1. Amoxicillin 500 mg capsule 1x2x10-14 or 250 mg capsule 1x3x10-14

2. Doloraz 400mg tablet 1 x 3 until fever subside

3. Nasonex 0.05% nasal spray 2 sprays in each nostril once a day

If there are excessive secretions and sneezing   add:

• clara 10mg orally once a day

 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

Amoxicillin  :

Dosage Forms & Strengths

1000mg, 1g, 500mg, 750mg 625mg tablets, 500mg, 250mg capsules, 375mg/5ml suspension ,250mg/5ml suspension, 125mg/5ml suspension 

Trade names  :Amoxil,Moxiram,Penamox,Ultramox,Moxilen,Hymox,Amoxapen,Julphamox,Ospamox,Amoxydar,Amoxibel

Therapeutic indication and dose :

Ear, Nose, & Throat Infections

Mild to moderate infections

• 500 mg PO q12hr or 250 mg PO q8hr for 10-14 days

Severe infections

• 500 mg PO q8hr for 10-14 days

Genitourinary Tract Infections

Mild to moderate infections

• 500 mg PO q12hr or 250 mg PO q8hr

Severe infections

• 500 mg PO q8hr

Skin & Skin Structure Infections

Mild to moderate infections

• 500 mg PO q12hr or 250 mg PO q8hr

Severe infections

• 500 mg PO q8hr

Lower Respiratory Tract Infections

• 500 mg PO q8hr for 10-14 days

Helicobacter Pylori

H pylori infection and active or 1-year history of duodenal ulcer

Triple therapy

• 1 g PO q12hr for 14 days with lansoprazole (30 mg) and clarithromycin (500 mg)

Dual therapy

• 1 g PO q8hr for 14 days with lansoprazole (30 mg) in patients intolerant of, or resistant to, clarithromycin

Infective Endocarditis

Prophylaxis

• 2 g PO 30-60 min before procedure

Chlamydial Infection in Pregnant Women 

• First trimester: 500 mg PO q8hr for 7 days

Contraindications:

• Hypersensitivity to penicillin’s, semi-synthetic penicillin’s or cephalosporin. 
• Liver problems
• Renal impairment

Pregnancy:

• Category B

Breastfeeding :

• Amoxicillin is excreted into breast milk in small quantities
• Diarrhea and fungus infection of the mucous membranes are possible in the breast-fed infant, so that breast-feeding might have to be discontinued. 

Common side effects:

• Anaphylaxis
• Anemia
• AST/ALT elevation
• Mucocutaneous candidiasis
• Diarrhea
• Headache
• Nausea
• Vomiting
• Rash
• Pseudomembranous colitis

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 (Mometasone)

• help to relieve inflammation(swelling and irritation of the nose), sneezing, itching and a blocked up or runny nose.

Available forms:

• Nasonex, Tabunex, Sinocort: 05% nasal spray

 Indications:

• to treat the symptoms of seasonal allergic rhinitis (also called hayfever) and perennial (long lasting) rhinitis in adults and children aged 3 and older;
•  to treat nasal polyps in adults aged 18 and over

Dose:

Adult:

• recommended dose is two sprays in each nostril once a day. 
• Once symptoms are controlled, dose reduction to one spray in each nostril may be effective for maintenance.
• may  increase to  the dose; the maximum daily dose is four sprays into each nostril once a day. 

Children aged 3 to 11 years :

• the usual dose is one spray into each nostril once daily. 
• May used some days before the start of the allergy season, as this will help to prevent  allergic rhinitis symptoms from occurring. 
• Prophylaxis must be initiated up to 2-4 weeks prior to the anticipated start of the allergy season.
•  Benefit of treatment may be achieved in the first two days.
•  Maximum benefit is achieved within 1-2 weeks following initiation of treatment. Therefore, patients should continue regular use to achieve full therapeutic benefit. 

For patients who use MOMEX® at regular intervals for treatment of allergic rhinitis,:

• recommended dose is a spray into each nostril once a day. For children between the ages of 2 and 11 years the usual recommended dose is one spray in each nostril once a day.

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