1.

..
sasa2022

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


1)
)(Suckling Power

.
Appetite
. Activity 2)
high grade fever,,poor suckling
power,,low acivity>>>>bacterial infection

Fever
3
septicemia
..

:
...
>>> 3)1

\normal saline nasal drops

R\Lyse Nasal drops Or R\Otrivin Ped Nasal drops or
R\Salinex nasal Drops

nostril

\Herbal prerarations
R\Flu-Cease Syp
5

\
6 6

R\pyral drops or R\cetal drops or R\Abimol Drops

2drops/kg/dose
6

>>>

\Antihistamincs

Free
Bronchitis
secretions


R\fenistil drops or R\zyrtec drops

1drop/kg/day

:
Nasal Aspirator



..
) (

.
>>> 3)2

normal saline nasal drops

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

3

+Flu-cease
6 +

R\Brufen syp

6 3 8

+AntiHistamincs
>>> )3
)1
Systemic Decongestant

bronchial Ashma


secretions

21
21

:pure systemic decongestant

R\Sudophine syp


very iritable

:systemic decongestant+Antihistamincs

R\michaelon susp or R\new triaminic drops or R\rhinostop

drops

:systemic decongestant+Antihistamincs+Antipyritics
R\congestal syp(paracetamol) or R/Dolo-D syp(Ibuprofen)
or R\Vegaskin syp

systemic decongestant

Psudophedrine

 congestal
Phenyl Ephrine
R\Sine-Up

phenyl proparolamine

rhinomol ,noflu.flustop
2)
Ibuprofen>>>R\brufen syp or R\marcofen syp 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 syp or R\paramol syp

:



Rhinostop drops and Aminophyllin


1st generation

&2nd generation

sedative &non sedative
non sedative(Cetrizine sulphate)>>>R\zyrtec drops&syp Or
R\Histazine 1 Drops&syp Or R\cetrak syp

1drop/kg/24hours as single dose

drowsnes

non-sedative
1)Loratidine
R\loratidine syp Or R\loratan syp Or R/claritine syp

1.5

5

2)Ebastin
R\Evastin Syp

loratan

Allergic Rhinitis
:
. )1
)2
obstructe nose
:Violet color in mucous membrane of 3)
nose
:
\systemic Antihistamincs
nasal drops
fenistil

\Nasal Corticosteroids
severly resistant
6
oral
Candidiasis

 beclomethasone
R\beclosone nasal spray
container 22 88

R\beclo nasal spray
nostril

\Prophylactic teatment
prophylactic beclosone )1
2)
Mast Cell Stabilizes
6
3 4
sodium cromoglycate
R\Nasotal Drops

Ketotifen


Appetite)1
Sedative )2

 Allergic Systemic Corticoseroids

Rhinitis

Sinusitis

:
mucopurulent discharge 1)

prolonged cough )2
posterior nasla
discharge
in mild
attacks
sinusitis
low grade fever 3)
acute sinustis high grade


headache 4)
4




brain oedema ..aneurysm..meningitis..space ocupping
lesion
:
:Nasal Decongestant
sinusitis opening
:Systemi Antihistaminics
opening oedema
Viscid Secretions
Mucolytics

:Analgesics &Anti-inflammatory

48
secretions


:Antibiotics
58 288 Ampicillin )1

R\Ampicillin 125mg or 250 mg

Amoxicillin +clavulinic 2)
18mg/kg/dose/3 doses daily
R\curam 156 or 312 or 457 susp

R\augmentine 156 or 312 or 457 susp

R\E-moxClav 156 or 312 susp

R\Hibiotic N 230 or 460 susp

R\Megamox 228 or 457 susp

3) Cefaclor 28 mg/kg/dose/3 doses daily

R\ceclor or bacticlor 125 &250 susp

4) Cefuroxime 58 mg/kg/day

R\Zinnat 125&250 susp

resistant culture
&sensitivity mucopurulent dicharge



AIM
AIM.CLUB
1AIM.GROUP


http://elkhair.info/code_for_vb/islamrw3a_com.txt

www.elkhair.info

05-06-2012#2

Mar 2009

1,966

6

><b
Otitis Media

</b>
.
4 3
Austachian Tube narrow
,small.staright
obstruction congesion in middle ear

conflict on drum congesion

:
1)Acute suprative
2) chronic H secretory

<b>
A)Acute O.M
</b>
:

