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sasa2022

Common Cold
Running Nose ,Sneezing ,obstructed nose ,mild Fever, Rhinorrhea :

(Suckling Power)


.
Appetite
Activity . high grade fever, poor suckling power, low
activity>>>>bacterial infection
Fever 3 septicemia
..
: ...
3:
normal saline nasal drops :
R\Lyse Nasal drops Or R\Otrivin Ped Nasal drops or R\Salinex nasal Drops
nostril
Herbal preparations :
R\Flu-Cease Syrup
5
\ : 6 6

R\Pyral drops or R\Cetal drops or R\Abimol Drops
2drops/kg/dose 6

antihistaminic : Free Bronchitis
secretions
R\fenistil drops or R\Zyrtec drops
1drop/kg/day
: Nasal Aspirator
( ..
) .

 3
normal saline nasal drops
nasal decongestant
R\Afrin nasal drops R\ Iliadin nasal drops or R\Oxymet Nasal drops
7- 5 3 21
3 chemical irritation

+Flu-cease
6 +
R\Brufen syrup
8 3 6
+Antihistaminic

bronchial Asthma Systemic Decongestant

21 secretions
21
pure systemic decongestant :
R\Sudophine syrup

very irritable
systemic decongestant + antihistaminic :
R\michaelon Susp or R\New Triaminic drops or R\Rhinostop drops
systemic decongestant + Antihistaminic + Antipyretics :
R\congestal syrup(paracetamol) or R/Dolo-D syrup(Ibuprofen) or R\Vegaskine syrup
Pseudoephedrine systemic decongestant
Sine-Up Phenyl Ephrine congestal
phenylpropanolamine
rhinomol ,Noflu. Flustop

Ibuprofen>>>R\Brufen syrup or R\Marcofen syrup or R\Marcofen 100 or300 Supp
1
Declofenac>>>R\dolphin 12.5 or 25 Supp or R\Baby relief 12.5 or 25 supp
Paracetamol>>>R\paracetamol syrup or R\paramol syrup

 :
Rhinostop drops and Aminophylline

1st generation
&2nd generation sedative &non sedative
& Non sedative(Cetrizine sulpha)>>>R\Zyrtec drops & syrup Or R\Histazine 1 Drops
Syrup Or R\Cetrak syrup
1drop/kg/24hours as single dose
drowsiness
non-sedative
1)Loratadine
R\loratadine syrup Or R\Loratan syrup Or R/Claritine syrup

1.5
5
2)Ebastine
R\Evastin Syrup
Loratan

Allergic Rhinitis
:
)2 .
)1
obstructed nose
)3 Violet color in mucous membrane of nose
:
systemic Antihistaminic
nasal drops
fenistil
>- Nasal Corticosteroids severely resistant
6
oral Candidiasis
Beclomethasone
R\Beclosone nasal spray
22 88 container
R\Beclo nasal spray
nostril

Prophylactic treatment :
)2 Beclosoneprophylactic
)1 Mast Cell Stabilizes
6 3 4
Sodium Cromoglycate
R\Nasotal Drops
Ketotifen

)2Appetite
)1 Sedative
: Systemic Corticosteroids Allergic Rhinitis

Sinusitis

:
)2 mucopurulent discharge
)1 prolonged cough
posterior nasal discharge mild in attacks
sinusitis
)3 fever low grade high grade acute sinusitis

)4 headache 4

:

brain oedema ..aneurysm, meningitis, space occupying lesion
:
Nasal Decongestant opening sinusitis
Systemic Antihistaminic oedema opening
Viscid Secretions Mucolytic
Analgesics &Anti-inflammatory
48
secretions

Antibiotics
288 58 Ampicillin ) 2
R\Ampicillin 125mg or 250 mg
mg/kg/dose/3 doses daily18 Amoxicillin +clavulinic ) 1
R\Curam 156 or 312 or 457 Susp
R\Augmentin 156 or 312 or 457 Susp
R\E-Mox Clav 156 or 312 Susp
R\Hibiotic N 230 or 460 Susp
R\Megamox 228 or 457 Susp
mg/kg/dose/3 doses daily28 Cefaclor ) 3
R\Ceclor or Bacticlor 125 &250 Susp
mg/kg/day 58 Cefuroxime ) 4
R\Zinnat 125&250 Susp
mucopurulent culture &sensitivity resistant
discharge

Otitis Media
.
4 3
narrow ,small, straight Eustachian Tube
congestionconflict on drum congestion in middle ear obstruction
:
suppurative Acute )2
secretorychronic H )1

