- Cefaclor 250-500 mg capsules orally 1 x3 x10
- Divide 75mg tab 1×2 until fever subside
- Avamys 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Fexofast 120mg orally once a day
If there is nasal obstruction add :
- Rinomest 6.5mg/ml spray 1puff 4-6 times daily
Cefaclor
Dosage Forms & Strengths:
500mg caps, 250 mg caps, 375 tabs, 500 mg tabs, 750mg tabs, 125mg/5ml suspension, 250mg/5ml suspension, 375mg/5ml, suspension
Trade names :
Ceclor, Cloracef, Forticef, Biocef, Forbatec , Cefabac , Midocef ,Pharmaclor , Tibifor
Therapeutic indication and dose :
Lower Respiratory Tract Infections
- Capsules: 250-500 mg PO q8hr
Otitis Media
- Capsules: 250-500 mg PO q8hr
Uncomplicated Skin and Skin Structure Infections
- Capsules: 250-500 mg PO q8hr
- Extended-release tablets: 375 mg PO q12hr for 7-10 days
Urinary Tract Infections
- Capsules: 250-500 mg PO q8hr
Bronchitis
- Extended-release tablets: 500 mg PO q12hr for 7 days
Pharyngitis and Tonsillitis
- Capsules: 250-500 mg PO q8hr
- Extended-release tablets: 750 mg PO q12hr for 10 days
Contraindication: Hypersensitivity to cephalosporin.
Pregnancy and Breast-feeding
- Small amounts of cefaclor have been detected in breast milk following of single 500mg doses.
- Caution should be exercised when prescribing for the pregnant patient.
Side effects:
- Diarrhea, Nausea and vomiting
- Colitis, including rare instances of pseudomembranous colitis
Hypersensitivity, pruritus and urticarial
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).
Fexofenadine
Available forms:
- Telfast, Exofen, Fexofast, Fexodex, Fenadex, Feskine, Fexadine:
- 120mg, 180mg tab
Theraputic indication:
for symptoms that occur with hay fever (seasonal allerigic rhinitis) such as sneezing, itchy, running or blocked nose and itchy, red an watery eye ).
Dose:
For adults and children aged 12 years and over:
- 120 mg Tablets: The recommended dose is one tablet (120mg) daily. Taken with water before a meal.
- 180 mg Tablets: The recommended dose is one tablet (180mg) daily. Taken with water before a meal.
Pregnancy and breast-feeding
- Fexofenadine hydrochloride is not recommended duing pregnancy breast-feeding.
Common side effects
- headache
- Drowsiness
- feeling sick (nausea)
- dizziness
Rinomist 6.5mg/ml nasal spray
- Sodium chloridenatural nasal decongestant spray
- is an over the counter (OTC) moisturizing nasal spray that relieves the symptoms of dry, irritated nasal mucosa due to nasal congestion, dry weather, smoking, colds, nose bleeds, and other similar conditions.
Dose:
1puffs 4-6 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