Doctor'S Note: A Guide To Prescription and Advice Form

DOCTOR’S NOTE
A Guide to Prescription and Advice Form
Raymond E. Jouwena, MD
Ateneo School of Medicine and Public Health 2016
Lic No 134950
TABLE OF CONTENTS
TABLE OF CONTENTS .................................................................................................................................... 1
ABRASION ..................................................................................................................................................... 3
ACUTE GASTRITIS/ DYSPEPSIA ...................................................................................................................... 3
ACUTE GASTROENTERITIS ............................................................................................................................ 4
ACUTE TONSILITIS......................................................................................................................................... 6
ALLERGIC CONJUNCTIVITIS ........................................................................................................................... 7
ALLERGIC RHINITIS ....................................................................................................................................... 7
BACTERIAL CONJUNCTIVITIS ........................................................................................................................ 8
BRONCHIAL ASTHMA IN ACUTE EXACERBATION ......................................................................................... 8
BURN .......................................................................................................................................................... 10
CELLULITIS .................................................................................................................................................. 11
CIRCUMCISION ........................................................................................................................................... 11
COSTOCHONDRITIS .................................................................................................................................... 12
DENGUE ...................................................................................................................................................... 13
TYPE 2 DIABETES MELLITUS........................................................................................................................ 14
DYSLIPIDEMIA ............................................................................................................................................. 14
FOLLICULITIS/ FURUNCLE/ CARBUNCLE ..................................................................................................... 15
GASTROESOPHAGEAL REFLUX DISEASE ..................................................................................................... 16
GOUTY ARTHRITIS ...................................................................................................................................... 17
HYPERSENSITIVITY REACTION .................................................................................................................... 17
HYPERTENSION ........................................................................................................................................... 18
IMPETIGO ................................................................................................................................................... 19
IRRITANT/ ALLERGIC CONTACT DERMATITIS.............................................................................................. 20
LACERATION ............................................................................................................................................... 21
LEPTOSPIROSIS ........................................................................................................................................... 21
LOW BACK PAIN SYNDROME ...................................................................................................................... 23
LYMPHADENITIS ......................................................................................................................................... 23
MEASLES, RUBELLA, ROSEOLA ................................................................................................................... 24
MUMPS ...................................................................................................................................................... 24
MUSCULOSKELETAL STRAIN ....................................................................................................................... 25
1
OSTEOARTHRITIS ........................................................................................................................................ 26
OTITIS EXTERNA.......................................................................................................................................... 26
PNEMONIA (ADULT) ................................................................................................................................... 27
PNEUMONIA (PEDIATRICS)......................................................................................................................... 28
PRESEPTAL CELLULITIS................................................................................................................................ 30
PULMONARY TUBERCULOSIS ..................................................................................................................... 31
BACTERIAL VAGINOSIS ............................................................................................................................... 32
STD (GONOCOCCAL/ CHLAMYDIA) ............................................................................................................. 32
STD (TRICHOMONIASIS) ............................................................................................................................. 33
SYSTEMIC VIRAL ILLNESS ............................................................................................................................ 33
UPPER RESPIRATORY TRACT INFECTION (ADULT) ...................................................................................... 33
UPPER RESPIRATORY TRACT INFECTION (PEDIATRICS) .............................................................................. 34
URINARY TRACT INFECTION ....................................................................................................................... 36
URTICARIA .................................................................................................................................................. 37
VARICELLA .................................................................................................................................................. 38
VIRAL CONJUNCTIVITIS ............................................................................................................................... 40
SUBCONJUNCTIVAL HEMORRHAGE ........................................................................................................... 40
DRY EYE SYNDROME ................................................................................................................................... 40
APPENDIX ................................................................................................................................................... 42
2
ABRASION
A>T/C Abrasion
P>DIET: Regular Diet, Increase oral fluid intake
LABS: Optional: X-ray, CBC w/ PC
MEDS:
1. Paracetamol 500mg/tab, take 1 tab every 4 hours as needed for fever
2. Naproxen
• Naproxen 550mg/tablet, take 1 tablet now for pain with meals (Initial dose for
Dysmenorrhea/Musculoskeletal)
• Naproxen 275mg/tablet, take 1 tablet every 6 to 8 hours as needed for pain with meals
(Maintenance dose for Dysmenorrhea/Musculoskeletal)
3. Diclofenac 50mg/tablet, take 1 tablet twice a day or three times a day as needed for pain with meals
(Max: QID)
4. Meloxicam
• Meloxicam 7.5mg/tablet, take 1 tablet once a day for pain with meals (OA and elderly or on
dialysis)
• Meloxicam 15mg/tablet, take 1 tablet once a day for pain with meals (RA)
5. Celecoxib 200mg/capsule, take 1 capsule twice a day for 3 days or as needed for pain
6. Etoricoxib 30 60 90 120mg/tablet, take 1 tablet daily for 4 days as needed for pain (OA: 30 or 60mg OD;
Gout or dysmenorrhea: 120mg OD max 8 days)
7. Mupirocin ointment
8. TT/ATS
• Tetanus toxoid 0.5mL/ampule - 0.5mL IM into deltoid muscle
• Human Tetanus Immunoglobulin - 250IU IM (Prophylaxis), 500IU IM (>24 hours, burn, dirty
wound)
PROCEDURE: Wound cleaning and dressing
ADVISE: Trauma precaution, daily wound care
FOLLOW UP: once with result
ACUTE GASTRITIS/ DYSPEPSIA

