- Ciprofloxacin 500 mg tablet 1×2 x10 days
- Dolocet 500mg tablets 1x 4 up to 2 x 4 until fever subside
If there are excessive secretions and sneezing add:
- Histal 10mg orally once a day
If there is nasal obstruction add :
- Xylomet 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily not more than 7 days
Ciprofloxacin
Dosage Forms & Strengths
- 250, 500, 1000 mg (xl) 750mg tab, 200mg/100ml infusion, 400mg/200ml infusion
Trade names :
- Bactiflox, Floroxin,Cibrobay,Ciproflacin, Ciprolon, Ciproflox, Bactall ,Siprosan, Cipro, Ciprover, Quinox, Floxacin ,Ciproquin, Cipropharm, Omacip, Serviflox
- Cipromid, Ciprogen ,Ciprodar ,Floxar, Mecado ,Topistin, ufexil, cefloxine ,Ciprox
Therapeutic indication and dose :
Acute Sinusitis
- Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 10 days
Bone & Joint Infections
- Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for ≥4-6 weeks
- Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for ≥4-6 weeks
Chronic Bacterial Prostatitis
- Indicated for chronic bacterial prostatitis caused by Escherichia coli or Proteus mirabilis
- Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 28 days
Infectious Diarrhea
- Mild/moderate/severe: 500 mg PO q12hr for 5-7 days
Empirical Therapy in Febrile Neutropenic Patients
- Severe: 400 mg IV q8hr for 7-14 days
Intra-abdominal Infections
- Complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Lower Respiratory Tract Infections
- Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
- Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days
Nosocomial Pneumonia
- Mild/moderate/severe: 400 mg IV q8hr for 10-14 days
Skin/Skin Structure Infections
- Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
- Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days
Urinary Tract Infections
- Acute uncomplicated: Immediate-release, 250 mg PO q12hr for 3 days; extended-release, 500 mg PO q24hr for 3 days
- Mild/moderate: 250 mg PO q12hr or 200 mg IV q12hr for 7-14 days
- Severe/complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
Urethral & Cervical Gonococcal Infections
- Uncomplicated: 250-500 mg PO once
Anthrax Infection
Postexposure therapy
- Inhalation (prophylaxis/postexposure): 500 mg PO q12hr or 400 mg IV q12hr for 60 days
- Cutaneous: 500 mg PO q12hr or 400 mg IV q12hr for 60 days
Plague
Indication for treatment and prophylaxis of plague due to Yersinia pestis
- 500-750 mg PO q12hr x14 days, OR
- 400 mg IV q8-12hr x 14 days
Contraindications:
- Hypersensitivity to the active substance
Pregnancy and lactation:
- It is preferable to avoid the use of ciprofloxacin during pregnancy.
Breast-feeding
- Ciprofloxacin is excreted in breast milk. Due to the potential risk of articular damage, ciprofloxacin should not be used during breast-feeding
Side effects:
- Nausea, Diarrhea, abdominal pain, insomnia
Paractamol
- Analgesic and antipyretics
- Not anti-inflammatory effect
- Suitable for Temperature between (37.5C – 38.5C)
- Safe under 6 months
Trade names : ( Revanin ,Adol,Panda,Dolocet ,Feverol, panadol )
Concentrations: 500 mg tablet, ,1g tablet ,125 mg/5 ml syrup, 250 mg/5 ml syrup, 125 mg suppositories, 250 mg suppositories,1g/100ml solution for infusion
Dose :
Tablet, capsule :
- 500mg tabs 1-2 tabs /cap every 6 hours
Syrup, suspension :
- < 5year : 125mg/5ml susp (w/2) Every 4 – 6 hours
- 5-12 year : 250mg/5ml susp (w/4) Every 4 – 6 hours
Suppositories :
- <1Y : 125 mg supp Every 8 hours (1 supp x 3 )
- >1Y : 250mg supp Every 8 hours ( 1supp x 3 )
Iv solution 1g/100ml :
- <10kg : 0 .75ml/kg
- >10kg , <50kg : 1.5ml/kg
- >50kg : 100ml Slowly over 15 minute
Maximum dose : 4g daily
Pregnancy and lactation : Paracetamol is the first choice of painkiller in pregnancy and breastfeeding
Loratadine
Available forms:
- Loratan, clara, histal, Klarihist, Loreen, Lorine Lohist, Ramitin:10mg tab, 5mg/5ml syrup
- Tidilor, Claritine, Lorax :10mg tab, 1mg/1ml syrup
- Loratin, Restamine:10mg tab
- Lostamin: 5mg/5ml syrup
Indications:
- Relief of symptoms associated with allergic rhinitis, such as sneezing, nasal discharge (rhinorrhea) as well as ocular itching and burning.
- indicated for the relief of symptoms and signs of chronic urticaria and other allergic dermatologic disorders.
Dose:
- Adults and children 6 years and older who weigh more than 30kg : 1 x tablet once daily
- Adults and children over 12 years of age: 2 teaspoons (10 ml), once a day, with or without food.
- The dosage for children aged 2-12 is by weight:
- Body weight over 30 kg: 2 teaspoons (10 ml), once a day, with or without food.
- Body weight of 30 kg or less: one teaspoon (5 ml), once a day, with or without food.
Pregnancy and breast-feeding :
As a precautionary measure, it is preferable to avoid the use of Loratadine Tablets during pregnancy. Loratadine is excreted in breast milk so preferable to avoid the use in lactation
side effect:
- drowsiness
- headache
- increased appetite
- difficulty sleeping.
Otrivine
Otrivine Nasal Spray contains the active ingredient xylometazoline hydrochloride which helps to open up and clear the nasal passages by reducing the excessive nasal secretions and returning the swollen blood vessels to their normal size.
Used in :
- nasal congestion (blocked nose, including colds)
- allergic rhinitis
- sinusitis.
- Not used>5 days Cause rebound congestion
Pregnancy : not recommended
Available forms:
- Otrivin 0.1% spray/drop , .05% spray /drop
- Decozal 0.1% spray/drop , .05% spray /drop
- Xylomet 0.1% spray
Dose:
Adult
- 0.1% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child>6y
- 0.05% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child 6months-6y
- 0.05% Nasal drop 1drops in each nostrils up to 3 times daily
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