Phenylephrine is used to gain temporary relief from stuffy nose, sinus, and ear symptoms caused by the allergies, common cold, flu, or other breathing illnesses such as sinusitis and bronchitis. This medication works by decreasing swelling in the nose and ears which makes breathing easier and lessens any discomfort.
Mild upset stomach, lightheadedness, seizures, mood changes, trouble sleeping, dizziness, shaking, headache, nervousness or fast and irregular heartbeat may occur as side effects to this medicine. It may also reduce blood flow to hands or feet, causing them to feel cold. Smoking may worsen this effect. So you are advised to dress warmly and avoid tobacco use.
To ensure complete safety, before starting the medicine tell your doctor if you suffer from blood vessel problems, diabetes, overactive thyroid, high blood pressure, mood disorders, glaucoma, heart disease, seizure disorder, difficulty sleeping or trouble urinating. This medication is recommended for use in younger children.
The dosage is based on your age. Without your doctor’s approval, do not increase your dose or frequency of this medication. Improper use of this drug can cause you serious harm.
Information given here is based on the salt and content of the medicine. Effect and uses of medicine may vary from person to person. It is advicable to consult a Pulmonologist before using this medicine.
Sinusitis: Management and Prevention
Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows:
● acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms
● subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms
● recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which
Recur at intervals of at least 10 days apart
● chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms
● acute bacterial sinusitis superimposed on chronic sinusitis:
New symptoms that occur in patients with residual symptoms from prior infection (s). With treatment, the new symptoms resolve but the residual ones do not.
Physical findings and clinical presentation
● patients often give a history of a recent upper respiratory illness with some improvement, then a relapse.
● mucopurulent secretions in the nasal passage
● purulent nasal and postnasal discharge lasting more than 7 to 10 days
● facial tightness, pressure, or pain
● nasal obstruction
● decreased sense of smell
● purulent pharyngeal secretions, brought up with cough, often worse at night
● erythema, swelling, and tenderness over the infected sinus in a small proportion of patients
● diagnosis cannot be excluded by the absence of such findings.
● these fi ndings are not common, and do not correlate with number of positive sinus aspirates.
● intermittent low-grade fever in about one half of adults with acute bacterial sinusitis
● toothache is a common complaint when the maxillary sinus is involved.
● periorbital cellulitis and excessive tearing with ethmoid sinusitis
● orbital extension of infection: chemosis, proptosis, impaired extraocular movements.
Characteristics of acute sinusitis in children with upper respiratory tract infections:
● persistence of symptoms
● bad breath
● symptoms of chronic sinusitis (may or may not be present)
● nasal or postnasal discharge
● facial pain or pressure
● nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation.
● each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum).
● acute viral infection
● infection with the common cold or infl uenza
● mucosal edema and sinus infl ammation
● decreased drainage of thick secretions, obstruction of the sinus ostia
● subsequent entrapment of bacteria
A. Multiplication of bacteria
B. Secondary bacterial infection
Other predisposing factors
● foreign bodies
● congenital choanal atresia
● other entities that cause obstruction of sinus drainage
● dental infections lead to maxillary sinusitis.
● viruses recovered alone or in combination with bacteria (in 16% of cases):
● parainfluenza virus
● respiratory syncytial virus
● the principal bacterial pathogens in sinusitis are streptococcus pneumoniae, nontypeable haemophilus influenzae, and moraxella catarrhalis.
● in the remainder of cases, fi ndings include streptococcus pyogenes, staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (peptostreptococcus, fusobacterium, bacteroides, prevotella).
Infection is polymicrobial in about one third of cases.
● anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children.
● fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon
Pathogens in the paranasal sinuses. Fungal pathogens include aspergillus, pseudallescheria, sporothrix, phaeohyphomycoses, zygomycetes.
● nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised.
● s. Aureus
● pseudomonas aeruginosa
● klebsiella pneumoniae
● enterobacter spp.
● proteus mirabilis
Organisms typically isolated in chronic sinusitis:
● s. Aureus
● s. Pneumoniae
● h. Infl uenzae
● p. Aeruginosa
● water’s projection: sinus radiograph
● ct scan
● much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses
● recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to
● used for diagnosis of frontal and maxillary sinusitis
● place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses.
● absence of light transmission indicates that sinus is filled with fluid.
● dullness (decreased light transmission) is less helpful in diagnosing infection.
● used to visualize secretions coming from the ostia of infected sinuses
● culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture
● sinus puncture
● gold standard for collecting sinus cultures
● generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis.
Treatment Nonpharmacologic therapy
● sinus drainage
● nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5%
● topical decongestants should not be used for more than a few days because of the risk of rebound congestion.
● systemic decongestants
● nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone
● nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow)
● use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting,
Which blocks the ostia, thus interfering with sinus drainage.
