★Boil কি?
Boil is a painful pusfilled Bump.বাংলায় যাকে আমরা ফোঁড়া হিসেবে চিনি।
-হেয়ার ফলিকলের আশেপাশে বেশীরভাগ ক্ষেত্রে staphylococcus aureus নামক ব্যাকটেরিয়া দিয়ে ইনফেকশন হয়ে তৈরী হয়।
-Deeper layer of skin পর্যন্ত ইনফেকশন যেতে পারে।
(Folliculitis is a most superficial type of inflammation of hair follicle)
★Carbuncle কি?
-group of boils
-Larger and deeper than boil.
★ কারণ:
সাধারণত আমাদের স্কিন এবং নাকের ভেতর Normal flroa হিসাবে staphylococcus aureus থাকে।স্কিনের কোথাও কেটে গেলে কিংবা পোকা কামড় দিলে সেখানে ব্যাকটেরিয়া সহজেই প্রবেশ করে boil /cabuncle develop করে.
Personal hygiene maintain না করলে কিংবা immune compromised থাকলে বেশি বেশি boil হতে পারে, যেমন DM, malnourished children etc
★কোথায় দেখা যায়?
(সাধারণত Friction area গুলোতে হয়)
-Thigh
-Buttocks
-Armpit
-breast
-neck
-Face
★clinical feature:
-হঠাৎ স্কিনের কোনো জায়গায় Redness developed করে হালকা ব্যাথা হবে, তারপর এইটা ফুলে যেতে পারে, একসময় এখানে pus formation হবে।
-Round papule, pastule থাকে,
-মাঝেখানে pus /suppuration দেখা যেতে পারে,
আশেপাশের lymphnode গুলি ফুলে যাবে, কারো কারো জ্বর চলে আসতে পারে।
চিকিৎসা —
•Small boil কিভাবে ট্রিট করতে হবে?
-গরম ভেজা কাপড়ের সেঁক দিতে হবে বারবার।
★কোন কিছু দিয়ে গুতানো বা squeeze করা যাবে না।★
-boil নিজে নিজে rupture হয়ে গেলে পরিষ্কার ব্যান্ডেজ গজ দিয়ে ঢেকে দিতে হবে।এরপর ভালোভাবে সাবান দিয়ে হাত ধুয়ে ফেলতে হবে।
এভাবে কিছুদিন থেকে কয়েকসপ্তাহের মধ্যে ভাল হয়ে যাবে।
★Investigation :
-Pus for CS
-RBS(Boil/abcess নিয়ে আসলে অবশ্যই RBS দেখে নিতে হবে,কারণ sugar level কন্ট্রোল না হলে boil ভালো হবে না)
★Treatment:
-Warm wet cloth compression অর্থাৎ গরম পানিতে একটা কাপড় ভিজিয়ে তা দিয়ে সেক দিবে।
-Shoudn’t prick(pin /sharp object দিয়ে গুতানো যাবে না।কারণ এতে ইনফেকশন ছড়িয়ে যেতে পারে)
-বেশি pus থাকলে incision and drainage if needed
-Analgesics
-Oral antibiotic
★★তাহলে Rx for boil/carbuncle
1.Tab. Rolac 10mg ( ibuprofen /Ketorolac)
1+1+1—-5days
Incase of severe pain, Voltalin suppository can be used
2.Cap. Exium 20mg (PPI)
1+0+1—–5days
3.cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
1+1+1+1——-5days
Indications of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Fluclox is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by penicillinase producing staphylococci. These indications include:
- Skin and soft tissue infections: Boils, abscess, carbuncles, infected skin conditions (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).
- Respiratory tract infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.
- It is also used for the treatment of other infections i.e. osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia caused by Fluclox-sensitive organisms.
- As a prophylactic agent, it is used during major surgical procedures where appropriate; for example, cardiothoracic and orthopedic surgery.
Pharmacology of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Flucloxacillin is active against Gram-positive organisms including penicillinase producing strains. It has little activity against Gram-negative bacilli. Flucloxacillin acts by inhibiting the formation of cell wall of bacteria. Flucloxacillin is isoxazolyl penicillin which combined the properties of resistance to hydrolysis by penicillinase, gastric acid stability and activity against gram-positive bacteria. Flucloxacillin is a bactericidal antibiotic that is particularly useful against penicillinase-producing staphylococci. Flucloxacillin kills bacterial cellwall, thus interfering with peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that provides the cell wall with its mechanical stability. The final stage of peptidoglycan synthesis involves the completion of the cross-linking with the terminal glycine residue of the pentaglycin bridge linking to the fourth residue of the pentapeptide (D-alanine). The transpeptidase enzyme that performs this step is inhibited by Flucloxacillin. As a result the bacterial cellwall is weakened, the cell swells and then ruptures. Flucloxacillin resists the action of bacterial penicillinase probably because of the steric hindrance induced by the acyl side chain which prevents the opening of the β- lactam ring.
Dosage of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Oral administration:
- Adult: 250 mg four times daily. Dosage may be doubled in severe infections. In osteomyelitis and endocarditis, up to 8 gm daily is used in 6-8 hourly divided doses.
- Children (2-10 years): 1/2 of adult dose.
- Children (Under 2 years): 1/4 of adult dose.
Parenteral administration:
Adult or Elderly:
- Intramuscular Injection: 250 mg four times daily.
- Intravenous Injection: 250 mg-1 g four times daily by slow injection over 3 to 4 minutes or by intravenous infusion.
- All systemic doses may be doubled in severe infections: doses up to 8 g daily have been suggested for endocarditis or osteomyelitis.
Children:
- 2-10 years: half of the adult dose.
- Under 2 years: a quarter of the adult dose.
Administration of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Oral doses should be administered 1 hour before meal.
Interaction of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Concurrent use of Fluclox and may result in increased level of Fluclox in blood for prolonged period.
Contraindications of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Flucloxacillin is contraindicated in penicillin hypersensitive patients.
Side Effects of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
There have been some common side effects of gastrointestinal tract such as nausea, vomiting, diarrhoea, dyspepsia and other minor gastrointestinal disturbances. Besides these rashes, urticaria, purpura, fever, interstitial nephritis, hepatitis and cholestatic jaundice have been reported.
Pregnancy & Lactation of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
US FDA Pregnancy Category of Flucloxacillin is B. There are, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Flucloxacillin have been shown to be excreted in human milk. So, caution should be exercised when Flucloxacillin is administered to a lactating mother.
Therapeutic Class of cap Fluclox 500mg (AS A (Flucloxacillin Sodium) AS A Penicillinase-resistant penicillins)
Penicillinase-resistant penicillins
Advice:
-দিনে ৩-৪বার গরম ভেজা কাপড়ের সেঁক দিতে হবে।
-নখ/পিন/ধারালো কিছু দিয়ে আক্রান্ত স্থান খুটা যাবেনা।
Raiyyan tahsan Date:22-01-2025 Wednesday Time:10-37-45 PM
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