1. Ciprofloxacin 500 mg tablet 1×2 x10 days
2. Voltaren  75mg tablet 1 x 2 until fever subside
3. Rhinocort 32mcg/dose nasal spray two sprays into each nostril in the morning

     If there are excessive secretions and sneezing   add:

• Allerfin 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

Ciprofloxacin 

Dosage Forms & Strengths

• 250, 500, 1000 mg (xl) 750mg tab, 200mg/100ml infusion, 400mg/200ml infusion

Trade names  : 

• Bactiflox, Floroxin,Cibrobay,Ciproflacin, Ciprolon, Ciproflox, Bactall ,Siprosan, Cipro, Ciprover, Quinox, Floxacin ,Ciproquin, Cipropharm, Omacip, Serviflox
• Cipromid, Ciprogen ,Ciprodar ,Floxar, Mecado ,Topistin, ufexil, cefloxine ,Ciprox

Therapeutic indication and dose :

Acute Sinusitis

• Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 10 days

Bone & Joint Infections

• Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for ≥4-6 weeks
• Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for ≥4-6 weeks

Chronic Bacterial Prostatitis

• Indicated for chronic bacterial prostatitis caused by Escherichia coli or Proteus mirabilis
• Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 28 days

Infectious Diarrhea

• Mild/moderate/severe: 500 mg PO q12hr for 5-7 days

Empirical Therapy in Febrile Neutropenic Patients

• Severe: 400 mg IV q8hr for 7-14 days

Intra-abdominal Infections

• Complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Lower Respiratory Tract Infections

• Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
• Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days

Nosocomial Pneumonia

• Mild/moderate/severe: 400 mg IV q8hr for 10-14 days

Skin/Skin Structure Infections

• Mild/moderate: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days
• Severe/complicated: 750 mg PO q12hr or 400 mg IV q8hr for 7-14 days

Urinary Tract Infections

• Acute uncomplicated: Immediate-release, 250 mg PO q12hr for 3 days; extended-release, 500 mg PO q24hr for 3 days
• Mild/moderate: 250 mg PO q12hr or 200 mg IV q12hr for 7-14 days
• Severe/complicated: 500 mg PO q12hr or 400 mg IV q12hr for 7-14 days

Urethral & Cervical Gonococcal Infections

• Uncomplicated: 250-500 mg PO once

Anthrax Infection

Postexposure therapy

• Inhalation (prophylaxis/postexposure): 500 mg PO q12hr or 400 mg IV q12hr for 60 days
• Cutaneous: 500 mg PO q12hr or 400 mg IV q12hr for 60 days

Plague

Indication for treatment and prophylaxis of plague due to Yersinia pestis

• 500-750 mg PO q12hr x14 days, OR
• 400 mg IV q8-12hr x 14 days

Contraindications:

• Hypersensitivity to the active substance

Pregnancy and lactation: 

• It is preferable to avoid the use of ciprofloxacin during pregnancy. 

Breast-feeding 

• Ciprofloxacin is excreted in breast milk. Due to the potential risk of articular damage, ciprofloxacin should not be used during breast-feeding

Side effects: 

• Nausea, Diarrhea, abdominal pain, insomnia

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. 

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.

Chlorpheniramine

Available forms:

• Allerfin: 4mg tab, 10mg/ml ampule, 2.5mg/5ml syrup
• Anallerge: 4mg tab 2mg/5ml syrup
• Chlorohistol: 4mg tab

 Therapeutic indications:

• symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, vasomotor rhinitis, urticaria, angioneurotic oedema, food allergy, drug and serum reactions, insect bites.
• Also indicated for the symptomatic relief of itch associated with chickenpox.

Method of administration:

• Adults:  4 mg (1 tablet or 10 ml) every 4-6 hours. Not more than six doses (24 mg) a day if under 65 years of age, or more than a total of three doses (12 mg) a day if over 65 years.
• Children aged 6-11 years: 2 mg (5 ml) every 4-6 hours. Not more than a total of six doses (12 mg) a day.
• Children aged 2-5 years: 1 mg (2.5 ml liquid medicine) every 4-6 hours. Not  more than a total of six doses (6 mg) a day.
• Children 1 year-23 months: 1 mg (2.5 ml liquid medicine) twice daily, preferably morning and evening

Contraindications

• contra-indicated in patients who are hypersensitive to antihistamines or to any of the tablet ingredients.

Pregnancy

• There are no adequate data from the use of chlorphenamine maleate in pregnant women. The potential risk for humans is unknown. Use during the third trimester may result in reactions in the newborn or premature neonates. Not to be used during pregnancy unless considered essentially by a physician.

Lactation

• Chlorphenamine maleate and other antihistamine may inhibit lactation and may be secreted in breast milk. Not to be used during lactation unless considered essential by a physician

Side effects :

• Sedation
• drowsiness, dizziness, blurred vision and psychomotor impairment
• Nausea, dry mouth
• Disturbance in attention

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