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GP Guide

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0% found this document useful (0 votes)
800 views31 pages

GP Guide

Uploaded by

6yzrfrnpzb
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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‫ﺗم ﻋﻣل ھﺎذ اﻟﻣﻠف ﻛﺗﻠﺧﯾص ﻷﻛﺛر اﻟﺣﺎﻻت ﺷﯾوﻋﺎ اﻟﻠﺗﻲ ﯾﻘﺎﺑﻠﮭﺎ اﻟطﺑﯾب اﻟﻌﺎم ﻟﻣﺳﺎﻋدة زﻣﻼﺋﻧﺎ اﻷطﺑﺎء

اﻟﺟدد‬
‫د‪ .‬ﺳﻌﯾد ﻋﺑداﻟﻛﺎﻣل‬
‫د‪ .‬ﻣﺣﻣد ﺑدوان‬
‫د‪ .‬ﻋﺑداﻟرﺣﻣن ﻧور‬
‫د‪ .‬ﻗﯾس أﺑو اﻟرب‬
‫دﻋواﺗﻛم ‪..‬‬

‫‪Page 1‬‬
Antibiotics :
Amoxicillin : < mainly for URTI & part of H-pylori treatment >
 Ultramox: 500 (1x3) for 1 week
 Penamox: 500 (1x3) or 1000 (1x2)
Amoxicillin & Clavulanic acid: < mainly for URTI >
 Curam / 10 jd : 625 (1x3) or 1000 (1x2)
 Amoclan / 8 jd : 375 (1x3) or 625 (1x3) or 1000 BID (1x2)
 Klamoks / 5 jd : 1000 (1x2)

 Less than 35 kg  better to give syrup. Dose = 45 x weight


*aggressive dose = 90 x weight  used in otitis media or pneumonia
 Curam : 156 or 312 forte or 457 BID
 Amoclan : 156 or 312 forte or 200 BID or 457 BID or 600 BID
*Forte = (1x3) *BID = (1x2) ** keep in fridge after opened
*** Contraindicated in Pregnancy , esp. in first 2 semesters.
Cefixime : < mainly for URTI & UTI > Dose(mg) = 8 x weight
 Cefix / 12.5 jd : 200 (1x1) or 400 (1x1) for 5 days
 Suprax / 15.60 jd : 200 (1x1) or 400 (1x1)
 Apex / 15 jd : 200 (1x1) or 400 (1x1)
 Cefim / 11 jd : 400 (1x1)
* Better after eating

Syrup: Dose(mg) (1x1) = 8 x weight ( ≈ 5ml / 10 kg)


 Magnacef 100mg/5ml : (1x1) after eating for 6 days
 Cefix 100mg/5ml
 Suprax 100mg/5ml / 11jd
Ex: a 20 kg child  8x20=160 , when 5ml has 100mg, then he should
take 8ml per day
Page 2
Cefuroxime : < mainly for UTI > Dose = 10-20 x weight per day
 Zinnat / 6 jd : 500 (1x2) or 250 (1x2) for 5 – 10 days
* safe for pregnant
# Zinnat syrup : 125 or 250

Cefdinir : < mainly for severe UTI > Dose = 14 mg x weight


 Omnicif / 22 jd : 300 (1x2) for 5 days
* available also as Syrup 125mg/5ml or 250mg/5ml
 Sefarin , Dinixir  (same as Omnicif)

Ciprofloxacin : < mainly for UTI >


 Cipro : 500 (1x2) for 5 days , 10 days if complicated UTI
 Cipropharm : 250 or 500
* contraindicated in pregnancy and under 18 years old , because it can
cause tendon rupture & cartilage development problems

Levofloxacin : < may be used for UTI , Pneumonia or Prostatitis >


Dose = (1x1) for 7 or 14 days
 Ravivo : 500 / 5jd or 750 / 6.5jd
 Tavanic : 500 / 12jd
 Avoxin / Matador : 500 / 11.5jd or 750/ 17jd
*both levo & cipro interact with steroid , tramadol , warfarin ,
glimepiride + glyburide + insulin , clozapine

Doxycyclin : < mainly for dermatologic cases & acne >


 Doxydar , Vibramycin 100 / 2.5 jd : (1x1) for one month * (1x2) 1st day
* Contraindicated in pregnancy & younger than 8 years old + Vit. A
* better to avoid excessive sun exposure & milk products while using it

Page 3
Azithromycin : < mainly for URTI & first line for Pneumonia >
* safe in penicillin allergy and for pregnancy
 Zomax : 250 (1x2) or 500 (1x1) for 3 days
 Azomyne or Azi-once
* 250 dose can be given 2 tablets the first day, then 1 tablet daily

Syrup: (1x1) Dose(mg) = 10 x weight


 Zomax or Azomyne : for 3 days
(15ml or 22.5ml)  200mg/5ml or (30ml)  300mg/7.5ml

Trimethoprim-sulfamethoxazole : < mainly for UTI >


 Balkatrin 80 / 400 (2x2) for 5 days
 Septrin : 80 / 400 or 160 / 800
* used for 2 weeks
* S/E : Kidney stones , so need with it water more than 2-3 Liter daily
* interacts with ACE-I , ARBs , amloride & warfarin
Syrup: Balkatrin , septrin : 40/200 per 5ml Dose(mg sulfa) = 40 x weight
Ex: 20 kg child  20 x 40 = 800mg  20ml per day (divided into 2)

