aes SUMMARYReference values sei non hematology values ne 13-1 ‘omen: 11 Mean cell volume MCV | 76-968 Platelets i A White cells (total) Neutrophils Lymphocytes: Eosinophils pH. ava 7.35-7.45 Pan | >10.6kPa (75-100mmH9) ce = 47-6kPa (35-45 mmHg) "Base excess | £2mmol/L wets (urea and electrolytes) 135145mmol a 3.5-5mmol/L Creatinine ud 70-150umol/L Urea _ 25-6.7mmol/L eGFR >90 Bilirubin 3-17mol/L ALT 5-35iU/L AST 5-35/U/L Alkaline phosphatase (AP) 20-15 01U/L Albumin 30- Troponin T ua/L Greatinekinase | 25-1951 Lactate dehydrogenase, LDH | 70-250iU/L Cholesterol | <5mmov/L Triglycerides 0.5-1.9mmol/L Amylase 0-180 Somorgyil/dl _Eteactiveprotein, CRP | < 10mg Calcium (total) 2.12-2.65mmol/L Glucose, fasting 70- Prostate specific antigen, PSA | O-4ng/mi TA (total thyroxine) | 70-14 mol/L TSH nn EEDermatolo ES 4. Acne vulgaris A. Comedons: # Topical retinoic acid [causes severe irritation] R/Retin A cream sah Je J os 3 Ly call sake Lies as active lesions Ji je edeh, oe ne Spe Sak algal iy Sick tal 2. R/Primomycin cap ua tal, I 4 py JIG mild gS) slit al moderate 3k 3) 42 tal severe 3S g) Ghats yy Bab 3, R/Clindam 150, 300 (Clindamycin) » Sate in pregnancy + The best » Severe gastric imitation « Bloody diarrhea 4. R/Zithrocin [Azithromycin 500mg.) petal TF Sab Fpl ob ell T Gal od = Response: @ If good — ped pal (olgall O33 F pp om # Ifno response — sah S~ ees See ~ Abant j ab Ab jes ©Spreatment Summary [Page 2 2. Acne rosacea R 100 (or R/Vibramycin) | + R/Doxy~' cap. 1x2 + R/Rosagel |x: aglul A sal eles e 2 (Metronidazole) else gle> 3. Atopic dermatitis 1. R/Calminol lotion 1x2 2. + R/Betaderm cream or Dermovate cream 1x2 3 bee Y Jus! 3. + R/Apidone Syp. (if severe) 0.5- Img,/kg/day (if child + severe), 4.+ R/Allerban-SR 1x1 (long acting mast cell stabilizer) Or R/Zatidine or Ketoti 1x2 (short acting mast cell stabilizer) eg. 5. R/Diprosalic or Salibet cr. o> ¢ GB o sal BL ole 5 ad! ee pe de pp dele Bal orl Je 6. Systemic steroid injection (if severe) R/Epidrone Amp. @ (Short acting) Or R/Kenacort vial (long acting steroid) 7. Bandage on topical steroids 8. R/Fucicort 1x2 (if 2ry bacterial infection) paw *R/AI Cream 1x2 or R/Calminol lotion 1x2 + R/Fucicort 1x2 + R/Lorano 1x1 or Fenistil 1x1 or Anallarge or R/Zyrtec 1x1 - RWNizoral Shampoo Ba8 Aas) Gall Syb Legenl ose gual dat ntl Junky F dele Ys Bak Sey oll + R/Daktacort Cream 1x2 (4, attack) ns | _——_—_——__________ 6. Neuro-dermatitis *R/AI Cream bles alas + R/Betaderm Cream |,Lce alas + R/Atarax 1x1 clad ua ley 2 + R/Kenacort vial 3. jae as 7. Drug Eruption + Stop the drug + R/Betaderm 1x2 + R/Lorano 1x1 * R/Kenacort vial ) Sc ¥5 34\ Jc is 8. Urticaria + R/Betaderm 1x2 + R/Lorano Or R/Allerban SR 1x1 + R/Dexa Amp. (for acute urticaria) + R/Kenacort Vial (for chronic urti- caria) for 3 weeks + R/Zantac 150 1x2 (for acute urti- caria) 9. Scabies + R/Scabine cream ¢ Or R/Sulpher (5%, 2.5%) cream (if scabine is Cl) * Or R/Ectomethrine 5%, 10% (if scabine is CI) er lg ENG a aweu= cone hepa OO Pa a) sale Bb ple -%° oon) ate ; ; erbiasrs es A SS, et it J DO As. verze r eae TVs B elsiT + R/Kapritage Soap or Scabinol Soap « R/Fenistil or Lorano 1x1 U3 Saye aul oF ter on at 1. K> permenganate 1/1000 solu- tion Only for wet lesion, not dry dberl acl 7, te 1 2. R/Fusiderm gel or R/Fuci cream 1xZ 3. Systemic Antibiotic: R/Lincosin 300mg, 600mg. vials R/Tbhidroxil 1x2:syrup 125-250 tab 250, 500 1gm. 4. Betadine shampoo _-i) Ly lc Ryeefotax 1 san a Cefotax 1gm vial 11 4 J a © pdt sal el Bal Or R/Augmentin tab. 1gm 3 pe EL EL AY Furs 2. Systemic ttt for pediculosis 5. Systemic Ab. Long term penicillin R/Penadur vial 1,200 an 42 5 ie Soe a ist + Treatment of tinea pedis R/Batrfen nail solution _—. 1. R/Prioderm Lotion or Licid Lotion or spray gir dal eld © hs gh FT 85)gBS* wy fest Se ED Deel ypu iene Se ie Fal yl) (Oe ae (lsh wes) R/Iverzine tab cote gt SL AU Eel sit » R/Griseofulvin Syrup: <2yrs. Sem lag os 2-4 yrs, S cm ley Sir > dyrs. 10cm lay Ole Tab: 1 tab = 125mg. se: | tab/l0kg. for 4 wee! (not > 6 tab/day) is *R/Tineacure Lo sles * R/Epiderm amp. te BL Spel1.Ab : (1™ week) R/Lincosin 300 mg vial ae X81 6 fee Se 2.Systemic Steroid R/Epidrone Amp. . cuit zal Le» hee Se fy 3.Antifungal (As above) | A.V dep Jeane Qe ae ‘* Terbinafine is Cl as itis not secreted in sweat 1. R/Kizol tab i, b— 23 phi vs aa slat » Prophylactic ttt 3 tab/day. dsheat (all og Dh) at a NT » Hepatotoxic, Clin pregnancy Or ners ee ; ST ge pl Ve ae oS ae) Y hes Jie ae 2. Topical treatment A.R/SuperS cream j\=> RLalt SUG Je Wins belo + R/Nizapex shampoo sla aLall {SL Je pane fy eb) ee ae lt ee we, aah pel tok Ley Holy ip teal Site ee eae fol NG eet sy aL oe . Hea So) Or B.R/Ticon cream R/Justin Blue Shampoo - RySelsun blue sham) Nach oe é A.Topical: R/Dermatin nail solution 1x2 - R/Batrafen solution 1x2 R/Dermatin cream 1x2 B.Systemic (if extensive). R/Flucoral for 2 ths: cade dal be & as * R/Flucoral cap Lh -£ aak ppl ye . R/Dermatin cream pe tal Goline, ele clas + R/Super S cream |, +L» als = Broad spectrum anti-fungal A. R/Flucoral or ca) ell taal ay 5 s AF (moderate) a) ¥ 5 (mild) (sever phan B. R/Lamifen or Lamis! mig tab . Naat 41250 bee et c= + 2xIx7— then pLlt ae + Sy 2 Pulses => in finger nail = 3 Pulses — in toe nail R/Tryosed nail solution De UY JB EB igtila ue beng lew 4. R/Batrafen solution 1 bottle R/Diprosalic solution 3mi. R/Liposomal base or Or R/Tryosed nail solution Vole lee 2. If na CI for systemic fluconazole R/Flucoral cap 150 mgBS aa Jaeme cap au n SR cay ve eluall s 2 R/Tonoscalpin - R/Pantex lo- jon - R/Alopanthin lotion i a2 Jet Naa 9 35) Sas pe taely 3. R/Hairplex oll - RuRDetaee oil - R/ Complete hair oil 4,R/Luna shampoo hee ce - pti R/Liza shampoo & balsma - R/Prote care shampoo = R/Corpal HP shampoo jipotency