Levofloxacin  500mg capsules orally  1x1x10-14 or 750mg 1x1x5

1. Doloraz 400mg tablet 1 x 3 until fever subside

2. Avamys 50mcg/dose nasal spray 2 spray in each nostril once a day

     If there are excessive secretions and sneezing   add:

• Histazin 25mg tab 1tab at night

     If there is nasal obstruction add :

• Decozal 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily up to 7 days

Levofloxacin 

Dosage Forms & Strengths

• 250mg tablet ,500mg tablet, 750mg tablet , 500mg/100ml, 250mg/50ml, 5mg/ml for iv infusion

Trade names  : 

• Tavanic , Avoxin, Joswe avoxin , Levotop, Avicare, levanix, Levaquin, Zynolev, Loxacin, Matador, Uniflox, Evomax, joxevo, Tavaquin, Lefort, levoflox, Levonic, Talerin, Ravivo, Nevotic, Loxamox .

Therapeutic indication and dose :

Community-Acquired Pneumonia

• 500 mg PO/IV once daily for 7-14 days or 750 mg PO/IV once daily for 5 days

Nosocomial Pneumonia

• 750 mg PO/IV once daily for 7-14 days

Acute Bacterial Sinusitis

• 500 mg PO/IV once daily for 10-14 days or 750 mg PO/IV once daily for 5 days

Acute Bacterial Exacerbation of Chronic Bronchitis

• 500 mg PO/IV once daily for ≥7 days

Skin/Skin Structure Infections

• Uncomplicated: 500 mg PO/IV once daily for 7-10 days
• Complicated: 750 mg PO/IV once daily for 7-14 days

Chronic Bacterial Prostatitis

• 500 mg PO/IV once daily for 28 days

Complicated Urinary Tract Infections & Acute Pyelonephritis

• 250 mg PO/IV once daily for 10 days or 750 mg PO/IV once daily for 5 days

Uncomplicated Urinary Tract Infections

• 250 mg PO/IV once daily for 3 days

Limitations-of-use: Reserve fluoroquinolones for patients who do not have other available treatment options for uncomplicated urinary tract infections

• 500 mg PO/IV once daily for 10-14 days

Acne Vulgaris (Off-label)

• 100 mg PO q8hr for 4 weeks

Epididymitis (Off-label)

• 500 mg PO qDay for 10 days

Contraindications

• Hypersensitive to levofloxacin or other quinolones
• Patients with epilepsy
• History of tendon disorders related to fluoroquinolone administration
• In children or growing adolescents
• During pregnancy
• In breast-feeding women

Side effect:

• Headache, Dizziness
• Vomiting, Nausea, Diarrhea
• Insomnia

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

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). 

 Promethazine

Available forms:

• Histazin : 5mg/5ml syrup, 25mg tab
• Promet: 25mg tab
• Promethazine: 50mg/2ml for iv,im injection 

Therapeutic indications

• As symptomatic treatment for allergic conditions of the upper respiratory tract and skin including allergic rhinitis, urticaria and anaphylactic reactions to drugs and foreign proteins.
• As an antiemetic.
• For short term use in treatment of insomnia in adults.
• For short term use as a paediatric sedative.

The usual doses are:

25mg tablet:

• Adults  and Children>10 years : Start with 1 tablet (25 mg) taken at night. This maybe increased to a maximum of 1 tablet (25 mg) twice a dayif necessary.
• Children 5-10 years: A single tablet (25 mg) given at night. DO NOT give more than 25 mg per day.

50mg/2ml for iv,im injection 

• Adult : 25 mg; may be repeated in 2 hours when necessary; switch to PO as soon as possible
• Pediatrics≥2 years: 12.5-25 mg IM at bedtime

5mg/5ml syrup:

• 2-5 years: 5-15 mg(1-3ml) daily in 1 or 2 divided doses
• >5-10 years : 10-25(2-5ml) mg daily in 1 or 2 divided doses

Contraindications

• should not be used in patients in coma or suffering from CNS depression of any cause.
• should not be given to patients with a known hypersensitivity to any of the excipients.
• contraindicated for use in children less than two years of age because of the potential for fatal respiratory depression..

pregnancy and lactation

• should not be used in pregnancy unless the physician considers it essential.
• The use is not recommended in the 2 weeks prior to delivery in view of the risk of irritability and excitement in the neonate.
• Available evidence suggests that the amount excreted in milk is insignificant. However, there are risks of neonatal irritability and excitement.

Side effects 

• drowsiness, dizziness, restlessness, headaches, nightmares, tiredness, and disorientation. blurred vision, dry mouth and urinary retention 

Otrivine

Otrivine Nasal Spray contains the active ingredient xylometazoline hydrochloride which helps to open up and clear the nasal passages by reducing the excessive nasal secretions and returning the swollen blood vessels to their normal size.

 Used in :

• nasal congestion (blocked nose, including colds)
• allergic rhinitis
• sinusitis.
• Not used>5 days Cause rebound congestion

Pregnancy : not  recommended

Available forms:

• Otrivin 0.1% spray/drop , .05% spray /drop
• Decozal 0.1% spray/drop , .05% spray /drop
• Xylomet 0.1% spray

Dose:

Adult

• 0.1% Nasal drop 2-3 drops in each nostrils up to 3 times daily

Child>6y

• 0.05% Nasal drop 2-3 drops in each nostrils up to 3 times daily

Child 6months-6y

• 0.05% Nasal drop 1drops in each nostrils up to 3 times daily