Clarithromycin : < mainly for URTI & part of H-pylori treatment >
 Klacid : 250 or 500 / 14jd
* available also as syrup 250mg/5ml or 125mg/5ml
 Claritt : 500 / 10jd
* Contraindicated in pregnancy

Page 4
Clindamycin : < mainly for dental cases >
 Clindacin / Dalacin C : 150/ 4 jd , 300/ 6.5 jd (1x3) for 5 days
* Contraindicated in pregnancy , esp. in first semester.
* S/E : Diarrhea , nausea & vomiting , upset stomach

Metronidazole & Spiramycin : < mainly for Gum cases > (Gingivitis)
 Dentagyl / 3.5 jd : (2x2) for 5 days
 Rodogyl / 4.80 jd : (2x2) for 5 days
* Contraindicated in pregnancy

Page 5
UTI :
Pregnant  Zinnat : 500 (1x2) for 5 days
Non-pregnant  1st : Zinnat , 2nd : Cipro , 3rd : balkatrin
Male  1st : Cipro , 2nd : Levofloxacin

I.M Antibiotics :
Ceftriaxone :
 Axone : 500 or 1000
 Samixon : 500 or 1000
 Triaxone : 500 or 1000
 * given slowly
 * never mix with ringer lactate or any calcium containing fluid.

Lincomycin : < mainly for dental cases > Dose = 10-20 x weight
 Lincocin 600mg/2ml / 2 jd

Antiviral :
Acyclovir :
 Zovirax :
- Tablet : 200/ 7.5jd or 800 / 30 jd
- Cream : for mouth or for skin
- syrup / 4 jd
 imavir :
- cream : for eye , for mouth or for skin

Page 6
Amoeba :
 Adult  Flagyl or Nidazol 500 : (1x3)
 Child  Flagyl or Nidazol syrup : 125mg/ 5ml or 200mg/ 5ml
*Dose(mg) = 10 x weight by 3 for 5-10 days
* example : 20 kg child : 20 x 10 = 200mg  5ml (200mg) x 3
*** Contraindicated & interacts with mebendazole
 Protogyn { Tinidazole } : 12 tablet / 6.25 jd , 4 tablet / 2.25 jd
* taken 4 tabs daily for 3 days  pause 7 days  take 4 tabs on day 11

Vomiting :
 Clopram {metoclopramide} :
Oral (1x3) or I.M
* S/E : fever , rigidity (spasm) , autonomic dysfunction
* “medically” contraindicated for younger than 12 years old patients
, because it can cross the blood brain barrier & have pyramidal effects.
 Onda {ondansetron}: Dose(mg) = 0.15 x weight
I.M 4mg or 8mg / 4 jd & oral 8mg / 20 jd (15 tablet)
* allowed from age of one year * one hour before meal
Dompridone :
 Motilat , Motilium / 2.5 jd :
Oral (1x3) 30 minutes before meal
Available also as syrup : for pediatric 5 ml x 3
Diarrhea :

 Vacontil , Imodium : taken 2 tablets together , then 1 after each diarrhea


 Diarox syrup: (1x3)
 Floratil : Sachet/ 4.65 jd & Tablet / 4.5jd(10) or 10jd(30) (1x1)
 ORS: 10 sachet/1.6jd , Smecta: 30 sachet/3.5jd , sobarice: 2 sachet/3.5jd (1x2)

Page 7
Constipation :
 Dulcolax : taken 2 tablets before sleep * max. for 1 week
 Duphalac , Ramlac syrup: (1x1) adult  20ml , child  10ml
 Glycerin suppository , Eva/qu suppository (adult or children)
 Movicol : 20 sachet / 5 jd (1x2) , forlax / 3jd , fortrans / 10jd
 EuCarbon : better not to eat 2 hours before & after

IBS :
*Diet : ↑ fiber, water \ ↓ spicy , salt , stress , legumes , caffeine
 Deflat , Gazix : chewable when needed , after meal
 Duspatalin (mebeverine) : (1x2) 135 or 200 *1 hour before meal
 EuCarbon : better not to eat 2 hours before & after
 Deanxit {antipsychotic + antidepressant}
 Vita colon relief / 19 jd : Probiotic
 Colo one / 22 jd : Probiotic (2x2) before meal
 Gas colon / 9 jd : (1x2) after meal
 Poxedium or Librax : (1x1) , S/E : bowel laziness , dependence

Supplements & Appetite stimulant

 Kid appetite 200 ml / 5jd : small spoon daily in the morning


 Mr Tumme candy : ‫ﻏﺎﻟﻲ‬

Page 8
Upset stomach / Abdominal cramps :

 Buscoban {hyoscine bromide} : (1x3) when needed


 Antipan I.M / spasmopan I.M
* indicated also in the treatment of acute gastrointestinal, biliary, and
genitourinary spasm including biliary and renal colic.
 Riabal : injection , syrup , tablet (normal or compound with paracetamol)
* Contraindications : BPH causing urinary problems , ↑ ocular pressure
* syrup dose : ↓ 6 m : 1 ml X 3 / 6-12 m : 2 ml X 3 / 1-2 y : 5 ml X 3 / 2-6 y : 10 ml X 3
 Peptoz : available as tablet / 5.25jd or syrup / 8.5jd (1x3)
 For Pediatric gases: Flatam plus (1 drop/kg) or Deflat , Gazix (15 drops X 3)
* available as drops or chewable (1x3)

Epigastric pain und heartburn :

* all preferred before meal but not a must.