vita zinc Stee sly ; . a aysv 1. R/Rosercinal 2% i lotion soy ese z R/Calamina lotion W.. Rally tp as . WAnallarge spl bad nkce a 4. VitC; Rae RiCevitil cff. 20 je 3 3 Boel bye sla ‘Or R/Cevilin Drops Jab 4 drops 3 times daily Or R/Vitacid-C eff tab. 1x1 1. Plane warts (smal! in the face) = Electrocautry Tl Se * Topical retinoic acid (Acnetin A) Wiles plas + RvSali Hic acid 10% oint. _ > 2. Plantar warts (Painful) + Cryocamiry plits le Cll Je asl S- es J! + Chemical: 1 R/Collomak sol. (pble| an bats La) Jo ely ble alae 5 Ly pe Fe tall AEN a ca SMe aL) 3 glaall Or R/Sansolua solution + R/Aluminum chloride 20% aS; in absolute alcohol Cream 1x2 REREGESR 4c _ page aes Pept || ote OEE ae meee sede ge s| wailed len peepee For septic foci (hag She Ot ge ; Ja 9 4 = cal: Sympathectomy ROARS De oat 4 Cream taxin injection (good pea eT result but expensive) Fh lela ie oeLe pS abl - SII et ee R/Shad it cream. = ek Py 9 as US ole? + R/Focus cream 1. Amoebiasis & Giardiasi R/Flagyl 250 mg. susp. 1x3x10 2. Ascaris & Ankylstoma & Oxyuris R/Antiver (tab & syp) R/Fluvermal 1x2x36,—\ 2» 1S» Or R/Bendax (tab & syp) , cregl an Se F ely Be He 8 ol otale ee R/A1 cream 1x2 (emollient) R/Micort cream 1x2 (mild topical steroid) R/Avit cap py 8 ex A pu (vit A) We jeall B Baely be Ghy Game 4b U2 cute Sle cp the k we git pad (had 9 os | Ast Gas, GUY, iy e5 systemic steroid AL 3 SER, Ul (Ad! 2352) ala y gball Foe © R/Glycerol soap ob el ate R/Atoderm cream(4-e ¢>1) Veloney elie Uns _ R/Diflucan cap. pli \+ ab bey J R/Ezaflu mw ley O\je¥ danae R/Daktarin oral gel 1x3 ° R/Carbamid cream SHAN OS ele oles e R/ Heal Foot oint. 2. R/Dermacure cream R/Reti cream 1x2 ana R/Octazinc cap TX] jog sah oy, iS Reassure the patient that the con- dition is self limiting. 2.Abs are not usually recommended, but if 2ry bacterial infection Give R/ Augmentin 625 1x3 g sal Sls 28 Or R/Ceporex 500 tab Gor sah dol WY SK 8 3. Analgesic Give paracetamol R/Cetal syrup Sel Sy R/Panadol els) Ks 4. For Cough e For dry cough give: R/Codaphen syp. lw» lr Or R/Cough rest syp. 1x3 For productive cough give: R/Toplexil syp. Or ale R/Ultrasolv syp. Wee Ol 5. Steam inhalation se! Fi R/Bradoral +p o\-0 D7 Or R/Strepsils 1x3 FS Sly Y taleeee ey zs 1 or topical decongestant 1. Ofucongestal tab or syp. 1x3 Otrivin ND OT ag ly ¥ tos JS oelis Or both eTopical decongestants should not be used over 3 days to avoid rebound congestion. 2. Antipyretic o R/Cetal syp. 1x4 or R/Brufen syp. 1x3 o Warm saline gargle ¢3\o bis 3. Advice: 2S ele G2 - ie\, [# Pneumonia For home treatment: Trade name hi Yak tab. 1x2x3 - R/Ceftriaxone 1gm els VV / oy 5 of uae de « Then R/Megamox 1gm Treatment Summary [Page 7 > Gh 3. Chronic cough if Give 2 weeks of amoxicillin or penicillin combination R/E-mox 1x3x14 or R/Augmentin 625 tab eel sal lL A Gog 2. If no response give 2 weeks of PPI e.g. Lansoprazole 15mg Od (once daily) R/Lansoprazole (15 mg) \slou sso, 4! 