- Cefaclor 125mg/5ml suspension (w x 0.533) x3x10 OR Cefaclor 250mg/5ml suspension (w x 0.266)x3x10
- Voltaren 5 mg suppositories every 12 hour
In excessive nasal secretions (Rinorrhea,sneezing),congestion :
- Desloratadine 5mg/ml syrup 2.5 ml (1/2 of a 5 ml spoonful) of oral solution once a day.
- Vibrocil nasal drops 1 to 2 drops 3 to 4 times a day in each nostril
Cefaclor
Lower Respiratory Tract Infections
- ≥1 month: 20-40 mg/kg/day PO divided q8hr; not to exceed 1 g/day
Otitis Media
- ≥1 month: 20-40 mg/kg/day PO divided q8-12hr; not to exceed 1 g/day
Uncomplicated Skin and Skin Structure Infections
- ≥1 month: 20-40 mg/kg/day PO divided q8hr; not to exceed 1 g/day
Pharyngitis and Tonsillitis
- ≥1 month: 20-40 mg/kg/day PO divided q8-12hr; not to exceed 1 g/day
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
Desloratadine
Available forms:
- Aerius :5mg tab, 0.5mg/ml syrup
- Lorius Dora, Noura :5mg tab
- Aeriallerg, Histcare, Iris : 5mg tab, 0.5mg/ml syrup
- Rina, Dislara :5mg tab, 2.5mg/5ml syrup
Dose :
Children 1 through 5 years of age:
- The recommended dose is 2.5 ml (1/2 of a 5 ml spoonful) of oral solution once a day.
Children 6 through 11 years of age:
- The recommended dose is 5 ml (one 5 ml spoonful) of oral solution once a day.
Adults and adolescents 12 years of age and over:
- The recommended dose is 10 ml (two 5 ml spoonfuls) of oral solution once a day.
- one tablet once a day.
Pregnancy, breast feeding
- Taking Desloratadine is not recommended in pregnancy or nursing a baby
Side effect:
- diarrhea
- fever
- insomnia
- fatigue
- dry mouth
- headache
Vibrocil
Composition :Nasal drops, nasal spray: Dimetindeni maleas 0.25 mg, Phenylephrinum 2.5 mg
Indications Therapeutic use :
- Common colds, acute and chronic rhinitis, seasonal (hay fever) and non-seasonal allergic rhinitis, acute and
- chronic sinusitis, pre- and postoperative care, adjuvant in cases of acute otitis media.
Dosage:
Nasal drops
- Children from 1to 6 years: 1 to 2 drops 3 to 4 times a day in each nostril.
- Children over 6 years and adults: 3to 4 drops 3 to 4 times a day in each nostril.
Nasal spray
- Adult: apply 1 to 2 sprays in each nostril, 3to 4 times a day.
pregnancy and breast-feeding :
- Vibrocil should not be used as a precaution because too little experience is available
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