A) Acute O.M
:
Hidden fever ) 2
Tonsillitis UTI febrile convulsions ) 1
congested &bulging $may be suppurative( Drum Otoscope
perforated) s
:

mild to moderate fever
&mild to moderate pain

Nasal decongestant) 2
Analgesics & Anti-Inflammatory )1
Eustachian tube oedema Systemic Decongestant ) 3
antihistaminic
Eustachian tube secretion
71 48
severe pain &High grade fever
sinusitis ......
Ampicillin +sulbactam
mg/kg/dose/8 hours 2 R\Unictam Susp 250
28 48

the generation cephalosporins 3 Ceftriaxone )2
R\Cefaxone 250& 500 &1000gm vial
R\ceftriaxone 250& 500&1gm vial
R\Rocephin 500&1000gm vial
mg/kg/day/as single daily dose 58
cefuroxime ) 1
R\Zinnat 250&750&1500 vial
Antibiotic Ear Drops acute OM
8 R\Cipro ear drops
culture &sensitivity ( Suppuration)
:
healing
Drainage Drum

Chronic OM
:
Acute OM Adenoids
loss of cone of light retracted drum
effusion behind Tympanogram secretions
drum
loss of hearing
:
antibiotics &analgesics Anti-inflammatory nasal acute
decongestant


)2 Oral corticosteroidsprednisolone
R\Predsol syrup mg/kg/day1
)1 Adenoids
R\Maxilase syrup
)3
Tympanogram 58 6
6

Pharyngitis & follicular Tonsillitis

:

very high fever 40.5 OR 41 viral low grade fever
good appetite &good activity
one spot of Pus On tonsils
.toxic look>>Exhausted bacterial
congested tonsils with pus
:
Analgesics &Anti-inflammatory )2
)2 Antibiotics
Procaine penicillin
R\Penicillin -G Sodium
4 4 21
:

Injection 3 4 5


Tonsillitis
macrolides first generation cephalosporins
3th cephalosporins Claforan

Adenoids
adenoids 1 4
nasal obstruction suffocate
Adenoidectomy 5 recurrence

:
Analgesics &Ant-inflammatory) 2
Cetal drops 3
Brufen 6
Declofenac
Anti-edematous ) 1
R\Maxilase syrup
8
8
nasal decongestant) 3
normal saline resistant
R\Physiomer spray baby 115 or gentle 135 Sterile sea water
48

Laryngitis

tongue depressor B Agonist

sign Stridor croup
noisy inspiratory breathing duo to partial obstruction at level of larynx and Stridor
trachea
:
Infection )2
Viral croup >> laryngio-tracheo bronchitis
meningitis Acute bacterial epiglottitis &tracheitis

Spasmodic Stridor(Allergic type) )1
stridor 4 28
foreign body aspiration ) 3
history
localized wheezing
stridor croup
branching cough or metallic cough :

viral low grade fever

allergic cause fever

bacterial high grade fever toxicity
hoarseness of voice
Stridor Degrees
Stridor only on crying or exercise )2
Stridor at rest or exaggeration but no stress ) 2
severely distress>>Intercostal .sternal, suprasternal retraction ) 3
cyanosis and shock ) 4
:
stridor mild :
I.M corticosteroid Iv ) 2
R\Fortecortin Flebocortid decadron Solu-Cortef Amp
cm /kg/12hour2
volatile oil ) 1
R\Vapozol inhaler
188 5
hoarseness of voice :
R/Flonaze cap
Stridor severe :
corticosteroids Iv) 2
)1
2 28888\2 2888\ 2

bradycardia 3 R\Epinephrine Amp

tracheostomy tube intubation
Acute epiglottitis &tracheitis :
toxic And septicemic

enlarged and edematous Epiglottis x ray lateral view on neck tissue
&obstructed air way

6 Corticosteroids IV
heart rate 4 Adrenalin Nebulizer
:
Amoxcillin & Ampicillin in a dose of 300mg/kg/day

Zinnat Iv In Dose of 150 mg/kg/day

ceftriaxone in dose 100 mg/kg /day
: spasm of larynx

B Agonist O2 demand stridor

stridorwheezy chest
Adrenaline Nebulizer Stridor

Cough Preparations


Herbal Productions
Mucolytic &Expectorant )2
Mild Effect :
R\Four mix syrup
Or R\Fast syrup
Moderate Effect :
R\Broncare syrup
Or R\cough Aid syrup
:
R\Broncho Syrup
: ( )


