- Ciprofloxacin 500 mg tablet 1×2 x10 days
- Doloraz 400mg tablet 1 x 3 until fever subside
- Rhinase 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Allerfin 4mg tab 1tab every 4-6 hours
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
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
Brufen
- Analgesic and antipyretics
- Has anti-inflammatory effect
- Suitable for Temperature( 38-38.5) C
- Not save under 6 months
- Taken After meal
- 200mg every 6-8 hours, May increase to 400mg every 6-8hours
Trade names : brufen (Taskine , Doloraz, Iburam,Remofen ,Ibugesic,Sapofen,Perofen,Rupan,Bulkaprofen,Advil liquid-gel , Profast, Nashat ,Midofen,Ibusoft).
Other concentration: 800mg and 400mg tablet 600mg tablet, 100mg/5ml syrup
Dose:
Tablets :
Syrup, suspension :
- 100mg/5ml Syrup (Wx0.375) every 6-8hours
Oral drops :
40mg/1ml
- 6-11 months : 1.25ml every 8 hours
- 12-23months : 1.8ml every 8 hours
Maximum dose : 3200 mg per day
Contraindication:
- History of hypersensitivity to aspirin or other NSAIDs
- current or recent stomach ulcer
- severe heart failure.
- severe liver disease
Pregnancy : not usually recommended in pregnancy
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).
Chlorpheniramine
Available forms:
- Allerfin: 4mg tab, 10mg/ml ampule, 2.5mg/5ml syrup
- Anallerge: 4mg tab 2mg/5ml syrup
- Chlorohistol: 4mg tab
Therapeutic indications:
- symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
- Also indicated for the symptomatic relief of itch associated with chickenpox.
Method of administration:
- Adults: 4 mg (1 tablet or 10 ml) every 4-6 hours. Not more than six doses (24 mg) a day if under 65 years of age, or more than a total of three doses (12 mg) a day if over 65 years.
- Children aged 6-11 years: 2 mg (5 ml) every 4-6 hours. Not more than a total of six doses (12 mg) a day.
- Children aged 2-5 years: 1 mg (2.5 ml liquid medicine) every 4-6 hours. Not more than a total of six doses (6 mg) a day.
- Children 1 year-23 months: 1 mg (2.5 ml liquid medicine) twice daily, preferably morning and evening
Contraindications
- contra-indicated in patients who are hypersensitive to antihistamines or to any of the tablet ingredients.
Pregnancy
- There are no adequate data from the use of chlorphenamine maleate in pregnant women. The potential risk for humans is unknown. Use during the third trimester may result in reactions in the newborn or premature neonates. Not to be used during pregnancy unless considered essentially by a physician.
Lactation
- Chlorphenamine maleate and other antihistamine may inhibit lactation and may be secreted in breast milk. Not to be used during lactation unless considered essential by a physician
Side effects :
- Sedation
- drowsiness, dizziness, blurred vision and psychomotor impairment
- Nausea, dry mouth
- Disturbance in attention
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