Rx
Notes
In emergency
Disease annotations
Rx
- Cefuroxime 500mg tab orally 1 x 2 x 10
- Doloraz 400mg tablet 1 x 3 until fever subside
- Rhinocort 32mcg/dose nasal spray one spray in each nostril once a day
If there are excessive secretions and sneezing add:
- Noura 5mg orally once a day
If there is nasal obstruction add :
- Otrivin 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily not more than 7 days
Notes
Cefuroxime
Dosage Forms & Strengths:
- 125 mg, 250mg, 500mg tablet, 125mg /5ml suspension, 250 mg/5ml suspension , 750mg 1500mg 250mg vial for iv injection
Trade names :
- Zinnat , U-cef ,Cefovex, Ceftal ,Zamur, Oraxim Daroxime, Medo-axitine,Cefutil, Zinoximor, Cefurex , Cefuzime, Furocef ,Maxil , Vaxcel cefuroxime, Xorim , Xorimax , Zilisten, Zinacef, Zinoxime
Therapeutic indication and dose :
Pharyngitis/Tonsillitis
- 250 mg PO q12hr for 10 days
Acute Bacterial Maxillary Sinusitis
- 250 mg PO q12hr for 10 days
Acute Bacterial Exacerbations of Chronic Bronchitis
- 250-500 mg PO q12hr for 10 days
- 500-750 mg IV q8hr; switch to oral therapy as soon as clinically possible
Secondary Bacterial Infections of Acute Bronchitis
- 250-500 mg PO q12hr for 5-10 days
Uncomplicated Pneumonia
- 750 mg IV/IM q8hr
Uncomplicated Skin/Skin Structure Infections
- 250-500 mg PO q12hr for 10 days
- 750 mg IV/IM q8hr; switch to oral therapy as soon as clinically possible
Uncomplicated Urinary Tract Infections
- 125-250 mg PO q12hr for 7-10 days
- 750 mg IV/IM q8hr; switch to oral therapy as soon as clinically possible
Gonorrhea
- Uncomplicated: 1 g PO once or 1.5 g IM once at 2 different sites with 1 g probenecid PO
- Disseminated: 750 mg IV/IM q8hr
Severe or Complicated Infections
- 1.5 g IV/IM q8hr; may be administered q6hr in life-threatening situations
Contraindications
- Hypersensitivity to cephalosporin antibiotics.
- History of severe hypersensitivity to any other type of betalactam antibacterial agent (penicillins, monobactams and carbapenems).
Pregnancy
- Cefuroxime axetil should be prescribed to pregnant women only if the benefit outweighs the risk.
- Category B
Breastfeeding
- Cefuroxime is excreted in human milk in small quantities. A risk of diarrhea and fungus infection of the mucous membranes cannot be excluded.
- Breastfeeding might have to be discontinued due to these effects, Cefuroxime should only be used during breastfeeding after benefit/risk assessment by the physician in charge.
Side effect:
- Candida overgrowth
- System disorders
- Eosinophilia
- Headache, dizziness
- Diarrhea, nausea, abdominal pain
Transient increases of hepatic enzyme levels
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