- Cefaclor 125mg/5ml suspension (w x 0.533) x3x10 OR Cefaclor 250mg/5ml suspension (w x 0.266)x3x10
- Brufen 100mg/5ml syrup (Wx0.375) + Paracetamol ( Revanin) 125mg/5ml Syrup (w/2) alternately every 6 hours until fever subside
In excessive nasal secretions (Rinorrhea,sneezing),congestion :
- Chlorpheniramine maleate 5mg/5ml syrup 2.5 ml every 4-6 hours
- 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
Paractamol
- Analgesic and antipyretics
- Not anti-inflammatory effect
- Suitable for Temperature between (37.5C – 38.5C)
- Safe under 6 months
Trade names : ( Revanin ,Adol,Panda,Dolocet ,Feverol, panadol )
Concentrations: 500 mg tablet, ,1g tablet ,125 mg/5 ml syrup, 250 mg/5 ml syrup, 125 mg suppositories, 250 mg suppositories,1g/100ml solution for infusion
Dose :
Tablet, capsule :
- 500mg tabs 1-2 tabs /cap every 6 hours
Syrup, suspension :
- < 5year : 125mg/5ml susp (w/2) Every 4 – 6 hours
- 5-12 year : 250mg/5ml susp (w/4) Every 4 – 6 hours
Suppositories :
- <1Y : 125 mg supp Every 8 hours (1 supp x 3 )
- >1Y : 250mg supp Every 8 hours ( 1supp x 3 )
Iv solution 1g/100ml :
- <10kg : 0 .75ml/kg
- >10kg , <50kg : 1.5ml/kg
- >50kg : 100ml Slowly over 15 minute
Maximum dose : 4g daily
Pregnancy and lactation : Paracetamol is the first choice of painkiller in pregnancy and breastfeeding
Brufen
- Analgesic and antipyretics
- Has anti-inflammatory effect
- Suitable for Temperature( 38-38.5) C
- Not save under 6 months
- Taken After meal
- 200mg every 6-8 hours, May increase to 400mg every 6-8hours
Trade names : brufen (Taskine , Doloraz, Iburam,Remofen ,Ibugesic,Sapofen,Perofen,Rupan,Bulkaprofen,Advil liquid-gel , Profast, Nashat ,Midofen,Ibusoft).
Other concentration: 800mg and 400mg tablet 600mg tablet, 100mg/5ml syrup
Dose:
Tablets :
Syrup, suspension :
- 100mg/5ml Syrup(Wx0.375) every 6-8hours
Oral drops :
40mg/1ml
- 6-11 months : 1.25ml every 8 hours
- 12-23months : 1.8ml every 8 hours
Maximum dose : 3200 mg per day
Contraindication:
- History of hypersensitivity to aspirin or other NSAIDs
- current or recent stomach ulcer
- severe heart failure.
- severe liver disease
Pregnancy : not usually recommended in pregnancy
Chlorpheniramine
Available forms:
- Allerfin: 4mg tab, 10mg/ml ampule, 2.5mg/5ml syrup
- Anallerge: 4mg tab 2mg/5ml syrup
- Chlorohistol: 4mg tab
Therapeutic indications:
- symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
- Also indicated for the symptomatic relief of itch associated with chickenpox.
Method of administration:
- Adults: 4 mg (1 tablet or 10 ml) every 4-6 hours. Not more than six doses (24 mg) a day if under 65 years of age, or more than a total of three doses (12 mg) a day if over 65 years.
- Children aged 6-11 years: 2 mg (5 ml) every 4-6 hours. Not more than a total of six doses (12 mg) a day.
- Children aged 2-5 years: 1 mg (2.5 ml liquid medicine) every 4-6 hours. Not more than a total of six doses (6 mg) a day.
- Children 1 year-23 months: 1 mg (2.5 ml liquid medicine) twice daily, preferably morning and evening
Contraindications
- contra-indicated in patients who are hypersensitive to antihistamines or to any of the tablet ingredients.
Pregnancy
- There are no adequate data from the use of chlorphenamine maleate in pregnant women. The potential risk for humans is unknown. Use during the third trimester may result in reactions in the newborn or premature neonates. Not to be used during pregnancy unless considered essentially by a physician.
Lactation
- Chlorphenamine maleate and other antihistamine may inhibit lactation and may be secreted in breast milk. Not to be used during lactation unless considered essential by a physician
Side effects :
- Sedation
- drowsiness, dizziness, blurred vision and psychomotor impairment
- Nausea, dry mouth
- Disturbance in attention
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