 Lanzotec {lansoprazole} / 3.60 jd 15 or 30 *cheaper (1x1)
 Oprazol or Gasec {omeprazole} 20 / 3.5 jd : (1x1) * available as inj.
 Nexium {esmoprazole} : 20 / 10.5 jd or 40 / 14 jd
* also available as sachet dose 10
 Pariet {rapiprazole} : 10 / 5 jd or 20 / 8.5 jd
 Razon {pantoprazole} 20 / 3.80jd
** check for Vitamin B12 & Mg deficiency with chronic use of PPI
 Famodar {H2 blocker} : 10 / 1.3jd or 20 or 40 / 4.5jd (cheap)

Acid Reflux (Antiacid) :

 Life style : small meals , stay up after meals , ↓ coffee , spicy , Sauer , fat
 Gaviscon : available as syrup ( normal & advance) or chewable
 Rennei or Tums / 3.60 jd : chewable
 Fawar Fruit / 0.60 jd : sachet
Page 9
Cough :
Dry cough : (1x3)
 Cofex / 1 jd
 Sinecod { butamirate } / 5 jd
 Drycod { butamirate } / 2.5 jd

Productive cough : (1x3)


 IVY
 Pelargos / 4.70 jd
 Mucosolvan { ambroxol } / 3.30 jd : available as tablet & syrup
 Fluibron { ambroxol } / 2.60 jd : available as tablet & syrup
 Mucinex { Guaifenesin } / 6 jd : available only as tablet (1x2)

Pregnant :
 Broncare / 2.70 jd
 Melrosum
 prospan : available also as suppositories for pediatric

Infant :  Hedral : available as drops / 2.5 jd or syrup / 2 jd

Steroid cough syrup : * used for 3-5 days maximum


 Orexon / predone {prednisolone} /6 jd (1x1 or 1x2)
* 15mg/5ml -dose(mg) = 0.75 mg/kg , dose(ml) = 0.25 x weight
 Decadron {dexamethasone} / 2 jd ‫ اﯾﺎم‬6 ‫اول ﯾوم ﻣﻌﻠﻘﺗﯾن ﻛﺑﺎر ﻋﻠﻰ ﻧﺻﯾن ﺛم ﻧﻧﻘص ﺗدرﯾﺟﻲ ﻟﻣدة‬
 Citadone {betamethasone} 0.6mg/5ml ‫ اﯾﺎم‬6 ‫اول ﯾوم ﻣﻌﻠﻘﺗﯾن ﻛﺑﺎر ﻋﻠﻰ ﻧﺻﯾن ﺛم ﻧﻧﻘص ﺗدرﯾﺟﻲ ﻟﻣدة‬

Other : ‫ اﺳﺗﻧﺷﺎق ﺑﺧﺎر اﻟﻣﺎء و اﻟﻣﻧﺛول‬, ‫ ﻏرﻏرة ﺑﻣﻲ و ﻣﻠﺢ‬, ‫ زﻧﺟﯾﺑل‬, ‫ﻋﺳل ﻣﺧﻠوط ﺑﻣﺎء داﻓﺊ او ﻟﯾﻣون‬
Page 10
Nebulizer :
 Ventolin 20 ml / 3 jd: duration : 10 minutes
*pediatric  1 ml Ventolin + 2 ml normal saline
* Adult  2 ml Ventolin + 4 ml normal saline
- S/E: tachycardia , headache
 Pulmicort 20 ampules / 15 jd :
* 1 ampule + 2 ml normal saline
 Combivent 20 ampules / 9.5 jd: ( weaker & less irritating)
* no need to be diluted
- S/E : frequency + dysuria

Asthma exacerbation & wheezy chest:


 1- Oxygen
2- Ventolin nebulizer
3- If no response  Hydrocortisone 100 or Pulmicort nebulizer
OR

 ½ ml salbutamol + ½ ml adrenaline + 2 cc dexa  in nebulizer for 15 minutes

Croup :
 1 ml adrenaline + 2 ml saline

Page 11
Antihistamine :
Chlorphenlamine melate *Better before sleep.
 Allerfin : available as *dose syrup: 0.2 -0.5 mg / kg
* injection 10 mg *dose : (1x1) mostly
*tablet 4 mg (1x1) to (1x4)
*syrup (1x1) or (1x2)  younger than 2 years = 2ml\day (≈ 1 mg )
 2 – 8 years = 3-4 ml\day (≈ 2 mg)
Dimetindene : * has sedative effects
 Fencil , Fenistil : available as gel , drops & tablet 1 drop/kg

Cetirizine : * has sedative effects


 Cerin : available as tablet or syrup.
 Zyrtec , Finallerg : available as tablet or syrup or drops

levocetrizine :
 Layal : available as syrup or tablet (quantity : 10 or 30 )
 Xyzal : available as tablet.

