1. Moxifloxacin 400 mg tablet 1×1 x5-10 days
2. Voltaren 75mg tablet 1 x 2 until fever subside
3. Aierxem 50mcg/dose nasal spray 2 spray in each nostril once a day

If there are excessive secretions and sneezing   add:

• Fenistil 4mg tab 1tab every 4-6 hours

     If there is nasal obstruction add :

• Otrivin 0.1% spray/drop 2-3 drops in each nostrils up to 3 times daily not more than 7 days

Moxifloxacin

Dosage Forms & Strengths

• 400mg tablet, 436.8 mg tab ,400mg/250ml solution for injection, 5mg /ml solution for injection , 1.6mg/ml solution for injection

Trade names  :

• Muxava, Avaquin,Avalox, AVORES JPM, Vigamox, Elevemox , Mofloxine , Moxiquin

Therapeutic indication and dose :

Acute Bacterial Sinusitis

• 400 mg PO/IV qDay for 5-10 days

Community-Acquired Pneumonia

• 400 mg PO/IV qDay for 7-14 days

Acute Exacerbation of Chronic Bronchitis

• Indicated for acute exacerbations of chronic bronchitis caused by bacterial infections
• 400 mg PO/IV qDay for 5 days

Skin & Skin Structure Infections

• Uncomplicated: 400 mg PO/IV qDay for 7 days
• Complicated: 400 mg PO/IV qDay for 7-21 days

Intra-abdominal Infections

• Complicated: 400 mg PO/IV qDay for 5-14 days

Pneumonic & Septicemic Plague

• Indicated in adults for the treatment of plague, including pneumonic and septicemic plague, caused by susceptible isolates of Yersinia pestis; it is also indicated for prophylaxis of plague in adults
• 400 mg PO/IV qDay x10-14 days
• Begin administration as soon as possible after suspected or confirmed exposure to Yersinia pestis

Contraindications

• Hypersensitivity to moxifloxacin, other quinolones
• Pregnancy and lactation
• Patients below 18 years of age. 
• Patients with a history of tendon disease/disorder related to quinolone treatment. 

Side effects:

• Headache
• Dizziness
• Nausea, Vomiting, Diarrhea
• Gastrointestinal and abdominal pains

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
  • Skin: Urticaria, pruritus of various etiology, endogenous eczema with previous medical diagnosis.
  • Respiratory system: Seasonal (hay fever) and perennial rhinitis with previous medical diagnosis.

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). 

 Dimetindene

Available forms:

• Fenistil:  drop 1mg/1ml, 4mgcaps, 1mgtab
• Pedia fast: drop 0.1g/100ml, 0.01g/100ml syrup
• Alergin:  drop 1mg/1ml (1 ml = 20 drops).
• Fencil:  drop 1mg/1ml
• 1 ml contains dimetindene maleate 1 mg (1 ml = 20 drops).

 Therapeutic indications

• Symptomatic treatment of allergic diseases:
• Relieve of itching associated with infectious diseases (e.g. chickenpox) with previous medical diagnosis or after an insect bite or stings.

Dose:

1mg/1ml oral drops, 0.1g/100ml drop:

• Adults :The recommended daily dose is 3 – 6 mg of dimetindene maleate divided into 3 doses, 
• 20 –40 drops 3× a day.
• Paediatric  The recommended daily dose for children 1 – 11 years is 0.1 mg dimetindene maleate/kg body
• 2 drops/kg/day divided into 3 doses.

1mg tablet:

• 1 to 2 milligrams three times daily 

0.01g/100ml syrup:

• the recommended dose is 1 teaspoonful (5 ml) of a 0.01g/100ml syrup 3-4 times daily

4mg capsule :

• 1capsule once  daily 

Contraindications :

• Hypersensitivity to the active substance or to any of the excipientsInfants and children under 1 year of age.

pregnancy and lactation :

• Pregnancy There are no data about the use of dimetindene maleate during pregnancy. 
• Dimetindene maleate should not be used in pregnant women unless the benefit of treating the mother outweighs the risk for the foetus

Breast-feeding :

• There is a well-founded presumption that dimetindene can be excreted in human milk. So its not recommended.

Side effect :

• Fatigue
• Somnolence, nervousness

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