1. Cephalexin 250 mg capsule 1×4 or 500 mg capsule  1×2
2. Diclogesic 75 mg tab 1×2 until fever subside
3. Avamys 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

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). 

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