Desloratadine :
 Aerius , Aeriallerge , Histacare,Dora,iris : available as tablet or syrup.

Loratidine: *safe in pregnancy


 Clara , Loratan : available as tablet or syrup.
 Clarinase { loratadine and pseudoephedrine (a decongestant)}
* avoid using pseudoephedrine containing drugs in HTN & prostate
Hydrocortisone 100 mg I.V or I.M
Diprofos injection  for seasonal allergy
Page 12
Runny nose :
Decongestant :
 Otrivin or Decozal : (1x1) for 3-5 days maximum
* available for Children or Adults & as drops or spray
 Steroid : used in missuse of Otrivin
*Rhinocort or Sinocort or Nasonex (2x2) *spray laterally after wash
 Trifed or Unifed : available as tablet or syrup. (1x1)
* Contraindicated in younger than 6 years old patients.
*Trifed syrup  normal or plus / Unifed syrup  normal , DM , extra , expectorant

Other:
 Snip : (1x3 or 2x3) *S/E: dryness ( better not use it for a long time)
 Panadol , Panadol sinus , Panadol cold & flu
 Abisal nasal spray: NaCl in allergic rhinitis
 Pelargos or Zorex (sugar free)

# In case of allergic rhinitis give :


- Antihistamine for 7-10 days (1x1)
- steroid nasal spray for 2 weeks
# In case of new rash give :
- I.M allerfin + Dexa , with antihistamine for 7 days
- or Hydrocortisone 100 , with antihistamine for 7 days
Insict bite :
 Tarrad after bite
 Fenistil
Fusicort
 Hydrocortisone 100 if sever
Page 13
Analgesics & Antipyretic : *dose : (1x3 or 1x4) mostly
Paracetamol:
 Tablet : Panadol , Panda , Adol , Revanin
 Syrup : Panda , Adol , Revanin one dose syrup(mg): 12.5 mg / kg
 suppositories : Adol , Revanin
 I.V  Perfalgan
NSAID: ask always : asthma , peptic ulcer , kidney disease , pregnant
 Ibuprofen :
*Oral  Brufen 400,600,800 , Advil 200 , Doloraz 400 , Ibugesic 200,400
* Syrup 100  Ibugesic , Doloraz , Brufen one dose syrup(mg): 8 mg/kg
* Drops  Jofen
 Ibuprofen + paracetamol : Ibumol 400 / 1.60 jd
 Diclofenac sodium: < has more Antipyretic effects, delayed+prolonged >
*Oral  Voltaren , Divido , Declogesic , Tratul , Voldic SR
* suppositories  Voltaren 50 or 100 , Declogesic 12.5 or 50 or 100
* I.M  Voterx 75 , Almiral 75 , Olfen 75 , Tratul 90
 Diclofenac Potassium : < has more Analgesic effects , rapid + short >
Rapidus , Voltfast ( available also as sachet ) , Voldic K , Cataflam
 Naproxen : No Pain 250 & 500 , Proxen 250 & 500
 Memfenamic : < very good for Dysmenorrhea & menstrual cramps >
Fendol , Fenamic : available as syrup or tablet 500 (1x2)
 Dexketoprofen : Ketesse  available as tablet , sachet or injection

# we can mix Paracetamol & Diclofenac suppositories


Example : the child can take para & after 6 hours take Diclofenac supp.
Gel :
 Diclofenac sodium : Voltaren , Declogesic , Tratul
 Ibuprofen : Doloraz Ketoprofen : Fastum Gel , Ketofast Gel
Page 14
Joints :
 Panadol joint : (2x3)
 Etoricoxib (1x1) for 7 days maximum
- Etoxa : 60 , 90 , 120 ‫ﺧﻔﯾف ﻋﻠﻰ اﻟﻣﻌدة‬
- Arcoxia , Atoxia : 60 , 90 , 120
- Torix : 90 , 120
 Celecoxib
- Celebrex : 100 / 5 jd or 200 / 5 jd (1x1 or 1x2) strong
** Celecoxib & Etoricoxib can be given to peptic ulcer patients

 TemprMandubular Joint pain  Nimelide 100mg after meal

Muscle Relaxant :
Oral : (2x2)
 Tolperisone : Mydocalm / 7 jd or Myomax
 Eperisone : Myonal / 6 jd
 With Paracetamol : Myogesic / 1 jd or Relaxon / 2.80 jd
Gel:
 Tratul or Voltaren / normal  3jd , 12 hour  5jd or Fastum Gel
 Deep heat / 4.5 jd or Harrar / 2.5 jd or Barrad / 3.5 jd

sleep disorder
 Melatonin : under tongue tablet
 Panadol night : (2x1) half hour before sleep.
 Allerfin
 Magnesium  used for chronic insomnia & joint pain
 For pediatric  Bonnuit drops : older than 2 years : 20-30 drops/day
Page 15
Eye/Ear Drops :
Antibiotic : * drops (1x4) / ointment (1x2)
 Abigen drops/ointment {gentamycin} : for eyelid infection (weak)
 Tobradex or Tobrason {tobramycin & dexamethasone }
 Tobrex or Tobracin {tobramycin }
 Oflox {ofloxacin }
 Ciprocin {ciprofloxacin } * for bacterial ear infections
 Fucithalamic ointment / 3.25 jd : for eye stye / hordeolum ‫ﺷﺣﺎذ اﻟﻌﯾن‬

