- Erythrodar 500mg orally 1x2x10
- Voltaren 75mg tablet 1 x 2 until fever subside
- Flixonase .50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Cerin 10mg tab once daily
If there is nasal obstruction add :
- Sinomarin nasal spray 1puff 4-6 times daily
Erythromycin
Dosage Forms & Strengths:
250mg tablet , 400mg tablet , ,200mg tablet , 200mg/5ml suspension
Trade names :
Rythromac ,Erythrodar
Therapeutic indication and dose :
General Dosing Recommendations
- 400 mg PO q6hr or
- 250-500 mg PO q6-12hr or 500 mg q12hr or 333 mg PO q8hr
- Severe infections: Up to 4 g/day
Intestinal amebiasis
- 400 mg PO q6hr for 10-14 days
Legionnaire Disease
- 400-1000 mg PO q6hr for 21 days
Pertussis
- 500 mg PO q6hr for 14 days
Streptococcal infections
- 400 mg PO divided q12hr for 10 days
Urethritis
- 800 mg PO q8hr for 7 days or
- 500 mg PO q6hr for 7 days
Lymphogranuloma Venereum
- 500 mg PO q6hr for 21 days
Contraindications:
- Known hypersensitivity to erythromycin.
- Erythromycin is contraindicated in patients taking simvastatin
Pregnancy and lactation:
- Observational studies in humans have reported cardiovascular malformations after exposure to medicinal products containing erythromycin during early pregnancy.
- Erythromycin has been reported to cross the placental barrier in humans, but foetal plasma levels are generally low.
- There have been reports that maternal macrolide antibiotics exposure within 7 weeks of delivery may be associated with a higher risk of infantile hypertrophic pyloric stenosis (IHPS).
- Erythromycin can be excreted into breast-milk. Caution should be exercised when administering erythromycin to lactating mothers
Side effect:
- Upper abdominal discomfort, nausea, vomiting, diarrhea
- Pancreatitis, anorexia, infantile hypertrophic pyloric stenosis.
- Allergic reactions ranging from urticaria and mild skin eruptions to anaphylaxis
- Deafness, tinnitus
Diclofenac sodium
- Mainly analgesic
- Has anti-inflammatory effect
- Suitable for temperature >39
- Contraindicated in < 1year age
- After meal
Trade names of diclofenac : (Diclogesic,Votrex,Infla-ban,Voltaren,Tratul,RofenacDiclofen,Olfen,Optifen,Almiral, Clofen, Diclosal, Divido,Diclomax, Nalgofen, Difen,)
Other concentrations: 12.5 mg, 50, 100 suppositories, 25, 50, 100 tablet, 100 capsules, 75 mg/3ml mg injection
Dose :
Tablet:
- 75 mg to 150 mg daily in two or three divided doses.
Suppositories :
Adults: 75-150mg daily, in divided doses every 12 hour
children:
- 1-3 years or <15 kg: 12.5 mg suppositories every 12 hour
- 3-12years or >15kg : 25mg suppositories every 12 hour
IM Injection 75mg/3ml
Adults : 25 to 75 mg depending on the severity pain.
The maximum daily dose is :150 mg.
Contraindication:
- History of hypersensitivity to diclofenac sodium
- Asthma
- Hypertension
- current or recent stomach ulcer
- severe heart failure.or evere 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).
Cetirizin
Available forms:
- Zyrtic: 10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
- Cerin :10mg tab, 1mg/1ml syrup
- Zertazin : 10mg tab, 5mg/5ml syrup
- Zeran :10mg tab
- Zain :10mg tab
- Siraz : 5mg tab, 5mg/5ml syrup
- Finallerg :10mg tab, 1mg/1ml syrup, 10mg/ml oral drop
- Sezonal :10mg tab
- Omcet : 5mg tab, 5mg/5ml syrup, 10mg/ml syrup
Therapeutic indication:
- for the relief of nasal and ocular symptoms of seasonal and perennial allergic rhinitis
- for the relief of chronic nettle rash (chronic idiopathic urticaria).
Pregnancy and breast-feeding :
- Cetirizin should be avoided in pregnant women. Accidental use of the medicine by a pregnant
- woman should not produce any harmful effects on the foetus. Nevertheless, the medicine should be only administered if necessary and after medical advice.
- Cetirizine passes into breast milk. Therefore, should not taken during breast feeding
How to take Cetirizin Sandoz :
Adults :
- The recommended dose is 10 mg once daily as 1 tablet
Use in children between 6 and 12 years old:
- The recommended dose is 5 mg twice daily as a half tablet twice daily
side effects :
- fatigue
- dry mouth, nausea, diarrhoea
- dizziness, headache
- somnolence (sleepiness)
- pharyngitis (sore throat), rhinitis (swelling and irritation inside the nose)
Sinomarin (sea water)
- 100% natural, clinically proven nasal spray that relieves nasal congestion naturally, thins mucus and cleanses the nasal cavities effectively, helping to protect from infections. It is ideal both for regular nasal hygiene and congestion relief.
Use in cases of
- Infectious rhinitis (common cold & flu)
- Allergic rhinitis (seasonal hay fever or year-long)
- Other causes of rhinitis (e.g. pregnancy
- Sinusitis
- Regular nasal hygiene
- Nasal hydration
Dose:
- 1puffs 4-6 times daily
Pregnancy and lactation:
- Save
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