● analgesics, antipyretics.
● most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics.
● current treatment recommendations favor symptomatic treatment for those with mild symptoms.
● antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of
● antibiotic therapy is usually empirical, targeting the common pathogens.
● first-line antibiotics include amoxicillin, tmp-smz.
● second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin.
● for patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the
Costlier second-line agents.
● surgical drainage indicated
● if intracranial or orbital complications suspected
● for many cases of frontal and sphenoid sinusitis
● for chronic sinusitis recalcitrant to medical therapy
● surgical débridement imperative for treatment of fungal sinusitis
When you are diagnosed with atrial fibrillation, or afib, the most common type of irregular heartbeat, putting your heart back in its proper rhythm is only half the goal. Stroke prevention is the other.
Both objectives require rethinking certain foods and medications that once seemed innocuous and now could be a danger to your health. From common over-the-counter drugs to some of the healthiest vegetables on the planet, here's a list of atrial fibrillation dangers to sidestep.
Caffeine can trigger atrial fibrillation
Chugging cup after cup of coffee may help you stay awake, but too much caffeine can be an atrial fibrillation trigger, causing more frequent episodes of the irregular heartbeat. The same goes for caffeine pills, energy drinks, and other caffeine-containing substances.
" they [energy drinks] have the capacity to make afib worse or more frequent, even in people who have never had afib before" says larry chinitz, md, a cardiologist and professor of medicine at nyu langone medical center in new york city. But, Dr. Chinitz notes, when you have afib, only&nbsp;excessive caffeine intake is a problem, so you can sip a latte here or there without any trouble.
Alcohol can be toxic to your heart
Think twice before you order that next round alcohol and atrial fibrillation can be a dangerous combination. Alcohol in excessive amounts is a depressant to the brain, but a stimulant to the heart. This stimulation can worsen or instigate afib episodes.
" it's also a direct toxin to the heart muscle" chinitz says. Sometimes, heavy drinking over a short period of time can cause episodes of atrial fibrillation in people who have not been previously diagnosed with it, a condition known as holiday heart syndrome.
Cold and allergy medications can trigger afib
For most people, nonprescription medications for stuffy and runny noses are fine, but cold/allergy medicine and atrial fibrillation don't mix well. Use caution when taking these remedies because they could cause more frequent episodes of an irregular heartbeat.
" all medications that are trying to decrease secretions or dilate the airways or lungs are all direct stimulants to the heart" chinitz explains. A few common stimulating over-the-counter (otc) medications to watch out for include actifed (chlorpheniramine and phenylephrine), sudafed (pseudoephedrine), and contac (acetaminophen, chlorpheniramine, and phenylephrine), though others may present the same atrial fibrillation dangers. Talk to your doctor before taking any of these medications if you have afib.
Leafy green vegetables affect blood clotting
Whoever thought that veggies could be bad for you? but as it turns out, some of them can be dangerous if you have atrial fibrillation. If you're on a blood thinner such as warfarin (coumadin, jantoven) for atrial fibrillation to prevent stroke, you should carefully monitor your intake of green leafy vegetables like spinach and kale, which contain high amounts of vitamin k.
Vitamin k can counteract the blood-thinning effects of warfarin, making some veggies atrial fibrillation dangers. But you don't have to give up vitamin k for afib management; the key is to eat about the same amount of k-rich foods every day" you shouldn't have none for a month and then huge amounts over the course of a few days" chinitz says.
Vitamins and herbal supplement cautions
Though otc supplements are often thought of as harmless, some of them can affect atrial fibrillation. Vitamin e, for example, has a blood-thinning effect so if you're on a blood thinner, talk to your doctor before taking it. The same goes for herbal medications that have a stimulant effect, like ma huang (chinese ephedra) and st. John's wort.
Extreme exercise puts a strain on your heart
For most people with atrial fibrillation, moderate exercise isn't a problem and can be beneficial by helping you control your weight and improve your mood. But a few people with afib find that particularly difficult workouts can launch a fibrillation episode" we do caution those people against excessive amounts [of exercise]" chinitz says" but most people's exercise routines are not affected"
If you notice irregular heart rhythms during or just after a workout, talk with your doctor about the best way to proceed so that healthy workouts don't turn into atrial fibrillation dangers.
Stress, anxiety, and depression weigh on the heart
Emotions can play a role in bringing on an atrial fibrillation episode. People with afib who have more severe anxiety and depression symptoms may have more afib episodes than people with less-severe anxiety and depression. To help reduce stress and lower your risk of an afib episode, pay close attention to your emotions and schedule relaxing activities that you enjoy.
If your stress, anxiety, or depression becomes overwhelming, talk to a healthcare professional about ways to lighten your emotional load.
A very uncommon and rare condition, which can occur in case a person is diabetic or has undergone a surgery, a medical disorder known as retrograde ejaculation. It is a condition in which semen enters the bladder rather than going out of the penis after orgasm. This causes a problem as very little or no semen is ejaculated.