Antihistamine : (1x3)
 Olopat / 3.5 jd
 Naphcon A / 1.5 jd *don’t use for a long period
 Orchazid / 3 jd

Antiviral :  Imavir

Moisturizing :
 Abisal (NaCl) / 1 jd : for Eye & Nose
 Isotears / 2.5 jd : for Eye
 Tears Guard / 4.5 jd : for Eye

Other :
 Waxol or Dewax / 1 jd : for ear wax * used twice daily for 3-7 days
 Otocol { Chloramphenicol + Benzocaine } : for ear pain & itching
 Phenicol ointment {chloramphenicol} : for eye infections but very
good for Epistaxis & also for dry nose
Page 16
Creams & Ointments :
Antifungal :
 Mycoheal { miconazole }
*Available as cream , oral gel , vaginal cream & suppositories
 Daktarin { miconazole } : Available as cream & oral gel
 Travocort { isoconazole } cream
 Lamisil { Terbinafine } < best for foot fungal disease >
* Available as cream or Spray
 Baneocin : Available as cream or powder
* used after circumcision or for infant umbilicus

Oral Thrush (candida) :


 Mycoheal oral gel {miconazole} : (1x1) for 5 days
 Deflucan / 4 jd or Flucand / 3.5 jd {fluconazole} : given with a fatty
meal as a single dose (1 tablet) & can repeat after 3 days if didn’t improve.
* contraindicated in pregnancy
 No response ?  Mycosat {nystatin} : continue for 4 days after
improvement ‫ﻣﺿﻣﺿﺔ ﺛم ﺑﻠﻊ‬

Fungal infection of the scalp :


 1st  Nizoral : ketoconazole shampoo , used once daily
 2nd  Deflucan or Flucand : take 2 tablet and repeat after one week .

Fungal vaginal infection:


 Deflucan or Flucand : take 2 tablet and repeat after one week .
 Mycoheal vaginal cream

Page 17
other :
 Bepanthin cream/ 2.5 jd or Panthophil < moisturizing, sun burns & wounds >
 Mebo or mebo s (scars) < for burns >
 ialuset plus / 7 jd < for burns >
* better to avoid sun exposure
 Contractubex /3.5jd : <for new wounds scars> *use after 1 weak of injury

 *Fucidin or *Dermofucin or Fusibact { Fusidic Acid} (1x2)


 Fusicort or Tobizone or Fusibact-b { Fusidic Acid & Betamethasone}
• don’t use for acne , burns , wounds & diabetic foot *delay healing
 Fucidin H { fusidic acid & hydrocortisone acetate }
*available as cream (mainly for the face) or ointment (*)
 {clindamycin} : clindacin gel , Clinimycin T gel  < for acne >
 {erythromycin} : Spotex , Zineryt  < for acne >

 Acretin 0.025% or 0.05% , Differin cream or gel , Azelderm : ‫ < ﻣﻘﺷر‬for acne >

 { Betamethasone 0.1%}  Betaval (cream + ointment) or


betnovate (cream + ointment + scalp)
 Delor or cloderm { clobetasol 0.05%}
 Elica , Elna , Elocom { Mometasone Furoate 0.1 % }

 Reparil gel or premaril gel : < for swelling & contusions >
 Panderm / 2jd : < for everything :) > (1x2) *don’t use for a long period
Hemorrhoids :
 Procto-Glyvenol {tribenoside+lidocaine}: suppositories (1x2) or (1x1)
 New healer : cream / 4 jd or suppositories / 3jd (1x2)
 Proctoheal : cream or suppositories / 2.5jd (1x2)
 Herox : cream or suppositories
 Xylophil {lidocaine}
 + Daflon 500 (1x4)
Page 18
Hand foot mouth disease:
 Antihistamine (allerfin) / Antihistamine cream or drops (Finistil):drop/kg
 Paracetamol or ibuprofen (Fencil)
 Oral gel if have difficulty eating (mycoheal)

Warts :
 Wartan cream / 9jd , Cornex cream / 5.5jd (1x2)
 Avomack , Collomack solution / 3jd (1x2) *put Vaseline around the wart

Lice ‫ﻗﻣل‬
 Lice shampoo: Paranix shampookeep on head for 10 minutes
 Nyda spray or Delice spray : use 3 hours before showering

Scabies ‫ﺟرب‬
 Sporofulvin : ( 1x3 )
* available as tablet or syrup , but hard to find

Chicken pox ‫ﺟدري اﻟﻣﺎء‬


 Calamine lotion / 1.5 jd
 Antihistamine ( aerius, aeriallerg, , , , )
* avoid showering & contact with others for 7-14 days.