1) Hidden fever
2) febrile convulsions UTI
Tonsillitis

 Otoscope Drum congested

&bulging $may besupprative( perforated) s

mild to moderate fever
&mild to moderate pain

1) Nasal decongestant
2) Analgesics&Anti-Inflammatory
3) Systemic Decongestant oedema
austachian tube

antihistamincs
secretion austachian tube

71 48

severe pain &High

grade fever

 sinusitis

Ampicillin +salbuctam
R\unictam susp 250 2 mg/kg/dose/8 hours

48
28

Cefotrixone(1 3 th generation cephalosporins
R\Cefaxone 250& 500 &1000gm vial

 R\cefotrixone 250& 500&1gm vial

R\Rocephin 500&1000gm vial

58 mg/kg/day/as single
daily dose

2) cefuroxime
R\Zinnat 250&750&1500 vial

acute OM Antibiotic Ear Drops

R\Cipro ear drops 8

(Suppration) culture &sensitivity






healing

Drainge Drum

Chronic OM
:

Acute OM Adenoids

retracted drum
losss of cone of light
secretions
effusion behind drumtympanograme

loss of hearing

acute antibiotics &analgesics

Anti-inflammatory&nasal decongestant


1) Oral cortiosterioids prednisolone
R\predsol syp
1 mg/kg/day

2) Adenohds
R\Maxilase syp

3)

tympanograme

 6 58
6

pharyngitis&follicular Tonsillitis
:

viral
very high fever 40.5 OR 41 low grade fever
good appetite &good activity

one spot of Pus On tonsills

bacterial:
.toxic look>>Exhusted
congested tonsills with pus
:
1)Analgesics &Anti-inflammatory
2) Antibiotics
Procaine penicillin

R\Penicillin -G Sodium

4
21 4




3 4 Injection 5

Tonsilllitis

first generation cephalosporins macrolids
th cephalosporins 3
claforan

Adenoids
adenoids 1
4
nasal obstruction
suffocate
adenectomy 5
recurrence
:
Analgesics &Ant-inflammatory1)
cetal drops 3
6 brufen
declofenac
Anti-odematous 2)
R\Maxilase syp
8
8
nasla decongestant )3
resistant normal saline

 Sterile sea water R\Physiomer

spray baby 115 or gentle 135
48

Laryngitis

B Agonist tongue
depressor

croup Stridor sign

Stridor
noisy inspiratory breathing duo to partial

obstruction at level of larynx and trachea

1)Infection
Viral croup >> laryngio-tracheo
bronchitis
Acute bacterial epiglotitis &tracheiits
meningitis

2)Spasmodic Stridor(Allergiac type)a

28 4
stridor

foreign body aspiration )3

history

localized wheezing

croup
stridor

braching cough or metalic cough :

viral low grade fever

allergic cause fever

bacterial high grade fever toxicity

hoarsness of voice

 Degrees Stridor
1)Stridor only on crying or excercise
2) Stridor at rest or exaggeration but no stress
3) severly distress>>Intercostal
.sternal.suprasternal retarction
4) cyanosis and shock

:
) mild
stridor

1) corticostroid Iv Im
R\fortecortine flebocortid decadron solucortef Amp
2 cm /kg/12hour

 volatile oil2)
R\vapozol inhaler
5 188

:
hoarsness of voice

R/flonaze cap

:
severe
Stridor

 corticosteroids Iv )1
2)

2888\ 228888\2
2


R\Epinephrine Amp

3
bradycardia

intubation
tracheostomy tube

 Acute epiglottitis
&tracheiits

toxic And
septiceamic

x ray lateral view on neck tissue enlarged and

oedomatous Epiglotis &obstructed air way

Coticosteroids IV 6
Adranalinr Nebulizer 4
heart rate

Amoxcillin&Ampicillin in adose of 300mg/kg/day

Zinnat Iv In Dose of 150 mg/kg/day
Cecefotrixone in dose 100 mg/kg /day

spasm of larynx

 O2 demand B Agonist
stridor

wheezy chest stridor
Stridor Adrenaline Nebulizer

05-06-2012#3

Mar 2009

1,966

6

Cough Preparations


:Herbal Productions
Mucolytic &Expectorant)1
Mild Effect
:
R\Fourmex syp

Or R\Fast syp

Moderate Effect
:
R\Broncare syp
Or R\cough Aid syp

:
R\Broncho Syp

) (


2) Cough Suppresent
mild
:
R\Coughseed ped&Inf Supp
Or R\Herba cough syp

01 mg/kg/day
:Chemical Production
1) Bronchodilators
spasm
:
salbutamol :
R\Salbutamol
R\Ventolin syp
R\salbovent syp

