EDLU Drugs

EDLU Drugs

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z ALL
Drug Name Dosage / Duration

Dapsone

Leprosy

100mg(paeds 1-2mg/kg) po once a day for 6-12 months

Sickle Cell Anaemia ,malaria prophylaxis

1 tablet po once weekly continuously

Dermatitis herpatiformis

50mg po daily, titrate to 300mg to achieve desired effects

Adverse Effects-

hemolysis, methemoglobinuria, insomnia, headache, dermatitis, nausea, vomiting, anaemia, leukopenia, agranulocytosis, hepatitis, SLE

Drug Interactions:

Serious-BCG vaccine, calcium carbonate, sodium bicarbonate, typhoid vaccine.

Significant- carbamazepine, clarythromycin, digoxin, efavirenz, erythromycinestradiol, isoniazid, rifabutin

Benzathine penicillin

Rheumatic Fever

0,6MU im single dose

Prophylaxis after rheumatic fever

2,4MU im monthly upto 21 to 30 years

RPR Positive and syphilis in pregnancy

2.4MU im once a week for 3 weeks

Genital Ulcers

2,4MU im stat

Adverse Effects- skin rashes, urticaria, serum sickness, pseudomembranous colitis

Drug Interactions:

Serious-cholera vaccine, amodacycline, seracycline

Significant-magnesium oxide, estradiol valerate, apalutamide

Dexamethasone

Preterm Labour

12mg im for 2 doses 12 hours apart

Post Cataract Surgery

0,1% eye drops 1 drop 6 hourly for 6 weeks

Bacterial Otitis Externa

3 ear drops twice daily for 7 days

Croup

0,1-0,6mg/kg IV 6 hourly

Raised Intracranial Pressure

12-16mg po once daily, review

 

Adverse Effects

allergic reactions,rash, dermatitis, decreased glucose tolerance, cushingoid state, supresion of growth in paeds, fluid and electrolyte disturbances, neurological and psychiatric effects

Drug Interactions

Contraindicated-apixaban, coatemether, praziquantel

Serious-BCG vaccine, clarithromycin, dabigatran, diptheria and tetanus toxoid, erythromycin, hemophilus influenza b vaccine, HPV vaccine, ketoconazole, polio vaccine, typhoid vaccine, yellow fever vaccine

Enalapril

Hypertension

40mg po once a day long term

Chronic Heart Failure

5-20mg po once daily long term

Nephrotic Syndrome

5-10mg po once daily, review

Adverse effects

dizziness,hypotension,headache,hyperkalemia,nausea,vomiting

Drug interactions

serious-allopurinol,asprin,celecoxib,diclofenac,ibuprofen

significant-azathioprine,carbamazepine, carbidopa,cyclosporin, digoxin

F-75

(children 6-59 months) malnutrition phase1(stabilisation phase)

130  ml  per  kg  of  body  weight  per  day until  the  patient  regains  appetite. Start  with  2  hourly  feeds  (12  feeds  per  day),  and gradually  decrease  the  frequency  of  feeding  and increase  the  volume  of  each  feed  until  the  patient  is getting 3 hourly  feeds  (8  feeds  per  day

F-100

(Children  6 to  59 Months) malnutrition transition and rehabilitation phase

Replace  F75  with  F 100 at 150ml per kg body weight  per  day. Gradually  introduce RUTF  in  small  amounts  until   the  child    can  consume  ¾  Sachet  per  day ? When  accepted,  provide  RUTF  at  130kcal  per  kg  of body  weight  per  day

 

Factor VII

Hemophilia A

Mild  bleed

(nose,  gums etc.) 14  IU/kg 

Moderate  bleed 

joint, muscle,  GIT,  minor  surgery 20  IU/kg

Major bleed

(e.g.cerebral) 40 IU/kg

Prophylaxis for major surgery

60 IU/kg

Adverse effects

fever, hemorrhage, hypertension, bradycardia, edoma, hypersensitivity, injection site pain, arthrosis

Drug interactions

anti-inhibitorcoagulant complex, factor IX complex

 

Factor IX

Hemophilia B

Mild bleed

factor IX concentrate 2 x 500 IU daily then Review

Major bleed

factor IX concentrate 3-6 x 500 IU daily then Review

Adverse effects

headache, dizziness, nausea, urticaria, dyspnea, allergic reaction, flushing , fever

Drug interactions

contraindicated-prothrombin complex concentrate,tranexemic acid injection

serious-tranexemic acid oral

Famciclovir

Herpes zoster ophthalmicus(250mg tablet)

500mg 3 times per day 7 days

Acute herpes zoster(shingles)

500mg po 3 times a day for 7days(initiate within 72hrs of symptoms or lesion onset

Herpes labialis, genital herpes

250mg po 3 times a day for 7 to 10 days

Prevention of Herpes siplex virus reactivation in HIV positive patients

500mg po twice per day

Adverse effects

headache, nausea, abdominal pain, pruritus, rash, parasthesia, neutropnea, fatigue

Drug interactions

contraindicated-varicella virus vaccine live, zoster vaccine live

serious-talimogene laherparepvec

monitor closely-digoxin,probenecid, raloxifene, tenofovir, 

minor-cimetidine, promethazine

Fentanyl inj

Surgery premedication

50-100mcg/dose or slow IV 30-60minutes prior to surgey

General anasthesia

minor procedure-0,5-2mcg/kg/dose IV

major procedure-2-20mcg/kg/dose initially then 1-2mcg/kg/hr maintanance infusion IV. Discontinue infusion 30-60minutes prior to end of surgery

Analgesia

1-2mcg/kg IV bolus or 25-100mcg/ dose PRN

Adverse effects

asthesia, confusion, constipation, dry mouth, nausea, somnolence, anorexia, anxiety, euphoria

Drug interactions

contrandicated-phenelzine, rasagiline, safanamide, tranylcypromine, isocarboxazid

serious-atazanivir, atracurium, chlorpromazine, cimetide,doxycycline, fluconazole, haloperidol

monitor closely-atropine, carbamazepine, dexametahsone, efavirenz, furosemide, nevarapine, phenytoin, tinidazole

 

Ferrous sulphate

babies born at <36 weeks gestation and/or <1.5kg starting at 1month

(60mg/5mls = 12mg elemental iron /5mls) 3-6 mg/kg elemental iron   once a day to age 3mths

Severe acute malnutrition 

(Fe once a day 14 days) 

4-<6kg 6mg

6 - <10kg 12mg    

1-3yrs  18mg  

3-5yrs 24mg

Anaemia in hookworm

( once a day 30 days)

6 - <10kg 12mg 

1-3yrs  18mg     

3-5yrs 24mg

Anaemia in pregnacy

(prophylaxis in ANC) 200mg once a day Throughout pregnancy (treatment of microcytic anemia) 200 3 times a day

Anaemia

200[60mg  iron] (Paed  =  12mg  iron,  <1yr  =  6mg  iron) 3  times  a day for 1 month

Adverse effects

constipation, dark stool, nausea, stomach pain, vomiting, urine discolouration, contact irritation

Drug interactions

contraindicated- eltrombopag

serious-doxycycline,gemifloxacin, tetracycline, ofloxacin,lymecycline

monitor closely-cimetidine, ciprofloxacin, dolutegravir, esomeprazole, famotidine, levodopa, methydopa

minor- calcium carbonate, carbidopa, manganese, calcium gluconate, didanosine, acetohydroxamic acid

Fluconazole

Cryptococcal meningitis

Amphotericin B +fluconazole po 800mg Once a day 2 weeks

then fluconazole po 800mg Once a day 8 weeks

then Fluconazole po 200mg Once a day Until CD4 count >200 cells/mm3 for 6 months

(If iv Amphotericin B is not available) :fluconazole po  1200 mg Once a day 2 weeks

then fluconazole po 800mg Once a day 8 weeks

 then Fluconazole po 200mg Once a day Until CD4 count >200 cells/mm3 for 6 months

Neonate under 2 weeks

fluconazole po B V 6–12 mg/kg every 72 hours

neonates2-4weeks

 fluconazole po  6–12 mg/kg every 48 hours 

Infant or Child    

fluconazole po  6–12 mg/kg (maximum 800 mg) daily

Oesophageal candidiasis: fluconazole po  200mg Twice a day 7 – 14days

Adverse effects

headache, nauesea, rash, vomiting, rash, alopecia, angiodema,hypokalemia

Drug interactions

contraindicated-erythromycin, lovastatin, quinidine, simvastatin, 

serious-amiodarone, amitriptyline, chlopromazine, clopedogrel , colchicine, epinephrine, fentanyl

monitor closely-amitripyline, artovastatin, carbamazepine, diazepam, diclofenac, indinavir

minor-diazepam, efavirenz, gentamycin, ibuprofen,itraconazole, nifedipine, phenobarbital

Fluoxetine

Depresssion

20-80mg once daily in the morning with food for 2 weeks then assess

Depression with psychomotor retardation, obsessive compulsive disorder, premenstrual dysphoric disorder

20-60mg po once daily continual

Panic disorder

10mg daily for the first week then 20mg po daily

Adverse effects

nausea,isomnia, anxiety , nervousness, diarrhoea, tremors, dizziness, somnolence

Drug interactions

contraindicated-artemether/ lumefantrine,goserelin, isocarboxazid, phenelzine, selegilin

serious-amiodarone, amitriptyline,carvedilol, cimetidine, fentanyl, haloperidol, morphine

monitor closely- aspirin, carbamazepine, celecoxib, diazepam, diclofenac, ibopreofen, metformin

minor-codaine, losartan, marijuana, omeprazole, ritonavir, torsemide, furosemide, chloroquine

 

 

Flupentixol decanoate

Organic psychosis

20mg as a test dose, then after at least 1 week 20 – 40mg every 2 – 4 weeks depending on response

Adverse effects

blurred vision, circular eye movements, tachycardia, muscle spasms of neck and back, hypotension, constipation, tremors, akathisia, extrapyramidal disorder

Drug interactions

serious-bromocriptine, carbamazepine, dopamine, fluoexitine, ketoconazole, levodopa

monitor closely-albeterol, amitriptyline, atracurium, captopril, chlopheneramine, dexamethasone, insulin

 

Fluphenazine decanoate

Organic psychosis

12.5mg as a test dose, followed after 2 weeks by  25 – 50mg once every 4 weeks, continual

 Adverse effects

akathesia, dystonia, muscle stiffness, parkinsonism, tardive dsykinesia,confusion, decreased gag reflex, sedation, erectile dysfunction

Drug intractions

contraindications-cisapride, disopyramide, quinine, sotalol, procainamide, pentamide

serious- amiodarone, amitriptyline, artemether/ lumefantrine, dopamine, fentanyl, epinephrine, fluconazole

monitor closely-albuterol, amoxapine, atracurium, atropine, caffeinne, diazepam, haloperidol

Fluticasone furoate intranasal spray

Allergic rhinosinusitis

1 puff  once a day for 1 month

Adverse  effects

pharyngitis, fever,epistaxis, headache, nasal congestion, aches and pains, nasal ulcers

Drug interactions

serious-atazanivir, isoniazid, quinidine,ketoconazole,clarithromycin, voriconazole,nicardipine,darunivir

monitor closely-letermovir,stiripentol

 

Folic acid

Severe acute malnutrition 

<6kg 2.5mg once a day 14 days    

>6kg 5mg 

Pregnancy

5mg once a day   Preconceptionally and up to 3  months of pregnancy

Folic acid deficiency

5mg once a day 3 months and review

Adverse effects

broncospasms, erythema, malaise, pruritus, rash, slight flushing

Drug interactions

monitor closely-pyrimethamine, pancrelipase, green tea, glucarpidase, omodacycline

minor-aspirin, carbazepine, estradiol, chlorothiazide, furosemide, metformin,phenytoin,sulfamethoxazole, phenobarbital

Forscanet 

cataract surgery

(24mg/ml)  90mg/kg infusion 12 hourly 2-3 weeks

Fresh frozen plasma

haemophilia B

Minor bleed

4-6 bags  every 24hrs

if bleeding continues 8-12 bags every 12 hours then review

Major bleed 

8 – 12bags every 24hrs if bleeding continues

liver disease 

4 bags review  

Adverse effects

headache, parasthesia, hemolytic transfusion reactions, allergic reactions, circulatory overload, septic reactions, pruritus, urticaria, transfusion related acute lung injury

Frusemide

Nephrotic syndrome :

40 – 80mg once a day,  5 days 

If no response:  frusemide po or iv  40 – 200mg twice a day until resolution

Apsrin/salycilate poisoning :

frusemide iv 0.25-1mg/kg once review

Cardiac failure :

frusemide po 40-80mg 1-2 times a day long term

Resistant hypertension

20-80 mg po twice per day

Hyperkalemia in Advanced Cardiac Life Support(ACLS)

40-80mg IV

Hypermagnesemia in ACLS

20-40mg IV 3-4hourly per rising need

Adverse effects

hyperuricemia, hypokalemia, anaphylaxis, glucose intolerence, hearing impairement, hypokalemia,hypotension, tinnitus

Drug interactions

serious-amikacin, gentamycin, kanamycin, streptomycin, pottasium phosphate, paromomycin,netmilcin

monitor cosely-acebutolol, albuterol, aspirin, beclomethasone, atenolol, acemetacin, amiloride

Beclomethasone Inhaler

COPD exercerbation

200mcg twice a day PRN

Bronciectasis

200mcg twice daily

Asthma

200-400mcg po twice or four times a day depending on severity

 

Adverse Effects- pharyngitis, headache, upper respiratory tract infection, vomiting,sinusitis, oral candidiasis

Drug Interactions- Serious: BCG vaccine,tacrolimus ointment. Significant:Amphotericin B, chlorothiazide,frusemide, hydrochlorothiazide

Benzhexol

Parkinsonism

2-5mg 3 times a day review duration

Side effects of antipsychotics

5mg po 1 to 2 times a day for 1 week

Adverse effects

anticholinergic side effects, suppurative parotitis, hallucinations, paralytic ileus

Drug interactions

serious-glycopyrronium tosylate topical, revefenacin, secretin,

monitor closely-amitriptyline, atropine, chlopromazine, haloperidol, ipratropium

minor-levodopa

 

 

 

Benzoyl peroxide

Acne

5% gel apply every night then review

Adverse effects

contact dermatitis, erythema, peeling, skin dryness

Drug interactions

monitor closely-dapsone topical

Benzyl benzoate

Scabies in pregnant, lactating mothers and children less than 6 months

25% emulsion apply from neck down once at night for 3 nights

Adverse effects

giant hives, itchiness, rash, skin inflamation, stinging sensation of skin

Drug interactions

 

