Name: Thulasi Muniappan

NIM: 0702005190
Class: B

Case I. Allergic Rhinitis

1) I chose to prescribe second-generation anti histamine, eg: Loratadine 10mg PO 1
tablet/day to this patient because second-genaration drugs are less sedative although they are
more expensive. Plus, loratadine has longer half-life in the body and requires only single dose
per day to achieve the therapeutic concentration. The drug can be consumed before or after
meal and should be taken by patient for 5 days.
2) First-generation antihistamine is a receptor antagonist that acts on smooth muscle and
blocks the autonomic receptors. In addition, it also penetrates blood brain barrier more
readily (compared to second-genaration AH1), thus causing more sedative effect. Example is
chlorpheniramine maleate. On the other hand, the second-generation AH1 has less sedative
effect but it is expensive. As for intranasal corticosteroid, it is unnecessary to if secondgeneration AH1 can relieve the symptoms. Immunotherapy is a treatment of disease by
inducing, enhancing or suppressing an immune response but we cannot perform this kind of
therapy if the allergen is unknown.
3) Herbal medicine such as Echinacea purpurea which can enhance our immune system and
prevent cold can be given.

Case II. Infection

1) The initial antibiotic therapy is erythromycin 500mg PO 2x/day or doxycycline 100mg PO
2x/day for 10 days. This therapy is maintained while waiting for the bacterial cultural result.
If there is any evidence of drug resistance streptococcus pneumonia (DRSP), then the
regimen should be converted to levofloxacin 500mg/d PO or amoxicillin 1000mg 3x/day.
Otherwise, the previous regimen is maintained. Paracetamol 500mg 3x/day can be given to
reduce fever and malaise.

2) Amoxicillin and erithromycin