 Terbutaline Sulphate :
R\Bricanyl syp
R\Aironyl syp

expectorant :
R\Ventolin Expectorant syp
R\Bronchovent syp

Expectorant Mucolytic :
R\All-Vent syp

 (

)
R\ospect syp

Cough Suppressent)2
: central
R\Codaphen N syp

: mm
R\Selgon Inf supp&Drops&Tab




trisolvin&Farcosolvin &mucophyllin :

accurate dose&toxic dose
iiritability&involuntry movement&convulsios
mg/kg/day 3
51
011

mg/3kg 0
mg/6kg 0


toplexil&bronchophan




cough suppressent&expectroant

Bronchitis
:
fever,cough.vomiting related to cough duo to viscid
mucous
running
nose&mucupurulen discharge
:
harsh vesicular sound
sibilant sonorous ronchi
secretions coarse crepitations
:
secretons
productive cough secretions
fast mucolytic &expectorant )1

 spasm bronchodilator )2

salbutamol

nasal obstruction )3
nasal drops
)4

Athmatic
spasm

 Simple bronchitis
wheezy Bronchitis
upper hand sibilant ronchi



self limited 91



poor suckling appetite&activtity
:
mg/kg/dose amoxcillin& clavulinic acid 01

mg/kg/dose ceclor susp 01

th generation cephalosporins 3

:


cough seed

bronchiolitis

:
Respiratory sensitial virus

bronchioles oedema interstitial pneomonia
spasm

6

respiratory distress &running nose&loe grade fever&grunting
&tachypnea&wheezy chest
may no air entry
th attack asthma 3 bronchiolitis
.. (

Asthma term bronchiolitis
below 1 year


oxygen
ORS rehydration
B Agonist
b recepor


R/ventolin evohaler
Asthma

percussion physiotherapy &suction secretions

 flaring of infection corticosteroids

severly distress
hydrocortisone

inhaled corticosteroids
R/Beclo spray

bronchitis&fever

Bronchial Asthma
.

mild
&Moderate&Severe&status
asthmaticus

severly distress
wheezy
Asthma
asthma .


sibilant ronchi

 air entry
silent
asthma.
grades of respiratory
distress:
1. tachypnea &working alae nasi
2. intercostal&subcostal retraction
3. expiratory grunting
4. central cyanosis &disturbed
conciousness

Bronchdilators

inhaled nebulizer
vapour water machine

(
oxygen
water
vapour
)
salbutamol
:

Beta 2 Receptors are not well developed below age of 18 month.so the
therapetic use of beta2 agonist is minimal

beta 2 agonist
salbutamol



R/Atrovent ped nebulizing solution
kg 5/1.0


R/Farcolin nebulizing solution
kg 01/1.3

(
0 0
)0
farcolin atrovent

003 0 3
.

. 3 distress

parentral
corticosteriods
0 01

:
R/dexamethasone amp

R/solucortef amp

:
6 1. farcolin nebulizer

2. cortecosteroids either dexa or
solucortef Iv/6hours
3. antibiotics
nosocomial infection
4. Oxygen
6 8
. 00
corticosteroids.

infection

beta 2 inhaler 1.
agonist
:
R\Ventolin inhaler(Evohaler) OR

 Air Holding Chamber

. 3
.

.

6 8

6 4 4 8 4 4
00 4
04 beta 2 agonist
adaptation 04 beta recepors
response
ventolin ventolin
:
R/Combivent Inhaler

 beta 2 agonist ibatrobium bromide

smooth muscle relaxation
00
2) beta 2 agonst inhaler
Corticosteriod Inhaler
R/beclosone inhaler

R/Flixotide inhaler

Prophylaxis treatment

Inhaled
corticosteroids 00

oral candidiassis
.
must cell stabilizers Sodium
cromoglycate R/Intal
Inhaler&nebulizer
Anti-histamincs R/claritine syp
R/Evastin syp

Role Of Systemic Corticosteroids

: asthma
R/predsol syp
mg/kg/day/8 hours 0
5 7

R/Dexamethasone Amp
3 mg/10kg 0

Excercise Indused Asthma

4
air holding chamber beta 2 agonist

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

aminophyllin ingection


5

distant between therapeutic dose&toxic dose
is very narrow
no avaliability to control dose by blood level
mg/kg/day 3


4
peak

Peak
tuff 4

tuff

4 6 8

status Asthmaticus

theophylline continous iv drip
mg/kg/1hour 0

 01 511 51

511 51
01 01

511 01 01
011 511 01