Rx
Notes
In emergency
Disease annotations
Rx
- Moxifloxacin 400 mg tablet 1×1 x5-10 days
- Panadol sinus 2 caplets every 4-6 hours as required
- Aierxem 50mcg/dose nasal spray 2 spray in each nostril once a day
If there are excessive secretions and sneezing add:
- Fenistil 4mg tab 1tab every 4-6 hours
Notes
Moxifloxacin
Dosage Forms & Strengths
- 400mg tablet, 436.8 mg tab ,400mg/250ml solution for injection, 5mg /ml solution for injection , 1.6mg/ml solution for injection
Trade names :
- Muxava, Avaquin,Avalox, AVORES JPM, Vigamox, Elevemox , Mofloxine , Moxiquin
Therapeutic indication and dose :
Acute Bacterial Sinusitis
- 400 mg PO/IV qDay for 5-10 days
Community-Acquired Pneumonia
- 400 mg PO/IV qDay for 7-14 days
Acute Exacerbation of Chronic Bronchitis
- Indicated for acute exacerbations of chronic bronchitis caused by bacterial infections
- 400 mg PO/IV qDay for 5 days
Skin & Skin Structure Infections
- Uncomplicated: 400 mg PO/IV qDay for 7 days
- Complicated: 400 mg PO/IV qDay for 7-21 days
Intra-abdominal Infections
- Complicated: 400 mg PO/IV qDay for 5-14 days
Pneumonic & Septicemic Plague
- Indicated in adults for the treatment of plague, including pneumonic and septicemic plague, caused by susceptible isolates of Yersinia pestis; it is also indicated for prophylaxis of plague in adults
- 400 mg PO/IV qDay x10-14 days
- Begin administration as soon as possible after suspected or confirmed exposure to Yersinia pestis
Contraindications
- Hypersensitivity to moxifloxacin, other quinolones
- Pregnancy and lactation
- Patients below 18 years of age.
- Patients with a history of tendon disease/disorder related to quinolone treatment.
Side effects:
- Headache
- Dizziness
- Nausea, Vomiting, Diarrhea
- Gastrointestinal and abdominal pains
- Skin: Urticaria, pruritus of various etiology, endogenous eczema with previous medical diagnosis.
- Respiratory system: Seasonal (hay fever) and perennial rhinitis with previous medical diagnosis.
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).
Dimetindene
Available forms:
- Fenistil: drop 1mg/1ml, 4mgcaps, 1mgtab
- Pedia fast: drop 0.1g/100ml, 0.01g/100ml syrup
- Alergin: drop 1mg/1ml (1 ml = 20 drops).
- Fencil: drop 1mg/1ml
- 1 ml contains dimetindene maleate 1 mg (1 ml = 20 drops).
Therapeutic indications
- Symptomatic treatment of allergic diseases:
- Relieve of itching associated with infectious diseases (e.g. chickenpox) with previous medical diagnosis or after an insect bite or stings.
Dose:
1mg/1ml oral drops, 0.1g/100ml drop:
- Adults :The recommended daily dose is 3 – 6 mg of dimetindene maleate divided into 3 doses,
- 20 –40 drops 3× a day.
- Paediatric The recommended daily dose for children 1 – 11 years is 0.1 mg dimetindene maleate/kg body
- 2 drops/kg/day divided into 3 doses.
1mg tablet:
- 1 to 2 milligrams three times daily
0.01g/100ml syrup:
- the recommended dose is 1 teaspoonful (5 ml) of a 0.01g/100ml syrup 3-4 times daily
4mg capsule :
- 1capsule once daily
Contraindications :
- Hypersensitivity to the active substance or to any of the excipientsInfants and children under 1 year of age.
pregnancy and lactation :
- Pregnancy There are no data about the use of dimetindene maleate during pregnancy.
- Dimetindene maleate should not be used in pregnant women unless the benefit of treating the mother outweighs the risk for the foetus
Breast-feeding :
- There is a well-founded presumption that dimetindene can be excreted in human milk. So its not recommended.
Side effect :
- Fatigue
- Somnolence, nervousness
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