Moxifloxacin 400 mg tablet 1×1 x5-10 days
- dolocet 500mg tablets 1x 4 up to 2 x 4 until fever subside
If there are excessive secretions and sneezing add:
- Anallerge 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
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
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
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