Hair loss & weakness


 Biotin (vitamin B7) , Perfectil / 13 jd (1x1) for 3 months
 Seba-med anti-hairloss shampoo

Colic or discomfort in urinary tract / stones :


 Alka-ur or Coli-urinal / 1.5 jd : (1x3)
One Tablespoon in a cup of water x 3 per day
Page 19
Dizziness : dose : (1x3)
 Betaserc { Betahistine } : 16mg/ 13 jd or 8mg / 8 jd
 Mezan { Betahistine } : 16mg / 7.5 jd or 8mg / 4.5 jd
 Vertizin { Cinnarizine} / 1.75 jd “weaker”
 Can be given a mixture I.M injection of clopram + antipan + dexa

Hypothyroidism :
 Euthyrox or Eltroxyn 25 , 50 , 100 , 150 (1x1)
* dose = 1.6 x weight , 50 is usually the initial dose.
* should be taken as early as possible 30 minutes minimum
before breakfast & better to have a fixed hour.
* return to clinic after 2 weeks for assessment

Hyperthyroidism :
 Carbimazol / 7jd

Raynaud phenomenon :
 Lowvasc 5 { CCB : amlodipine / nifedipine} once daily

Stiffness and pain in the neck


 Dexa + votrex
 Muscle relaxant for 5 days
 analgesic / relaxant gel

H-pylori treatment :
1- tavanic 500 { Levofloxacin} (1x1) for 2 weeks or Clarithromycin 500 (1x2)
2- Panamox 1g {amoxicillin} (1x2) for 2 weeks
3- Lanzotec 30 {PPI} (1x2) for 6 weeks
* Quadrable  add Flagyl 500 {metronidazole} (1x2)
Page 20
Oral iron :

 Glucofer Remafer \ 2.60 jd : 1x3 ‫ﺿﻌﯾف‬


S/E : constipation & epigastric pain

 Tradiferron \ 2.65 jd : 1x2 or 1x1

 Feroglobin \ 8 jd : 1x1 for 3 months


Iron + other supplements

 Ferrotron \ 13 jd : 1x1 for 3 months


Iron + vit.C + other supplements

 Bioferrin \ 15 jd : 1x1 for 3 months

 Irofix \ 15 jd : Drops , syrup or tablet


Iron + vit.C + other supplements

 Ative Iron / 22 jd

* Vitamin C is recommended with all types to reduce constipation


* after 1 month redo Ferritin & after 3 months redo CBC
* oral iron is better taken at an empty stomach (to enhance absorption)
* avoid calcium containing food with it ( milk products , green leafy vegetables)

Page 21
IV Iron :

 Venofer / 6 jd per ampule


each 2 ampules raises 1 HB
One ampule taken every other day in 500 NS for 45 minutes

 Ferromax / 3 jd per ampule


each 2 ampules raises 1 HB
One ampule taken every other day in 500 NS for 45 minutes
* 2 ampules can be taken together

 Ferrasil / 3.25 per ampule


each 3 ampules raises 1 HB
One ampule taken every other day in 500 NS for 45 minutes
* 2 ampules can be taken together

 Ferinject / 125 jd : 5ml or 10ml , both 500 concentration


taken in 500 NS for 75 minutes
Once every 6 months

* i.v iron is better taken after a meal (because it may lower the blood pr.)
* avoid giving i.v iron when the female patient is at her period.

Iron allergy :
1- 100 hydrocortisone I.V
2- wait 5 minutes
3- another 100 hydrocortisone I.V
4- no response ?
5- 0.5 ml adrenaline I.M or S.C ( not I.V !!)
Page 22
Pediatric iron :
Drops :
younger than one year : 5 drops daily , 1-2 years : 10 drops daily
 Irofix drops / 11 jd
 Ironorm drops / 6 jd
Syrup :
3 – 6 years old : 2.5 ml daily , 6 - 13 years : 5 ml daily
 Irofix / 12 jd ( iron + Vitamins )
 Irona / 3 jd
 Feroglobin / 8 jd
 novoferr
 Feromix : 5 ml once daily for 3 months
* drink water after it

Vitamin B12 :
• Cyanocobalamin (initial form)  mecobalamin  hydroxycobalamin (best)
 {cyanocobalamin} / 7 jd (10 ampules)
 Mythycobal { mecobalamin} / 10 jd (10 ampules) ‫اﺟﻧﺑﻲ‬
 Cobal { mecobalamin} / 7.65 jd (8 ampules) ‫اردﻧﻲ‬
 Vit B12 Depot { hydroxycobalamin } / 4.5 jd (3 ampules)

* available in I.M & oral / 5 jd  (1x1 or 1x2) has 30 tablet


* I.M taken every other day.
* prophylaxis only once monthly.

 Neurobion (vit b1 , b6 , b12 { cyanocobalamin } ) / 2.35 jd :


one tablet every other day * available as injection & tablet
Page 23
Folic Acid :

- 0.4 mg = 400 microgram : Prophylaxis or for pregnancy


- 4-5 mg : in case of deficiency , for 4 months
 * When the patient has b12 & folic acid def. , give first b12 then give
folic acid.