A>T/C Acute Gastritis/Dyspepsia
P>DIET: Low Fat Diet, Increase oral fluid intake
LABS: Optional: CBC w/ PC, UA, Whole abdominal ultrasound, 12L ECG
MEDS:
1. Omeprazole 20mg/capsule, 1 capsule 30 minutes before meals once a day for 7 days
3
2. Hyoscine-N-butylbromide (Buscopan) 10mg/tablet, take 1 tablet every 6 hours for abdominal spasms
(6 yrs old - Adult)
3. Dicloverine
• Dicycloverine drops 5mg/ml, give 0.5-1ml every 4 to 6 hours for abdominal pain (6mos to 2 yrs
old)
• Dicycloverine syrup 10mg/5ml, give 2.5ml every 4 to 6 hours for abdominal pain (2 to 5 yrs old)
• Dicycloverine syrup 10mg/5ml, give 5ml every 4 to 6 hours for abdominal pain (6 to 12 yrs old)
4. Domperidone 0.25mg/kg/DOSE TID PRN 15-30 minutes before meals
• Domperidone drops 5mg/ml, give ?ml 3 times a day or every 8 hours for abdominal pain 15-30
minutes before meals
• Domperidone syrup 5mg/5ml, give ?ml 3 times a day or every 8 hours for abdominal pain 15-30
5. Aluminum hydroxide+magnesium hydroxide+simethicone (Maalox plus)
• Aluminum hydroxide+magnesium hydroxide+simethicone (Maalox plus) chewable tablet, chew 2
tablets 4 times a day or every 6 hours, 20 min to 1 hour after meals and at bedtime
• Aluminum hydroxide+magnesium hydroxide+simethicone (Maalox plus) oral suspension, take
15ml or 1 tablespoon 4 times a day or every 6 hours, 20 min to 1 hour after meals and at bedtime
6. Na alginate, Na bicarbonate, Ca carbonate (Gaviscon)
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) chewable tablet, 1 to 2 tablets every after
meals and at bedtime, chew tab thoroughly before swallowing
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet, take 1-2 sachet(s) every after
meals and at bedtime (>12 yrs old and ADULT)
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet, give 1/2-1 sachet every after
meals and at bedtime (6-12 yrs old)
ADVISE: Avoid smoking and drinking alcohol, Advise endoscopy if refractory to medications
FOLLOW UP: once with results or as needed
ACUTE GASTROENTERITIS
A>T/C Acute Gastroenteritis
P>DIET: Increase oral fluid intake, BRAT diet
LABS: Optional: FA, CBC, UA, Electrolytes
MEDS:
1. Oral Rehydration Salts
• Oral Rehydration Salts (Glucolyte), dissolve 1 sachet in 100ml or 1/2 glass of water as per volume
replacement
• Oral Rehydration Solution (Pedialyte), give 500ml every 4 hours as tolerated, as per volume
replacement
• Oral Rehydration Salts (Hydrite), dissolve 1 sachet in 200ml water as per volume replacement
2. Bacillus clausii (Erceflora)
4
• Bacillus clausii (Erceflora) vial, give 1 vial once a day or twice a day for ? days (1 month - 11 yrs
old)
• Bacillus clausii (Erceflora) vial, give 1 vial every 8 hours for ? days (Adult)
3. Zinc
• Zinc oral drops 27.5mg/ml,give 0.5ml once a day as zinc supplement for 14 days (Infant to
<6months)
• Zinc syrup 55mg/5ml, give 1.25ml once a day as zinc supplement for 14 days (1-3 yrs old)
• Zinc syrup 55mg/5ml, give 5ml once a day as zinc supplement for 14 days (9-13 yrs old)
5. Dicycloverine
old)
6. Hyoscine-N-butylbromide (Buscopan) 10mg/tablet, take 1 tablet every 6 hours for abdominal spasms
(6 yrs old - Adult)
7. Racecadotril
• Racecadotril granules 10mg/sachet, dissolve 1 sachet in small amount of water or add to food and
take 3 times a day before meals until with 2 episodes of normal stools; max treatment for 7 days
(<9kg)
• Racecadotril granules 10mg/sachet, dissolve 2 sachets in small amount of water or add to food
and take 3 times a day before meals until with 2 episodes of normal stools; max treatment for 7
days (9-13kg)
days (13-27kg)
days (>27kg Child)
• Racecadotril 100mg/capsule, take 1 capsule 3x a day before meals until with 2 episodes of normal
stools; max treatment for 7 days (Adult)
8. Cefalexin 25-100mg/kg/DAY QID (50-100mg for severe infections and otitis media)
• Cefalexin drops 100mg/ml, give ml? 4 times a day or every 6 hours for 7 days
• Cefalexin suspension 125mg/5ml, give ?ml 4 times a day or every 6 hours for 7 days
• Cefalexin 500mg/capsule, take 1 capsule 4 times a day or every 6 hours for 7 days
9. Cotrimoxazole
10. Metronidazole 30-50mg/kg/DAY TID
• Metronidazole suspension 125mg/5ml, take ?ml every 8 hours for 7 days
5
• Metronidazole 500mg/tablet, take 1 tablet every 8 hours for 7 days
ADVISE: Avoid drinking Gatorade, avoid giving anti-diarrheal medications, if with moderate to severe
dehydration - refer to hospital
ACUTE TONSILITIS
A>T/C Acute Tonsillitis
P>DIET: Regular to Soft diet, Increase fluid intake
LABS: CBC w/ PC
MEDS:
1. Paracetamol
• Paracetamol drops 100mg/ml, give ?ml every 4 hours as needed for fever
• Paracetamol syrup 250mg/5ml, give ?ml every 4 hours as needed for fever
• Paracetamol 500mg/tab, take 1 tab every 4 hours as needed for fever
2. Co-amoxiclav 30mg/kg/DAY BID (<3months); 20-40mg/kg/DAY TID or 25-45mg/kg/DAY BID (>3months)
• Co-amoxiclav drops 62.5mg/ml, give ?ml every 8 hours for 7 days
• Co-amoxiclav suspension 156.25mg/5ml, give ?ml every 8 hours for 7 days
• Co-amoxiclav suspension 457mg/5ml, give ?ml every 12 hours for 7 days
• Co-amoxiclav 625mg/tablet, 1 tablet every 12 hours for 7 days (>12 or adult mild-mod)
• Co-amoxiclav 625mg/tablet, 1 tablet every 8 hours for 7 days (>12 or adult severe, lower respi)
• Co-amoxiclav 1000mg/tablet, 1 tablet every 12 hours for 7 days
3. Cefalexin 25-100mg/kg/DAY QID (50-100mg for severe infections and otitis media)
4. Azithromycin 10 mg/kg/DAY OD for 3 days or 10mg/kg/DAY at day 1 then 5 mg/kg/DAY for days 2 to 5,
maximum dose of 500mg/day
• Azithromycin suspension 200mg/5ml, give ?ml once a day for 3 days
• Azithromycin suspension 200mg/5ml, give ?ml for day 1 then ?ml for days 2 to 5 once a day
• Azithromycin 500mg/tablet, take 1 tablet once a day for 3 days
• Azithromycin 500mg/tablet, take 1 tablet for DAY 1
• Azithromycin 250mg/table, take 1 tablet for DAYS 2 to 5 once a day
5. Clarithromycin 15 mg/kg/DAY, maximum dose of 1000 mg/DAY in BID for 7 days
• Clarithromycin 125mg/5ml, give ?ml twice a day or every 12 hours for 7 days
• Clarithromycin 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
6. Kamillosan spray, 2 sprays three times a day as needed for throat pain
6
7. Benzydamine lozenge, 1 lozenge every 1 to 2 hours as needed for throat pain
ADVISE: Good oral hygiene, Bactidol gargle very after meal, Consult to ENT for possible tonsillectomy if
conditions are met or if with severe symptoms
ALLERGIC CONJUNCTIVITIS
A>T/C Allergic Conjunctivitis
LABS: None
MEDS:
1. Diphenhydramine 1-2mg/kg/dose or 5mg/kg/day TID (CI: asthma, <2 yrs old)
• Diphenhydramine 12.5mg/5ml syrup, give ?ml 3 times a day or every 8 hours for
• Diphenhydramine 50mg/capsule, take 1 capsule 3 times a day or every 8 hours
• Diphenhydramine 50mg/capsule, take 1 capsule 30 minutes before bedtime as needed for
insomnia
2. Hydroxyzine 1-2mg/kg/day
• Hydroxyzine syrup 2mg/ml, give ?ml 3 times a day or every 8 hours (1-6 yrs old)
• Hydroxyzine 25mg/tablet, take 1 tablet 3 times a day or every 8 hours (ADULT)
3. Cetirizine 0.25mg/kg/dose
• Cetirizine drops 2.5mg/ml, give 1ml once a day (6 months to 1 yrs old)
• Cetirizine drops 2.5mg/ml, give 1ml twice a day (1 to 2 yrs old)
• Cetirizine syrup 5mg/5ml, give 5ml once a day (2-5 yrs old)
• Cetirizine syrup 5mg/5ml, give 10ml once a day (>6 yrs old)
• Cetirizine 10mg/tablet, take 1 tablet once a day (>12 yrs old)
2. Olopatadine eye drops
• Olopatadine eye drops 0.1% solution, 1 drop to affected eye(s) twice a day, 6 to 8 hours apart
• Olopatadine eye drops 0.2% solution, 1 drop to affected eye(s) once a day
3. Optional: Eye lubricants
• Tears Naturale II, 1 to 2 drops as needed for dry eyes
• PEG 400 + Propylene glycol eye drops (Systane Ultra), 1-2 drops in the affected eye(s) as needed
ADVISE: Lid hygiene, Cold compress, avoid scratching of eyes. avoid contact lens use, avoid
allergens/triggers
FOLLOW UP: as needed
ALLERGIC RHINITIS
A>T/C Allergic Rhinitis
7
P>DIET: Regular Diet, Increase oral fluid intake, Hypoallergenic diet
LABS: None
MEDS:
1. Intranasal corticosteroids
2. Antihistamine oral or intranasal
3. Oral decongestant (avoid using intranasal decongestants)
4. Saline sprays
ADVISE: Avoid allergens and triggers, frequent hand washing, avoid smoking
BACTERIAL CONJUNCTIVITIS
A>T/C Bacterial Conjunctivitis
P>DIET: Regular Diet, increase oral fluid intake
LABS: CBC w/ PC (Optional)
MEDS:
1. Tobramycin eye drops
• Tobramycin eye drops, 1 to 2 drops to both eyes every 4 hours for 7 days (Mild to Moderate
disease)
• Tobramycin eye drops, 2 drops to both eyes every hour until with noted improvement of
symptoms followed by 2 drops to both eyes every 4 hours for 7 days (Severe infection)
• Tobramycin eye ointment, place 1.5cm of ointment in the lower eyelid every 8-12 hours for 7 days
(Mild to Moderate disease)
• Tobramycin eye ointment, place 1.5cm of ointment in the lower eyelid every 3-4 hours until with
noted improvement of symptoms followed by 1.5cm of ointment in the lower eyelid every 8-12
hours for 7 days (Severe disease)
2. Erythromycin ointment
• Erythromycin ointment, place 1cm of ointment in the lower inner eyelid every 12 hours for 7 days
(or up to 6 times daily in ADULTS)
and massage gently to spread the ointment (CHILD)
ADVISE: Lid hygiene, cold compress then warm compress, avoid scratching of eyes, frequent hand
washing; WOF: periorbital edema, photophobia, proptosis, blurring of vision, limitation of eye movement,
fever
BRONCHIAL ASTHMA IN ACUTE EXACERBATION

A> Bronchial Asthma in Acute Exacerbation
P>DIET: NPO if with DOB
8
LABS: CBc w/ PC (if with URTI), Chest x-ray PA
MEDS:
At the clinic:
1. O2 supplement (Target: Adult >=93%, Pedia >= 94%)
2. Salbutamol + Ipratropium nebule, 1 nebule 15 minutes apart for 3 doses
3. Prednisolone: Adults: 1mg/kg/DAY max:50mg ; Pedia: 1-2mg/kg/DAY max:40mg
Take home medication:

