- Roxithromycin 300mg tablet orally 1 x1
- Voltaren 75mg tablet 1 x 2 until fever subside
- Rhinocort 32mcg/dose nasal spray one spray 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 :
- Rhinaction Hypertonic sea water spray1puff 4-6 times daily
Roxithromycin:
Dosage Forms & Strengths:
- 300mg tab, 150mg tab
Trade names :
- Roximac, Roxipharm, Rulid, Roxamed ,Ruxid, Romac
Therapeutic indications:
- Acute pharyngitis, tonsillitis, sinusitis
- Acute bronchitis
- Exacerbation of chronic bronchitis
- Pneumonia
- Skin and soft tissue infections
- Non gonococcal urethritis
- Impetigo
Dose:
- 300mg once a day Or 150mg twice a day
Contraindications:
- Known hypersensitivity to Roxithromycin
Pregnancy: Category B.
Side effects:
- Oral thrush – white, furry, sore tongue and mouth
- Vaginal thrush – sore and itchy vagina and/or discharge
- Nausea, vomiting, stomach pain, diarrhea, flatulence
- Loss of appetite
- Red and/or itchy skin
- Headache, dizziness, ringing in the ears
- Tiredness
- Altered taste.
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 (Budesonide)
Available forms:
- Rhinocort :32mcg/dose,64mcg/dose
Indications:
- corticosteroid indicated for the management of thenasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients aged 6years and older.
Dose:
- Rhinocort :32mcg/dose For intranasal use only.
Starting dosage:
Adult and children >6 years:
- 64 mcg (one spray per nostril ) once daily.
Maximum dosages:
- Adults: 256 mcg (four sprays per nostril of Rhinocort :32mcg/dose) once daily.
- Pediatric patients (6 to <12 years of age): 128 mcg (two sprays per nostril Rhinocort :32mcg/dose) once daily.
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)
Rhinaction Hypertonic sea water spray
- Sea water
- is a natural nasal decongestant spray
- Clearing and purifying solution, combining hypertonic seawater with a complex of 3 essential oils: Ravintsara, Thyme Linalool and Field Mint.
- Enables a reduction in symptoms of congestion, rhinorrhoea (runny nose) and sneezing by eliminating viruses and bacteria from nasal passages through draining effect
- Quickly relieves blocked nose and for up to 8 hours with a regular application of 1 spray per nostril, 6 times a day.
Dose:
- 1 spray per nostril, 6 times a day.
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