Vitamin D :
*always should be taken after a big fatty meal
Drops :
Each 1 drop = 400 microgram
*Younger than 6 months old : 1 drop daily
*2-5 years old: 2 drops daily *older than 5 years old: 4 drops if def.
 Dedrogyl : doesn’t needs refrigeration
 Biodal / 5.75 jd : doesn’t needs refrigeration
 Hi-dee / 4 jd : needs refrigeration

Tablet :
50 000 once weekly for 3 months , then once monthly for 1 year.
 Biodal / 10 jd (12 tablet 50 000)
 Hi-dee / 8 jd (12 tablet 50 000)
 D3 max / 12 jd (20 tablet 50 000)

Injection :
 D-rise 200 000 / 37.5 jd : given I.M once monthly
 Dibasa 300 000
Page 24
Notes :

 Normal Saline for children: 10-20 × weight


Example : 20 kg child  give 200 – 400 ml NS

 To distinguish bacterial tonsilitis from viral tonsilitis use modified


Centor criteria

 To examine the ear :


Adults  pull the ear backward , laterally & upward
Pediatric  pull the ear backward , laterally & downward

 Before GI endoscopy can the patient be given :


4 tablets of Dulcolax + 1 sachet of Picoprep

 Gallstones in bile duct  Rowachol (2x3) for max. 3 days


 kidney and urinary tract stones  Rowatinex (1x3) before meal

 silent GERD : recurrent URTI  give H2 blocker ( Famodar )

 Neuralgia : votrex , b12 , Tiapridal


Page 25
 Motion sickness :
* Navidoxine , Vominore {meclozine + vit. B6 }

 Coma cocktail : “DONT”


D : Dextrose 100 ml ( the cause may be hypoglycemia )
O : Oxygen ( the cause may be hypoxemia )
N : Naloxone 1 mg , i.v ( the cause may be opioid toxicity)
T : Thiamine 100 mg , i.v ( the cause may be alcohol toxicity )

 Helminths : {Mebendazole}  Bendazole , Vermox


* Pinworm : 1 tablet (100mg) & can be repeated after 2 weeks
* Whipworm & Roundworm & Hookworm : 100mg tablet X 3 or
one 500mg daily for 3 days, the course can be repeated after 2 weeks

Dexamethasone & Votrex ( diclofenac sodium ) in Pediatric


Dexa :
• “medically” allowed from age of 2 years
• Dexa ampule has 2 ml  each 1 ml contain 4 mg dexa.
• Dose (mg) = 0.2 – 0.5 x weight
Example : 27 kg child : 27 x 0.3 = 8 mg  can be given 1 ampule
* should be given starting from 20 kg : 20 x 0.2 = 4mg = 1ml

Votrex :
• “medically” allowed from age of 6-12 years
• Votrex ampule has 3 ml  each 1 ml contain 25 mg diclofenac
• Dose (mg) = 1 – 2 x weight
Example : 25 kg child : 25 x 1.5 = 37.5 mg = 1.5 ml = half ampule
* should be given starting from 20 kg : 20 x 1.25 = 25mg = 1ml
*can be repeated after 8 hours
Page 26
Paracetamol :
 I.V perfalgan can be given from the age of one month & sometimes
even earlier.

 Dexa , allerfin , clopram , antipan :


 0-5 years old : 1/4 the ampoule
 5-12 years old : 1/2 the ampoule
 12-18 years old : 3/4 the ampoule
 above 18 years old : whole ampoule

 I.V 100mg hydrocortisone :


 0-3 years old : 25 mg
 3-5 years old : 50 mg
 5-12 years old : 75 mg
 12-18 years old : 100 mg
 above 18 years old : can be given 200 mg

* don’t mix Votrex with Antiban , because it will generate a thick solution.
* don’t mix Furosemide with Metoclopramide

Page 27
> Sphygmomanometer > Thermometer > Pulse oximeter
> Glucometer > Nebulizer > Weighing Scale > Otoscope

> Normal saline 0.9% > Ringer lactate > Dextrose 5%

> Canula & Syringes > Alcohol swabs > iodine


> Stitching Kit & Sutures > dressings & plaster > Gause & Cotton
> Tongue depressor > Nebulizer mask > I.V set
> Gloves > Bed sheets > Blades > Foleys catheter

> Allerfin 10mg/ml (only i.m) > Allermin 10mg/ml (i.m or i.v)
> Diclofenac 75mg/3ml (except tratul 90mg/3ml) > Dexamethasone 8mg/2ml
> Clopram 10mg/2ml > Antipan 20mg/ml > Omeprazole 40mg
> Furosemide 20mg/2ml > Hydrocortisone 100mg (dissolved in NS)
> Antibiotic: Ceftriaxone (500mg or 1g dissolved in 4ml lido) or Lincomycin (600mg/2ml)

> Fucidin > ialuset plus > Lidocaine (cream+spray) > Phenicol

> Paracetamol suspension (100ml) > Salbutamol (ventolin)


> ipratropium + albuterol (Combevent) > ipratropium (Atrovent)
> Budesonide (Pulmicort) > Salisal plus + isosorbide “suspected MI ”
Page 28
** Life style : ↑ sport , ↓ weight , ↓ salt , ↓ coffee , ↓ smocking