Benzyl penicillin

Acute appendicitis, appendiceal abcess

2,5 MU four times a day

Intestinal obstruction, acute cholecystitis, perforated duodenal ulcer

2,5MU iv four times a day

Neonatal sepsis, severe pneumonia- 0,1MU/kg 6hourly

Acute mastoiditis- 0,1MU/kg stat

Diptheria- 0,1MU/kg 6 hourly for 7 days

Adverse effects

skin rashes, urticaria, pseudomembranous colitis, serum sicknesslike reactions

Drug interactions

methotraxate, rifambicin, rifabutin,combined oral contraceptive pills

 

Betamethasone

Eczema

0,1 % in a base ointment

Post Cataract Surgery

0,1% eye drops 1 drop 6 hourly for 6 weeks

Adverse effects

blurred vision, nervousness, cataracts, diavetis mellitus, pyschosis, osteoporosis, acne, myopathy, 

Drug interacations

asprin, clotrimazole, gentamicin, neomycin, maganesium sulphate,vitamin B12

Biperiden

Severe adverse reactions of antipsychotics

2 to 4mg im/iv 2-4mg once only

Adverse effects

dry mouth, blurred vision, drowsiness, euphoria, urinary retension, constipation, nausea

Drug interactions

miperidine, amitriptyline, amoxapine, desipramine, cetrizine, clopheneramine

 

 

Bisacodyl

Constipation

5-10mg nocte as required

Adverse effects

abdominal cramps, electrolyte imbalances, diarrhoea,nausea, rectal burning sensation, vertigo

Drug interactions

serious- sodium/ magnesium/potassium sulphate

monitor closely-deflazacort, dichlorphrnamide, potassium citrate

minor-potassium acid phosphate, potassium chloride

Bisoprolol

Heart Failure secondary to left ventricular systolic dysfunction

1.25-10mg once a day long term

hypertension

2.5-5mg po once a day long term

Adverse effects

dizziness, insomnia, bradyarrhythmia, pharyngitis, hypotension, arthralgia

Drug interactions

serious-acebutolol,digoxin,atenolol, labetolol, verapamil, propranolol

monitor closely-amiloride, asprin,amlodipine,atazanavir, calcium carbonate

minor- cocaine, rifambin, guanabenz, adenosine, neostigmine, melatonin

 

Boric acid

Bacterial Otitis Media

1% ear drops 3 drops twice daily for 7 days

Adverse effects

burning senstaion, watery discharge, redness, fever , chills, high blood pressure

Drug interactions

estrogen, magnesium supplememts

 

 

Bupivacaine hydrochloride

Spinal Anaesthesia

2mg/kg

Local Anaesthetic

2mg/kg local infiltration

Adverse effects

anginal pain, axiety, bradycardia, cardiac arrest, hypotension, miosis, nausea

Drug interactions

monitor closely- captopril, benazepril, nadolol, propranolol, timololnevirapine

minor-hyaluronidase

                                    

Calamine lotion

Scabies, Chicken Pox

Apply as needed

 

Adverse Effects-irritation, pruritis

Calcium gluconate /chloride

Hyperkalaemia

10ml of 10% once then 50mls of 50% glucose + 10 units of short acting insulin over 10 mins

 

Adverse Effects-bradycardia, hypotension, headache, constipation, hypomagnesemia, hypophosphatemia, diarrhea, nausea, vomiting

Drug Interactions: Contraindicated- ceftriaxone. Serious- doxycycline, tetracycline. Significant-amlodipine, atenolol, bisoprolol, carvedilol, ciprofloxacin, digoxin, labetalol, levofloxacin, nifedipine, timolol

Calcium Resonium

Hyperkalaemia

45g as enema

Captopril

Acute Myocardial Infection

12.5-25mg twice daily
long term

Acute hypertension

12.5-25mg (may repeat per rising need)

Congestive cardiac failure

6.25-12,5mg
po three times a day(wihtcardiac glycosideand diuretic therapy

Left ventricular dysfunction after myocardial infarction

6.25mg initially followed  by12.5mg three times a day. increase to 25mgpo
threee times a day

Diabetic neuropathy

25mg po three times a day

Adverse effects

hyperkalemia, hypersentivity reactions, hypotension, pruritus, cough, palpitations,tacycardia

Drug interactions

serious-allopurinol, asprin, celecoxib, diclofenac, ibuprofen, indomethacin

monitor closely- amiloride, amphoterin B, asprin, cacium carbonate, celecoxib, digoxin

minor-chlopromazine, promethazine, tamsulosin, salicylates, thalidomide

 

Carbamazepine

Post herpetic Neuralgia

100-200mg po nocte for 10 days(increase dose to 400mg over 10 days)

Epilepsy

800-1200mg once a day long term

Bipolar mania

200mg po twice per day

Schizophrenia

200-1300mg once a day times 8weeks

Adverse effects

ataxia, dizzines, drowsiness , nausea, dry mouth

 Drug interactions

serious-atazanivir, artemether/ lumefantrine, efavirenz, diazepam, esomeprazole

monitor closely- amitriptyline, amlodipine, atazanavir, carvedilol, ciprofloxacin, dexamethasone,

minor- acetaminophen, amitriptyline, celecoxib, diclofenac, folic acid, ibuprofen

 

 

 

Cefixime

Typhoid Fever

500 to 750mg po twice daily for 7 to 14 days

Urethral Discharge In Men

400mg po single dose

Otitis media,tonsillitis, pharyngitis, uncomplicated urinaty tract infection

400mg once a day times times one week

Typhoid fever

15-20mg/kg/day po twice a day for 7-14days

Adverse effects

diarrheaa, candidiasis, dyspepsia, leukopnea, headache, pseudomembranous colitis, thrombocytopnea

Drug interactions

serious-BCG vaccine live, cholera vaccine, typhoid vaccine live,

monitor closely-warfarin, estradiol, probenecid, estradiol,ethynynestradiol

minor-asprin, chloramphenicol, furosemide, cyclopenthiazide,meloxicam

 

 

 

Ceftriaxone

Surgical Prophylaxis

1g IV single dose

Meningoccocal Meningitis Contacts

500mg im stat

Urethral Discharge In Men

250mg im stat

Vaginal Discharge

250mg im stat

Ophthalmia Neonatorum

50mg/kg im stat

Segmental/Lobar Pneumonia

1g IV twice daily for 7 days

Klebsiella and other gram negative Pneumonia

1g IV twice daily for 10 to 14 days

Native Valve Endocarditis

1g IV twice daily for 4 to 6 weeks

Bacillary Desentry

1g IV twice daily for 5 days

Pyogenic Liver Abscess

1g IV once a day

Bleeding Oesophageal Varices

1g IV twice daily for 5 days

Acute Pyelonephritis

1g IV once daily then review

Bacterial Meningitis

1g IV twice daily for 14 days

Acute Mastoiditis

80mg/kg im/IV stat

Appendicitis, Appendiceal Mass

1g IV twice daily

Intestinal Obstruction

1g IV twice daily

Perforated Duodenal Ulcer

1g IV twice daily

Adverse effects

eosinophylia, thrombocytosis, diarrhea, anaemia, rash, anaphylaxis

Drug interactions

serious-BCG vaccine live, cholera vaccine, enoxaparin, heparin, warfarin, typhoid vaccine

monitor closely-chloramphenicol, doxycycline, erythromycin, tetracycline, probenecid

minor-furosemide, choline ,magnesium trisalicylate

 

Cefuroxime

Caesarian Section Prophylaxis

750mg IV single dose

Pharyngitis/tonsillitis/acute maxillary sinusitis

250mg po twice a day for 10days

Acute bronchitis

250-500mg po twice a day 5-10days

Uncomplicated pneumonia

750mg IV/IM three times a day

Uncomplicated urinary tract infections

125-250mg po twice aday for 7-10days

Gonorrhea

1gm po once or 1,5g IM once at 2 diffent sites

Adverse effects

decreased heamoglobin/hematocrit, eosinophilia, vaginitis, nausea, diapar rash, thrombophlebitis

Drug interactions

serious-cholera vaccine, enoxaparin, fondaparinax, heparin, warfarin, deltaparin

monitor closely-azithromycin, doxycycline, erythromycin, cimetidine, ibuprofen, omeprazole

minor-chloramphenicol, furosemide, choline magnesium trisalicylate

 

 

 

Cetirizine

Allergic Rhinisinusitis

10mg po nocte for 7 days

Urticaria/hay fever/allergies

5-10mg po once daily as required

Adverse effects

somnolence, headache, fatigue, dry mouth, broncospasm,vomiting, epstaxis

Drug interactions

serious-isocarboxazid, tranylcypromide

monitor closely-ritonavir, hyaluronidase, phenelzine, clobazam, lomitapide, fostamatinib

minor-theophylline, dyphylline

 

 

 

Ciprofloxacin

Urinary Tract infection

500mg twice a day for 7 days

Urinary Tract Surgery

500mg po single dose

Cholera

20mg/kg twice daily for 3 days

Post Miscarriage Sepsis

500mg po twice daily for 10 days

Genital Ulcers

500mg po twice dily for 3 days

Bloody Diarrhea

500mg po twice daily for 5 days

Typhoid Fever

500mg po twice daily for 10 to 14 days(carriers for 4 weeks)

Bacillary Dysentery

500mg po twice daily for 5 days

Pyogenic Abscess

500mg po twice daily for 5 days

Bacterial Eye Infection

0,3% eye drops 1 to 2 hourly for 2 days then reduce to 4 hourly for 12 days

Bacterial Otitis Media

eye drops 3 drops twice daily for 7 days

Malignant Otitis Media

500mg po twice daily for 12 weeks

Adverse effects

nausea, abdominal pain, vomiting, headache, restlessness, allergic reactions, angina pectoris

Drug interactions

serious-cholera vaccine, mefloquine, theophylline, warfarin,

monitor closely-amiodarone, artemether/lumefantrine, asprin, captopril, celecoxib, diclofenac, estradiol, metformin

minor- diazepam, digoxin, pyridoxine, thiamine, vitamin K1

 

Citalopram

Depression

10-40mg po once daily in the morning for 2 weeks then assess

Alcoholism

20-40mg po daily

Generalised anxiety disorder

10mg po daily

Hot flahses

10mg po daily, may increase to 20mg per day after one week

Adverse effects

dry mouth, somnolence, xerostomia, sweating, tremor, fatigue, dyspepsia

Drug interactions

serious-amitriptyline, clarihromycin, fentanyl, morphineSt John's Wort, rizatriptan

monitor closely-activated charcoal,amiodarone, antithrombin III, celecoxib, diclofenac, furosemide

minor-simeprevir

Chloramphenicol

Pyrexian of unknown origin

1g IV four times a day, review dose

Surgical Prophylaxis

1g IV single dose

Neonatal Sepsis

12,5mg/kg IV

Laryngotracheobronchitis(croup)

12,5mg/kg IV 6 hourly for 7 days

Infection in severe malnutrition

25mg/kg IV/IM 8 hourly for 5 days

Pelvic Inflammatory disease

500mg IV 6 hourly for 2 to 3 days

HIV related diarrhea

500mg po four times a day for 7 days

Plague(Bubonic)

12,5 to 25 mg/kg in adults,6,25 to 12,5 mg/kg in paeds IV 6 hourly for 10 days

Typhoid Fever

1g po four times a day for 14 to 21 days

Bacterial Meningitis

500 mg IV 6 hourly for 14 days

Acute Bacterial Conjunctivitis, Corneal Abrasion, Corneal Ulcers

1% eye ointment four times a day for a week

Bacterial Otitis Media

3 ear drops twice daily for 7 days

Adverse effects

nightmares, headache, rash, diarrhea, stomatitis, enterocolitis, aplastic anaemia, peripheral neuropathy

Drug interactions

BCG vaccine live, typhoid vaccine, lurasidone

serious- cefoxime, warfarin, deferiprone, vilazodone

monitor closely-ceftriaxone, estradiol, maraviroc, phenytoin, tinidazole

minor-amoxicillin, ampicillin, cefaclor, cocaine, folic acid, penicillin, phenobarbital

Chlorhexidine Oral

Oral Ulcers/gingivitis

0.2% mouth rinse 2-4 times a day

Adverse effects

oral irritation, staining of tooth, bronchitis, stomatitis, altered taste

Drug interactions

monitor closely- digoxin, estradiol, estropipate, conjugated estrogens, mestranol

minor-pyridoxine, thaimine, vitamin K1, biotin, pantothenic acid

Chloroquine

Rheumatoid Arthritis, Juvenille Chronic Arthritis, SLE

150mg base po once a day continuous/review

Malaria prophylaxis

500mg (300mg base) once per week

Amebiasis, extraintestinal

1g po daiy for 2 days then 500mg daily for 14-21days

Porphyria cutanea tarda

125-250 mg po twice weekly

Adverse effects

hypersensitivity, psoriasis, visual field changes

Drug interactions

serious-cimetidine, apalutamide, dacomitinib, influenza vaccine trivalent

monitor closely-ampicillin, asprin, bupropion, carvedilol, ciprofloxacin, codaine, efavirenz

minor-BCG vaccine live, chlorpromazine, diptheria and tetanus toxoids, hepatitis B vaccine, praziquantel, promethazine

Chlorpheniramine

Allergic Rhinosinusitis

4mg po three times a day for 7 days

Scabies, Chicken Pox, Eczema, Urticaria

4mg po three times a day for 3 days(in paeds 0,1mg/kg)

Anaphylaxis

10mg in 1L normal saline/ringers lactate 6 hourly for 24 hours

Adverse effects

CNS depression, drowsiness, dizziness, epigatsric distress, anorexia, tachycardia, dysuria

Drug interactions

serious-apalutamide, eluxadoline, isocarboxid, ivacaftor, sodium oxybate

monitor closely-amitriptyline, codaine, diazepam, dopamine, fentanyl, haloperidol, phenobarbital

minor-ashwadanda, eucalyptus, brimonidine, nettle, sage

Chlorpromazine

Psychosis

50 to 200mg 2 to 3 times a day continual

Nausea and vomiting

10-25mg po three times a day

25-50mg IV/IM three times a day

Intractable hiccups

25-50mg po three times a day, if persistant after 2-3 days give 25-50mg IV 4hrly, if persistant 25-50mg IV infusion slowly with patient lying flat in bed, monitor BPs

Adverse effects

extrapyramidal symptoms(akathisia, dystonia, muscle stiffness, parkinsonism, tardive dyskinesia), weight gain, sedation, erectile dysfunction, amenorrhea

Drug interactions

serious-amiodarone, amitriptyline, epinephrine, fentanyl, fluconazole, haloperidol, ketoconazole

monitor closely-albeterol, atracurium, atropine,ciprofloxacin, codaine, diazepam

minor-atropine, captopril, celecoxib, chloroquine, enalapril, marijuana, ritonavir

