- Cefpodoxime 200 mg tab orally 1 x2x10
- Voltaren 75mg tablet 1 x 2 until fever subside
- Rhinocort 32mcg/dose nasal spray one spray in each nostril once a day
If there are excessive secretions and sneezing add:
- Dislara 5mg tab orally once a day
If there is nasal obstruction add :
Sterimar Isotonic sea water spray 1puff 4-6 times daily
Cefpodoxime
Dosage Forms & Strengths:
- 100mg tablet , 200mg tablet, 100mg/5ml suspension, 50 mg/5ml suspension, 40mg/5ml suspension
Trade names :
- Cefodox , Podecif , Metoxim, Auropodox, Cefpo
Therapeutic indication and dose :
Acute Bronchitis & Acute Exacerbations of Chronic Bronchitis
- 200 mg PO q12hr for 10 days
Acute Community-Acquired Pneumonia
- 200 mg PO q12hr for 14 days
Acute Maxillary Sinusitis
- 200 mg PO q12hr for 10 days
Pharyngitis/Tonsillitis
- 100 mg PO q12hr for 5-10 days
Skin/Skin Structure Infections
- 400 mg PO q12hr for 7-14 days
Gonorrhea
- 200 mg PO once
Urinary Tract Infections
Acute uncomplicated
- 100 mg PO q12hr 5-7 days
Complicated, including pyelonephritis
- 200 mg PO q12hr
Contraindications:
- Hypersensitivity to cephalosporin
Pregnancy and lactation:
- Should not be used in pregnancy or in nursing mothers unless considered essential by the physician.
Side effects:
- Nausea, Vomiting, Diarrhea
- Stomach pain
- Swelling, redness, irritation, burning, or itching of the vagina
- White vaginal discharge
- Headache
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 (Budesonide)
Available forms:
- Rhinocort :32mcg/dose,64mcg/dose
Indications:
- corticosteroid indicated for the management of thenasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients aged 6years and older.
Dose:
- Rhinocort :32mcg/dose For intranasal use only.
Starting dosage:
Adult and children >6 years:
- 64 mcg (one spray per nostril ) once daily.
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
Sterimar Isotonic sea water spray
- Is a natural nasal decongestant spray
- Is an isotonic filtered sea water solution, 100% natural and free from preservatives
- Restores natural moisture of the nose (air conditioning, heating, travel). To assist when ENT disorders (sinusitis, colds, hayfever, allergies, dry & stuffy noses).
Dose:
- 1puffs 2 to 6 times a day in each nostril as required or as needed.
Pregnancy and lactation:
- Save
Maximum dosages:
- Adults: 256 mcg (four sprays per nostril of Rhinocort :32mcg/dose) once daily.
Pediatric patients (6 to <12 years of age): 128 mcg (two sprays per nostril Rhinocort :32mcg/dose) once 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