3. If failed give 2 weeks of inhaled Beclometasone 400 micrograms BD (twice daily) R/Clenil forte (Beclometasone 250 meg) log. oS ose 4. If this fails: refer Waar + R/Cefotax 1gm 1x2x3 + Then R/Augmentin gm t. 1x2x3 __needed ated. o id] e Treat for 7 days at least e Consider referral if moderate or severe ¢ Review with 48 hours: Re-assess clinical state: if deteriorating or not improving consider CXR. © Refer if atypical or MRSA sus- pected + R/Klacid 500 t. 1x2 ~« R/Panadol 2x4 or R/ _ Perfalgan 500mg ivi as « R/Solucortef iv 1x3 if asthma or COPD associ- Icystiene sa- (causes gastritis) 3 ees 1x3 ¢ R/Klarimix 500 t. 1x2 ¢ R/Sigmacortin 500mg ) 2: Je © de Je 6°) dens ee ate g de ¢ Or R/Dexa amp 1x2 ~ R/Ambroxol syp. 1x3 * Or R/Mucosol syp. 1x3 ; e Refer if not responding to treat- ment. ¢ Failure of pyrexia to respond within 48 We or developing of systemic features — Admit ¢ Other medications that may be needed: 3 © O; (guided by pulse oximeter or ABO) iiiexix.Advice to the patient © Do not smoke o Rest at home o Drink plenty of fluids R/Miflonide cap 1x2 ys R/Ventolin inhaler ¢,;U\ we ie R/Clear air 10mg \eLoe 4 aclu Ley Go,8 SB, geal, G59) and ll deeb Ny Arley R/Tavacin 500 t. 1x1x5 or 1x1x10 R/Acetylecystiene sachets 1x3 R/Foradil cap. 1x2 scl V/ Lait iS R/Miflonide cap.1x2icL. \¥/Lait S| R/Expectyle syp. 1x3 1. Manage the underlying dse if detected. 2. Treat distressing haemoptysis by diazepam (Neuril) 3. Give: R/Dycinon amp. 255 4> R/Cyclokapron amp. gee Sole Yes Ge Syne R/Konakion 4, Jsi 4. Refer for bronchoscopy if diag- nosis is uncertain. 5. Cough suppressant (R/Cough cut 1x3), avoid mucolytics and expectorants. | ‘ural toilet. 5. TMJ [ + R/Megamox 625 t. 1x3x7 R/Brufen 400 t 1x3 (69) a2 2. Wax: R/Ceruminex N 2x2x3 3. Perforated ear drum: R/E-mox 500 1x3x5. 4, Frunculosis: R/Flumox 500 cap. 1x4x7 5. dysfunction — * R/Olfen gel 1x3x3. + Stabilize the joint 6. Blocked nose R/Otrivin ND 1x3x4 (don’t use for more than 4 days as it causes re- bound congestion) 7. Hay fever & allergic rhinitis: + R/Clarinase 1x3 + R/Ventolin inhaler. ¢3!\ se + R/Beclo spray 2 sprays/Nostril x2 Or R/Avamys nasal spary (£+ 44) very powerful + R/kenacort vial 5% ¥ 5 g¥\ jaar ti ‘throat _ Viral: R/Brufen 400 1x3 R/H20, mw 1x3 = R/Bradoral t. 1x3 Gyer| Lal al Bacterial: R/Megamox 625 1x3x7 R/H202 mw 1x3 R/Brufen 400 1x3 Follicular tonsillitis: R/Ceftriaxone 1gm vial 1x2x3 Then R/Megamox 625 1x3x4 R/Brufen 400 1x3 R/H,0, mw 1x3 » R/Bradoral t. 1x3 Gee! Vell R/Augmentin |gm/12 hrs x5 days R/Flagy! (500+250) 1x3R/Oraldene mw 1x3 Or pa stele mw 1x3 ‘Aural toilet R/Otal EDs 1x3 or R/Tobradex ED R/Augmentin 625 1x3x7 R/Brufen 400 1x3 Bed rest. e Decongestant R/Otrivin ND 1x3x4. « Analgesia: R/Brufen 400 1x3 §9\ 1. e Abs iQuenparmetsty 625 1x3x7 e Squeeze the n nose below the bony part for 10-15 