 

Clarithromycin

Peptic Ulcer Disease

400mg po twice daily for 2 weeks

Acute exacerbation of chronic bronchitis

250-500mg po twice a day for 7-14days

Acute maxillary sinusitis

500mg po twice a day for 14days

Mycobacterial infection

500mg po twice a day for 7-14days

Pharyngitis/tonsillitis

250mg po twice a day for 10days

Community acquired pneumonia

250mg po twice a day for 7-14days

Skin infection

250mg po twice a day for 7-14 days

Endocarditis

500mg po 30-60mins before a procedure

Adverse effects

abnormal taste, .nausea, vomiting, abdominal pain, rash, dyspepsia, headache, anapylaxis

Drug Interactions

serious-amiodarone, amitriptyline, artovastatin, cholera vaccine, diazepam, digoxin, eryrthromycin

monitor closely-amlodipine, atazanavir, bromocriptine, cimetidine, dexamethasone, efavirenz, fluoxetin

minor-efavirenz, fluconazole, griseofulvin, metronidazole,nevirapine, penicillin

Clindamycin

Septic Athritis, Acute Osteomyelitis

600mg IV three times daily for 4 to 6 weeks

Compound Fracture

600mg IV 3 times daily for 5 days

Toxoplasmosis

600mg po four times a day for 6 weeks

Breast Abscess

300-600mg IV three times a day for 2 days, then po for 5 days

Mastitis

450mg po three times a day for 7 days

Adverse effects

abdominal pain, agranulocytosis, eosinophyllia, hypersensitivity, steven Johnson's syndrome, hypotension

Drug interactions

serious-atracurium, cholera vaccine, succinylcholine, vecuronium, tubocurarine,

monitor closely-digoxin, estradiol, warfarin, levonogerstrel, mestranol, ospemifene

minor-erythromycin, pyridoxine, thiamine, pantothenic acid, biotin,

Clofazimine

Leprosy

50mg po once daily for 12 months(0,5-1mg/kg in paeds) and 300mg once a month for 12 months (5-10mg/kg in paeds) (supervised dose)

Erythema Nodosum Leprosum

100mg po three times daily for 3months then 100mg po twice daily for 3 months then 100mg po once a day for 6 months

Adverse effects

skin discolouration, abdominal pain, ichthyosis, rash, pruritus, urine discoloration, conjuctival and corneal pigmentation

Drug intrarctions

serious-ivosidenib, macimorelin, ribociclib

monitor closely-gemtuzumab, lofexidine, oxaliplatin, magnesium oxide

minor-rifampin

 

Clonapine

Psychosis

50-100mg po 1-2 times a day long term

Clonazepam

Tardive Dyskinesia

0.25-5mg po upto 1mg per day long term

Anxiety Disorders

0,5mg po upto three times daily for upto two weeks

Adverse effects

somnlence, ataxia, depression, dizziness, fatigue, confusion, rhinitis, coughing

Drug interactions

serious-apalutamide, hydrocodone, ivacaftor, valerian,

monitor closely- albeterol, amitriptylline, atazanivir,cimetidine, codaine, diazepam,epinephrine

minor-ciprofloxacin, omeprazole, rifabutin, valproic acid, succinylcholine, vecuronium

 

Clopidogrel

Acute Myocardial Infection

75-300mg once daily as required

Vascular Disease

75mg once daily

Adverse effects

upper respiratory tract infections, headache, dizziness, rash, diarrhea, rhiniitis, depression

Drug interactions

serious- asprin, carbamazepine, efavirenz, erythromycin, isoniazid, omeprazole, rifambin

monitor closely-asprin, atazanavir, celecoxib ,cimetidine,dexamethasone, fluconazole, heparin, lumefantrine

minor-ginger, phenytoin, salicylates, torsemide, ethotoin, tolbutamide

Clotrimazole

Vaginal Discharge in Pregnancy

pessary 500mg once daily for 3 days

Fungal Otitis Media

3 ear drops once daily for 7 days

Tinea Corporis, Tenia Pedis

1% cream apply 2-3 times daily for 7 or more days after resolved

Adverse effects

abnormal liver function tests, nausea, vomiting, burning sensation of skin, vaginal irritation

Drug interactions

serious-bosutinib, warfarin, eliglustat

monitor closely-amitriptylline, artovastatin, azithromycin,chlorpromide, digoxin, gentamycin

minor-cyclosporine, gentamycin, kanamycin, phenobarbital, rifampin,tacrolimus, strptomycin

Cloxacillin

Staphylococcal Pneumonia

1-2g IV 6 hourly for 14 days

Empyema

1g IV 6 hourly for 10 to 14 days

Prosthetic valve and culture positive endocarditis(staphylococcal)

2g IV 6 hourly for 4-6 weeks

Septic Arthritis, Acute Osteomyelitis

1-2g IV 6 hourly for 4-6 weeks

Compound Fracture

1-2g IV 6 hourly for 5 days

Impetigo

250-500mg(paeds 125-250) po four times daily for 7-10 days

Furunculosis, Acute Cellulitis, Acute Paronychia

250-500mg(paeds 125-250) po four times daily for 7 days

 Breast Abscess

500mg IV 6 hourly for 2 days then po for 5 days

Mastitis

500mg po four times daily for 7 days

Adverse effects

nausea, vomiting, mouth sores, bloating, stomach upset, diarrhea

Drug interactions

gentamycin, tobramycin, methrotraate, tetracycline, doxycylline, warfarin, typhoid vaccine

 

Coal tar ointment

Psoriasis

5% ointment in salicylic acid 2% apply twice a day as needed

Seborrhea dermatitis

Apply sparingly to affected area upto 4times per day.Decrease frequency to 2-3 times per week once improvement observed.

Adverse effects

stinging/burning skin, desquamation, follicutlitis, photosensitivity

cautions

topical use only, avoid contact with eyes, avoid inflammed or broken skin, avoid exposure to sunlight, keep away from fire

Co-amoxiclavulanic acid

Lung Abcess, Empyema

625mg po 3 times a day

Lower repiratory tract infection

500mg po twice a day for 10days

Chronic obstructive pulmonary disease

500mg po tree times a day

Acute bacterial sinusitis

200mg po twice a day for dancing

Animal/human bite, skin abcess, pyelonephritis

875mg po twice a day or 500mg po three times a day for 3-5 days

Adverse effects

diarrhoea, nausea, mycosis, candidiasis, vaginitis, anaphylaxis, agranulocytosis, pseudomembranous colitis

Drug interactions

serious:BCG vaccine live, cholera vaccine, doxycycline, tetracycline, typhoid vacine

monitor closely:acyclovir, asprin, hydrochlorothiazide, methotraxte, warfarin, sulfasalazine

minor:azithromycin, chloramphenicol, pyridoxine, clarithromycin, amiloride

 

 

 

Codeine phosphate

HIV Related Diarrhea

30-60mg po upto 4 times a day for 7 days

Acute Gastroenteritis

30mg po three times daily review

Moderate Pain

15-60mg po 4 hourly as required

Peripheral Sensory Symptoms

30-60mg po 6 hourly as required

Adverse effects

light-headedness, dizziness, sedation,nausea , vomiting, euphoria, constipation, dysphoria, pruritus

Drug interactions

alcohol, prochlorperazine, chlopromazine, trifluperazine,

Colchicine

Acute Gout

0.5-1mg po upto 6 times a day for 2 days

Chronic Gout

0,5mg po twice daily for 7 days

Adverse effects

fatigue, pharyngolaryngeal pain, headache, disseminated intravascular coagulation, myelosuppresion

Drug interactions

serious-amiodarone, atazanavir, atorvastatin, carbamazepine, digoxin

monitor closely- dexamethasone,grisiofulvin, hydrocortisone, lumefantine, nevirapine

minor-efavirenz, cyanocobalamin

Combined oral contraceptive pill

Emergency Oral Contraception

2 tablets(50mcg ethinyloestradiol, 150-250mcg levonogestrel) repeat after 12 hours OR 4 tablets (30-35mcg ethiniloestradiol,150-250mcg levonogestrel) repeat after 12 hours

Adverse effects

intermenstrual spotting, nausea, breast tenderness, headaches, weight gain, mood swings

drug intractions

carbamazepine, phenobarbitone, phenytoin, rifambicin, ethosuximide, primidone

Medicines made less effective by combimbed oral contraceptives

phenytoin, imipramine, methyldopa, corticosteroids, diazepam

 

Cotrimoxazole

Prophylaxis In HIV

960mg po once daily for life/ until CD4>350 for 6 months

Pneumocystis Jiroveci Pneumonia

1920mg po three times daily for 21 days

Adverse effects

anorexia, nausea, vomiting, hyperkalemia, urticaria, steven Johnson syndrome, hyponatremia

Drug interactions

serious-amiodareone, antithrombin III, cholera vaccine, enoxaparin, heparin, fondaparinux

monitor closely-amiloride, asprin, caevedilol, chlopromazine, cimetidine, digoxin, efavirenz, fluconazole

minor-azathioprine, celecoxib, dapsone,ganciclovir, hydrochlorothiazide, losartan, metformin

 

 

 

Cryoprecipitate

Hemophillia A

6 bags per dose every 24-48 hours if bleeding continues

Adverse effects

hemolytic transfusion reactions, allergic reactions, septic reactions, circulatory overload, post transfusion purpura

Cyclopentolate

Cataract

0.5% or 1% eye drops 1-3 drops stat pre-op

Mydriasis/ cycloplegia

1-2 drops in the eye, repeat in 5minutes per rising need

Adverse effects

blurred vision, light intolerence, tachycardia, conjuctivis, raisef intraocular pressure, drowsiness

Drug interactions

fluticasone, salmeterol, alcohol, co-amocyclav, cotrimoxazole, furosemide,gabapentin, esomeprazole, paracetamol

Dextrose

Hypoglycemia

50% slow IV infusion 1ml/kg or 4 ml/kg/hr of 10% dextrose

Acute Liver Failure

3L per day of 10% infusion

Hyperkalaemia

50ml 0f 50% IV plus 10units of short acting insulin

Adverse effects

hyperosmolality, edema, fever, tachypnea, diarrhoea, cerebral oedema, phlebitis, cerebral hemorrhage

Drug interactions

minor-magnesium chloride, magnesium citrate, magnesium hydroxide, magnesium oxide, magnesium sulfate

Gamma benzene hexachloride

Scabies

gamma benzene hexachloride 1% lotion apply from neck down once and wash off after 24hrs once only

Pubic lice 

gamma benzene hexachloride 1% lotion C V Wash off after 24hrs Reapply 7 to 10 days later to kill hatched lice

Adverse effects

local irritation, cardiac arrhythmia, ataxia, dizziness, pain, seizures, alopecia, urticaria, nausea, vomiting, aplastic anaemia

Drug interactions

Antidepressants,Theophylline,Cyclosporinemycophenolate mofetil, tacrolimus capsules, Penicillins, imipenem, quinolone antibiotics, Chloroquine sulfate, pyrimethamine, Isoniazid, Meperidine,Radiographic contrast agents,Methocarbamol

Ganciclovir

Cytomegalovirus retinitis

5mg/kg infusion  12 hourly  14-21 days

Adverse effects

neutropnea, anaemia, thrombocytopnea, neuropathy, pruritus, sepsis, confusion, retinal detachment

Drug interactions

contraindicated- zidovudine

serious-abacavir, bacitracin, imipenem

monitor closely-acalabrutinid, altretamine, doxorubucin, emtricitabine, hydroxyuria, tenofovir

minor-acyclovir, amphotericin B, aspirin, celecoxib, diclofenac,hydrochlorothiazide, ibuprofen, mefenemic acid, vincristine

Gentamycin

Septicemia

4–5mg /kg  once a day max 2 weeks

Neonatal sepsis

2.5mg/kg 5 days

<1000gm once every 24hrs

>1000gm every 12hrs

<1200gm every 12hrs

>1200gm every 8hrs

Severe pneumonia

5-7mg/kg Once daily 10 days

Retropharyngeal abcess

6mg/kg 24 hourly 7 days

Empyema/lung abcess, mastoiditis

5-7mg/kg  24 hourly 14 days

Severe pelvic inflamatory disease

60mg 12 hourly 48-72hrs

Atypical pneumonia

120mg 12 hourly 10-14 days

Peritonitis

4mg/kg   once a day 5-10 days

Acute pyelonephritis

4-7mg/kg once a day review

Eye infection

0.3% eye drops 1 drop 2-6 hourly  14 days

Burns

80mg 8 hrly review

Adverse effects

neurotoxicity, ototoxicity, nephrotoxicity, edema, rash, itching, reddening of skin, allergic reactions, erythema

Drug interactions

contraindications-agalsidase alfa/beta, BCG vaccine live, typhoid vaccine

serious-amphotericin B, atracurium, furosemide, neomycin, quinidine, vecuronium

monitor closely-acetabutolol, acyclovir, albetorol, aspirin, bisoprolol, carvedilol, digoxin, furosemide, ibuprofen,losartan,nifedipine

minor-celecoxib, diclofenac, itraconazole, magnesium sulphate, pyridoxine, salicylates,vancomycin

Glibenclamide

Diabetes

2.5-10mg once or twice a day long term

 Adverse effects

hypoglycemia, dizziness, anxiety, drowsiness, headache, nausea, vomiting,dermatologic reactions, abdominal pain, flatulence, depression, urticaria

Drug interactions

contraindicated-ethanol

serious-aminolevulinic acid oral/ topical, ivosidenib, lumacaftor, mrthyl aminolevulinate

monitor closely-aceclofenac, aspirin, aripiprazole, atazanavir, calcium carbonate, captopril, celecoxib, cimetidine, diclofenac, fluconazole, ibuprofen, mefenemic acid, probenecid

minor-amitriptyline, chloramphenicol, clonidine, isoniazid, omeprazole, prednisolone, sulfasalazine

Gliclazide

Diabetes

80-160mg once or twice a day long term

 Adverse effects

abdominal pain, mucle pain, constipation, headache, heartburn, nausea, vomiting,headache, dizziness, hypoglycemia

Drug interaction

abiraterone, acetylsalicylic acid(ASA), enalapril, alcohol, amiodarone, losartan, aripiprazole, carbamazepine, fluticasone, dexamethasone,danazole,efavirenz,ranitidine,mifepristone

Glycerine suppository

Constipation

2-2,8 g suppository per rectal as required -  retain for about 15minutes or as directed

