- Cefdinir 125mg/5ml suspension (w x 0.56) x1x10
- 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 :
- Lesonal 0.5 mg /ml syrup 2.5 mL (1/2 teaspoon) once a day taken in the evening
- Vibrocil nasal drops 1 to 2 drops 3 to 4 times a day in each nostril
Cefdinir
Acute Bacterial Otitis Media
- 6 months-12 years: 7 mg/kg PO q12hr for 5-10 days or 14 mg/kg PO q24hr for 10 days
Pharyngitis/Tonsillitis
- 6 months-12 years: 7 mg/kg PO q12hr for 5-10 days or 14 mg/kg PO q24hr for 10 days
Acute Maxillary Sinusitis
- 6 months-12 years: 7 mg/kg PO q12hr or 14 mg/kg PO q24hr for 10 days
Skin/Skin Structure Infections
- 6 months-12 years: 7 mg/kg PO q12hr for 10 days
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
Levocetirizine
Available forms:
- Xyzal, Levosyn, levar, Levozal, Zolix, Cetazal :5mg tab
- Layal : 5mg tab, 2.5 mg /5ml syrup
- L-cet : 5mg tab, 0.5mg/ml syrup
- Hpi –levocetirizine : 5mg tab
- Lesonal : 5mg tab, 0.5 mg /ml syrup
Theraputic indications:
- allergic rhinitis (including persistent allergic rhinitis);
- nettle rash (urticaria).
Dose:
Adults :
- 5 milligrams (mg) or 10 mL) (2 teaspoons) once a day taken in the evening. Some patients may be given 2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening.
Children 6 to 11 years of age :
- 2.5 mg or 5 mL (1 teaspoon) once a day taken in the evening. Do not take more than 2.5 mg per day.
Children 6 months to 5 years of age :
- 1.25 mg or 2.5 mL (1/2 teaspoon) once a day taken in the evening. Do not take more than 1.25 mg per day.
For oral dosage form (tablets):
- Adults and children 12 years of age and older—5 mg (1 tablet) once a day taken in the evening. Some patients may be given 2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 5 mg per day.
- Children 6 to 11 years of age—2.5 mg (1/2 tablet) once a day taken in the evening. Do not take more than 2.5 mg per day.
Side effect:
- dry mouth,
- headache,
- tiredness
- somnolence/drowsiness.
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