1. Salbutamol + Ipratropium nebule, 1 nebule every 8 hours as needed for difficulty of breathing
2. Salbutamol
• Salbutamol syrup 2mg/5ml, give ?ml three times a day or every 8 hours (0.1-0.5mkd TID)
• Salbutamol 1mg + Guaifenasin 50mg/5ml syrup, give 5 OR 10ml three times a day or every 8 hours
(2-6 yrs old)
• Salbutamol 1mg + Guaifenasin 50mg/5ml syrup, give 10ml three times a day or every 8 hours (7-
12 yrs old and elderly
• Salbutamol 2mg + Guaifenasin 100mg/capsule, take 1 capsule three times a day or every 8 hours
(>12 yrs old and adults)
3. Prednisolone
• Prednisolone syrup 1mg/ml, take ?ml twice a day with meals for 3-5 days (Pedia)
• Prednisolone syrup 15m/5ml, take ?ml twice a day with meals for 5-7 days (Adults)
• Prednisolone syrup 20mg/5ml, take ?ml twice a day with meals for 5-7 days (Adults)
• Prednisolone 5mg/tablet, take 1 tablet twice a day with meals for 5-7 days (Adults)
• Prednisolone 20mg/tablet, take 1 tablet twice a day with meals for 5-7 days (Adults)
4. Montelukast (CI <2yrs old)
• Montelukast chewable 4mg/tablet, give 1 tablet once a day before bedtime (2-5 yrs old)
• Montelukast 10mg/tablet, take 1 tablet once a day before bedtime (>15 yrs old)
5. Metered Dose Inhaler:
• Salbutamol 100mcg MDI, 1 puff as needed for difficulty of breathing, maximum: 4 times daily
(CHILD)
• Salbutamol 100mcg MDI, 1-2 puffs as needed for difficulty of breathing, maximum: 4 times daily
(ADULT)
• Salbutamol 100mcg MDI, 2 puffs 10 to 15 minutes before activity as prophylaxis
6. Salmeterol + Fluticasone
• Salmeterol + Fluticasone (Seretide) 25/50 MDI, 2 puffs twice a day or every 12 hours as
maintenance (>=4 yrs old)
• Salmeterol + Fluticasone (Seretide) 25/50, 25/125, 25/250 MDI, 2 puffs twice a day or every 12
hours as maintenance (>=12 yrs old and ADULT)
7. Budesonide + Formoterol
9
• Budesonide + Formoterol (Symbicort) 160/4.5mcg, 1-2 puffs twice a day or every 12 hours for
relief of DOB
• Budesonide + Formoterol (Symbicort) 160/4.5mcg, 2 puffs twice a day or every 12 hours for
maintenance
• Budesonide + Formoterol (Symbicort) 320/9mcg, 1 puff twice a day or every 12 hours (COPD)
8. Allergic Rhinitis Intranasal Steroids
• Budesonide nasal spray 64mcg, 1 spray per nostril twice a day or every 12 hours (>6 yrs old)
• Fluticasone nasal spray, 1 spray per nostril once a day (2-11 yrs old)
• Fluticasone nasal spray, 2 sprays per nostril once a day (>12 yrs old to ADULT)
• Fluticasone nasal spray, 1 spray per nostril once a day for maintenance (>12 yrs old to ADULT)
ADVISE: Moderate to Severe exacerbation - Refer to hospital; Avoid allergens and triggers; WOF:
recurrence and worsening of symptoms
BURN
A>T/C Burn
P>DIET: Regular diet, Increase oral fluid intake
LABS: Optional: CBC with PC
MEDS:
1. Silver sulfadiazine, apply twice a day to affected area for 7 days
2. Pain Reliever
• Diclofenac 50mg/tablet, take 1 tablet twice a day or three times a day as needed for pain with
meals (Max: QID)
dialysis)
• Celecoxib 200mg/capsule, take 1 capsule twice a day for 3 days or as needed for pain
• Etoricoxib 30 60 90 120mg/tablet, take 1 tablet daily for 4 days as needed for pain (OA: 30 or
60mg OD; Gout or dysmenorrhea: 120mg OD max 8 days)
3. Oral antibiotics if warranted
PROCEDURE: Apply wet to dry dressing; debridement if necessary
ADVISE: Trauma precaution, daily wound care, if severe burn - refer to hospital
10
CELLULITIS
A>T/C Cellulitis
LABS: CBC w/ PC, FBS, Xray
MEDS:
1.Paracetamol
2. Clindamycin 10-30mg/kg/day QID
• Clindamycin syrup 75mg/5ml, give ?ml 4 times a day or every 6 hours for 7 days
• Clindamycin 300mg/tablet, take 1 tablet 3 times a day or every 8 hours for 7 days
3. Cotrimoxazole
4. Co-amoxiclav 30mg/kg/day BID (<3months); 20-40mg/kg/day TID or 25-45mg/kg/day BID (>3months)
• Co-amoxiclav suspension 156.25mg/ml, give ?ml every 8 hours for 7 days (125)
• Co-amoxiclav suspension 228.5mg/5ml, give ?ml every 8 hours for 7 days (200)
• Co-amoxiclav suspension 457mg/5ml, give ?ml every 12 hours for 7 days (400)
• Co-amoxiclav 375mg/tablet, 1 tablet every 8 hours for 7 days (>12 yrs old)
ADVISE: Daily Skin Care, regular bathing, warm compress. If no improvement of symptoms after 3 days or
if there is worsening of symptoms - Refer to Hospital
FOLLOW UP: once with results
CIRCUMCISION
A>T/C Circumcision
LABS: None
MEDS:
1. Cloxacillin 500mg/tablet, 1 tablet every 6 hours or 4 times a day for 7 days
2. Co-amoxiclav
11
3. Clindamycin 300mg/tablet, take 1 tablet 3 times a day or every 8 hours for 7 days
5.Naproxen
(Max: QID)
7. Meloxicam
dialysis)
10. Mupirocin ointment (optional)
PROCEDURE: Secure consent, Cleaning, dorsal slit incision, suturing and dressing
ADVISE: Daily wound care, apply warm compress, bathing done 24 hours after procedure, avoid
swimming, avoid activities like basketball, running for 2 weeks
FOLLOW UP: to come back after 3 days
COSTOCHONDRITIS
A>T/C Costochondritis
LABS: 12L ECG
MEDS:
2. Naproxen
(Max: QID)
4. Meloxicam
12
dialysis)
7. Eperisone 50mg/tab, 1 tablet every 8 hours to be taken with meals as muscle relaxant
ADVISE: Avoid carrying heavy objects, apply warm compress, avoid strenuous activities, massage
DENGUE
A>T/C Dengue
P>DIET: Regular Diet, No DARK colored foods, increase oral fluid intake
LABS: CBC w/ PC, NS1 Antigen (1-5d fever), Dengue IgM/IgG (7-14d fever); IF CONFIRMED WITH DENGUE:
Serial CBC w/ PC, AST, ALT
MEDS: AVOID Aspirin, NSAIDs
1. Paracetamol
2. ORS TID (given based on weight - LUDAN METHOD)
>3-10kg 100 ml/kg/DAY
>10-20kg 75 ml/kg/DAY
>20-30kg 50-60 ml/kg/DAY
>30-60kg 40-50 ml/kg/DAY
replacement
replacement
ADVISE: Temperature monitoring Q1, Tepid sponge bath, WOF warning signs: severe abdominal pain,
black stool, drowsiness, mental confusion or seizures, pale, cold or clammy hands and feet, DOB,
decreased or no UO within 6 hours - REFER TO HOSPITAL
13
TYPE 2 DIABETES MELLITUS
A>T/C Type 2 Diabetes Mellitus, uncontrolled
P>DIET: DM diet, adequate fluid intake
LABS: FBS, RBS, HbA1c, 75g-OGTT, Lipid profile, Optional: CBC w/ PC, UA, LFTs, Creatinine
MEDS:
1. Metformin
• Metformin 500mg/tablet, take 1 tablet once a day with meals
• Metformin 500mg/tablet, take 1 tablet twice a day, morning and evening with meals
2. Metformin+Glipizide
• Metformin+Glipizide 2.5mg+250mg/tablet, take 1 tablet once a day (Patients inadequately
controlled on diet and exercise)
• Metformin+Glipizide 2.5mg+500mg/tablet, take 1 tablet morning and evening with meals daily
(Patients w/ fasting plasma glucose (FPG) 280-320 mg/dL)
3. Metformin+Sitagliptin
• Metformin+Sitagliptin 500mg+50mg/tablet, take 1 tablet morning and evening with meals daily
ADVISE: CBG monitoring, lifestyle modification, exercise, weight reduction, avoid smoking and drinking
alcohol
DYSLIPIDEMIA
A> Dyslipidemia
P>DIET: Low fat, low cholesterol diet, high fiber diet, increase fluid intake
LABS: Lipid profile, Liver function tests, Optional: FBS, Crea
MEDS: Ator 40mg = Rosu 10mg
1. Atorvastatin
• Atorvastatin 10mg/tablet, take 1 tablet once a day to lower cholesterol (CHECK LFT)
• Atorvastatin 20mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol
2. Rosuvastatin
• Rosuvastatin 5mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol (CHECK LFT)
• Rosuvastatin 10mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol
• Rosuvastatin 20mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol
3. Simvastatin
14
• Simvastatin 20mg/tablet, take 1/2 tablet once a day at bedtime to lower cholesterol (If with renal
insufficiency)
• Simvastatin 20mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol (CHECK LFT)
• Simvastatin 40mg/tablet, take 1 tablet once a day at bedtime to lower cholesterol (Homozygous
familial hypercholesterolemia) (CHECK LFT)
4. Fenofibrate (If with hypertriglyceridemia only)
• Fenofibrate 145mg/capsule, take 1 capsule once a day with meals to lower triglycerides (CHECK
LFT)
• Fenofibrate 200mg/capsule, take 1 capsule once a day with meals to lower triglycerides
ADVISE: Lifestyle modifications, exercise, weight reduction, avoid smoking and drinking alcohol
FOLLICULITIS/ FURUNCLE/ CARBUNCLE

A>T/C Folliculitis/Furuncle/Carbuncle
LABS: CBC w/ PC
MEDS:
1. Paracetamol
2. Cefalexin 25-100mg/kg/day QID (50-100mg for severe infections and otitis media)
3. Cloxacillin 50-100mg/kg/day QID
• Cloxacillin 125mg/5ml, give ?ml every 6 hours or 4 times a day for 7 days
• Cloxacillin 250mh/5ml, give ?ml every 6 hours or 4 times a day for 7 days
• Cloxacillin 500mg/tablet, 1 tablet every 6 hours or 4 times a day for 7 days
4. Co-amoxiclav 30mg/kg/DAY BID (<3months); 20-40mg/kg/day TID or 25-45mg/kg/day BID (>3months)
15
5. Ertyhromycin 30-50mg/kg/day QID
• Erythromycin 250mg/5ml suspension, take ?ml 4 times a day or every 6 hours for 7 days
• Erythromycin 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
6. Doxycycline 100mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days (Adult, children >8 yrs
old)
7. Mupirocin ointment, apply to lesion 3 times a day for 7 days
ADVISE: Daily skin care, regular bathing, warm compress, I and D if warranted (conset should be secured)
GASTROESOPHAGEAL REFLUX DISEASE