Adverse effects

burning sensation, cramping pain, rectal irritation, tenesmus

Diazepam

Acute Alcoholic Mania

10mg slow IV infusion immediately then 5mg every 5 mg until controlled, then 5-10 mg 8 hourly as required

Alcohol Withdrawal with Seizures

0,05-0,1mg/kg IV as required

Anxiolysis

5-10mg po/ 0,2mg/kg slow IV infusion

Convulsion

0,3kmg/kg IV/PR once

Bleeding Oesophageal Varices

5-15mg IV as necessary

Status Epilepticus

10mg IV(in paeds 5mg) over 2-3 min(may be repeated after 5 min,

maximum dose 40mg)

Psychosis,Mood Affective Disorders Rapid Tranquilisation

5-10mg IV/im can be repeated after 6 hours until calm and can be given orally

Extrapyramidal Side Effects

5-10mg po 1-2 times a day for 7 days

Alcohol Dependence

10mg IV once daily, then 20-40mg po once daily, reduce by 5mg every other day for 7 to 14 days

Carbon Monoxide Poisoning

0,05-0,1mg/kg IV as required, maximum 30mg

Adverse effects

euphoria, incoordination, somnolence, diarrhea, rash, hypotension, fatigue, respiratory depression, blurred vision

Drug interactions

serious-carbazepine, cimetidine, clarythromycin, itraconazole, ketoconazole

monitor closely-amitriptyline, atazanavir, artemether/lumefantrine,codeine, efavirenz,haloperidol

minor-paracetamol,fluconazole,labetolol, omeprazole,phenobarbital,rifambin,

 

Glyceryl trinitrate

Stable Angina pectoris

Sub-lingual 500mcg not more than 3 tablets every 15 mins

Unstable angina

iv 10-20mcg /min infusion as required

Adverse effects

headache, hypotension, tachycardia, dizziness, lightheadedness, blurred vision, xerostomia, syncope, thrombocytopnea, prolonged bleeding time, exfoliative dermatitis, syncope, nausea/vomiting

Drug interactions

contraindicated- sildenafil, avanafil, riociguat, tadalafil, vardenafil

serious-carbegolin, ergoloid mesylates, ergonovine, lofexidine, methylergonovine, 

minor closely- arginine, benazepril, captopril, maraviroc, tetracaine, dapsone cream

minor-acetylcysteine

 

Diclofenac

Post Operative Pain

25-50mg po three times a day/ 25-100mg pr twice daily review

Back And Neck Pain, Arthritis

25-50mg po three times a day, review

Adverse effects

constipation, diarrhoea, abdominal pain/cramps,dyspepsia, agranulocytosis, tinnitus, aplastic anaemia

Drug interactions

serious-captopril, methotraxte, tacrolimus, enalapril, ketorolac

monitor closely-amiloride, asprin, atazanavir, captopril,carvedilol, ciprofloxacin

minor-carbamazepine,celecoxib,cimetidine, furosemide, ibuprofen, mefenemic acid

 

Glycopyrrolate

reversal of non-depolarising neuromuscular blockade

200mcg/1mg of neostigmine

Drooling

0.1mg/kg po twice a day 

Adverse effects

dry mouth, anhidrosis, photophobia, palpitations, xerophathalmia, constipation, urinary retention, mydriasis, cardiac arrythmia,angioedema, dysphonia

Drug intraractions

contraindicated- pramlintine, umeclidinium bromide

serious-glycoprronium tosylate, macimorelin, revefenacin, secretin,

monitor closely-aclidinium, amantadine, amitriptyline, atenolol, atropine,chlopramazine, chlopramine, digoxin,fluphenazine,haloperidol,levodopa,metformin

minor-desipramine,promethazine, thioridazone, rimantidine, prochlorperazine, galantamine, proazine

Griseofulvin

Tinea pedis

 500mg  once a day 8 weeks   [Paed = 10mg/kg] 

Tinea capitis

 500mg once a day  14 days   [Paed = 10mg/kg] 

 Adverse effects

rash, urticaria, fatigue, headache, dizzines, insomnia, mental confusion, nausea, photosensitivity, leukopnea, hepatotoxicity,nephrosis,parasthesia

Drug intractions

contraindicated-ergotamine, lovastitin, erythromcin, lovastatin,sertindole,simvastatin, terfenadine

serious-aminolevulinic acid, athinylestradiol, segesterone, ulipristal

monitor closely-amiodarone, arirpirazole, aspirin, atorvastatin, carbamazepine, clopidogrel, darunavir, dexamethasone, diltiazem, estradiol, indinavir, levonorgestrel,maraviroc, nicardipine, predinisolone,sildenafil

minor-amitriptyline, amlodipine, clarithromycin,cyclosporine,efavirenz,finasteride, imipramine, ketoconazole,nifedipine,paclitaxel,quinine,

 

Digoxin

Chronic Heart Failure, Arrhythmias after MI

0.25-0.5mg 3 times a day first 24 hours then 0.125-0.25mg(paeds 0,01mg/kg) once a day long term

Adverse effects

dizziness, diarrhea, headache, nausea, vomiting, anorexia, visual disturbances

Drug interactions

serious- amiodarone, atenolol, esomeprazole, propranolol, timolol, verapamil

monitor closely-acebutolol,asprin, atropine, captopril, carvedilol,clindamycin

minor- cimetidine, ciprofloxacin, ibuprofen, magnesium sulfate, cyclosporin, clarythromycin

Dihydralazine

Severe Hypertension

6.25-25mg IV/im prn until desired BP(measure BP ever 5-10 minutes)

Adverse effects

hypotension, palpitations, vomiting, chest pain,paralytic ileus, vascular collapse

Drug interactions

serious- lofexidine

monitor closely-acebutolol, asprin, atenolol,ibuprofen, levodopa, tinidazole,

minor-pyridoxine, celiprolol, tizanidine, brimonidine, forskolin

Dobutamine

Cardiac Failure

2-20mcg/kg/min

Adverse effects

hypertension, tachyarrhythmia, angina, dyspnea, fever, palpitations, hypokalemia

Drug interactions

serious-amitriptyline, clomipramine, doxapram, isoflurane, ether, ergotamine

monitor closely-acebutolol, amiloride,asprin,bromocriptine, celecoxib, chlopromazine, diclofenac

minor-furosemide, bumetanide, desmopressin, indapamide, hydrochlorothiazide, eucalyptus

 

Dopamine

Shock

2-20mcg/kg/min IV slowly

Adverse effects

arrhythmia, tacycardia, dyspnea, nausea , vomiting, azotemia

Drug interactions

serious-amitriptyline, chlopromazine,desipramine, haloperidol, isoflurane

monitor closely-bromocriptine, caffeine, chlopromazine, codeine, digoxin, ethanol,methyldopa

minor- desmopressin, eucalyptus, sage

 

Doxazocin

Hypertension

4-16mg once a day long term

Benign prostatic hyperplasia

1mg po daily. may titrate by doubling daily dosesat 1-2 weeks intervals to a maximum of 8mg/ day

Adverse effects

dizziness, fatigue, headache, vertigo, abdominal pain, anxiety, palipitations

Drug interactions

serious-sildenafil, tamsulosin,vardenafil

monitor closely-acetaminophen, asprin, celecoxib, diclofenac, iboprufen, levodopa,nifedipine

minor-brimonidine, ethanol, phenylephephrine, tizanidine, treprostinil

Labetalol

Pregnancy induced hypertension due for induction of anaesthesia and severe hypertension: 

 IV  Labetalol continuos infusion  (total dose should not exceed 300 mg)20 mg IVI stat over 2 mins, then 10-80 mg IVI every ten minutes until desired BP level achieved then 2 mg IVI per minute by Lactulose po 30-50ml 3 times a day

Hypertension

100mg po twice a day

Adverse effects

dizzines, lightheadedness, nausea, fatigue, parastesia, diaphoresis, hypotension,elevated live enzymes, edema, bronccospasm, dyspnea, angioedeema, hepatitis, urinary retension

contraindicated-iobenguanel

serious- acebutolol, atenolol, carvedilol, propranolol, satolol, timolol, vilanterol, lofexidine

monitor closely-aceclofenac, albuterol, amiloride, aspirin, atazanavir, calcium carbonate, carbidopa, celecoxib, chlorothiazide,digoxin,furosemide, gentamuvin, hydralazine, ibuprofen, ketamine, levodopa,nicardipine,piroxicam, spironolactone, theophylline, verapamil

minor-adenosine, brimonidine, diazepam, melatonin, neostigmine, sildenafii, vardenafil,yohimbe,tizanidine

 

 

Doxycycline

Severe Acne

100mg once a day for 2-4 months

Post Miscarriage Sepsis, Acute Epidydimo-orchitis, Plague

100mg po twice daily for 10 days

Pelvic Inflammatory Disease, STI Prophylaxis for sexual assault survivors, Urethral Discharge In Men, Vaginal Discharge

100mg po  twice daily for 7 days

Genital Ulcers

100mg po twice daily for 20 days

Lymphogranuloma Venerium, Syphillis

100mg po twice daily for 14 days

Anthrax, Tick Typhus

200mg po first dose then 100mg po once daily for 7 days

Malaria second line, COPD exercerbation

100mg po once daily for 7 days

Acute Liver Failure

100mg po twice daily until recovery

Adverse effects

anorexia, dental discolouration, diarrhea, hypoglycemia, hemolytic anaemia, nausea, neutropnea

Drug interactions

serious-amoxicillin, ampicillin, calcium gluconate,fentanyl, penicillin, sodium bicarbonate

monitor closely-ceftriaxone, digoxin,estradiol,methotraxate, tamsulosin

minor-antithrombin III, ethanol, fondaparinux,heparin,phenytoin,warfarin, pyridoxine

Lamotrigine

Bipolar affective disorder

50-200mg 2 times a day continual

Seizure disorder

50mg po daily for two weeks then 100mg po twice a day for 2 weeks then 100mg po daily

Adverse effects

dizziness, diplopia, ataxia, rhinitis, somnolence, insomnia, chest pain, fatigue, suicidal ideation, dermatitis, migraine, tremor, palpitations

monitor closely- atazanavir, carbamazepine, astradiol, fluoxetine, lopinavir, mestranol, phenobarbital, rifampin, valproic acid, vilazodone

Minor-acetaminophen, atracurium, biotin, cisatracurium, lecocarnitine, succinylcholine, vecuronium, tubocurarine

Duloxetine

Depression

30mg po once daily in the morning with food continual

Diabetic peripheral neuropathy

60mg/ day orally inna single dose or devided 12 hourly

Chronic musculoskeletal pain, fibromyalgia

30-60mg po for a week

Adverse effects

nausea, vomiting, headache, somnolence, fatigue, constipation, insomnia, agitation, anxiety,blurrred vison, 

Drug interactions

serious-amitriptyline,carbamazepine, cimetidine,fluoxtin,metochlopramide, omeprazole

monitor closely-asprin, captopril, celecoxib,ciprofloxacin,diclofenac, ergotamine, ibuprofen

minor-carvedilol, chlopromazine, furosemide,haloperidol,lithium, promethazine 

 

Levobunolol hydrochloride

Open-angle glaucoma

0.5% eye drops 1-2 drop 12 hourly continually

Adverse effects

mild ocular stinging, ataxia, burning sensation, blepharitis, conjuctivitis, erythema, iridocylitis, taering, urticaria, ptosisi, cerebral ischemia, hypersensitivity reactions

Drug Interactions

digoxin, clonidine, propranolol, diltiazem, epinephrine,fingolimod, phenothiazines, prochlorperazine

Emulsifying ointment

Eczema

as a soap substitute

Levocarb(Levodopa 250mg+ carbidopa 25mg)

Parkinsonism and parkinson like disorders

(sinemet)25mg/100mg po three times a day

or 10mg/100mg 3-4 times a day

carbidopa must be 70-100mg/ day not to exced 200mgper day

levodopa must not exceed 800mg/day

Adverse effects

edema, agitation, ataxia,bruxism, confusion, dyskinesia, dystonia, euphoria, insomnia, fainting, malaise, nightmares, testlesssness, trismus, vivid dreamsalopecia, hot flushes

Drug interactions

contraindicated-isocarboxazid, phenelzine, selegiline, procarbazine,tranylcypromine

serious-aripiprazole, chlorpromazine, clozapine, droperidole, haloperidole, linezolid,methyline blue, olanzapine, paliperidone, promethazine, risperidone, trifluoperazine

monitor closely-acebiutolol, amiloride, amlodipine, atenolol, atropine, captopril, carvedilol, cyclazine, diltiazem, doxazosin, enalapril, esmolol, furosemide, hydralazine, losartan, methyldopa, metoprolol, metoclopramide, olmesartan, phenytoin, 

minor-atropine, benztropine, ferrous sulphate, ipratropium, oxybutin, sapropterin, oxybutin, mepenzolate, homatropine

 

 

Levonorgestrel

Implant

2 rods once only in 5yrs

oral

750mcg 1 tablet repeat after 12 hrs

Adverse effects

headache, acne, amenorrhea, abdominal pain, vulvovaginitis, depression, migraine, alopecia, breats tenderness, menorrhagia, pelvic pain, angioedema, uterine bleeding, dysmerrhea, failed insertion

Drug interactions

serious-antithrombin III, argotroban, darunavir, enoxaparin, fondaparinux, warfarin, protamine, phenindione, bivaluridin

monitor closely-atazanivir, carbamazepine, efavirenz, etravirine, griseofulvin, insulin, metformin, mifepristone,nevirapine, phenytoin, rifambin, tesamorelin

 

Enoxaparin

Oedematous and bed ridden

40mg once daily as required

Adverse effects

hemorrhage, fever,thrombocytopnea, atrial fibrillation,pilmonary edema

Drug interaction

serious-azithromycin, ceftriaxone, clathromycin, heparin, levonorgestrel

significant-asprin, captopril, carbamazepine, celecoxib, diclofenac, enalapril

Lignocaine

Local anaesthesia:

lignocaine 1% local infiltration Up to max of 10ml once

lignocaine HCl 2% plain max = 3mg/kg 2-10 min 1-2 hours 

lignocaine HCl 2% + adrenaline 1: 200 000 max = 7mg/kg 2-10 min 1-2 hours

lignocaine hydrochloride  Inj 3mg/kg without adrenaline 7mg/kg with adrenaline

Ventricular tachycardia

lignocaine iv 75-100mg stat, then  4mg/min for 30 mins, then 1-2mg/min for 12-24 hours 30mins then 1-2mg/min for 12-24 hours

Arrhythmias

lignocaine 2% iv (preservative free) 500mg over 2-4mins,  then 1-2mg/min by infusion

Cardiac arrest

lignocaine HCl preservative-free iv 100mg iv [or 200mg endotracheal tube], and repeat DC shock 360joules.

