- Cephadroxil 500 mg capsule 1x2x10
- Divido 50 mg tab 1×3 until fever subside
- Flixonase .50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- loreen10mg tab orally once a day
If there is nasal obstruction add :
- Xylomet 0.1% spray 2-3 drops in each nostrils up to 3 times daily up to 7 days
Cephadroxil
Dosage Forms & Strengths:
- 500mg caps, 1g tab, 125mg /5ml suspension, 250mg /5ml suspension, 500mg/5ml suspension
Trade names :
- Droxicef , Biodroxil, Cefadroxil, Cefadroxil, Droxil, Cedrox, Cefadril, Duricef, Midroxil
Therapeutic indication and dose :
Pharyngitis
- 1 g PO qDay or divided q12hr for 10 days
Skin & Skin Structure Infections
- 1 g PO qDay or divided q12hr
Tonsillitis
- 1 g PO qDay or divided q12hr for 10 days
Urinary Tract Infections
- 2 g PO qDay or divided q12hr
Endocarditis
- Prophylaxis (dental, upper respiratory procedure): 2 g PO 1 hour before procedure
Contraindications:
- Hypersensitivity to cefadroxil and to any of the cephalosporins
- History of severe reactions to penicillins or to any other beta-lactam drug
Pregnancy: The safe use during pregnancy has not been established.
Breast-feeding:
- Cefadroxil is present in low concentrations in breast milk
- Sensitization, diarrhea or colonization of the infants’ mucosa with fungi are possible.
- The use of cefadroxil during pregnancy and in lactating mothers should therefore be handled very strictly.
Side effect:
- Nausea, vomiting, diarrhoea, dyspepsia, abdominal pain, glossitis
Pruritus, rash, allergic exanthema, urticaria
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).
Loratadine
Available forms:
- Loratan, clara, histal, Klarihist, Loreen, Lorine Lohist, Ramitin:10mg tab, 5mg/5ml syrup
- Tidilor, Claritine, Lorax :10mg tab, 1mg/1ml syrup
- Loratin, Restamine:10mg tab
- Lostamin: 5mg/5ml syrup
Indications:
- Relief of symptoms associated with allergic rhinitis, such as sneezing, nasal discharge (rhinorrhea) as well as ocular itching and burning.
- indicated for the relief of symptoms and signs of chronic urticaria and other allergic dermatologic disorders.
Dose:
- Adults and children 6 years and older who weigh more than 30kg : 1 x tablet once daily
- Adults and children over 12 years of age: 2 teaspoons (10 ml), once a day, with or without food.
- The dosage for children aged 2-12 is by weight:
- Body weight over 30 kg: 2 teaspoons (10 ml), once a day, with or without food.
- Body weight of 30 kg or less: one teaspoon (5 ml), once a day, with or without food.
Pregnancy and breast-feeding :
As a precautionary measure, it is preferable to avoid the use of Loratadine Tablets during pregnancy. Loratadine is excreted in breast milk so preferable to avoid the use in lactation
side effect:
- drowsiness
- headache
- increased appetite
- difficulty sleeping.
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