A>T/C Gastroesophageal reflux disease
P>DIET: Avoid: tomato products, citrus products, greasy food, chocolate, coffee, softdrinks, sour food;
adequate fluid intake
LABS: Whole abdominal ultrasound (Optional), 12L ECG
MEDS:
1. Omeprazole 20mg/capsule, 1 capsule 30 minutes before meals once a day for 14 days
3. Aluminum hydroxide+magnesium hydroxide+simethicone (Maalox plus)
4. Na alginate, Na bicarbonate, Ca carbonate (Gaviscon)
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet, take 1-2 sachet(s) every after
meals and at bedtime (>12 yrs old and ADULT)
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet, give 1/2-1 sachet every after
meals and at bedtime (6-12 yrs old)
ADVISE: Eat small meals throughout the day; avoid carrying heavy objects, elevate head at bedtime, avoid
eating or drinking too much at least 3 hours before lying down; avoid smoking and drinking alcohol
16
GOUTY ARTHRITIS
A>T/C Gouty Arthritis
P>DIET: Low Purine Diet, Increase oral fluid intake
LABS: Blood uric acid, Creatinine, Urinalysis, X-ray
MEDS:
1. Colchicine
• Colchicine 500mcg/tablet, take 2 tablets now
• Colchicine 500mcg/tablet, take 1 tablet every 3 hours up to 6-8 tabs/day until there is pain relief,
vomiting, diarrhea or abdominal pain
• Colchicine 500mcg/tablet, take 1 tablet every 8 hours for 2 days
• Colchicine 500mcg/tablet, take 1 tablet once a day
2. Pain Reliever
meals (Max: QID)
dialysis)
3. Steroids
• Methylprednisolone 16mg/tab, take 1 tablet in the morning once a day for 3 days only
4. Omeprazole 20mg/capsule, 1 capsule once a day 30 minutes before breakfast for 3 days
5. Allopurinol 100mg/tablet, take 1 tablet once a day for 2 weeks (increase to 300mg-600mg daily
depending on level of serum uric acid. Monitor serum creatinine, SGPT and SGOT every few months.
6. Febuxostat 40mg/tablet, 1 tablet once a day for maintenance (Increase after 2 weeks to 80mg if BUA
>=6mg/dl
ADVISE: Avoid drinking alcohol
HYPERSENSITIVITY REACTION
A>T/C Hypersensitivity Reaction
P>DIET: Hypoallergenic diet, Increase oral fluid intake
MEDS:
17
1. Diphenhydramine 1-2mg/kg/DOSE or 5mg/kg/DAY TID (CI: ASTHMA, <2 yrs old)
insomnia
2. Hydroxyzine 1-2mg/kg/DAY
3. Cetirizine 0.25mg/kg/DOSE
4. Steroid
PREDNISONE 1-2mg/kg/DAY BID-TID
• Prednisone 5mg/5ml, give ?ml twice a day or thrice a day for 5 days
• Prednisone 5mg/tab
PREDNISOLONE 1-2mg/kg/DAY BID-TID
• Prednisolone 15mg/5ml, give ?ml twice a day or thrice a day for 5 days
METHYLPREDNISOLONE
• Methylprednisolone 16mg/tab
ADVISE: Mild soap, avoid allergens/triggers, avoid scratching, WOF: difficulty of breathing, edema,
abdominal pain, vomiting, dizziness, loss of consciousness - refer to hospital
HYPERTENSION
A>T/C Hypertension, uncontrolled
P>DIET: DASH diet, adequate fluid intake
MEDS: Hypertension package: CBC w/ PC, FBS, Lipid profile, AST/ALT, BUN, Crea, BUA, Na, K, 12L ECG,
Chest x-ray(optional)
1. Losartan
• Losartan 50mg/tablet, 1 tablet once a day
• Losartan 100mg/tablet, 1 tablet once a day to control blood pressure
18
2. Amlodipine
• Amlodipine 5mg/tablet, 1/2 tablet once a day (ELDERLY due to hepatic impairment, initial dose)
• Amlodipine 5mg/tablet, 1 tablet once a day to control blood pressure
• Amlodipine 10mg/tablet, 1 tablet once a day to control blood pressure
3. Losartan+Amlodipine 50mg+5mg/tablet, take 1 tablet once a day to control blood pressure (May
increase to 2 tablets daily if the BP control is inadequate after 1-2 wk)
4. Captopril SL 25mg/tablet, take 1 tablet sublingually for BP>160/90 15-30 minutes apart to control blood
pressure; NOT to be taken >3 times consecutively
5. Clonidine 75mcg/tablet, take 1 tablet sublingually for BP>160/90 15-30 minutes apart to control blood
pressure; NOT to be taken >3 times consecutively
ADVISE: BP monitoring, Lifestyle modifications, exercise, reduce weight, avoid smoking, drinking alcohol
IMPETIGO
A>T/C Impetigo
LABS: CBC w/ PC
MEDS:
1. Paracetamol
2. Cefalexin 25-100mg/kg/day QID (50-100mg for severe infections and otitis media)
4, Mupirocin ointment, apply 3 times a day to lesion and both nostrils for 7 days
ADVISE: Daily skin care, regular bathing
19
IRRITANT/ ALLERGIC CONTACT DERMATITIS

A>T/C Irritant/Allergic Contact Dermatitis
MEDS:
1. Diphenhydramine 1-2mg/kg/dose or 5mg/kg/day TID (CI: ASTHMA, <2 yrs old)
insomnia
2. Steroid
METHYLPREDNISOLONE
ADVISE: Mild soap, avoid allergens/triggers, avoid scratching, apply hypoallergenic lotion, WOF: difficulty
of breathing, edema, abdominal pain, vomiting, dizziness, loss of consciousness - refer to hospital
20
LACERATION
A>T/C Laceration
LABS: Optional: X-ray
MEDS:
1. Cloxacillin 500mg/tablet, 1 tablet every 6 hours or 4 times a day for 7 days
2. Co-amoxiclav
3. Clindamycin 300mg/tablet, take 1 tablet 3 times a day or every 8 hours for 7 days
5. Pain reliever
meals (Max: QID)
dialysis)
6. Mupirocin ointment
7. TT/ATS
wound)
PROCEDURE: Secure consent, wound cleaning, suturing and dressing
ADVISE: Daily wound care, apply warm compress, bathing done 24 hours after procedure, TCB after 1
week for ROS
LEPTOSPIROSIS
A>T/C Leptosirosis
21
LABS: CBC w/ PC, UA; Lepto MAT; Serum creatinine, PT/PTT, Electrolytes, Chest X-ray
MEDS:
1. Paracetamol
2.Doxycycline 100mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days (Adult, children >8 yrs
old)
INSTRUCTIONS FOR DOXYCYCLINE INTAKE:
• Avoid exposure to sunligt. Use sunscreen and wear protective clothing.
• Do not take iron and calcium sup, multivitamins,antacids or laxatives 2 hrs before or after taking
doxycycline
• Take it with food or after a meal
• Advise patient not to lie down for an hour after intake of the drug to prevent esophageal damage
• Avoid taking it with NSAIDS
4. Azithromycin 10 mg/kg/day OD for 3 days or 10mg/kg/day at day 1 then 5 mg/kg/day for days 2 to 5,
ADVISE: Temperature monitoring q1, tepid sponge bath, UO monitoring, Moderate to Severe Leto
(unstable vital signs, jaundice/icteric sclerae, abdominal pain, nausea, vomiting and diarrhea,
oliguria/anuria, meningismus /meningeal irritation, sepsis / septic shock, altered mental states or
difficulty of breathing and hemoptysis): REFER TO HOSPITAL
POST-EXPOSURE PROPHYLAXIS: FOR LEPTOSPIROSIS
• LOW Risk (Single exposure, no wounds): Doxycycline 100mg/capsule, take 2 capsules as a single
dose within 24 to 72 hours form exposure
• MODERATE Risk (single exposure, with wounds): Doxycycline 100mg/capsule, take 2 capsules
once a day for 3-5 days to be started immediately within 24 to 72 hours from exposure
• HIGH Risk (Continuous exposure): Doxycycline 100mg/capsule, take 2 capsules every week until
the end of exposure
•
22
LOW BACK PAIN SYNDROME
A>T/C Low Back Pain Syndrome
P>DIET: Regular Diet, Increase oral fluid intake, DASH diet, DM diet, BRAT diet, Hypoallergenic diet,
Continue breast feeding
LABS: Lumbosacral X-ray, Optional: UA, KUB UTZ
MEDS:
2. Pain reliever
meals (Max: QID)
dialysis)
• Eperisone 50mg/tab, 1 tablet every 8 hours to be taken with meals as muscle relaxant
ADVISE: Proper posture, reduce weight, massage, warm compress, ergonomic chair
LYMPHADENITIS
A>T/C Lymphadenitis
LABS: CBC w/ PC, Chest x-ray PA (optional)
MEDS:
1. Paracetamol
23
ADVISE: Temperature monitoring q1, tepid sponge bath, if lesion persists after 1 week of antibiotic
treatment - Refer to ENT?
MEASLES, RUBELLA, ROSEOLA