If defibrillation is successful, to maintain a stable rhythm: (stable VT, significant ectopy, wide complex tachycardias) lignocaine HCl preservative-free iv infusion 4 mg/minute for 1 hour, then  2 mg/minute for 2 hours, and  1 mg/minute thereafter

Local incisions

lignocaine 1% local infiltration Up to max of 10ml once

Adverse effects

arrythmias, hypotension, agitation, confusion, dizziness, parasthesia, seizures, tinnitus, skin lesions, urticaria, pyschosis, nervousness, euphoria, lightheadedness, disorientation, heartblock, cardivascular collapse, respiration depression

Drug interactions

axitinib, busotinib, fluvoxamine, fosamprenavir, mefloquine, phenytoin, pimozide, pamalidomide, bupivacaine, 

Lisinopril

Hypertension(second line)

5-40mg once a day long term

Advere effects

dizziness, cough, headache, hyperkalemia, diarrhoea, hypotension, chest pain, fatigue, nausea, vomiting,psoriasis, anuria, alopecia

Drug Interactions

contraindicated-aliskiren, protein of column, sacubitril/valsartan

serious- aspirin, azilsartan, candesartan, celecoxib, diclofenac, ibuprofen, ketorolac, losartan, mefenemic acid, piroxicam, valsartan, 

monitor closely-albiglutide, alfuzosin, amiloride, avanafil, bumetanide, carbidopa,digoxin, furosemide, glipizide, heparin, insulin, ketorolac, lithium, maraviroc, prazosin, sulfasalazine, tadalafil,trimethoprim

minor-acetamin, chlopromazine, fluphenazine, probenecid, promazin, rifampin, salicylates, tolfenamic acid

 

Ephedrine sulphate

Hypotension Secondary to anaesthesia

Increments of 5mg IV until BP has been restored

Adverse effects

nausea,tachycardia, reactive hypertension, dizziness, restlessness

Drug interactions

serious-amitryptiyline, isolurane, carbagoline, desflurane, sevoflurane

significant- acetazolamide, amitriptyline, asprin,  atenolol, celecoxib,

Lithium carbonate

Bipolar affective disorder

po 250mg-1g at night continual

Adverse effects

leukocytosis, dry mouth, polyuria, confusion, headache, decreased memory, muscle twitch, vertigo, hyperreflexia, extrapyramidal symptoms, acne, hair thinning, coma, lethargy, seizures, renal toxocity

Drug interactions

serious- azilsartan, candesartan, isocarboxid, linezolid, losartan, mefloquine, valsartan, valazodone,olmesartan, linezolid

monitor closely-amitriptyline, aspirin, captopril, celecoxib, clozapine, cocaine, desipramine, diclofenac, enapril, fluphenazine, haloperidol, ibuprofen, insulin,ketorolac, mefenemic acid, promethazine

minor-atracurium,clomipramine, desipramine, imipramine, lofepramine, metronodazole, phenytoin, theophylline, vecuronium, verapamil

Liquid paraffin

Constipation

10-30ml as required

Ergotamine

Migraine Headache

1mg po at onset repeat once only after 1 hour if needed

Adverse Effects-Abnormal heart valves, Angina, Arrhythmias, Vasoconstriction, Tachycardia, Rebound headaches, Abdominal pain, Paraesthesia, Possible Gangrene

Drug Interactions:Contraindicated:-Clarithromycin, Glyceryl trinitrate, Itraconazole, Nitroglycerine, Voriconazole. Serious- Atazanavir, Artemether/Lumefantrine, Cimetidine, Carbamazepine, Cyclosporin, Dopamine, Efavirenz, Epinephrine, Erythromycin, Isoniazid, Isosobide dinitrate,Metronidazole, Nifedipine, Neverapine. Minor-Azithromycin

 

Loperamide

Chronic diarrhoea

po 2- 4mg stat then 2mg per loose stool as needed

Acute diarrhoea

po 2mg  <8mg/day Review

Irritable bowel syndrome

2-8mg 2 times a day Review

Adverse effects

dizziness, fatigue, nausea, constipation, dry mouth, angioedema, rash, flatulence, pancreatitis, abdominal pain

Drug interactions

serious-fentanyl, eluxadoline, quinidine

monitor closely-amiodarone, atorvastatin, clarithromycin, dronedarone, erythromycin, indinavir, itraconazole, lovastatin, phenobarbital, phenytoin,rifampin, simvastatin, verapamil

minor-gemfibrozil

Lorazepam

Psychosis

lorazepam inj 1-2 mg IMI (diluted with equal amount of water of injection or normal saline) Initially then can be repeated after 6hpurs Until calm and/or can be given oral medication

Bipolar affective disorder

lorazepam Im  1 – 2mg Initially then Till calm can be repeated After 6 hours

Adverse effects

sedation, dizziness, weakness, fatigue, confusion, drowsiness, amnesia, depression, suicidal ideation, ataxia, asthenia, extrapyramydal symptoms, respiratory depression, tremor, hypotension, impotence, jaundice, constipation

Drug interactions

serious-hydrocodone, sodium oxybate, valerian, sodium oxybate

monitor closely-albeterol, amitriptyline, amobarbital, aripiprazole, baclofen, benzphetamine, caffeine, cannabidol, clonazepam, codeine, diazepam, dopamine, haloperidol, ketamine, loprazolam, melatonin, methadone, oxazepam, pimozide, promethazine, tramadol, trimipramine

minor-acetaminophen, atracurium, esomeprazole, levofloxacin, ofloxacin, rifabutin, vecuronium, succinylcholine

Erythromicin

Ophthalmia Neonatorum

16mg/kg po 6 hourly for14 days

Impetigo, Eryspelas

250-500mg(paeds 125-250mg) po four times a day for 7-10 days

Acute Paronychia

250-500mg(paeds 125-250mg) po four times a day for 5 days

Burns

500mg(12,5mg/kg) po four times a day, reassess after culture

Acute Pelvic Inflammatory Disease

500mg po four times a day for 10 days

Granuloma Inguinale, Lymphogranuloma Venerium, Syphillis

500mg po four times a day for 14 days

Congenital Syphillis

2,5mg/kg po four times a day for 10 days

Losartan

Hypertension(second line)

po 25-100mg 1-2 times a day long term

Adverse effects

fatigue, hyopoglycemia, anaemia, chest pain, diarrhoea, weakness,cough, hypotension, dizziness, gastritis, cellulitis, gastritis, nausea, angioedema

Drug Interactions

contraindicated- aliskiren

serious-apalutamide, captopril, enalapril, lisinopril, perindopril,quinapril, trandopril

monitor closely-acetabutolol, amiloride, aspirin, atenolol, brimonidine, carvedilol, celecoxib, diclofenac, digoxin, enoxaparin, etravirine, fluconazole,gentamicin, ibuprofen, indomethacin,insulin, ketoconazole

minor-amobarbital, cimetidine, fluconazole, itraconazole, ketoconazole, rifabutin, sulfamethoxazole, secobarbital, primidone

Etomidate

General Anaesthesia

0.2-0.4mg/kg IV 30-60 seconds onset

Low molecular weight heparin

Deep vein thrombosis prophylaxis

40mg once a day

Deep vein thrombosis in pregnancy

40mg once a day 1 month post-partum

Adverse effects

erythema, pain, irritation, pulmonary embolism. epistaxis, headache, nausea, hemorrhage, back pain, fever, rash, dyspnea, pancytopnea, hematuria

Drug interactions

contraindicated-abciximab, clopidogrel, estradiol, mestranol, ticlopidine

serious-antithrombin III, azithromycin, cefazolin, clarythromycin. enoxaparin, fondaparinux, heparin, primidone, roxithromycin,sulfamethoxazole, warfarin

monitor closely-aceclofenac, alteplase, aspirin, azathioprine, candesartan, carbamazepine, cyclophosphamide, diclofenac, enalapril, ginger, ibuprofen, losartan, oxaprozin, phenytoin

minor-doxycycline, lymecycline, mineral oil, glyburide, minocycline, oxytetracycline, vitamin E, verteporfin

 

Etonogestrel

1 rod once only in 3 years

Nalidixic acid

Dysentry

po <10kg = 125mg 4 times a day for 5 days

 >10kg =250mg

  5-12yrs =375mg

  Adults =500mg

Urinary tract infections in pregnancy

po 500mg 4 times a day for 7 days

Bacillary dysentry

po 1gm 4 times a day for 7days

Adverse effects

diarrhea, dizziness, drowsiness, headache, nause, vomiting, abdominal pain, allergic reactions, blurred vision, convulsions, itching, numbness

Drug interactions

warfarin, quinidine, procainamide,amiodaarone, satolol, cisapride, erythromycin, amitriptyline, cyclosporine, melphalan, theophylline, probenecid

 

Naloxone

Ethanol(alcohol) poisoning

iv 0.01mg/kg as required

Respiratory depression in neonates if mother was given pethidine

20mcg/ml im   <1kg  10mcg =0,5ml

                               1-2kg 20mcg=1ml

                            2-3kg 30mcg=1,5ml

                            >3kg 40mcg =2ml

Adverse effects

cardiac arrest, ventricular fibrillation, dyspnea, pulmonary eodema, diarrhoea, hypertension, parasthesia,shivering, diaphoresis,myalgia, weakness, rhinorrhe, sneezing

Drug interactions

serious-naldemedine, naloxegol

minor-elvitegravir

 

 

Neomycin

Acute liver failure

1g po every 6 hrs until recovery

Hepatic encephalopathy

4-12g po qid for 5-6 days

Adverse effects

diarrhoea, nausea, vomiting, contact dermatitis, dyspnea, eosinophilia, nephrotoxicity, neurotoxicity, ototoxicity

Drug Interactions

contraindicated-amikacin, amphotericin B, BCG vaccine, cyclosporine, ioversil, tacrolimus, teicoplanin, typhoid vaccine

serious-acyclovir, atracurium, bumetanide, capreomycin, cephaloridine, cholera vaccine, colistin, furosemidde, gentamycin, quinidine, succinylcholine, vecuronium

monitor closely-defovir, amiodarone, carboplatin, cisplatin, clotrimazole, cyclosporine, digoxin,erythromycin, estradiol, ethotoin, foscaenet, indinavir, ketoconazole,nifedipine, penicillin,ritonavir, tenofovir, verapamil, warfarin

minor-aceclofenac,aspirin, biotin, calcium acetate,celecoxib, clotrimazole, diclofenac, fluconazole, ibuprofen, ketorolac, mefenemic acid, oxprozin, piroxicam, pyridoxin, thiamine, Vitamin A,zolendronic acid

 

Neostigmine bromide

2.5-5 mg after/with 1-1.8mg atropine sulphate.

[Paed =50mcg/kg with/after 20mcg/kg atropine] 2.5-5mg with 1-1.8mg atropine sulphate

Mysthenia gravis

0.5-2.5mg IV/IM/SC per day then 15-375mg po tds

Adverse effects

allergic reactions, dizziness, convulsions, drowsiness, headache, dysrthria, miosis,visual changes, cardic arrhythmia, bradycardia, dyspnea, rash, urticaria, nausea, emesis, flatulence

Drug Interactions

serious-ambenonium, triamcinolone acetonide injectable suspension

Monitor closely-acclidinium, ambenonium, amitriptyline, amoxapine, actracurium, atropine, bethanechol, clomipramine, cycline, dicyclomine, doxepin, glantamine, homatropine, ipratropium, rivastigmine, vecuronium

Minor-acebutolol, atenolol, betaxolol, carvedilol, esmolol, galantamine, nadolol, procainamide, propranolol, satolol. timolol. trazodone

 

Nicotinamide

HIV wasting syndrome

50mg po once a day review

Pellagra

100mg po once a day 2 weeks or review

Adverse effects

pruritus, rash, diarrhoea, flushing, diarrhoea, headache, arrhythmias, postural hypotension, abdominal pain, rhabdomyolyisis,nausea, vomiting

Drug interactions

serious-artovastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin

monitor closely-cholestyramine, erythromycin, insulin, metformin, omadacycline, roxithromycin

minor-carbamazepine, cefamandole, colestipol, doxycyline, isoniazid, minocycline, temocilin, tetracycline, meropenem, pivmecillinam

Nifedipine

Hypertension

SR po 10-40mg 1-2 times a day long term

Adverse effects

peripheral oedema, dizziness, flushing, headache, heartburn, nausea, muscle cramps, mood changes, nervousness, cough, palpitations, wheezing, urticaria, constipation, chest pain

Drug interactions

contraindicated-cisapride, everolimus, pimozide, terfenadine

serious-aftinib,apalutamide, cisapride, edoxaban, ergotamine, erythromycin, everolimus, lovastatin, phenytoin, simvastatin, sirolimus,venetoclax

monitor closely-acebutolol, almotriptan, alprazolam, amikacin, amiodarone, amitriptyline, amlodipine,bisoprolol, buspirone,carbidopa, cortisone, cyclosporine, dexamethasone, dialtiazem,efavirenz,etravirine,flouxetin, gentamycin,indinavir, isoniazid,itraconazole,ketoconazole,lopinavir, maraviroc, nadolol,nevirapine, paclitaxel,phenobarbital,prednisolone, prednisone, rifampin, streptomycin,tacrolimus,theophylline, warfarin

Minor-agrimony, amlodipine, amobarbital,atazanavir, atracurium, brimonidine, budesonide, cyclosporine, dapsone, efavirenz, fluconzole, itraconazole, metformin, posaconazole, ritonavir, tamoxifen, vecuronium, vincristine,ziprasidone

 

Nitrofurantoin

Urinary Tract Infection

50-100mg po qid for 7 days

Adverse effects

anorexia, arthralgia, chills, cough, diarrhoea, dizziness, drowsiness, dsynea, fatigue, headache,hepatitis, itching, nausea, numbness, parasthesia, vomiting, weakness, urine disclouration,vasculitis

Drug interactions

contraindicated-BCG vaccine live, typhoid vaccine live

serious-cholera vaccine

monitor closely-acalabrutinib, apalutamide, calcium carbonate, daclatasvir, digoxin, estradiol,mestranol,ponatinib, tetracaine

minor-balsaalazide, biotin, magnesium citrate, metoclopramide, pyridoxine, thiamine

Norethisterone

Long term hormonal contraceptive

norethisterone enanthate im  200mg once every 2 months

Adverse effects

edema, weakness, anorexia, amenorrhea, deep vein thrombosis, depression, dizziness, headache, nervousness, somnolence, vomiting, weight gain, nausea, vomiting