minutes. « If bleeding does not stop, pack the nose with adrenaline soaked gauze or v.c (Otrivin) + local anesthetic (2% topical lidocaine). « If the bleeding persists pack (Ant.) with vaseline gauze. SUN RETE tole gy SM JS log Sle TG 348 dale + R/Rantidol 150\.L.0, Llc 69 N35 23 SMES Tee JS bog le aS tile cad 150 log Slo Y SV IS G23] © R/Omez 20 \elue nS ° Full rioee PPI R/Peptazole 30 1x2x7 een Glcas ea ace -mox 1gm 1x2x7 rymetl Bah dele VY Sa) pS Ey lacid 500 1x2x7 fori sah dele VY JS Uo8 ae Or R/Peptazole 30 1x2x7 SEP Glace aly + R/Flagyl 500 1x2x7 real Bak dol VY OS ate lacid 250 1x2x7 ve uF 1. Antacids e.g. R/Mucogel 1x3 2. H: Blockers e.g. R/Zantac or Rantac 150,300 or Famotak 20, 40 1x1 or 1x2 3. PPI Omeprazole e.g. R/Omepak 20, omez 10 1x1 Lansoprazole e.g. R/Controloc 20, 40 1x1 Lansoprazole e.g. i R/Peptazole 30, Lansoprazole TS alexcl Esomeprazole e.g. { R/Nexium 40 1x1 Rabeprazole e.g. R/Rabicid 10,20 1x1 Acute constipation ¢ Disimpaction by Glycerin supp Enema (R/Enemax) Or manual evacuationFor constipation: R/Sennalax 2-8 tabs at night «For Nausca & bloating: R/Primperan 10 1x3 or R/Motilium 1x3 . © For colic R/Colona 1x3 ic xx Js! bs: ¢ For diarrhea: R/Imodium 4. 4) Sheet) By I e For flatulence: R/Disflatyl tab Su + Lag Ole T SESS fae ones Ne aut le & eee ons, el; spall JB © OMe pe Siete ae pty JAI, hj, Gis © efer to dentist for oral assessment e Advise an oral hygiene and tooth and tongue brushing ¢ Advise on smoke cessation « Avoid garlic, onion, curries . RUListerine mouth wash Wiekses Wg, Calpe Y Airean Or R/Oraldene mw 1x3 ¢ R/Flagyl 500 1x3 for 2 weeks R/Augmentin 375 1x3x7 8. Vira h 500 1x3x7 + R/Bacticlor Fluids. eases | ¢ Bed rest with simple analgesia e Full well balanced diet & adequate R/Zymogen forte 1x3 §9\ J3 + R/Disflatyl chewable tabs 2x3 « R/Buscupan 1x3 . Dehydration No dehydration: R/Rehydran N or Rehydrozinc <2ys = 100ml. /loose stool > 2ys = 200 ml. /loose stool Sie Fee) ce ee Ve> de ot (Gee & VSS tales oh iat Jalal ake Others: Refer to the topic 2. Anti-Medicinal Therapy for Gastroenteritis ‘ Amoeba: R/Flagyl, Amrizole 50mg./kg./d for 10 days © Giardia: R/Flagyl 30mg./kg./d for 5 days ¢ Shigella & Salmonella: R/Amoxicillin: 50mg./kg,/d. for S- 7 days R/Ampicillin: 100mg./kg./d. Cholera: 3 days regimen of tetra- cycline 50mg./kg./d. R/Terramycin Syp.125mg./Sml. R/Tetracid cap. 25mg. intiemetics R/Primperan, Plasil or Meclopram drops Fee Ger ees Jo en Ye EY oS R/Primperan injection pail we oaS/e~ U8‘Cortigen B6 ped. amp. _ i oe a ae Salad) ¢ 9 jl we C= Racy eM ne 5S Jali) asd R/Motinorm Syp. Dene eee WB oly ¥ eS Y/ be I R/Motinorm or Motilium Supp. 10mg. cot we hole Yt Hy % R/Kapect syp. Semecta syp Wage Site #17 Ja 0 R/Semecta sachets hee Cle Tek OFM eo SI % R/Diakan-M susp. 32) Gat) beg Sle Y pio dale o (Styne ¥ i (Sly ¥ 58) beg Sle Y Spine ogtiale © > The most recommended anti- diarrheal