Cough Suppressant )1
mild :
R\Cough seed pediatric & Infa Supp
Or R\Herba cough syrup
mg/kg/day28
:Chemical Production
Bronchodilators )2
spasm
:

 salbutamol :
R\Salbutamol
R\Ventolin syrup
R\Salbovent syrup
Terbutaline :
R\Bricanyl syrup
R\Aironyl syrup


expectorant:
R\Ventolin Expectorant syrup
R\Bronchovent syrup

Expectorant Mucolytic:
R\All-Vent syrup
)
(
R\osipect syrup
Cough Suppressant )1
central:
R\Codaphen N syrup
mm:
R\Selgon Infa supp & Drops & Tab


:Trisolvin & Farcosolvin &mucophylline
accurate dose & toxic dose
irritability & involuntary movement &
convulsions
mg/kg/day3
58
288

mg/3kg 2

 mg/6kg 2


Toplexil & Bronchophane


cough suppressant & expectorant

Bronchitis
:
fever, cough .vomiting related to cough duo to viscid mucous
running nose & mucopurulent discharge
:
harsh vesicular sound
sonorous rhonchi sibilant
coarse crepitation secretions
:
secretions
secretionsproductive cough
)2 mucolytic &expectorant fast
)1 bronchodilator spasm
salbutamol
)3 nasal obstructionnasal drops
)4
Asthmatic spasm

Simple bronchitis
wheezy Bronchitis
sibilant rhonchi upper hand



98 self limited
:

appetite & activity poor suckling

:
Amoxcillin& clavulinic acid mg/kg/dose18
Ceclor Susp mg/kg/dose28
generation cephalosporins 3



...............

:
cough seed

Bronchiolitis
Respiratory syncytial virus :

interstitial pneumonia oedema bronchioles spasm

6

respiratory distress &running nose & low grade fever & grunting &tachypnea & wheezy
chest
may no air entry
bronchiolitis asthma the attack3
..
bronchiolitis term
Asthma below 1 year


oxygen
rehydration ORS
B Agonist
b receptor

R/ventolin inhaler
Asthma
secretions percussion physiotherapy &suction

 corticosteroids flaring of infection

severely distress hydrocortisone
inhaled corticosteroids
R/Beclo spray
bronchitis & fever

Bronchial Asthma
.
mild & Moderate & Severe & status asthmaticus
severely distress wheezy
Asthma asthma .
sibilant rhonchi
air entry silent asthma.
grades of respiratory distress:
.2
.1
.3
.4

tachypnea &working ale nasi

intercostal & subcostal retraction
expiratory grunting
central cyanosis &disturbed consciousness

Bronchodilators inhaled nebulizer
machine water vapor
( oxygen watervapor
(
salbutamol
:
Beta 2 Receptors are not well developed below age of 18 month.so the therapeutic use
of beta2 agonist is minimal
beta 2 agonist salbutamol



R/Atrovent Ped nebulizing solution
kg 5/8.1


R/Farcolin nebulizing solution
kg 28/8.3
(
2 2
2 )
atrovent farcolin
213 1 3
.
distress
3 .
parenteral corticosteroids
2 28
:
R/dexamethasone amp
R/Solu-Cortef amp


:
.2
.1
.3
.4

farcolin nebulizer 6
corticosteroids either Dexa or Solu-Cortef Iv/6hours
antibiotics nosocomial infection
Oxygen

6 8
21 .
corticosteroids.
infection

inhaler beta 2 agonist

:
R\Ventolin inhaler(inhaler) OR
Air Holding Chamber





3.
.
.

6 8

4 6 4 4 8 4 21 4

beta 2 agonist 24
beta receptors 24 adaptation response

ventolin ventolin :
R/Combivent Inhaler beta 2 agonist ipratropium
bromide smooth muscle relaxation 21
)1 beta 2 agonist inhaler
Corticosteroid Inhaler
R/Beclosone inhaler
R/Flixotide inhaler
6

Prophylaxis treatment

Inhaled corticosteroids 21 oral

candidiasis .
must cell stabilizers Sodium Cromoglycate & R/Intal Inhaler
nebulizer
Anti-histaminic R/Claritine syrup R/Evastin syrup

Role Of Systemic Corticosteroids

asthma :
R/Predsol syrup )1 2mg/kg/day/8 hours
5 7

R/Dexamethasone Amp )2 1mg/10kg 3

Exercise Induced Asthma

4 beta 2 agonist
air holding chamber

)2
95 6
5 asthmatic patient
)1
ON&OFF
prophylaxis .

aminophylline injection

5
distant
between therapeutic dose & toxic dose is very narrow
no availability to control dose by blood level
mg/kg/day3


4 peak

Peak
4 tuff
tuff

4 6 8

status Asthmaticus

theophylline continuous iv drip
mg/kg/1hour 2
28 588 58
588 58
28 28
588 28 28 288
588 28