Drug interactions

contraindicated-acitretin

serious-apalutamide, brigatinib, carbamazepine, darunavir, enzalutamide, phenytoin, primidone, rifampin, rifapentine, topiramate

monitor closely-atazanavir, clobazam, colesevelam, iloperidone, insulin, maraviroc, mifepristone, rufinamide, tesamorelin

Norfloxacin

Pelvic inflamatory disease second line

800mg po once a day single dose

Cystitis

400mg po 2 times a day 3 days

Acute pyelonephritis

400mg po 2 times a day 2 weeks

Adverse effects

nausea, dizziness, headache, stomach cramps, weakness, abdominal pain, anorexia, anxiety, arthritis, ataxia, backpain,confusion, diarrhoea, diplopia, dyspepsia, fever, heartburn

Drug interactions

monitor closely-segesterone/ethinyl estradiol

Nystatin

Oral candidiasis

nystatin suspension 200 000 units  5 times a day 7- 14days

nystatin lozenges  Sucked 5 times a day 7- 14 days

Adverse effects

diarrhea, nausea, vomiting, stomach pain, contact dermatitis, stevens-johnson syndrome, hypersensitivity reactions

Drug interactions

contrindicated-allogeneic cultured keratinocytes/ fibroblasts in bovine collagen

Ofloxacin

0.3% eye drops 1 drop 2-6 hourly for 14 days

Bronchitis Exercerbation

400 mg PO 12hourly for 10 days

Community Acquired Pneumonia

400 mg po 12hourly for 10 days

Skin Infections

400 mg po 12hourly for 10 days

Acute, Uncomplicated Urethral and Cervical Gonorrhea

400 mg po single dose

Nongonococcal Cervicitis/Urethritis or Mixed Infection of Cervix/Urethra

300 mg po 12hourly for 7 days

Acute Pelvic Inflammatory Disease

400 mg po 12hourly for 10-14 days

Uncomplicated Cystitis

Due to E. coli or K. pneumoniae: 200 mg po twice daily for 3 days

Due to other approved pathogens: 200 mg po twice daily for 7 days

 

Adverse Effects: Nausea, headache, insomnia, dizziness, vaginitis, diarrhea, chest pain, decreased appetite, fatigue, GI distress, rash, pyrexia, pharyngitis, palpitatios, steven johnson syndrome, vasculitis, syncope

Drug Interactions: Serious- Amiodarone, BCG Vaccine, ferrous sulphate, ferrous sucrase, quinidine, procainamide. Monitor Closely-Amitryptylline, Atermether/Lumefantrine, chlorpromazine, digoxin, cortisone, haloperidol, insulin, itraconazole, metrfomin, phenytoin

Olanzapine

Psychosis(second line)

5-10 mg  2 times a day continual

Bipolar Depression

5 mg po nocte

Chemotherapy associated nausea and vomiting

5-10mg po daily for 3 days

 

Adverse Effects:Ortghostatic hypotension, weight gain, hypertriglyceridaemia, hypercholesterolemia, extrapyramydal symptoms, weakness, dizziness, insomnia, somnolence, constipation, dyspepsia, hypotension

Drug Interactions:Serious-Dopamine, bromocriptine, levodapa, mefloquine, methyldopa. Monitor Closely-Acarbose, amitriptylline, atropine, baclofen, captopril, carbamazepine, cimetidine, ciprofloxacin, clonazepam, diazepam, fentanyl, insulin, propofol

Olopatadine [patanol]

Allergic conjuctivitis

1% eye drops 2 times a day for 2 weeks

 

Adverse Effects: Headache, blurred vision, asthenia, burning, dry eye, foreign body sensation, keratitis, hypersensitivity, id edema, nausea, pharyngitis, pruritus, sinusitis

Omeprazole

Gastroesophagial reflux

po 20mg twice a day for 2 months

In Hpylori eradication

po 20mg  Twice a day  2 weeks 

 

Adverse Effects: Headache, Abdominal pain, diarrhea, nausea, vomiting, flatulance, rash, cough, upper respiratory tract infections, anorexia, hepatotoxicity

Drug Interactions: Serious-Carbamazepine, atazanavir, clopidogrel, digoxin, isoniazid, ketoconazole. Monitor Closely- Ampicillin, cefuroxime, ciprofloxacilin, Clozapine, digoxin, efavirenz, fluconazole, methotrexate, lorsatan, phenobarbitone, rifampin, warfarin

Orphenadrine

Anti-psychotics side effects

po 50mg once a day for 1 week

Oxybuprocaine hydrochloride

Cytomegalovirus retinitis

0.4% eye drops 1 drop stat

 

Adverse Effects: Burning sensation, stinging, conjunctivitis, allergic contact dermatitis, conjunctival ejection, allergic corneal reaction

Oxytocin

Prolonged rupture of membranes

oxytocin infusion  1 unit initially  Then 4 units in 1L sodium chloride 0.9%  at 15, 30, 60 drops per minute until regular contractions

Cardic disease in pregnancy

oxytocin 10units once at delivery of the anterior shoulder

Induction of labour

oxytocin iv infusion Initially 1 unit, Then 4 units in 1L sodium chloride 0.9% at 15, 30, 60 drops per minute – until regular contractions are maintained.

If 4 units is insufficient, and it is the woman’s first pregnancy:  Increase the dose stepwise with regular monitoring – 16, 32 then 64 units in the litre of sodium chloride 0.9% - each time increasing the delivery rate through 15, 30 and 60 drops per minute.

 

Adverse Effects:Sinus bradycardia, neonatal seizures, neonatal jaundice, fetal death, low apgar, uteroplacental hypoperfusion, fetal hypoxia, fetal hypercarpnia, severe decrease in martenal blood pressure.

Drug Interactions: Serious- Mefloquine. Monitor Closely-Dobutamine, dopamine, norepinephrine  

 

Haloperidol

Rheumatic Fever

1.5-3mg(25-50mcg/kg) 3 times a day as required

Psychosis(rapid tranquilisation)

2-6mg im repeat after 6hours until calm

Psychosis

1,25-5mg po 2 to 3 times a days continual

Nausea And Vomiting

1,5-4,5mg nocte for 3-5 days

Adverse effects

extrapyramidal symptoms(akathisisa, dystonia, muscle stiffness, neuropathic pain,parkinsonism, tardive dyskinesia), sedation, weight gain, erectile dysfunction, anorexia, constipation

 Drug intaractions

contraindicated-amiodarone, methydopa, pentamidine,quinidine, satolol, pramipexole, lisuride

serious-amitiptyline, apomorphine,artemether/lumefantrine, chlorpromazine, epinephrine, erythromycin, fentanyl,imipramine,levodopa

monitor closely-albuterol, amiodarone, atropine,benztropine, caffeine,celecoxib,diazepam, imipramine, ipratropium, ketamine, sulfamethoxazole, tamoxifen

minor-aripiprazole,chorpromazine, ethanol,promethazine,trifluoperazine, phenobarbital, indomethacin

Heparin

Oedematous and bed ridden

5000 sc units 3 times a day as required

Unstable Angina

5000 units IV 6 hourly

Nephrotic Syndrome

5000 units three times a day until mobile

Deep Vein Thrombosis Prophylaxis

5000 units thrice daily review

Deep Vein Thrombosis Treatment

17500 units twice daily

Adverse effects

heparin induced thrombocytopnea, hemorrhage, anaphylaxis, osteoporosis, hypersensitivity, local irritation,pain

Drug interactions

contraindicated-abciximab, estradiol, dipyridamol, tirofiban,defibrotide,cilostazol, anagrelide

serious-amobarbital, antithrombin III, azithromycin, ceftriaxone, erythromycin, phenobarbital,warfarin

monitor closely-acematacin, aspirin,azathioprine,captopril, diclofenac, enalapril, ibuprofen,iodine,telmisartan

minor-acetaminophen, doxcycyline, quinididine , tetracycline, vasopressin, Vitamin E,protamine

Hydralazine

Severe Pregnancy Induced Hypertension

10mg im 4 hourly

Eclampsia

10mg im once

Severe Hypertension

6,25-25mg IV/im  until desired BP (measure BP every 5-10 minutes)

Antihypertensives in anaesthesia

5-10mg every 20-30mins

Adverse effects

hypotension, palpitations, tachycardia, headache, anorexia, diarrhoea, peripheral neuropaty,leukopenia, hepatotoxicity

Drug interactions

serious-lofexidine

monitor closely-acebutolol, aspirin, atenololcarvedilol, celecoxib,diclofenac,esmolol,ibuprofen, ketorolac, levodopa, mefenamic acid,propranolol,tinidazole

minor-brimonidine, pyridoxine, tizanidine, ruxolitinib, reishi, maitake

Hydrochlorothiazide

Hypertension

12.5-25mg  po once a day long term

Resistant Heart Failure

50mg po review  

Adverse effects

anaphylaxis, anorexia, confusion,fatigue, hypokalemia, hypotension,pancreatitis, respiratory distress, vertigo

Drug interactions

contraindicated- cisapride, dofetilide, isocarboxazid

serious-aminolevulinic, carbamazepine, cyclophosphamide, cyclosporine, tretinoin, squill

monitor closely-acetabutolol, albuterol, amoxicillin, aspirin,bumetanide,captopril,diclofenac, dicloxacillin, epinephrine,fentanyl,ibuprofen

minor- acarbose, acyclovir, albeterol, diclofenac,epinephrine, glimipiride, mefenemic acid,penicillin,predinisolone,salmeterol, verapamil

 

 

Hydrocortisone

Haemorrhoids and other painful perianal conditions

0,25% cream twice daily

Allergic Otitis Externa

1% cream once daily for 7 days

Pulmonary Embolism & life threatening arterial embolism

100mg IV once only

Anaphylaxis

200mg IV 6 hourly

Carbon Monoxide Poisoning

4mg/kg IV/im 4 hourly

Adverse effects

acne, cataracts, depression, delirium, epistaxis, fat embolism, hyperglycemia, insomnia, malaise, myopathy,osteoporosis, vertigo, psychosis, increased appetite

Drug interacions

contraindicated-anthrax vaccine, BCG vaccine live, diptheria and tetanus toxoid, hepetitis B vaccine, mifepreistone, typhoid vaccine, varicella virus vaccine, rotatvirus oral vaccine, rubella vaccine

serious-carbamazepine, cimetidine, clarithromycin, erythromycin, ketonazole,quinidine, rifabutin, rifampin, terfenadine

monitor closely-acematicin, amiodarone, antithrombin III, aspirin, artovastatin, actracurium, celecoxib, dexamethasone, efavirenz, fluconazole, griseofulvin, ibuprofen

minor-amitriptyline, amlodipine, atazanavir, dapsone, furosemide, glipizide, insulin, isoniazid, nifedipine,sulfasalazine, testosterone, vincristine

Hydroxycobalamin

Vitamin B12 deficiency

1mg im daily for 3 days then weekly for 3 weeks, monthly for 3 months and then every 3 months for 1 year then twice a year

Adverse effects

arthralgia, dizzzines, headache, nasopharyngitis,anaphylaxis, angiodema, dyspepsia, sore throat, glossitis, rhinitis, hypoesthesia

Drug interactions

monitor closely-dichlorphenamide, omadacyline

minor-acetazolamide, aspirin, carbamazepine, chloramphenicol, cimetidine, esomeprazole, ethanol, gabapentin, lorazepam, omeprazole, phenytoin, valproic acid

Hydroxyurea

Sickle Cell Anaemia

500mg po once a day indefinitely

Head and neck tumours, solid tumours

80mg / kg po daily for 3 days( 7 days prior to initiation of radiation)

Chronic myelocytic leukemia( resistant)

20-30mg/kg po daily

Thrombocytopnea

15mg/kg po daily

Adverse effects

infections, neutropea, fever, headache, vit D deficiency, anaemia, nausea, weight gain, constipation, hyperuricemia, skin ulcers, hyperpigmentation

Drug interactions

serious- adenovirus, BCG vaccine live, measles mumps and rubella vaccine live, polio virus,, varicella zoster vaccine, typhoid vaccine, stavudine

monitor closely- allopurinol, azathioprine, carboplatin, cisplatin, ganciclovir, mitomycin, probenecid, zidovudine, pyrimethamine

Hyoscine

Non Ulcer Dyspepsia

10mg 3 times a day for 4 weeks

motion sickness

transdermal patch(1mg/72hrs) behind the ear 4-12 hours before anticipated exposure to motion then every 3 days per rising need

Nausea and vomiting

0.3-0.65mg IV/IM/SC 6-8 hourly

Adverse effects

dry mouth, drowsiness, diziness, blurred vision. disorientation, confusion, pruritus, anticholinergic effects

Drug interactions

contraindicated- pramlintide

serious- macimorelin, secretin, umeclidium bromide

monitor closely-amantadine, amitryptline, aripiprazole, atropine, chlopromazine, desipramine, haloperidole, ipratropium, promethazine, tiotropium

minor-donepenzil, dimenyhydrinate, galantamine, levodopa

Rabies immunoglobulin{human)}

Rabies

10IU/kg im gluteal once only

Vecuronium

Muscle relaxant

 0.08-0.1mg/kg IV 3-5 mins 30-45mins 

 maintenance 0.02-0.03mg/kg

 

Adverse Effects: Muscle weakness and paralysis, Hypersensitivity reactions, Myositis ossificans, Respiratory Insufficiency

Drug Interactions:Serious-Amphotericin B, Clindamycin, Fentanyl, Gentamicin, Streptomycin

Verapamil

Arrhythmias after myocardial infarction- Ectopic beats

po 40-120mg 3 times a day review

Paroxysmal supraventricular tachycardia

iv 5-10mg bolus repeat after 10mins;

long term:  po 40-120mg 3 times a day long term

Angina, Hypertension

80 mg PO 8hourly initially; usual range: 80-120 mg PO 8hourly; not to exceed 480 mg/day

Migraine Prophylaxis

160-320mg po 6-8 hourly

 

Adverse Effects: Headache, Gingival Hyperplasia, Constipation, Dizziness, Hypotension, Increased Liver Enzymes, Dyspnea

Drug Interaction: Serious-Atenolo, Bisoprolol, Cimetidine, Cholchicine, Erythromycin, Fentanyl, Timolol

 

Vitamin A

Xerophthalmia/vitamin A deficiency

vitamin  A  200,000  iu [<1yr  = 100,  000iu] single  dose Day  1,  Day 2  and repeat  after 2  weeks (Nutritional  rehabilitation  is  indicated).