1- ACE-I : ACE press , Linopril  5mg or 10mg or 20mg


* 1st line therapy in HTN + DM patients
* S/E : cough , headache + dizziness , hyperkalemia , skin rash , angioedema
* need 15 to 30 days to show results
* CI : pregnancy , bilateral renal artery stenosis , Hx of angioedema
* both ACE-I & ARBs interact with Trimethoprim & Aliskiren

2- ARBs : Atacand , blopress  8 or 16 / ARBITEN  80 or 160 / Vivazac  150 or 300


* 1st line therapy in HTN + DM patients
* S/E : headache + dizziness , hyperkalemia
*** Enresto : valsartan + sacubitril

3- Beta-Blocker :
selective B1 : Concor , B-cor  2.5 or 5 or 10
*1st line therapy in asthma & bronchitis patients
Non-selective B1 + B2 : Indicardin  10 or 40
* CI in Asthma , and avoid in DM (can lower blood sugar) & dyslipidemia
* Non-selective can be used to treat Migrane .
* S/E for both : nausea , bradycardia , impotence , can’t be stopped suddenly

4- CCB :
Nondihydropyridine : works mainly on heart
Isoptin  80 or 240 / Dilzem  90
dihydropyridine : works mainly on blood vessels ( amlodipine / nifedipine )
Adalat  30 or 60 / Lowcasc , amlocard  5
* can be used to treat Ryanaud phenomenon
* interacts with Ketoconazole

Page 29
5- Loop diuretic : Lasix , Diusemid  40mg or ampoule 20mg/2ml
* S/E : ↑ blood sugar , ↑ uric acid , ↑ Lipid , ↓ Ca,K,Mg , ringing in ears
* CI : Gout , BPH , inability to urinate or obstruction
* interacts with gentamicin , streptomycin & amiodarone

6- Thiazide diuretic : Modrex  25 mg


* S/E : ↑ blood sugar , ↑ uric acid , ↑ Lipid , ↑ Ca , ↓K,Mg , impotence
* CI : Gout , hypokalemia , liver failure , lithium taking
* better to take morning + eat potassium containing food ( banana , date ..)
*interacts with Lithium & amiodarone

7- Spironolactone : aldacton , noracton  25 or 100


* S/E : ↑ K , gynecomastia , headache + dizziness , mouth dryness , dyspepsia
*interacts with ACE-I , ARBs & loperamide

• less than 55 old patients: start on 1- ACE-I , 2-Diuretic , 3- CCB , 4- BB


• more than 55 old patients: start on 1- CCB , 2- ACE-I , 3- Diuretic , 4- BB

1- Statin : Lipitor , Atorvast  10 or 20 or 40 or 80 / Crestor  10 or 20


* used mainly to reduce abnormal cholesterol levels
* S/E : nausea + vomiting , headache, skin rash , stool changes , myalgia
* should test LFT before starting
* CI : Pregnancy , abnormal x3 LFT
*interacts with Fenofibrate , Gemfibrozil & Itraconazole & amiodarone ,
amlodipine , clarithromycin , fluconazole , ketoconazole , verapamil
* better to be taken once before sleep

2- Fenofibrate: Lipanthyl  160 or 200 / Lopid  600


* used mainly to reduce abnormal TG levels
* S/E : headache, stool changes , myalgia & arthralgia , dyspepsia , skin rash
*interacts with Statin & warfarin & lopramide & pioglitazone
Page 30
1- Insulin

2- Metformin : Glucophage , formit  500 , 750 , 850 , 1000


* ↓ hepatic glucose production , ↓ GI glucose absorption , ↑ insulin sensitivity
* S/E : GI upset --> better taken after meal
* CI : chronic heart failure , DKA , severe renal disease

3- Pioglitazone : Actos  15 or 30 or 45
* ↓ hepatic glucose production , ↑ insulin sensitivity
* S/E : chest pain , problems with teeth & respiration , fatigue
* interacts with Clopidogrel & Gemfibrozil

4- Sulfonylurea : Amaryl , Glemax  1 or 2 or 3 or 4 / Glibil  5


* ↑ insulin from pancreas, ↓ hepatic glucose production, ↑ insulin sensitivity
* S/E : headache + dizziness , tachycardia or palpitation , anxiety , hunger
*better to be taken one hour before sleep
*** repaglinide has a similar action to Sulfonylurea but contain no sulfa :
NovoNorm  0.5mg or 1mg or 2mg

5- DPP4 inhibitor : Onglyza  2.5 or 5 / Galvus  50 / januvia  100


* block the metabolism of the incretins. ↑ insulin from pancreas, ↓ hepatic glucose production
* S/E : headache + dizziness , tachycardia or palpitation , anxiety , congestion
* better to be taken at a fixed time with meal + drink a lot of water & fluids

6- GLP-1 agonists (incretin mimetics) : injection


Ozimpec  0.25mg or 0.5mg or 1mg / Victoza  6mg/ml

7- SGLT2 inhibitors: empaxa  10 or 25 / Forxiga , Divinus  5 or 10


* inhibit the reabsorption of glucose in the proximal convoluted tubule
* S/E : ↑ sugar in the urine = ↑ the likelihood of UTI and fungal vaginitis

Page 31

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