A>T/C Measles, Rubella, Roseola
LABS: CBC w/ PC
MEDS:
1. Paracetamol
replacement
replacement
ADVISE: Temperature monitoring q1, tepid sponge bath, wear mask, WOF: drowsiness, mental confusion
or seizures, pale, DOB
MUMPS
A>T/C Mumps
P>DIET: Soft diet, avoid sour and spicy food, increase oral fluid intake
LABS: CBC w/ PC
MEDS:
1. Paracetamol
2. Isoprinosine
24
• Isoprinosine Initial and during peak stage: 100mg/kg daily; Maintenance: 50mg/kg daily; TID or
QID
• Isoprinosine syrup 250m/5ml, give 5ml every 4 hours until 1 to 2 days after symptoms subside
(Children >7 yrs old or >21kg)
• Isoprinosine syrup 250m/5ml, give 3.75ml every 4 hours until 1 to 2 days after symptoms subside
(14-21 kg)
(<9 kg)
(9-14 kg)
• Isoprinosine 500mg/tablet, take 1 tablet every 8 hours or three times a day until 1 to 2 days after
symptoms subside (CHILDREN)
• Isoprinosine 500mg/tablet, take 2 tablets every 8 hours or three times a day until 1 to 2 days after
symptoms subside (ADULT)
ADVISE: Temperature monitoring Q1, tepid sponge bath, wear mask, WOF: DOB, testicular pain, changes
in sensorium
MUSCULOSKELETAL STRAIN
A>T/C Musculoskeletal Strain
LABS: Optional: X-ray
MEDS:
2. Pain reliever
meals (Max: QID)
dialysis)
• Eperisone 50mg/tab, 1 tablet every 8 hours to be taken with meals as muscle relaxant
ADVISE: Reduce weight, massage, warm compress
25
OSTEOARTHRITIS
A>T/C Osteoarthritis
LABS: X-ray of knees APL, Blood Uric Acid
MEDS:
1. Paracetamol
• Paracetamol 650mg/tab, take 1 tab every 4 to 6 hours as needed for pain and fever
2. Pain Reliever
meals (Max: QID)
dialysis)
• Collagen supplements
• Pain, anti-inflammatory patch
ADVISE: Avoid extreme movements, warm compress, advise consult to Surgery if no improvement of
symptoms noted
OTITIS EXTERNA
A>T/C Otitis Externa
LABS: CBC w/ PC (Optional)
MEDS:
1. Paracetamol
2. Flucinolone + Neomycin + Polymyxin otic drops, 3-4 drops to affected ear every 6-12 hours for 7 days
(For intact TM)
4. Ciprofloxacin + Dexamethasone, 2 drops every 8-12 hours to affected ear for 7 days (For intact and
perforated TM, up to max of 14 days)
26
5. Cotrimazole otic drops, 4-5 drops to affected ear every 6-8 hours for 7 days (CI in perforated TM, avoid
in <2 yrs old)
ADVISE: Avoid swimming, avoid ear manipulation, avoid applying alcohol, betadine. Refer to ENT if no
improvement of symptoms after 3 days of treatment
PNEMONIA (ADULT)
A>T/C Pneumonia (Low to Moderate Risk, Adult)
P>DIET: Regular Diet, increase fluid intake
LABS: CBC with PC, Chest x-ray PA/L
MEDS:
1. Co-amoxiclav
• Co-amoxiclav suspension 457mg/5ml 35ml or 70ml bottle
• Co-amoxiclav 1g/tablet, 1 tablet every 12 hours for 7 days (if with stable co-morbid illness)
2. Azithromycin 500mg/tablet, take 1 tablet daily for 3 days
3. Clarithromycin 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
4. Cefuroxime axetil 500mg/tablet, tabke 1 tablet twice a day or every 12 hours for 7 days
5. Levofloxacin 500mg/tablet, take 1 tablet once a day for 7 days
6. Moxifloxacin 400mg/tablet, take 1 tablet once a day for 7 days
8. Ascorbic acid + Zinc tablet, take 1 tablet once a day
9. Ambroxol 30mg/tablet, 1 tablet three times a day or every 8 hours
11. Carbocisteine 500mg/capsule, give 1 capsule three times a day or every 8 hours taken with meals
12. Guaifenesin 200mg/capsule, take 1-2 capsules every 4 hours
13. Lagundi 600mg/tablet, take 1 tablet every 8 hours
14. Cetirizine 10mg/tablet, take 1 tablet once a day
15. Salbutamol 2mg + Guaifenasin 100mg/capsule, take 1 capsule three times a day or every 8 hours
ADVISE: WOF: DOB, change in sensorium
(For CAP HR) Refer to Hospital
Philippine CPG CAP Guidelines 2016
http://philchest.org/v3/wp-content/uploads/2013/05/CAP-Guidelines.pdf
27
PNEUMONIA (PEDIATRICS)
-A>T/C Pneumonia (PCAP A and B, Pedia)
P>DIET: Regular Diet, NPO if with DOB, increase fluid intake
LABS: CBC with PC, Chest-x ray PA or AP/L
MEDS:
2. Azithromycin 10 mg/kg/day OD for 3 days or 10mg/kg/day at day 1 then 5 mg/kg/day for days 2 to 5,
3. Clarithromycin 15 mg/kg/day, maximum dose of 1000 mg/day in BID for 7 days
4. Paracetamol
5. Zinc (Elemental zinc for ages 2 to 59 months to be given for 4 to 6 months)
• Zinc drops, give 1ml once a day (<6 months old)
• Zinc drops, give 2ml once a day (>6 months old)
• Zinc syrup, give 2.5ml once a day (<6 months old)
• Zinc syrup, give 5ml once a day (>6 months old)
6. Vitamin C + Zinc (Ceelin Plus)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5ml once a day (birth-<6 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5-1ml once a day (6-11 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 1ml once a day (1-2 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 2.5ml once a day (1-3 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5ml once a day (4-8 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5-10ml once a day (9-13 yrs old)
7. Ascorbic acid
• Ascorbic acid 500mg/tablet, take 1 tablet twice a day
28
• Ascorbic acid + Zinc tablet, take 1 tablet once a day
6. Ambroxol drops 6mg/ml, give 0.5ml twice a day (<= 6 months)
• Ambroxol drops 6mg/ml, give 1ml twice a day (7-12 months)
• Ambroxol drops 6mg/ml, give 1.25ml twice a day (1-2 yrs old)
• Ambroxol suspension 15mg/5ml, give 2.5ml three times a day or every 8 hours (2-5 yrs old)
• Ambroxol suspension 15mg/5ml, give 5ml three times a day or every 8 hours (6-11 yrs old)
• Ambroxol 30mg/tablet, 1/2 tablet three times a day or every 8 hours (5-10 yrs old)
• Ambroxol 30mg/tablet, 1 tablet three times a day or every 8 hours (>10 yrs old)
7. Carbocisteine
• Carbocisteine drops 40mg/ml, give 1.5ml three times a day or every 8 hours every after meal (1-
2 yrs old)
• Carbocisteine suspension 200mg/5ml, give 2.5ml three times a day or every 8 hours every after
meal (2-3 yrs old)
• Carbocisteine suspension 200mg/5ml, give 5ml three times a day or every 8 hours every after
meal (4-7 yrs old)
meal (8-12 yrs old)
• Carbocisteine 500mg/capsule, give 1 capsule three times a day or every 8 hours every after meal
(Adults)
8. Guaifenesin
• Guaifenesin 200mg/capsule, take 1-2 capsules every 4 hours (Adult)
• Guaifenesin 200mg/capsule, take 1 capsules every 4 hours (6-<12 yrs old)
• Guaifenesin 100mg/5ml syrup, give 5-10ml every 4 hours (6-<12 yrs old)
• Guaifenesin 100mg/5ml syrup, give 2.5-5ml every 4 hours (2-<6 yrs old)
9. Lagundi
• Lagundi 600mg/tablet, take 1 tablet every 8 hours (Adult)
• Lagundi 300mg/tablet, take 1 tablet every 8 hours (7-12 yrs old)
• Lagundi syrup: 15mg/kg/dose TID
• Lagundi 600mg/5ml, give 5ml every 8 hours (>40kg)
• Lagundi 300mg/5ml, give 7.5ml every 8 hours (20-40kg)
• Lagundi 300mg/5ml, give 5ml every 8 hours (15.5-20kg)
• Lagundi 300mg/5ml, give 2.5ml every 8 hours (10-15.5kg or >2 yrs old)
10. Cetirizine drops 2.5mg/ml, give 1ml once a day OR 1ml twice a day (6 months to 2 yrs old)
11. Salbutamol syrup 2mg/5ml, give ?ml three times a day or every 8 hours (0.1-0.5mkd TID)
(2-6 yrs old)
ADVISE: WOF: DOB, retractions, poor oral intake, poor activity, lethargy
29
(For PCAP C and D) Refer to hospital
PRESEPTAL CELLULITIS
A>T/C Preseptal Cellulitis
LABS: CBC w/ PC
MEDS:
1. Paracetamol
4. Cefaclor 20mg/kg/day TID; 40mg/kg/day TID in serious infections & otitis media
• Cefaclor oral drops 50mg/ml, give ?ml every 8 hours or 3 times a day for 7 days
• Cefaclor oral suspension 125mg/5ml, give ?ml every 8 hours or 3 times a day for 7 days
• Cefaclor 500mg/capsule, take 1 capsule every 8 hours or 3 times a day for 7 days
5. Cefuroxime 10mg/kg/day BID for usual infection; 15mg/kg/day BID for Otitis media/severe infections
• Cefuroxime 125mg/5ml, give ?ml twice a day or every 12 hours for 7 days with meals (2-12 yrs
old)
• Cefuroxime 250mg/5ml, give ?ml twice a day or every 12 hours for 7 days with meals (>2 yrs old
w/ otitis media or severe infections)
• Cefuroxime axetil 250mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days with meals
6. Cefixime 8mg/kg/day OD or BID
• Cefixime oral suspension 100mg/5ml, give ?ml twice a day or every 12 hours for 7 days
• Cefixime 200mg/tablet, 1 tablet every 12 hours for 7 days
• Cefixime 400mg/tablet, 1 tablet as a single dose (for Gonorrhea)
7. Clindamycin 10-30mg/kg/day QID
30
ADVISE: Lid hygiene,cold compress then warm compress, avoid scratching of eyes, frequent hand
washing; WOF: signs of orbital cellulitis: photophobia, proptosis, blurring of vision, limitation of eye
movement - REFER TO HOSPITAL
PULMONARY TUBERCULOSIS
A>T/C Pulmonary Tuberculosis
P>DIET: Regular diet, increase fluid intake
LABS: CBC with PC, Chest-xray PA, PPD (<=15 yrs old), Direct sputum smear microscopy x2, Xpert MTB/Rif
(if presumptive DRTB, HIV suspect, smear negative but positive CXR, EPTB)l IF CONFIRMED PTB: Check
also LFTS, Crea, UA, Visual Acuity test, FBS, BUA (not routinely recommended)
MEDS:
1. Paracetamol
2. Multivitamins
• Multivitamins + Buclizine HCl (Pediafortan-AS), 5ml once a day (2-6 yrs old)
• Buclizine HCl + Vitamin B-Complex + Iron capsule, 1 capsule once a day (Adult)
3. Heraclene
• Heraclene Forte 3mg/capsule, take 1 capsule once a day (Adult)
• Heraclene 1mg/capsule, take 2 capsules once a day (Child and Adol)
• Heraclene 1mg/capsule, mix contents of 1 capsule with milk or juice (Premature babies and
infants)
IF PTB: Refer to TB DOTS; for private patients refer to NTCP-MOP for management guidelines
(http://www.doh.gov.ph/sites/default/files/publications/MOP_Final_a.pdf) PAGE 39 to 40 for the
complete table
ADVISE: Wear mask
PULMONARY TB DRUGS:
Fixed dose combination drugs
INTENSIVE PHASE (2 months):
• Pyrazinamide 400 mg, rifampicin 150 mg, ethambutol HCl 275 mg, INH 75 mg/tablet (Quadmax
or Myrin-P Forte), take 2 tablets once a day for 2 months (30-37kg)
31
or Myrin-P Forte), take 5 tablets once a day for 2 months (>70kg)
CONTINUATION PHASE (4 months):

• Rifampicin 150 mg, INH 75 mg/tablet (Duomax or Myrin I), take 2 tablets once a day for 4 months
(30-37kg)
(38-54kg)
(55-70kg)
(>70kg)
•
BACTERIAL VAGINOSIS
A>T/C Bacterial Vaginosis
LABS: CBC w/ PC, UA, discharge GS/CS, HIV screening, VDRL/RPR, Hep B(Optional), Pap smear
MEDS:
1. Metronidazole 30-50mg/kg/DAY TID
• Metronidazole 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
2. Metronidazole 0.75% gel, apply to affected area intravaginally once daily or bid for 5 days.
ADVISE: Vulvar hygiene, avoid using panty liner everyday, avoid using soap in washing, advise use of
feminine wash 2x/week only
STD (GONOCOCCAL/ CHLAMYDIA)

