Basal Bolus Insulin therapy

calculate total insulin need of pt 0.5U/Kg

so In pt 70kg>>>35U

Give long acting onsulin (30% ot total dose at night) 30% of 35U=12U
the remaining (23U) is divided into 3 doses of rapid acting Insulin each given
befor each meal (8U)

Any pt (specially children) present with vomitting order RBS

Any pt with CAD , HTN, Stroke -- order RBS

DRUGS
BB:
1- Carloc ( carvedilol)6.25 mg: short acting, can start with 1/2 tab *2 and then
raise it
2- concor (bisprolol) 5mg: given once aday
BB in CHF used after the patient is dry and stable on ACEI

ACEI:
1- Lisinopril (cipril 5mg or 10mg) : long acting, used once aday
2- Ramipril 5 or 10mg: """""""""""""""""""""""""""""""""""""""""""""
3- enlapril (angiotec 5 or 10mg) intermediate acting, twice aday
4- Captopril (25mg) short acting, tid, can start with 1/2 tab
5- Losartan (kansar 25 or 50 mg) : once aday
any of the above with the littre H: mains with hydrochlorothiazide 12.5 mg
HCTZ is prefferable over other duiretics in HTN ttt
while Fursmide in CHF
and Spironolactone in Liver dis

Spironolactone in liver 100 mg starting dose, while in cardiac 25 mg

CCB
1- Amlodipine 5 mg: once aday, safe in CRF or ARF, does not cause heart block

Fursmide 20 mg can be helpful in HTN crisis(see Medscape) along with captopril

ABx
Cefuroxime (zinnat 400 mg) 2d G twice aday, cover gram + and -ve, can be used in
Pneumonia
Cefpodoxime (oralux) 2nd G
cefixime (fixoral) 3rd G, poor staph coverage

Azithromycin used once aday for 3days, and then beld agood blood level, can be used
subsequently as 1/2 tab