That is why this is sometimes also called as 'Dry orgasm'. The only treatment for retrograde ejaculation is to make the male fertile again because retrograde ejaculation is not particularly harmful to the individual. It has the following symptoms:
There are only three main symptoms associated with retrograde ejaculation.
The possible causes of retrograde ejaculation are:
It is worth noting that Dry orgasms have other causes as well, which includes:
Here is how retrograde ejaculation may get more complications
There are only two main complications which occur due to retrograde ejaculation. These include:
Treatment for retrograde ejaculation.
It is worth noting that certain medications, which are used to treat retrograde ejaculation can lead to serious complications and others may lead to a higher heart rate and blood pressure.
Medications which are usually used:
It is also worth noting that the treatment for male infertility is different and more advanced.
Govt bans 344 drugs, including phensedyl, corex
Sr. No. Product name (irrational fdc)
1 aceclofenac + paracetamol + rabeprazole
2 nimesulide + diclofenac
3 nimesulide + cetirizine + caffeine
4 nimesulide + tizanidine
5 paracetamol + cetirizine + caffeine
6 diclofenac + tramadol + chlorzoxazone
7 dicyclomine + paracetamol + domperidone
8 nimesulide + paracetamol
9 paracetamol + phenylephrine + caffeine
10 diclofenac+ tramadol + paracetamol
11 diclofenac + paracetamol + chlorzoxazone + famotidine
12 naproxen + paracetamol
13 nimesulide + serratiopeptidase
14 paracetamol + diclofenac + famotidine
15 nimesulide + pifofenone + fenpiverinium + benzyl alcohol
16 omeprazole + paracetamol + diclofenac
17 nimesulide + paracetamol injection
18 tamsulosin + diclofenac
19 paracetamol + phenylephrine + chlorpheniramine + dextromethorphan + caffeine
20 diclofenac + zinc carnosine
21 diclofenac + paracetamol + chlorpheniramine maleate + magnesium trisillicate
22 paracetamol + pseudoephedrine + cetrizine
23 phenylbutazone + sodium salicylate
24 lornoxicam + paracetamol + trypsin
25 paracetamol + mefenamic acid + ranitidine + dicylomine
26 nimesulide + dicyclomine
27 heparin + diclofenac
28 glucosamine + methyl sulfonyl methane + vitamini d3 + maganese + boron + copper + zinc
29 paracetamol + tapentadol
30 tranexamic acid + proanthocyanidin
31 benzoxonium chloride + lidocaine
32 lornoxicam + paracetamol + tramadol
33 lornoxicam + paracetamol + serratiopeptidase
34 diclofenac + paracetamol + magnesium trisilicate
35 paracetamol + domperidone + caffeine
36 ammonium chloride + sodium citrate + chlorpheniramine maleate + menthol
37 paracetamol + prochlorperazine maleate
38 serratiopeptidase (enteric coated 20000 units) + diclofenac potassium & 2 tablets of doxycycline
39 nimesulide + paracetamol suspension
40 aceclofenac + paracetamol + famotidine
41 aceclofenac + zinc carnosine
42 paracetamol + disodium hydrogen citrate + caffeine
43 paracetamol + dl methionine
44 disodium hydrogen citrate + paracetamol
45 paracetamol + caffeine + codeine
46 aceclofenac (sr) + paracetamol
47 diclofenac + paracetamol injection
48 azithromycin + cefixime
49 amoxicillin + dicloxacillin
50 amoxicillin 250 mg + potassium clavulanate diluted 62.5 mg
51 azithromycin + levofloxacin
52 cefixime + linezolid
53 amoxicillin + cefixime + potassium clavulanic acid
54 ofloxacin + nitazoxanide
55 cefpodoxime proxetil + levofloxacin
56 azithromycin, secnidazole and fluconazole kit
57 levofloxacin + ornidazole + alpha tocopherol acetate
58 nimorazole + ofloxacin
59 azithromycin + ofloxacin
60 amoxycillin + tinidazole
61 doxycycline + serratiopeptidase
62 cefixime + levofloxacin
63 ofloxacin + metronidazole + zinc acetate
64 diphenoxylate + atropine + furazolidonee
65 fluconazole tablet, azithromycin tablet and ornidazole tablets
66 ciprofloxacin + phenazopyridine
67 amoxycillin + dicloxacillin + serratiopeptidase
68 azithromycin + cefpodoxime
69 lignocaine + clotrimazole + ofloxacin + beclomethasone
70 cefuroxime + linezolid
71 ofloxacin + ornidazole + zinc bisglycinate