drug is R/Aqua ream Z susp. (15 mg elemental zinc/Sml) Dose: 10-20mg/day for 10-14 days ith colic ee cle etl Toe si + R/Gripe water poll Boat eth Y oye 551... Spice dials Or R/Baby drink or baby calm sachets Reade Gv cle ee dss Ye Gu ben be F Sos Or R/Spasmotal drops wen Che # call 3 Lise + R/Disflatyl or baby rest drops Lap Ole das 10-1. Or R/Digestin or Pedicalm syp beg Ole Toe Or R/Dentinox syp Ley Ola Yet v0 Bayne re YN Sao JULY ase PVG LUGS Hey So NES jet) G pede, Ualall eo Je ea Ail RE ee) Sue eu ses 5 3 See Le. 2 ora Rss Fels ay ole Jabal (SS) gat ear salle SH a il Shs 8 aay Je all ey 5 1L\ Rab SU OY UST pac © | DUS, tele ae, . BCC 6. Constipation Cag 1. The aim of treatment is to regain the child's confidence in being able to defecate painlessly 2. An enema to dislodge a fecal mass or 3. Give laxative ¢ R/Picolax drops © Mainly used in chronic consti- pation © Concentration: 7.5mg/ml = 0.3mg/drop © Dose: 0.3mg/kg/day .. oral .. once at night increased or decreased according to re- sponse a2S/ als 4. Give stool softener (eg lactulose 0.5ml/kg/day) R/Lactulose or Duphlac syp 1x3 5. The child should be encouraged to go to toilet in un hurried time, after each meal in order to encourage the gastro-colic re- flex.6. Contact laxatives: R/Glycerin supp. infantile. st we as MaLoN cy, er R/Bisadyl (infantile Smg/adult 10mg) sup. Or tablet ¢ | 2= eye ree 1. Treat the cause if you found it 2. If no specific cause is detected consider the following « Anti diarrheal: © R/Loperazine (loperamide) + Concentration: Img/Sm1 = Dose: 0.2 mg/kg/day =/ J» \ oral in divided doses + Avoid overdose (danger of paralytic ileus) « Avoid in acute GE o R/Digestin syp 1x3 o R/Kapect syp Teal Jas Lar cet ee ow Sal + lay Ole V bneeg bey Oly V apo del: Se oye 451° 3. Iron supplementation R/Ferose syp 1x1 4. + Antibiotics parentral (see acute diarrhea) 5. Multivitamins R/Multivit syp 1x2 Or R/Megavit syp 1x1 1. R/Mycostatin drops Fptle gall fe Legally (Je 1) ayaa «Jo 2. Or R/Miconaz or Daktarin oral gel WL sab Sle. VS GLAM Ne dake 4 Ryne We G Mall Jab pb) Sy Aanbl ele) Saal MSS Gard AY dle gles 5. + Multivitamins (R/Megavit syp 1x1) 9. Abdominal pain A. Infant: 1. For colic & distention o R/Gripe water ye sb de Rane Epic Haale SIV oye Jal e pl gol ty Bande gb gic slike : ttt oy 451 + ped Bly EF Je © Or R/Spasmotal drops is y-) ley Sly F ill o R/Simethicone drops (for dis- tension) py3/ol ¥ aa Y-) 2. For constipation © R/Glycerin inf. supp. pop ae a Y=) Lyd B. Children 5 years: © R/Visceralgin syp 23M we |. > o R/Digestin syp SU sa pedVOle F ee 10. Poor appetite R/Totavit or topvit ep Ole Y Le Or R/Acti-5 syp. ley Ole ¥ Wor Herpetic stomatitis 1. Oral hygiene R/Septoral or Oraldene mw 1x3. 2. Analgesic : R/Brufen syrup Sle. 1/ be ° R/BBC spray »,. §9\ J pill BE poll Oy FEL wei sah delosl sa SleLs V Or R/Oracure gel ¥ sll Je tale 4 ibs V+ si JB ped [Se