Supplement in severe acute malnutrition

 <6mnths 50,000iu once at the clinic and one dose at home -2 doses only 

6– 12mths 100,000iu    

1-5yr 200,000iu

 

Adverse Effects: Anaphylaxis, Facial dermatitis, Conjunctivitis, Dry mucus, Corneal opacity, Alopecia

Drug Interaction: Monitor Closely-Beta carotene, Cisplatin, Vincristine, Vinblastine

Vitamin B complex

Vitamin B12 deficiency

hydroxocobalamin (vitamin B12) im 1mg daily 3 days    then weekly for 3 weeks, and monthly for 3 months and then every 3 month for a year and then twice a year

Pernicious Anemia

30-50 mcg IM/SC once daily for &ge2 weeks for total dose of 1,000 mcg to 5,000 mcg administer concomitantly with 1 mg/day of folic acid for 1 month

 

Adverse Effects: Arthralgia, Dizziness, Headache, Nasopharyngitis, Anaphylaxis, Congestive cardiac failure, Pulmonary edema, diarrhea,glossitis

Drug Interactions: Minor-Acetazolmide, Asprin, Carbamazepine, Cimetidine, Gentamicin, Ibuprufen, Metrfomin, Omeprazole

 

Vitamin D

Nutritional Suppliments

0-12 months: 400 IU (10 mcg) PO once daily

1-18 years: 600 IU (15 mcg) PO once daily

Vitamin D-Resistant Rickets

12,000-500,000 IU (0.3-12.5 mg) PO once daily

Familial Hypophosphatemia

40,000-80,000 IU (1-2 mg) PO once daily with phosphate supplements

 

Adverse Effects: Arrhythimias, Constipation, Confusion, Dry mouth, Headache, Nausea, Vomiting, Muscle or bone pain, Lethagy

Drug Interaction: Monitor Closely- Calcium carbonate, Calcium Chloride, Digoxin, Hydrochlorothiazide, Phenytoin, Phenobarbitone

Vitamin K

Hypoprothrombinaemia

2,5-10mg po/IV/IM/SC

Reversal of warfarin effects

INR 4,5-10, no bleeding- 1,25mg po once

INR >10, no bleeding- 2,5-5mg po once

Minor bleeding, elavated INR- 2,5-5mg po once, may repeat after 24 hours if needed

Major Bleeding, elavated INR- 5-10mg IV infusion(dilute in 50ml IV fluids)

Nutritional Suplimentation

90-120mcg po daily

 

Adverse Effects: Anaphylaxis, Dyspnea, Cyanosis, Pruritis, Flushing, Hypotension, Hyperbilirubinemia

Drug Interactions: Serious- Warfarin. Monitor Closely- Asprin, Erythromycin, Ibuprofen, Mefenamic acid, Naproxen, Piroxicam. Minor- Ciprofloxacin, Chlohexidine, Cholestyramine

 

Ibuprofen

Back and Neck pain,Spinal Spondylosis, Rheumatoid, Juvenille & Degeneraive,Arthritis, Pain management

200-400mg po 3 times a day review

Adverse effects

dizziness, epigastric pain, constipation, nausea, tinnitus, headache, rash, edema, fluid retension, vomiting

Drug interactions

contraindicated-ketorolac

serious-aminolevulinic acid, aspirirn, captopril, enalapril,naproxen, tacrolimus, perindopril, methotraxate, benazepril

monitor closely-acebutolol, amiloride, aspirin, atenolol, captopril, carvedilol, dexamethasone,digoxin, efavirenz, enalapril, epinephrine,flucloxacillin, glipizide, heparin, labetolol, mefenamic acid, ,propranolol,salicylates, sulfasalazine

minor-acyclovir, amiodarone, aspirin,, carbamazepine, celecoxib, cimetidine, diclofenac, digoxin,furosemide, gentamicin, rifampin, valproic acid, voriconazole

Immunoglobin

Idiopathic Thrombocytopenic Purpura

1mg/kg IV once a day for 3 days

Imipramine

Depression

50mg po nocte an hour before sleep increase by 25mg every 2 nights upto 150mg assess progress after 2 weeks

Adverse effects

fatigue, sedation, weakness, constipation, dry mouth,agitation, anxiety, headache, insomnia, vomiting, sweating, rash, seizures

Drug interactions

contraindicated-cisapride, disopyramide, indapamide, isocarboxid, procainamide, quinidine, satolol, terfenadine

serious-albeterol, amiodarone, amitriptyline, artemether/ lumefantrine,clarithromycin, desipramide,dopamine, epinephrine, erythromycin,fluconazole

monitor closely-aripiprazole,atazanivir,atropine, chlorphenereamine, cimetidine,codeine, desipramine, diazepam, fluconazole,rifampin

minor-cortisone, dexametahsone, efavirenz, ethanol,glipizide, insulin, itraconazole, nifedipine, predinisolone, sulfamethoxazole, verapamil

Indomethacin

Herpes Zooster

25mg po 3 times a day for 7 days

Acute Gout

50mg four times a day for the first 24 hours then reduce by 25mg daily to 25mg three times a day and review

Chronic Gout

25-50mg three times a day for the first 3 months of allopurinol

Arthritis

25-50mg three times a day review

Joint/ Bone Pain

25-50mg every 4-6 hours review

Adverse effects

jaundice, transient renal insuffiency, headache,dizziness, dyspepesia, epigastric pain, nausea, constipation, somnolence, tinnitus, urticaria

Drug intearactions

contraindicated-ketorolac

serious-aminolevulinic acid, captopril, enalapril, methotraxate, tacrolimus, trandolapril

monitor closely-acetabutol, alteplase, amiloride, aspirin, bisoprolol, captopril, celecoxib,dexamethasone, enalapril, flucloxacillin, gentamicin, prazosin, propranolol, spironolactone, warfarin

minor-acyclovir, amikacin, celecoxib, diclofenac, furosemide, ibuprofen, mefenamic acid, vancomycin

Ipratropium

COPD exercerbation-inhaler

400mcg or nebulized 500mcg 6 hourly then review

Stable COPD

inhaler 400mcg PRN

Acute asthma exacerbation

inhaler-136mcg every 20minutes PRN for 3 hours

nebulizer-500mcg evry 20minutes for 3 doses then PRN

Adverse effects

broncitis, sinusitis, dyspnea, headache, backpain, cough, dyspepsia, dry mouth,dizziness, nausea,

Drug interactions

contraindicated-pramlintide

serious-macimorelin, revefenacin, umeclidinium bromide

monitor closely-amantadine, amisulpiride, amitriptyline, aripiprazole, clozapine, desipramine, haloperidol,sulpiride, titropium,vecuronium

minor-dimenhydrinate, donepezil, gelantamine, levodopa

 

Isoniazid

Tuberculosis

10mg/kg once a day for 2-6months

Adverse effects

nausea, vomiting, stomach pains, weakness, dizziness, slurred speech, agranulocytosis, anaemia, thrombocytopnea, seizures, progressive liver damage

Drug interactions

contraindications-cisapride, ketoconazole,lovastatin,terfenadine, pimozide,ivabradin,naloxegol

serious-aclarabrutinib, avanafil, cabazitaxel, clopidogrel, eplerenone, erythromycin,fentanyl, isocarboxid,omeprazole,simvastatin

monitor closely-acetaminophen, amiodarone,atazanavir,budesonide,cannabinol,clozapine,darunavir, dexamethasone, diazepam,efavirenz, ethanol, fluticasone, , lopinavir,maraviroc, nifedipine, warfarin

minor-acetaminophen, amitriptyline,caffeine,cortisone,dexamethasone,glipizide, insulin,phenytoin, predinisolone,valproic acid,

Isosorbide dinitrate

Unstable angina, Acute myocardial infarction

10-40mg 3 times a day as required

Adverse effects

rebound hypertension,syncope, flushing,palpitations, light headdedness, tachyarrhythmia, headache, nausea, methemoglobinemia

Drug intearactions

contraindicated-avanafil, sildenafil,tadalafil,vardenafil

serious-carbegolin, ergotamine,lofexidine, ergonovine, methylergonovine

monitor closely-arginine, captopril, dapsone, iloperidone, maraviroc, tetracaine, stiripentol

minor-acetylcysteine

Tetanus immune globulin

Neonatal tetanus

tetanus immunoglobulin im 500 – 1000 units  Once only single dose

Tetanus Prophylaxis

<7 years old: 4 Unit/kg or 250 Units IM 

>7 years old: 250 Units IM (single dose)

Tetanus Treatment

3000-6000 Units IM

 

Adverse Effects: Urticaria, Lethargy, Nausea and Vomiting, Injection site pain, Chest Tightness, Anaphylaxis, Nephrotic Syndrome (rare)

Drug Interactions:Monitor Closely- BCG , Measles, Mumps, Rubella live vaccines, Varicella, Smallpox(Live Vaccines)

Tetracycline Eye Ointment 1% 

Neonatal ophthalmia

Both eyes  once only

Bacterial conjuctivitis

Apply 3 times a day one week

Terbinafine 

Tinea pedis/capitis

250mg po daily for 6 weeks OR

apply cream twice a day for 6-8 weeks

 

Adverse Effects: Headache, Pruritus, Nausea, Vomiting, Diarrhea, Visual Disturbances, Elavated Liver Enzymes

 

Theophylline

Moderate chronic asthma

theophylline slow release po 200mg 2-3 times a day continual

Severe chronic asthma

theophylline slow release po  200mg 2-3 times a day continual

Mild asthma-children

theophylline po 5mg/kg < 4 times a day intermittent 

Neonatal Apnea

Loading: 4-5 mg/kg PO/IV once  

Maintenance: 3-6 mg/kg/day PO/IV divided 8 hourly

 

Adverse Effects: Central nervous system excitement, headache, insomnia, irritability, restlessness, seizure, diarrhea, nausea, vomiting, diuresis, exfoliative dermatitis, tachycardia, tremors, hypercalcemia

Drug Interaction: Contraindicated-Dipyridamole, Febuxostat. Serious- Allopurinol, Carbamazepine, Cimetidine, Ciprofloxacin, Clarythromycin, Erythromycin, Itraconazole, Rifabutin. Monitor Closely- Atazanavir, Bisoprolol, Carvedilol, Efavirenz, Fluconazole, Hydrocortisone, Isoniazid, Nifedipine, Phenytoin

Thiamine

HIV related wasting syndrome

thiamine po 50mg once a day review

Acute liver failure(ethanol atiology suspected)

 thiamine iv slow  250mg before dextrose infusion and daily for 3 days

Severe alcohol dependence

thiamine po 50mg once a day review

Ethanol(alcohol poisoning)

thiamine po 200mg once a day Review

Encephalopathy

thiamine iv/im  250mg once  - then thiamine po 200mg one a day 7 days

 

Adverse Effects: Anaphylaxis, Cyanosis, Diaphoresis, Restlessness, Nausea, Pulmonaery Edema, Weakness, Pruritus

Drug Interactions:Monitor Closely- Azithromycin, Clarythromycin, Erythromycin, Azikacin, Doxycycline, Frusemide

Thiopentone sodium

Status epilepticus

7mg/kg IV assess/review

Intravenous anaesthetic

slow IV  3-5mg/kg 10-15secs  5-10mins    repeat if necessary after 20-30secs

Thyroxine

Hypothyroidsm

thyroxine po 50 -100mcg initially once a day 4 weeks, then  increase by 25 - 50mcg every four weeks as necessary until euthyroid

Tilidine hydrochloride drops

Pain management in children

Tilidine hydrochloride drops 1 drop per year age (max. 5 drops) 6 hourly as drops

Timolol

Hypertension

10-30 mg PO 12hourly

Maintenance: 20-40 mg/day

No more than 60 mg/day

Acute Myocardial Infarction

10 mg PO 12hourly

Angina 

15-45 mg/day po divided 6-8hourly

Migraine, Prophylaxis

Initial: 10 mg PO 12hourly titrate to 10-30 mg/day

Glaucoma(chronic open angle)

Timolol maleate 0.5% eye drops 1 drop in each eye Twice a day Continual as per recommendation by specialist

 

Adverse Effects:Arrhythimias, Bradycardia, Syncope, Fatigue, Headache, Dyspnea, Bronchospasm, Edema, Nausea

Drug Interactions: Serious-Atenolol, Bisoprolol, Carvedilol, Digoxin, Epinephrine, Labetalol, Metoprolol, Verapamil. Monitor Closely-Asprin, Calcium carbonate and chloride, Diclofenac, Ibuprufen, Insulin, Lorsatan, Phenobabirtal, Propofol

Tramadol

pain in adults

Tramadol  50mg 6 hourly 5-7 days/ tramadol im 50mg/ml

 

Adverse Effects: Constipation, Nausea, Headache, Vomiting, Nervousness, Pruritus, Emotional Lability, Diarrhea, Anxiety, Agitation

Drug Interactions: Serious- Clonidine, Fentanyl, Atazanavir. Monitor Closely-Artemether/Lumefantrine, Carbamazepine, Cimetidine

Triamcinolone acetinide

Rheumatic or Arthritic Disorders

60 mg IM every 6 weeks; may be supplemented by additional 20-100 mg IM PRN

Intra-articular injection: Large joints, 5-15 mg; small joints, 2.5-5 mg

Dermatoses

Intralesional injection 1 mg per injection site

Inflammatory & Allergic Systemic Conditions

60 mg IM single injection; adjust dose to a range of 40-80 mg

 

Adverse Effects: Contraindicated-Mifeprestone. Serious-BCG live vaccine, Cimetidine, Carbamazepine, Clarythromycin, Erythromycin, Hepatitis B vaccine, Measles, Mumps, Rubella, Influenza vaccines. Monitor Closely-Asprin, Artemether/Lumefantrine, Ciprofloxacilin, Fluconazole, Ibuprufen

Trifluoperazine

Schizophrenia/Psychosis

<6 years: Safety and efficacy not established

6-12 years old: 1 mg PO Day or 12hourly; not to exceed 15 mg/day

12 years old: 2-5 mg PO 12hourly

 

Adverse Effects: Extrapyramidal side effects, Neuroleptic malignant syndrome, sedation, Anticholinergic effects, weight gain, Oligomenorrhea /amenorrhea, erectile dysfunction, insomnia, restlessness,Depression, tachycardia.