A>T/C Sexually Transmitted Infection (Gonococcal/Chlamydial)
LABS: CBC w/ PC, UA, discharge GS/CS, HIV screening, VDRL/RPR, Hep B, Pap smear
MEDS:
1. Ceftriaxone 250mg IM single dose OR Ceftriazone 1000mg/10ml IV, 2.5ml IM injection to R deltoid,
Azithromycin 500mg/tablet, take 3 tablets as a single dose
2. ALTERNATIVE: Cefixime 200mg/tablet, take 2 tablets as a single dose, Azithromycin 500mg/tablet, take
3 tablets as a single dose
3. If PURELY Chlamydial: Azithromycin 500mg/tablet, take 3 tablets as a single dose OR Doxycycline
100mg/tablet, take 1 tablet twice a day for 7 days
32
ADVISE: Safe sex, condom use, post coital hygiene
STD (TRICHOMONIASIS)
A>T/C Sexually Transmitted Disease (Trichomoniasis)
LABS: CBC w/ PC, UA, discharge GS/CS, HIV screening, VDRL/RPR, Hep B (optional), pap smear
MEDS:
1. Metronidazole 500mg/tablet, take 4 tablets as a single dose
2. Metronidazole 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
ADVISE: Safe sex, condom use, post coital hygiene
SYSTEMIC VIRAL ILLNESS

A>T/C Systemic viral illness
LABS: CBC w/ PC, Urinalysis
MEDS:
1. Paracetamol
replacement
replacement
ADVISE: Temperature monitoring Q1, Tepid sponge bath, WOF: epistaxis, difficulty of breathing,
persistent vomiting, severe, abdominal pain, black stool, changes in sensorium
UPPER RESPIRATORY TRACT INFECTION (ADULT)

A>T/C Upper respiratory tract infection
33
LABS: CBC w/ PC, Chest x-ray PA, PPD
MEDS:
2. Ambroxol 30mg/tablet, 1 tablet three times a day or every 8 hours
3. Carbocisteine 500mg/capsule, give 1 capsule three times a day or every 8 hours every after meal
4. N-Acetylcysteine 600mg/tablet, dissolve tablet or sachet in a glass of water daily before bedtime
5. Guaifenesin 200mg/capsule, take 1-2 capsules every 4 hours
6. Lagundi 600mg/tablet, take 1 tablet every 8 hours
7. Ascorbic acid 500mg/tablet, take 1 tablet twice a day
8. Benzydamine
• Benzydamine HCl + chlorhexidine gluconate (Difflam C solution), 15mL to be gargled for at least
30 sec every 3 hours as needed for throat pain
• Benzydamine lozenge, 1 lozenge every 1 to 2 hours as needed for throat pain
• Kamillosan spray, 2 sprays three times a day as needed for throat pain
• Hexetidine mouth wash, hold 10-15mL in the mouth, swish & gargle for 30 sec after meals
9. Salinase
• Salinase nasal drops, 2-4 drops in each nostril as needed for nasal congestion
• Salinase nasal spray, 2 sprays in each nostril as needed for nasal congestion
10. Levodropropizine syrup, take 10ml three times a day or every 8 hours
11. Cetirizine 10mg/tablet, take 1 tablet once a day
ADVISE: WOF: difficulty of breathing, changes in sensorium, retractions
UPPER RESPIRATORY TRACT INFECTION (PEDIATRICS)

A>T/C Upper respiratory tract infection
LABS: CBC w/ PC, Chest x-ray PA, PPD
MEDS:
1. Paracetamol
2. Ambroxol drops 6mg/ml, give 0.5ml twice a day (<= 6 months)
34
3. Carbocisteine
2 yrs old)
meal (2-3 yrs old)
meal (4-7 yrs old)
meal (8-12 yrs old)
4. N-Acetylcysteine
• N-Acetylcysteine 100mg/tablet, dissolve tablet or sachet in a glass of water twice a day (<2 yrs
old)
• N-Acetylcysteine 200mg/tablet, dissolve tablet or sachet in a glass of water twice a day (2-7 yrs
old)
5.Guaifenesin
6. Lagundi 300mg/tablet, take 1 tablet every 8 hours (7-12 yrs old)
7. Cetirizine drops 2.5mg/ml, give 1ml once a day OR 1ml twice a day (6 months to 2 yrs old)
8. Phenylpropanolamine HCl, brompheniramine maleate drops (Phenylpropa), give 0.25ml every 8 hours
for nasal congestion (1-3 months)
• Phenylpropanolamine HCl, brompheniramine maleate drops (Phenylpropa), give 0.5ml every 8
hours for nasal congestion (4-6 months)
• Phenylpropanolamine HCl, brompheniramine maleate drops (Phenylpropa), give 1ml every 8
hours for nasal congestion (1-2 yrs old)
• Phenylpropanolamine HCl, brompheniramine maleate syrup (Phenylpropa), give 2.5ml every 8
• Phenylpropanolamine HCl, brompheniramine maleate syrup (Phenylpropa), give 5ml every 8
35
9. Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5ml once a day as multivitamins (birth-
<6 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5-1ml once a day as multivitamins
(6-11 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 1ml once a day as multivitamins (1-
2 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 2.5ml once a day as multivitamins (1-
3 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5ml once a day as multivitamins (4-8
yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5-10ml once a day as multivitamins
(9-13 yrs old)
10. Multivitamins + Buclizine HCl (Pediafortan-AS), 5ml once a day as multivitamins and appetite stimulant
(2-6 yrs old)
• Multivitamins + Buclizine HCl (Pediafortan-AS), 10ml once a day as multivitamins and appetite
stimulant (7-12 yrs old)
• Buclizine HCl + Vitamin B-Complex + Iron capsule, 1 capsule once a day as multivitamins and
appetite stimulant (Adult)
11. Benzydamine lozenge, 1 lozenge every 1 to 2 hours as needed for throat pain
12. Salinase nasal drops, 2-4 drops in each nostril as needed for nasal congestion
ADVISE: WOF: difficulty of breathing, changes in sensorium, retractions
URINARY TRACT INFECTION

A>T/C Urinary Tract Infection, Acute Cystitis, Pyelonephritis
LABS: Urinalysis, CBC w/ PC; Urine culture, KUB UTZ (recurrent, complicated UTI)
MEDS:
1. Paracetamol
2. Nitrofurantoin macrocyrstals 100mg/capsule, take 1 capsule every 6 hours or 4 times a day for 5 days
3. Ciprofloxacin
36
• Ciprofloxacin 250mg/tablet, take 1 tablet every 12 hours or twice a day for 3 days
• Ciprofloxacin extended release 500mg/tablet, take 1 tablet once a day for 3 days
• ciprofloxacin 500mg/tablet, take 1 tablet twice a day or every 12 hours for 3 days
5. Cefuroxime axetil 250mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days
6. Cefaclor 500mg/capsule, take 1 capsule every 8 hourse or 3 times a day for 7 days
ADVISE: Perineal hygiene, safe sexual practices, cranberry juice (optional)
URTICARIA
A>T/C Urticaria
MEDS:
1. Diphenhydramine 1-2mg/kg/dose or 5mg/kg/day TID (CI: ASTHMA, <2 yrs old)
insomnia
2. Steroid
PREDNISOLONE 1-2mg/kg/day BID-TID
37
METHYLPREDNISOLONE
ADVISE: Mild soap, avoid allergens/triggers, avoid scratching, apply hypoallergenic lotion, advised consult
to allergologist for skin prick test
VARICELLA
A>T/C VARICELLA
P>DIET: Regular Diet, Hypoallergenic diet, increase oral fluid intake
LABS: CBC w/ PC, R/O DENGUE: NS1 Antigen (Day 1-5 of fever), Dengue IgM/IgG (Day 7-14 of fever), IF
DENGUE: Do serial CBC with PC, may add LFTs
MEDS:
1. Paracetamol
2. Acyclovir (given within 24 hours after appearance of rash in >12 yrs old or if immunocompromised)
ACYCLOVIR with MEALS
• HERPES SIMPLEX/GENITAL HERPES
• Acyclovir suspension 200mg/5ml, give 5ml 5 times a day or every 4 hours for 5 to 10 days
• Acyclovir 200mg/tablet, give 1 tablet 5 times a day or every 4 hours for 5 to 10 days
CHICKEN POX (<2 years old: 20mg/kg/DOSE QID)
• Acyclovir suspension 200mg/5ml, give ?ml 4 times a day or every 6 hours for 5 to 7 days (<2 yrs
old)
• Acyclovir suspension 200mg/5ml, give 5ml 4 times a day or every 6 hours for 5 to 7 days (2-4 yrs
old)
• Acyclovir suspension 200mg/5ml, give 10ml 4 times a day or every 6 hours for 5 to 7 days (4-6 yrs
old)
• Acyclovir suspension 200mg/5ml, give 20ml 4 times a day or every 6 hours for 5 to 7 days (>6 yrs
old)
HERPES ZOSTER
38
• Acyclovir 800mg/tablet, give 1 tablet 5 times a day or every 4 for 7 days
3. Isoprinosine (Optional)
• ISOPRINOSINE: Initial and during peak stage: 100mg/kg daily; Maintenance: 50mg/kg daily; TID or
QID
(14-21 kg)
(<9 kg)
(9-14 kg)
5. Hydroxyzine 1-2mg/kg/DAY
6. ANTIBIOTICS for suspected sec bacterial infection (Cloxacillin, Cefalexin, Erythromycin)

CEFALEXIN 25-100mg/kg/DAY QID (50-100mg for severe infections and otitis media)
CLOXACILLIN 50-100mg/kg/DAY QID
ERYTHROMYCIN 30-50mg/kg/DAY QID
• Doxycycline 100mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days (Adult, children
>8 yrs old)
ADVISE: Advise scratching of lesion, wear mask, regular bathing, isolation until all lesions crusted
39
VIRAL CONJUNCTIVITIS
A>T/C Viral Conjunctivitis
LABS: None
MEDS: Self limiting
1. Tobramycin eye drops, 1 to 2 drops to both eyes every 4 hours for 7 days (Mild to Moderate disease)
symptoms followed by 2 drops to both eyes every 4 hours for 7 days (Severe infection) (If with
secondary bacterial infection)
2. Tears Naturale II, 1 to 2 drops as needed for dry eyes
3. PEG 400 + Propylene glycol eye drops (Systane Ultra), 1-2 drops in the affected eye(s) as needed
4. CETIRIZINE 0.25mg/kg/DOSE
ADVISE: Lid hygiene, cold compress then warm compress, avoid scratching of eyes, frequent hand
washing, isolation. Watch out for eye pain, severe lid swelling, blurring of vision, and eye discharge
FOLLOW UP: after 7 days with ophthalmologist of choice or earlier if with problems
SUBCONJUNCTIVAL HEMORRHAGE
A>T/C Subconjunctival Hemorrhage
P>DIET: Regular Diet
LABS: None
MEDS: Self limiting
ADVISE: Cold compress over affected eye, 10-15 minutes 2-3x/ day for 48 hours then warm compress
afterwards. Watch out for blurring of vision, limitation of eye movements
DRY EYE SYNDROME

