- Cephalexin 250 mg capsule 1×4 or 500 mg capsule 1×2
- Panadol ActiFast 2 tablets up to 4 times daily
- Aierxem 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Xyzal 5mg orally once a day in the evening
If there is nasal obstruction add :
- Decozal 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily up to 7 days
Cephalexin
Dosage Forms & Strengths:
- 250mg capsule, 500mg capsule , 1g tablet, 125mg/5ml suspension, 250mg/5ml suspension
Trade names :
- Lexin, Cephadar, Unilexin, Keflex, Pharmexin, Flexin
Therapeutic indication and dose :
Genitourinary Tract Infections
- 250 mg PO q6hr; dosage range, 1-4 g/day in divided doses
Bone Infections
- 250 mg PO q6hr; dosage range, 1-4 g/day in divided doses
Uncomplicated Cystitis
- 250 mg PO q6hr or 500 mg PO q12hr; dosage range, 1-4 g/day in divided doses
Otitis Media
- 250 mg PO q6hr; dosage range, 1-4 g/day in divided doses
Skin/Skin Structure Infections
- 250 mg PO q6hr or 500 mg PO q12hr; dosage range, 1-4 g/day in divided doses
Respiratory Tract Infections
- 250 mg PO q6hr; dosage range, 1-4 g/day in divided doses
Streptococcal Pharyngitis
- 250 mg PO q6hr or 500 mg PO q12hr; dosage range, 1-4 g/day in divided doses
Cellulitis and Mastitis
- 500 mg PO q6hr; dosage range, 1-4 g/day in divided doses 500 mg PO q6hr for 7 days
Contraindications:
- Allergy to the cephalosporins group of antibiotics
- Cephalosporins should be given with caution to penicillin-sensitive patients, as there is some evidence of partial cross-allergenicity between the penicillins and the cephalosporins.
- Cefalexin is contraindicated in patients with acute porphyria.
Pregnancy: Caution should be exercised when prescribing for the pregnant patient.
Breastfeeding:
- The excretion of cefalexin in human breast milk increased up to 4 hours following a 500mg dose. Caution should be exercised when cefalexin is administered to a nursing mother, possible effects to the infant include modification of bowel flora.
Side effects:
- Pseudomembranous colitis
- Nausea and vomiting.
- Diarrhea
- Dyspepsia and abdominal pain
Panadol ActiFast Product Description:
- Panadol ActiFast is a fast effective pain and is gentle on the stomach.
- Panadol ActiFast is a pain reliever that is absorbed twice as fast as regular paracetamol.
- Panadol ActiFast is effective for the relief of fever and the treatment of mild to moderate pain including headache, migraine, rheumatic and muscular pain, period pain, pain of osteoarthritis, toothache, pain following dental procedures/tooth extraction, and pain after vaccination.
What is Paracetamol used for :
Paracetamol is a medication that is used for the relief of the following indications:
- Headache
- Period pain
- Backache
- Rheumatic pain (joints pain)
- Cold and flu
- Sore throat
- Mild arthritis pain (joints pain)
- Muscle Pain
- Toothache
- Fever
Contraindication:
- In allergy to Paracetamol, or any of the ingredients in this medicine.
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).
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.
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