- For oral use only.
Dose: Adults:
- 2 tablets every 4 hours as required.
- not more than 8 tablets in 24 hours.
Children (6 – 12 years):
- ½ to 1 tablet every 4 hours as required.
- No more than 4 tablets should be taken in 24 hours.
Not suitable for children under 6 years.
Hydroxyzine
Available forms:
- Atarax :25mg tab, 10mg/5ml syrup
- Newrax :10mg/5ml syrup
Therapeutic indications:
- Anxiety in adults
- Itching (pruritus) caused by allergic reactions in adults and children.
Dose :
- In adults the maximum daily dose is 100 mg (4 tablets) per day
Adults
For anxiety:
- The usual dose is ½ tablet at breakfast, ½ tablet at lunch and 1 tablet in the evening
- doctor may increase this to a maximum of 4 tablets taken three times a day.
For pruritis (itchiness of the skin):
- The usual dose is 1 tablet before going to bed
- doctor may increase this to 1 tablet three or four times a day
Children
- In children up to 40 kg, the maximum daily dose is 2 mg/kg/day.
For pruritis :
- The usual dose is 0.5 mg per kg of body weight twice a day
- doctor may increase this to a maximum of 1 mg per kg of body weight twice a day
The elderly
- In the elderly, the maximum daily dose is 50 mg (2 tablets) per day.
- The usual starting dose is 25 mg (1 tablet) a day
Contraindication :
- allergy to hydroxyzine hydrochloride or any of the other ingredients
- allergy to cetirizine, other piperazine derivatives, aminophylline or ethylenediamine
- pregnancy or breastfeeding
- porphyria.(A blood disease that can cause stomach pain, vomitingand mental disturbances such as depression
- ECG (electrocardiogram) shows a heart rhythm problem called “QT interval prolongation”
Pregnancy and breastfeeding :
- Not recommended in pregnancy or breastfeeding
Side effect:
- feeling sleepy
- dry mouth, feeling tired, headache
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 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