72 metronidazole + norfloxacin
73 amoxicillin + bromhexine
74 ciprofloxacin + fluticasone + clotrimazole + neomycin is
75 metronidazole + tetracycline
76 cephalexin + neomycin + prednisolone
77 azithromycin + ambroxol
78 cilnidipine + metoprolol succinate + metoprolol tartrate
79 l-arginine + sildenafil
80 atorvastatin + vitamin d3 + folic acid + vitamin b12 + pyridoxine
81 metformin + atorvastatin
82 clindamycin + telmisartan
83 olmesartan + hydrochlorothiazide + chlorthalidone
84 l-5-methyltetrahydrofolate calcium + escitalopram
85 pholcodine + promethazine
86 paracetamol + promethazine
87 betahistine + ginkgo biloba extract + vinpocetine + piracetam
88 cetirizine + diethyl carbamazine
89 doxylamine + pyridoxine + mefenamic acid + paracetamol
90 drotaverine + clidinium + chlordiazepoxide
91 imipramine + diazepam
92 flupentixol + escitalopram
93 paracetamol + prochloperazine
94 gabapentin + mecobalamin + pyridoxine + thiamine
95 imipramine + chlordiazepoxide + trifluoperazine + trihexyphenidyl
96 chlorpromazine + trihexyphenidyl
97 ursodeoxycholic acid + silymarin
98 metformin 1000/1000/500/500mg + pioglitazone 7.5/7.5/7.5/7.5mg + glimepiride
99 gliclazide 80 mg + metformin 325 mg
100 voglibose+ metformin + chromium picolinate
101 pioglitazone 7.5/7.5mg + metformin 500/1000mg
102 glimepiride 1mg/2mg/3mg + pioglitazone 15mg/15mg/15mg + metformin 1000mg/1000mg/1000mg
103 glimepiride 1mg/2mg+ pioglitazone 15mg/15mg + metformin 850mg/850mg
104 metformin 850mg + pioglitazone 7.5 mg + glimepiride 2mg
105 metformin 850mg + pioglitazone 7.5 mg + glimepiride 1mg
106 metformin 500mg/500mg+gliclazide sr 30mg/60mg + pioglitazone 7.5mg/7.5mg
107 voglibose + pioglitazone + metformin
108 metformin + bromocriptine
109 metformin + glimepiride + methylcobalamin
110 pioglitazone 30 mg + metformin 500 mg
111 glimepiride + pioglitazone + metformin
112 glipizide 2.5mg + metformin 400 mg
113 pioglitazone 15mg + metformin 850 mg
114 metformin er + gliclazide Mr. + voglibose
115 chromium polynicotinate + metformin
116 metformin + gliclazide + piogllitazone + chromium polynicotinate
117 metformin + gliclazide + chromium polynicotinate
118 glibenclamide + metformin (sr)+ pioglitazone
119 metformin (sustainded release) 500mg + pioglitazone 15 mg + glimepiride 3mg
120 metformin (sr) 500mg + pioglitazone 5mg
121 chloramphenicol + beclomethasone + clomitrimazole + lignocaine
122 of clotrimazole + ofloxaxin + lignocaine + glycerine and propylene glycol
123 chloramphennicol + lignocaine + betamethasone + clotrimazole + ofloxacin + antipyrine
124 ofloxacin + clotrimazole + betamethasone + lignocaine
125 gentamicin sulphate + clotrimazole + betamethasone + lignocaine
126 clotrimazole + beclomethasone + ofloxacin + lignocaine
127 becloemthasone + clotrimazole + chloramphenicol + gentamycin + lignocaine ear
128 flunarizine + paracetamole + domperidone
129 rabeprazole + zinc carnosine
130 magaldrate + famotidine + simethicone
131 cyproheptadine + thiamine
132 magaldrate + ranitidine + pancreatin + domperidone
133 ranitidine + magaldrate + simethicone
134 magaldrate + papain + fungul diastase + simethicone
135 rabeprazole + zinc + domperidone
136 famotidine + oxytacaine + magaldrate
137 ranitidine + domperidone + simethicone
138 alginic acid + sodium bicarbonate + dried aluminium hydroxide + magnesium hydroxide
139 clidinium + paracetamol + dicyclomine + activated dimethicone
140 furazolidone + metronidazole + loperamide
141 rabeprazole + diclofenac + paracetamol
142 ranitidine + magaldrate
143 norfloxacin+ metronidazole + zinc acetate
144 zinc carnosine + oxetacaine
145 oxetacaine + magaldrate + famotidine
146 pantoprazole (as enteric coated tablet) + zinc carnosine (as film coated tablets)
147 zinc carnosine + magnesium hydroxide + dried aluminium hydroxide + simethicone
148 zinc carnosine + sucralfate
149 mebeverine & inner hpmc capsule (streptococcus faecalis + clostridium butyricum + bacillus
Mesentricus + lactic acid bacillus)
150 clindamycin + clotrimazole + lactic acid bacillus
Avoid this combinations and be safe.