A>T/C Dry Eye Syndrome secondary to Meibomean gland Dysfunction
P>DIET: Regular Diet
LABS: None
MEDS: Self limiting
40
1. Tears Naturale II, 1 to 2 drops as needed for dry eyes
2. PEG 400 + Propylene glycol eye drops (Systane Ultra), 1-2 drops in the affected eye(s) as needed
ADVISE: Avoid rubbing/ touching eyes, proper hand hygiene, warm compress for 10-15 minutes on
affected eye twice daily, Lid scrub with Johnson’s baby shampoo twice daily
41
APPENDIX
ORAL REHYDRATION SOLUTION

replacement
replacement
BACILLUS CLAUSII (ERCEFLORA)

• Bacillus clausii (Erceflora) vial, give 1 vial once a day or twice a day for ? days (1 month - 11 yrs
old)
• Bacillus clausii (Erceflora) vial, give 1 vial every 8 hours for ? days (Adult)
ZINC SUPPLEMENT
• Zinc oral drops 27.5mg/ml,give 0.5ml once a day as zinc supplement for 14 days (Infant to
<6months)
• Zinc syrup 55mg/5ml, give 5ml once a day as zinc supplement for 14 days (9-13 yrs old)
PARACETAMOL
DIPHENHYDRAMINE 1-2mg/kg/DOSE or 5mg/kg/DAY TID (CI: ASTHMA, <2 yrs old)

insomnia
HYDROXYZINE 1-2mg/kg/DAY
CETIRIZINE 0.25mg/kg/DOSE
42
SALINASE NASAL SPRAY

• Salinase nasal drops, 2-4 drops in each nostril as needed for nasal congestion
PHENYLPROPA
• Phenylpropanolamine HCl, brompheniramine maleate drops (Phenylpropa), give 1ml every 8
• Phenylpropanolamine HCl, brompheniramine maleate syrup (Phenylpropa), give 2.5ml every 8
• Phenylpropanolamine HCl, brompheniramine maleate syrup (Phenylpropa), give 5ml every 8
• Phenylpropanolamine HCl, brompheniramine maleate tablet (Phenylpropa), take 1 tablet every
12 hours or twice a day (Adult; CI: epilepsy, brain damage)
AMBROXOL
• Ambroxol drops 6mg/ml, give 0.5ml twice a day (<= 6 months)
WITH FOOD
CARBOCISTEINE
2 yrs old)
meal (2-3 yrs old)
meal (4-7 yrs old)
meal (8-12 yrs old)
• Carbocisteine 500mg/capsule, give 1 capsule three times a day or every 8 hours every after meal
(Adults)
43
N-ACETYLCYSTEINE
• N-Acetylcysteine 100mg/tablet, dissolve tablet or sachet in a glass of water twice a day (<2 yrs
old)
• N-Acetylcysteine 200mg/tablet, dissolve tablet or sachet in a glass of water twice a day (2-7 yrs
old)
• N-Acetylcysteine 600mg/tablet, dissolve tablet or sachet in a glass of water daily before bedtime
(Adult)
GUAIFENESIN
• Guaifenesin 200mg/capsule, take 1-2 capsules every 4 hours (Adult)
LAGUNDI
• Lagundi 600mg/tablet, take 1 tablet every 8 hours (Adult)
• Lagundi 300mg/tablet, take 1 tablet every 8 hours (7-12 yrs old)
LEVODROPROPIZINE
• Levodropropizine syrup, take 10ml three times a day or every 8 hours (>12 yrs old or adult)
• Levodropropizine syrup, take 5ml three times a day or every 8 hours (20-30kg)
• Levodropropizine syrup, take 3ml three times a day or every 8 hours (10-20kg)
SALBUTAMOL
• Salbutamol syrup 2mg/5ml, give ?ml three times a day or every 8 hours (0.1-0.5mkd TID)
(2-6 yrs old)
• Salbutamol + Ipratropium nebule, 1 nebule every 4-8 hours or as needed for difficulty of breathing

44
MONTELUKAST (CI <2yrs old)

• Montelukast 10mg/tablet, take 1 tablet once a day before bedtime (>15 yrs old)
Metered Dose Inhaler:

SALBUTAMOL
• Salbutamol 100mcg MDI, 1 puff as needed for difficulty of breathing, maximum: 4 times daily
(CHILD)
• Salbutamol 100mcg MDI, 1-2 puffs as needed for difficulty of breathing, maximum: 4 times daily
(ADULT)
• Salbutamol 100mcg MDI, 2 puffs 10 to 15 minutes before activity as prophylaxis
OTHERS
• Salmeterol + Fluticasone (Seretide) 25/50 MDI, 2 puffs twice a day or every 12 hours as
maintenance (>=4 yrs old)
• Salmeterol + Fluticasone (Seretide) 25/50, 25/125, 25/250 MDI, 2 puffs twice a day or every 12
hours as maintenance (>=12 yrs old and ADULT)
• Budesonide + Formoterol (Symbicort) 160/4.5mcg, 1-2 puffs twice a day or every 12 hours for
relief of DOB
• Budesonide + Formoterol (Symbicort) 160/4.5mcg, 2 puffs twice a day or every 12 hours for
maintenance
• Budesonide + Formoterol (Symbicort) 320/9mcg, 1 puff twice a day or every 12 hours (COPD)
Allergic Rhinitis Intranasal Steroids

• Budesonide nasal spray 64mcg, 1 spray per nostril twice a day or every 12 hours (>6 yrs old)
• Fluticasone nasal spray, 1 spray per nostril once a day (2-11 yrs old)
• Fluticasone nasal spray, 2 sprays per nostril once a day (>12 yrs old to ADULT)
• Fluticasone nasal spray, 1 spray per nostril once a day for maintenance (>12 yrs old to ADULT)
Pain Reliever
meals (Max: QID)
dialysis)
45
• Reparil-N gel, apply to affected area as needed for pain

• Indomethacin cream, apply and massage to affected area as needed for pain (Avoid in pregnancy,
children<14 yrs old)
• Sulidin thermo lotion, appy to affected area twice or thrice a day for 7 days and as needed for
pain
• Ketoprofen gel, apply to affected area once or twice a day as needed for pain, avoid sun exposure
• Diclofenac gel, apply to affected area as needed for pain
• Gabapentin 300mg/tablet, 1 tablet 3 times a day or every 8 hours for pain (>18 yrs. old)
• Pregabalin 50,75,150mg ???
Oral solution
• Benzydamine lozenge, 1 lozenge every 1 to 2 hours as needed for throat pain
old)
Gastrointestinal Drugs
DOMPERIDONE 0.25mg/kg/DOSE TID PRN 15-30 minutes before meals
•
OTHERS
• Hyoscine-N-butylbromide (Buscopan) 10mg/tablet, take 1 tablet every 6 hours for abdominal
spasms (6 yrs old - Adult)
46

• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet,
• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) 10ml sachet,
• Racecadotril granules 10mg/sachet, dissolve 1 sachet in small amount of water or add to food and
take 3 times a day before meals until with 2 episodes of normal stools; max treatment for 7 days
(<9kg)
days (9-13kg)
days (13-27kg)
days (>27kg Child)
• Racecadotril 100mg/capsule, take 1 capsule 3x a day before meals until with 2 episodes of normal
stools; max treatment for 7 days (Adult)
• Omeprazole 20mg/capsule, take 1 capsule once a day 30 minutes before meals for 1 week
• Metoclopramide syrup 5mg/5ml, give 5ml 3 times a day or every 8 hours for vomiting (9-14 yrs
old or >30kg)
• Metoclopramide 10mg/tablet, take 1 tablet 3 times a day or every 8 hours for vomiting (Adult)
Anti-Hypertensive
• Amlodipine 2.5mg/tablet, 1/2 tablet once a day (ELDERLY due to hepatic impairment, initial dose)
• Amlodipine 5mg/tablet, 1 tablet once a day
• Amlodipine 10mg/tablet, 1 tablet once a day
• Losartan+Amlodipine 50mg+5mg/tablet, take 1 tablet once a day (May increase to 2 tablets daily
if the BP control is inadequate after 1-2 wk)
•
Antidiabetics
• Metformin 500mg/tablet, take 1 tablet once a day with meals
• Metformin 500mg/tablet, take 1 tablet morning and evening with meals daily
• Metformin+Glipizide 2.5mg+250mg/tablet, take 1 tablet once a day (Patients inadequately
controlled on diet and exercise)
47
• Metformin+Glipizide 2.5mg+500mg/tablet, take 1 tablet morning and evening with meals daily
(Patients w/ fasting plasma glucose (FPG) 280-320 mg/dL)
Supplements
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5ml once a day (birth-<6 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 0.5-1ml once a day (6-11 months)
• Vitamin C + Zinc (Ceelin Plus) 40mg+5mg/ml oral drops, give 1ml once a day (1-2 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 2.5ml once a day (1-3 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5ml once a day (4-8 yrs old)
• Vitamin C + Zinc (Ceelin Plus) 100mg+10mg/5ml syrup, give 5-10ml once a day (9-13 yrs old)
• Ascorbic acid + Zinc tablet, take 1 tablet once a day
• Zinc drops, give 1ml once a day (<6 months old)

• Zinc drops, give 2ml once a day (>6 months old)
• Zinc syrup, give 2.5ml once a day (<6 months old)
• Zinc syrup, give 5ml once a day (>6 months old)
• Buclizine HCl + Vitamin B-Complex + Iron capsule, 1 capsule once a day (Adult)
• Heraclene Forte 3mg/capsule, take 1 capsule once a day (Adult)

• Heraclene 1mg/capsule, take 2 capsules once a day (Child and Adol)
• Heraclene 1mg/capsule, mix contents of 1 capsule with milk or juice (Premature babies and
infants)
ANTIBIOTICS - ASK FOR ALLERGIES!!!

