- Ampicillin 250mg /5ml suspension (w/4) x 4×10
- 5 mg suppositories + Paracetamol ( Revanin) 125mg/5ml Syrup (w/2) alternately every 6 hours until fever subside
In excessive nasal secretions (Rinorrhea,sneezing),congestion :
- L-cet 5mg/ml syrup 2.5 mL (1/2 teaspoon) once a day taken in the evening
- Free breath 7.1mg/1ml nasal spray 1puffs 4-6 times daily
Ampicillin
General Dosing Guidelines
- 50-100 mg/kg/day PO divided q6hr; not to exceed 2-4 g/day
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
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
Levocetirizine
Available forms:
- Xyzal, Levosyn, levar, Levozal, Zolix, Cetazal :5mg tab
- Layal : 5mg tab, 2.5 mg /5ml syrup
- L-cet : 5mg tab, 0.5mg/ml syrup
- Hpi –levocetirizine : 5mg tab
- Lesonal : 5mg tab, 0.5 mg /ml syrup
Theraputic indications:
- allergic rhinitis (including persistent allergic rhinitis);
- nettle rash (urticaria).
Dose:
Adults :
- 5 milligrams (mg) or 10 mL) (2 teaspoons) once a day taken in the evening. Some patients may be given 2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening.
Children 6 to 11 years of age :
- 2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening. Do not take more than 2.5 mg per day.
Children 6 months to 5 years of age :
- 1.25 mg or 2.5 mL (1/2 teaspoon) once a day taken in the evening. Do not take more than 1.25 mg per day.
For oral dosage form (tablets):
- Adults and children 12 years of age and older—5 mg (1 tablet) once a day taken in the evening. Some patients may be given 2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 5 mg per day.
- Children 6 to 11 years of age—2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 2.5 mg per day.
Side effect:
- dry mouth,
- headache,
- tiredness
- somnolence/drowsiness.
Free breath 7.1mg/1ml nasal spray
- Metered dose nasal spray
- sea water natural nasal decongestant spray
- Physiological solution for rinsing the nose
- Makes the breathing easier
- Free Breath Metered Dose Nasal Spray moisturizes the nose and improves comfort during flight. Using this product daily can help restore and optimize this self-cleaning system.
- Helps to stimulate the body’s natural shield
- Natural way to relieve congestion
- Does not contain any medication, just salt and water
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