- Lincomycin500mg capsules orally 1×2
- Voltaren 75mg tablet 1 x 2 until fever subside
- Flixonase 50mcg/dose nasal spray 2 sprays in each nostril once a day
If there are excessive secretions and sneezing add:
- Atarax 25mg tab 1tab every 8-6 hours
If there is nasal obstruction add :
- Rhinaction Hypertonic sea water spray1puff 4-6 times daily
Lincomycin
Dosage Forms & Strengths:
- 600 mg/2ml vial injection ,500 mg capsule, 680.4mg/2ml
Trade names :
Lincocin, Lincodar, Ultralinc, lenamex, Lincomid
Therapeutic indication and dose :
Susceptible Infections
- IM: 600 mg q12-24hr
- IV: 600-1000 mg q8-12hr; not to exceed 8 g/day
- 1capsule every 12 hour
Contraindications: hypersensitive to lincomycin or clindamycin
Pregnancy and lactation: should only be administered during pregnancy if the benefit outweighs the risk.
Side effects:
- Diarrhea, stomach pain,
- Nausea, vomiting,
- Swollen or painful tongue,
- Vaginal itching or discharge,
- Mild itching or rash
- Ringing in your ears, and dizziness
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).
Hydroxyzine
Available forms:
- Atarax :25mg tab, 10mg/5ml syrup
- Newrax :10mg/5ml syrup
Therapeutic indications:
- Anxiety in adults
- Itching (pruritus) caused by allergic reactions in adults and children.
Dose :
- In adults the maximum daily dose is 100 mg (4 tablets) per day
Adults
For anxiety:
- The usual dose is ½ tablet at breakfast, ½ tablet at lunch and 1 tablet in the evening
- doctor may increase this to a maximum of 4 tablets taken three times a day.
For pruritis (itchiness of the skin):
- The usual dose is 1 tablet before going to bed
- doctor may increase this to 1 tablet three or four times a day
Children
- In children up to 40 kg, the maximum daily dose is 2 mg/kg/day.
For pruritis :
- The usual dose is 0.5 mg per kg of body weight twice a day
- doctor may increase this to a maximum of 1 mg per kg of body weight twice a day
The elderly
- In the elderly, the maximum daily dose is 50 mg (2 tablets) per day.
- The usual starting dose is 25 mg (1 tablet) a day
Contraindication :
- allergy to hydroxyzine hydrochloride or any of the other ingredients
- allergy to cetirizine, other piperazine derivatives, aminophylline or ethylenediamine
- pregnancy or breastfeeding
- porphyria.(A blood disease that can cause stomach pain, vomitingand mental disturbances such as depression
- ECG (electrocardiogram) shows a heart rhythm problem called “QT interval prolongation”
Pregnancy and breastfeeding :
- Not recommended in pregnancy or breastfeeding
Side effect:
- feeling sleepy
- dry mouth, feeling tired, headache
Rhinaction Hypertonic sea water spray
- Sea water
- is a natural nasal decongestant spray
- Clearing and purifying solution, combining hypertonic seawater with a complex of 3 essential oils: Ravintsara, Thyme Linalool and Field Mint.
- Enables a reduction in symptoms of congestion, rhinorrhoea (runny nose) and sneezing by eliminating viruses and bacteria from nasal passages through draining effect
- Quickly relieves blocked nose and for up to 8 hours with a regular application of 1 spray per nostril, 6 times a day.
Dose:
- 1 spray per nostril, 6 times a day.
Pregnancy and lactation:
- Save
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