CO-AMOXICLAV 30mg/kg/DAY BID (<3months); 20-40mg/kg/DAY TID or 25-45mg/kg/DAY BID (>3months)
CEFALEXIN 25-100mg/kg/DAY QID (50-100mg for severe infections and otitis media)
48
CEFACLOR 20mg/kg/DAY TID; 40mg/kg/DAY TID in serious infections & otitis media
• Cefaclor oral drops 50mg/ml, give ?ml every 8 hours or 3 times a day for 7 days
• Cefaclor 500mg/capsule, take 1 capsule every 8 hours or 3 times a day for 7 days
CEFUROXIME 10mg/kg/DAY BID for usual infection; 15mg/kg/DAY BID for Otitis media/severe infections
• Cefuroxime 125mg/5ml, give ?ml twice a day or every 12 hours for 7 days with meals (2-12 yrs
old)
• Cefuroxime 250mg/5ml, give ?ml twice a day or every 12 hours for 7 days with meals (>2 yrs old
w/ otitis media or severe infections)
• Cefuroxime axetil 250mg/tablet, take 1 tablet every 12 hours or twice a day for 7 days with meals
CEFIXIME 8mg/kg/DAY OD or BID

• Cefixime oral suspension 100mg/5ml, give ?ml twice a day or every 12 hours for 7 days
• Cefixime 200mg/tablet, 1 tablet every 12 hours for 7 days
• Cefixime 400mg/tablet, 1 tablet as a single dose (for Gonorrhea)
CLOXACILLIN 50-100mg/kg/DAY QID

CIPROFLOXACIN
• Ciprofloxacin 250mg/tablet, take 1 tablet every 12 hours or twice a day for 3 days
• Ciprofloxacin extended release 500mg/tablet, take 1 tablet once a day for 3 days
AZITHROMYCIN 10 mg/kg/DAY OD for 3 days or 10mg/kg/DAY at day 1 then 5 mg/kg/DAY for days 2 to 5,
CLARITHROMYCIN 15 mg/kg/DAY, maximum dose of 1000 mg/DAY in BID for 7 days

49
• Clarithromycin 500mg/tablet, take 1 tablet twice a day or every 12 hours for 7 days
ERYTHROMYCIN 30-50mg/kg/DAY QID

DOXYCYCLINE
>8 yrs old)
>8 yrs old)
INSTRUCTIONS FOR DOXYCYCLINE INTAKE:

• Avoid exposure to sunligt. Use sunscreen and wear protective clothing.
• Do not take iron and calcium sup, multivitamins,antacids or laxatives 2 hrs before or after taking
doxycycline
• Take it with food or after a meal
• Advise patient not to lie down for an hour after intake of the drug to prevent esophageal damage
• Avoid taking it with NSAIDS
CLINDAMYCIN 10-30mg/kg/DAY QID

METRONIDAZOLE 30-50mg/kg/DAY TID

• Metronidazole 500mg/tablet, take 1 tablet every 8 hours for 7 days
ACYCLOVIR with MEALS

Herpes simplex/Genital herpes
• Acyclovir suspension 200mg/5ml, give 5ml 5 times a day or every 4 to 5 hours for 5 to 10 days
• Acyclovir 200mg/tablet, give 1 tablet 5 times a day or every 4 to 5 hours for 5 to 10 days
Chickenpox
(>6 yrs old)
(4-6 yrs old)
• Acyclovir suspension 200mg/5ml, give 5ml 5 times a day or every 4 to 5 hours for 5 to 10 days (2-
4 yrs old)
50
• Acyclovir 800mg/tablet, give 1 tablet 5 times a day or every 4 to 5 hours for 5 to 7 days
ISOPRINOSINE: Initial and during peak stage: 100mg/kg daily; Maintenance: 50mg/kg daily; TID or QID
(14-21 kg)
(<9 kg)
(9-14 kg)
Nitrofurantoin macrocyrstals 100mg/capsule, take 1 capsule every 6 hours or 4 times a day for 5 days
EYE ANTIBIOTICS
• Tears Naturale II, 1 to 2 drops as needed for dry eyes
• PEG 400 + Propylene glycol eye drops (Systane Ultra), 1-2 drops in the affected eye(s) as needed
• Tobramycin eye drops, 1 to 2 drops to both eyes every 4 hours for 7 days (Mild to Moderate
disease)
symptoms followed by 2 drops to both eyes every 4 hours for 7 days (Severe infection)
• Tobramycin eye ointment, place 1.5cm of ointment in the lower inner eyelid every 8-12 hours for
7 days (Mild to Moderate disease)
• Tobramycin eye ointment, place 1.5cm of ointment in the lower inner eyelid every 3-4 hours until
with noted improvement of symptoms followed by 1.5cm of ointment in the lower inner eyelid
every 8-12 hours for 7 days (Severe disease)
• Tobramycin + Dexamethasone drops, 1 to 2 drops to both eyes every 2 hours for the 1st day then
1 to 2 drops every 4-6 hours for 6 more days (Mild to Moderate disease)
• Tobramycin + Dexamethasone eye ointment, place 1.5cm of ointment in the lower inner eyelid
every 6-8 hours for 7 days
(or up to 6 times daily in ADULTS)
and massage gently to spread the ointment (CHILD)
EAR ANTIBIOTICS
51
• Flucinolone + Neomycin + Polymyxin otic drops, 3-4 drops to affected ear every 6-12 hours for 7
days (For intact TM)
• Ciprofloxacin + Dexamethasone, 2 drops every 8-12 hours to affected ear for 7 days (For intact
and perforated TM, up to max of 14 days)
• Cotrimazole otic drops, 4-5 drops to affected ear every 6-8 hours for 7 days (CI in perforated TM,
avoid in <2 yrs old)
PULMONARY TB DRUGS
Fixed dose combination drugs for Category I
INTENSIVE PHASE (2 months):

or Myrin-P Forte), take 5 tablets once a day for 2 months (>70kg)
CONTINUATION PHASE (4 months):

(30-37kg)
(38-54kg)
(55-70kg)
(>70kg)
GOUT
• Colchicine 500mcg/tablet, take 1 tablet every 8 hours in acute attacks

• Colchicine 500mcg/tablet, take 1 tablet once a day or every 12 hours for 3-6 months from attack
• Febuxostat 40mg/tablet, 1 tablet once a day for maintenance (Increase after 2 weeks to 80mg if
BUA >=6mg/dl
52
TETANUS
• Administer 2 doses of the vaccine, with interval of 4-6 weeks (primary dose).
• The 3rd dose should be given after 6-12 months from the 2nd dose (complementary dose).
• This dose provides immunity which is maintained for 5-10 years.
• Administer 1 dose of the vaccine, but not earlier than 10 years after the last vaccination.
PREGNANCY
• Nonvaccinated women or those with incomplete basic vaccination being at risk of giving birth to
a child in unhygienic conditions should be vaccinated in the 2nd trimester of pregnancy.
• Women who received 1 or 2 doses of Tetana before pregnancy was confirmed, should complete
the vaccination cycle during pregnancy.
• Pregnant women who were vaccinated >10 years before should receive a booster dose in the 2nd
trimester of the pregnancy.
wound)
• Human Tetanus Immunoglobulin - 3,000-6,000IU (Treatment)
53

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DOCTOR’S NOTE

A Guide to Prescription and Advice Form

ACUTE GASTRITIS/ DYSPEPSIA

BRONCHIAL ASTHMA IN ACUTE EXACERBATION

Take home medication:

FOLLICULITIS/ FURUNCLE/ CARBUNCLE

GASTROESOPHAGEAL REFLUX DISEASE

IRRITANT/ ALLERGIC CONTACT DERMATITIS

MEASLES, RUBELLA, ROSEOLA

CONTINUATION PHASE (4 months):

STD (GONOCOCCAL/ CHLAMYDIA)

SYSTEMIC VIRAL ILLNESS

UPPER RESPIRATORY TRACT INFECTION (ADULT)

UPPER RESPIRATORY TRACT INFECTION (PEDIATRICS)

URINARY TRACT INFECTION

6. ANTIBIOTICS for suspected sec bacterial infection (Cloxacillin, Cefalexin, Erythromycin)

DRY EYE SYNDROME

ORAL REHYDRATION SOLUTION

BACILLUS CLAUSII (ERCEFLORA)

DIPHENHYDRAMINE 1-2mg/kg/DOSE or 5mg/kg/DAY TID (CI: ASTHMA, <2 yrs old)

SALINASE NASAL SPRAY

PREDNISONE 1-2mg/kg/DAY BID-TID

MONTELUKAST (CI <2yrs old)

Metered Dose Inhaler:

Allergic Rhinitis Intranasal Steroids

• Reparil-N gel, apply to affected area as needed for pain

• Na alginate, Na bicarbonate, Ca carbonate (Gaviscon) chewable tablet, 1 to 2 tablets every after

• Zinc drops, give 1ml once a day (<6 months old)

• Heraclene Forte 3mg/capsule, take 1 capsule once a day (Adult)

ANTIBIOTICS - ASK FOR ALLERGIES!!!

CEFIXIME 8mg/kg/DAY OD or BID

CLOXACILLIN 50-100mg/kg/DAY QID

CLARITHROMYCIN 15 mg/kg/DAY, maximum dose of 1000 mg/DAY in BID for 7 days

ERYTHROMYCIN 30-50mg/kg/DAY QID

INSTRUCTIONS FOR DOXYCYCLINE INTAKE:

CLINDAMYCIN 10-30mg/kg/DAY QID

METRONIDAZOLE 30-50mg/kg/DAY TID

ACYCLOVIR with MEALS

INTENSIVE PHASE (2 months):

CONTINUATION PHASE (4 months):

• Colchicine 500mcg/tablet, take 1 tablet every 8 hours in acute attacks

• Tetanus toxoid 0.5mL/ampule - 0.5mL IM into deltoid muscle

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