ENT
Viral Rhinitis (Common Cold)
نزلہ زکام
Inflammation of the nasal mucosa from a viral infection. Causes of rhinitis: viral and allergic.
- ICD-10
- —
- Source
- OPD handbook pp.14–20
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Sneezing, itching in the nose
- Runny nose, nasal congestion
- First episode, usually with changing weather or exposure to cold
- Body aches, low-grade fever
Diagnosis
- Take vitals of all patients: temperature about 100 °F, pulse about 110/min
- Examine the nose: inflamed nasal mucosa, redness, discharge in the nasal cavity
- Differential diagnosis: allergic rhinitis
Treatment
Step 1 of 6
1. Fever and pain (NSAIDs)
Prescription
Paracetamol (Acetaminophen)Analgesic / antipyretic
Dose1 g TDS
Brand Panadol
Also sold as Panadol, Calpol, Febrol, Pedrol, Calpol 6 Plus (250 mg/5 mL)
Caution: Do not exceed 4 g/day in adults or 60 mg/kg/day in children; Avoid in severe liver disease
IbuprofenNSAID
Dose200–400 mg TDS
Brand Brufen
Caution: Avoid in dengue (bleeding risk); Avoid in kidney disease, peptic ulcer, late pregnancy; Take with food
Step 2 of 6
2. Decongestants
- Topical xylometazoline is preferred in allergic cases
- Pseudoephedrine combination for adults
Prescription
Xylometazoline (topical nasal decongestant)Topical decongestant
DoseTopical nasal drops
Brand Xynosine
Preferred in allergic rhinitis
Ibuprofen + PseudoephedrineNSAID + decongestant
Dose1+1+1 TDS (adult)
Brand Tab Arinac Forte 200/60 mg
Also sold as Arinac Forte, Arinac syrup
Step 3 of 6
3. Antibiotics (only if indicated)
- Indication: high-grade fever, or greenish / yellow nasal discharge
Prescription
LevofloxacinFluoroquinolone antibiotic
Dose250 mg BD (1+1)
Brand L-Cyn
Also sold as L-Cyn, Leflox, Efflox (spelling unclear in book), Levo
AzithromycinMacrolide antibiotic
Dose500 mg OD (1+0)
Brand Azitma
Also sold as Zithromax, Azomax, Azitma, Arzomic, Zyto, Genthro
Caution: QT prolongation; caution with other QT-prolonging drugs
Step 4 of 6
4. Supplements
- Multivitamin to boost immunity
Prescription
Vitamin D3 injectionSupplement
Doseas written; schedule per the Urdu note in the book (verify)
Brand Inj D3 200,000 IU
Also sold as D3 (200,000 IU), D3 200,000 IU/mL
Step 5 of 6
5. Counselling
- Wear a mask
- Use juices, fruits, joshanda (herbal decoction), tea and soup
- Drink plenty of water
- Avoid cold things and oily food
Step 6 of 6
6. Paediatric prescription pattern
- Keep the child in warm clothes, maintain cleanliness, give plenty of fluids and honey; continue mother's milk in infants
Prescription
AzithromycinMacrolide antibiotic
Dose1½ tsf once daily (child 5 y, 15 kg); 1 tsf once daily (infant about 1 y, 10 kg)
Brand Syp Genthro 100 mg/5 mL
Also sold as Zithromax, Azomax, Azitma, Arzomic, Zyto, Genthro
Caution: QT prolongation; caution with other QT-prolonging drugs
Ibuprofen + PseudoephedrineNSAID + decongestant
Dose1½ tsf TDS (child 5 y, 15 kg)
Brand Syp Arinac 100 mg/15 mg per 5 mL
Also sold as Arinac Forte, Arinac syrup
Ivy leaf extract (cough syrup)Herbal cough suppressant / expectorant
Dose1+1 morning and evening
Brand Syp Hylixia (ivy leaf)
Also sold as Prospan, Samvy, Hylixid, Coferb Plus, Hylixia
Paracetamol + ChlorpheniramineCold and fever syrup
Dose1 tsf TDS (infant about 1 y, 10 kg)
Brand Syp Temperamine 100 mg/1 mg per 5 mL
Sample prescriptions from the book (patient details removed)
- Adult, 20 y, runny nose, congestion and itching for one day, nose mucosa red, no previous history: Tab Arinac Forte 200/60 mg 1+1+1; Tab Ca-C 1000 Plus once daily in a glass of water; wear a mask; avoid cold, oily things; drink plenty of water; use tea, joshanda, yakhni; more fruit and vegetables.
- Adult, 35 y, viral rhinitis with superadded infection, T 102 °F, pulse 134, fever and runny nose for 3 days with body aches: Tab Arzomic 500 mg 1+0; Tab Arinac Forte 1+1+1; Tab Ca-C 1000 Plus daily; Tab Panadol 2 tabs stat; mask, warm drinks, plenty of water.
- Pregnant woman, 26 y, fever with sneezing and watery nasal discharge (first episode, no allergy): Tab Azitma 500 mg 1+0; Tab Panadol 500 mg 2+2+2; Tab Ca-C 1000 Plus 1+0; more fruit and vegetables; hot drinks (joshanda, tea); reassured that it settles within days.