Drug Interactions:Contraindicated-Procainamide, Qunidine, Terfenadine, Sotalol. Serious-Amytriptilline, Artemethetr/Lumefantrine, Clarythromycin, Erythromycin, Itraconazole, Ketoconazole. Monitor Closely-Atropine, Clonazepam, Codeine, Diazepam, Haloperidol, Insulin

Trimeprazine tartrate

Pre-op sedation in children

2mg/kg 1-2 hrs before surgery

Tropicamide

Cataract

0.5% eye drops 1-3 drops stat pre-op

Refraction (Mydriasis)

Adult; 1-2 gtt of 1% solution in eye(s), repeat in 5 min, perform exam within 30 min of second instillation

Funduscopic Exam (Cycloplegia)

Adult; 1-2 gtt of 0.5% solution in eyes 15-20 min before exam, may repeat q30minutes PRN

 

Adverse Effects: Increased intraocular pressure, blurred vision, Tachycardia, photophobia, Headache, Allergic reactions, Dry mouth

 

Salbutamol

Wheezing in paedistrics:

salbutamol nebulised 5mg/ml in 2ml sterile water

 <1yr= 2.5mg

>1yr= 5mg  as required

Or salbutamol po  

2-12mnths  = 1mg

1-5yrs= 2mg 3 times a day

COPD excercerbation:

Mild/moderate: salbutamol inhaler 100-200mcg  6 hourly review

Severe: salbutamol nebulised 5mg 6 hourly review

Stable COPD: Salbutamol Inhaler 200mcg PRN

Bronchioectasis

Salbutamol inhaler 200mcg PRN 

Asthma

Mild intermitrent: salbutamol inhaler 100–200mcg  as needed, or before exercise

Mild /moderate/severe chronic asthma: salbutamol inhaler 100-200mcg  as required continual

Acute asthma attack: sulbutamol nebulised (in saline or sterile water) 5mg   repeat at ½ - 1 hr intervals, then every 2-4 hours until recovered

Acute asthma in children

salbutamol nebulised  (in saline or sterile water) - flow rate 6L/min  <5yrs = 2.5mg/2ml 

>5yrs = 5mg/2ml repeat 2 times in the first hour,then every 4 hours until recovered.

or salbutamol inhaler through a spacer 100-200mcg (1-2 puffs) as required

Severe acute asthma in children: salbutamol inhaler  200mcg – 400mcg as required

Mild acute asthma in children:  salbutamol inhaler  100-200mcg  as required intermittent

Hyperkalemia

salbutamol nebulised  2 times a day Review

 

Adverse Effects: Tremor, nervousness, Insomnia, nausea, fever, bronchospasm, vomiting, headache, dizziness, cough

Drug Interactions: Serious-Amytryptilline. Monitor Closely-Asprin, atenolol, bisoprolol, carvedilol, celecoxib, clonazepam, diclofenac, digoxin, frusemide, ibuprufen, indomethacin, lorazepam, naproxen

Salmeterol

Severe chronic asthma

inhaler 50mg or twice a day as required

 

Adverse Effects: Headache, pain, nasal congestion, hypertension, dizziness, edema, contact dermatitis, hyperglycaemia, conjunctititis, urticaria

Drug Interactions: Contraindicated- ritonavir, lopinavir. Serious- Amytriptilline. Monitor Closely-asprin, bisoprolol, carvedilol, chlorpheniramine, clonazepam, diclofenac, digoxin, gentamycin, frusemide, haloperidol, ibuprufen, mefenamic acid

Salicylic acid 2%

Psoriasis

apply once at night as needed

Acne Vulgaris

Twice daily, gently massage cleanser onto wet face & neck until lathered

 

Advesre Effects: Burning sensation, desquamation

 

Selenium sulphide 2.5%

Pityriasis versicolor(tinea versicolor)

Selenium sulphide 2,5% B N apply daily 5 days

Dandruff, Seborrhea

Wet skin/scalp and apply 5-10 mL of shampoo to areas to be cleansed; apply 2 times/week for 2 weeks initially, and THEN once q1-2weeks to control symptoms

Adverse Effects: Transient stinging, burning, lerthagy, alopecia,diaphoresis, abdominal pain, unusual dryness of scalp

Silver sulphur diazine 1% topical cream

Burns

apply daily avoid face

 

Adverse Effects: Pain, burning, itching, rash, necrosis of skin, erythema multiforme, hemolytic anaemia, agranulocytosis, thrombocytopenia, aplastic anaemia, adverse GI symptoms.

Drug Interactions: Monitor Closely-Trypsin, Collagenase. 

Sodium bicarbonate

Metabolic Acidosis

sodium bicarbonate 8.4% iv  50mmol as required (15-30min intervals)

Sodium bicarbonate

IV in dextrose 5% continuous infusion

Hyperkalemia

50mEquivalency over 5 minutes

Cardiac Arrest

Initial: 1 mEq/kg/dose IV x1; base subsequent doses on results of arterial blood pH and PaCO2 as well as calculation of base deficit

 

Adverse Effects: Cerebral emorrhage, edema, hypocalcemia, hypokalamia, tetany, metabolic alkalosis, gastric distension, tetany, hyperkalaemia, hyperosmolarity

Drug Interactions: Serious-Atazanavir, digoxin, doxycycline, itraconazole, ketoconazole, levofloxacin,tetracycline. Monitor Closely-Allopurinol, ampicillin, atenolol, azithromycin, captopril, carvedilol, enalapril, erythromycin, lisinopril, nitrofurantoin.Minor-Asprin, salysilates, sulfadiazine

Sodium citrate

Prior to general anaesthetics eg caesarian section

 sodium citrate po 15ml  once only

Sodium valprorate

Bipolar affective disorder

200-500mg 2 times daily continual

Complex Partial Seizures

10-15 mg/kg/day IV divided 12hourly infused over 1 hr; maximum dose 60 mg/kg/day; do not exceed 14 days (switch to PO as soon as possible)

PO: 10-15 mg/kg/day PO initially; increase by 5-10 mg/kg/day at weekly intervals; may increase dose up to 60 mg/kg/day

Simple and Complex Absent seizures

IV: 10-15 mg/kg/day IV divided 12hourly infused over 1 hr; maximum dose 60 mg/kg/day; do not exceed 14 days (switch to PO as soon as possible) 

PO :15 mg/kg/day PO initially, divided 6-12hourly; increase by 5-10 mg/kg/day at weekly intervals; may increase dose up to 60 mg/kg/day

Migraine Prophylaxis

250 mg PO 12hourly; adjust dose based on clinical response, not to exceed 1000 mg/day

 

Adverse Effects: Nausea, headache, increased bleeding time, tremor, infection, diarrea, dizziness, thrombocytopenia, vomiting, ataxia, rash, abdominal pain, diploplia, dyspepsia.

Drug Interactions: Serious-Imipenem, meropenem.  Monitor Closely- Asprin, Carvedilol, Estradiol, phenytoin, propofol, warfarin, zidovudine. Minor-Acetaminophen, atracurium, clozapine, erythromycin, isoniazid, ibuprofen, phenobarbital, succynylcholine

Spironolactone

Cardiac failure

25-50mg once daily long term

Ascites of chronic liver failure

 100-400mg once a day review

Primary Hyperaldosteronism

100-400 mg PO daily in preparation for surgery

Essential Hypertension

25-100mg PO daily or divided 12hourly

Hypokalaemia

25-100 mg PO daily

Hirsutism

50-200 mg PO daily or divided 12hourly

 

Advesrse Effects: Gastric bleeding, gastritis, ulceration, decreased libido, breast and nipple pain, thrombocytopenia, rash, urticaria, dizziness, ataxia, headache

Drug Interactions: Serious-Cyclosporin, potassium phosphate, potassium chloride. Monitor Closely- Asprin, Atorvastatin, ampicillin, azithromycin, atenolol, bisoprolol, carvedilol, celecoxib, captopril, chlorothiazide, dexamethasone, enalapril, diclofenac, fentanyl, frusemide, gentamycin, ibuprufen, levodopa, mycophenolate, ritonavir

Insulin

 

 Insulin therapy in adults

10 units immediately then 5 units hourly until blood sugar falls to 14 mmol/l

Soluble insulin iv paeds

0.1 unit/kg/hr until blood sugar falls below 15mmol/l then 0.05 units/kg/hr then 0.75-1 unit/kg/day sc in 3 divided doses before meals for 1 day then add isophane sc, apply the rule of thirds  [2/3 of the total daily dose in the morning and 1/3 in the evening]

Adverse effects

headache, dyspepsia, diarrhoea, back pain, hypoglycemia, pharyngitis, insulin resistance, lipodystrophy, hypokalemia

Drug interactions

contraindicated-pramlintide

serious-ethanol, macimorelin

monitor closely-aripiprazole, aspirin, atazanavir, captopril, ciprofloxacin, darunivir, enalapril, indinivir,levofloxacin,metformin,propranolol, timolol,valsartan 

Streptokinase

Pulmonary embolism/arterial embolism

streptokinase iv loading dose of 250 000 units over 30minutes, then     100 000 u every hour  24 – 72 hrs

Streptomycin

Moderate to Severe Infections

20-40 mg/kg/day IM divided 6-12 hourly 

Tuberculosis

Daily therapy: 20-40 mg/kg IM qDay; no more than 1 g/day

Twice wekly therapy: 20-40 mg/kg IM 2 times/week; no more than 1.5 g/day

Brucellosis

>8 years old: 20 mg/kg IM divided 12hourly during 7-14 days of tetracycline or co-trimoxazole therapy; no more than 1 g/day

Plague

streptomycin im 1g first dose Then 0.5g 6 hourly 10 days  ( Paed = 5-10mg/kg)

 

Adverse Effects: Ototoxicity,Hypotension, Neurotoxicity, Drowsiness, Headache, Rash, Nausea, Vomiting, Anaemia, Arthralgia, Tremor, Difficulties in breathing

Drug Interactions:Serious- Actracurium, BCG vaccine, Qunidine, Frusemide, Succinyl choline. Monitor Closely-Cisplatin, Clarithromycin, Digoxin, Erythromycin, Itraconazole, Ketoconazole, Nifedipine, Phenytoin, Tenofovir

Sulfadiazine

Toxoplasmosis

Given with pyrimethamine and folinic acid

100-200 mg/kg/day divided 6hourly PO x3-4 weeks OR

2g po 4 times a day for 6 weeks

Infants <2 months old: 25 mg/kg/day po divided QID

 

Adverse Effects: Diarrhea, headache, anorexia, oligospermia, nausea, vomiting, photosensitivity, hypersensitivity, dizziness, thyroid function disturbances, thrombocytopenia

Drug Interactions: Serious- BCG vaccine, fundoparinax, enoxaparin, heparin, methotraxate, warfarin. Monitor Closely- Digoxin, diclofenac, insulin

Sulphur ointment 5-10%

Scabies

[in children] apply 2 times a day 1-2 weeks

Seborrheic Dermatitis

Ointment: Apply 5-10% to affected area and rub in gently 2 times daily

Acne Vulgaris

Apply sparingly to affected area(s) twice daily

 

Adverse Effects: Erythema, excessive desquamation, skin irritation

 

Sulpiride

Psychoses

po 50-200mg 2-3 times a day long term

Suxamethonium chloride

Depolarising for intubation

suxamethonium chloride iv  0.5-1.5mg per kg  < 30secs up to 5min 

 

Adverse Effects: Muscle fasciculations, jaw rigidity, apnea, respiratory depression, bradycardia, hypotension,cardiac arrythmias, increased IOP, tachycardia, excessive salivation, rash

Drug Interactions: Serious-Amikacin, Amphotericin, Clindamycin, Fentanyl, Gentamicin, Doxycycline, Kanamycin, Streptomycin. Monitor Closely-Asprin, Atenolol, Atracurium, Carvedilol, celecoxib, chlorothiazide, digoxin, furosemide, ibuprofen, indomethacin

Quietapine

Bipolar Disorder depressive episodes

50-200mg once a day continual

Bipolar Disorder, Mania

400-800 mg/day(start with 100mg per day and increase daily by 100mg)

Schizophrenia

Day 1: 300 mg po daily 

Maintenance (monotherapy): 400-800 mg/day

Major Depressive Disorder

150-300 mg/day

Alcohol Dependence 

25-50 mg po at bedtime; may be titrated; not to exceed 300 mg

Insomnia

Usually, 25 mg/day po at bedtime 

 

Adverse Effects: Dizziness, fatigue, extrapyramidal symptoms, headache, constipation, dry mouth, somnolence, abdominal pain, dyspepsia, tremor, back pain, tachycardia, pharyngitis, postural hypotension, arthralgia, neutropenia.

Drug Interactions: Serious- Atazanavir, bromocriptine, cimetidine, clarythromycin, dopamine, itraconazole, ketoconazole, levodopa, methyldopa,rifampin. Monitor Closely: Amiodaron, atropine, baclofen, captopril, carbamazepine, clozapine, erythromycin, efavirenz, fentanyl, haloperidol, insulin, isoniazid, lopinavir, neverapine, nifedipine

 

Quinine

Uncomplicated malaria:  

< 5kg =10mg per Kg body weight Every 8 hours 7 days

2nd line adults = 600mg every 8 hrs for 7 days

First trimester pregnancy

Quinine tab 600mg every 8 hrs for 7 days

Severe malaria

< 5kg =quinine infusion in 5% dextrose 20mg/kg over 4 hours, monitor infusion rate carefully, (max loading dose = 1200mg)  then after 8hrs:  then (max maintenance dose = 600mg) 10mg/kg  over next 4 hours,  repeat every 8 hours until able to tolerate oral therapy.   then reduce to  5mg/kg every 8 hrs

adults :quinine im 10mg/kg every  4  hrs for  3  doses, then 10mg/kg every 8hrs for 7days

 

Adverse Effects: Flushing of skin, angina symptoms, fever, rash, pruritus, hypoglycaemia, pruritus, thrombocytopenia, hepatitis, epigastric pain, fever, optic atrophy, impared hearing, hypersensitivity reactions, nausea, vomiting, diarrhea, headache.

Drug Interactions:Serious- Colchicine, Fundoparinax, heparin, mefloquine, ritonavir, vecuronium. Monitor Closely- Amiodarone, amytriptyline, azithromycin, artemether/lumefantrine, carbamazepine, cimetidine, ciprofloxacillin, clarythromycin, haloperidol, erythromycin, isoniazid, rifampi, risperidone, 

 

Rabies vaccine(human diploid cell)

Pre-exposure  vaccination

human diploid cell im  0.5ml single doses on Day 0, 7 and 28 only(booster every 2-3yrs)

Post-exposure vaccination

human rabies immunoglobulin 10 IU/kg once only -  (instilled and infiltrated locally around the wound)  and human rabies immunoglobulin im (gluteal) 0 IU/kg once only human rabies immunoglobulin  B V 10 IU/kg once

2.1.1 vaccination schedule

(human diploid cell) im  0.5ml in each arm one dose  on Day 0   (upper arm site) Then 0.5ml in one arm one dose  on Days 7 and 21

 

Adverse Effects: Nausea, vomiting, abdominal pain, diarrea, fatigue, fever, chills, muscle ache, dizziness, malaise.

Drug Interactions: Serious- Cortisone, Dexamethasone, Etanacept, Infliximab. Monitor Closely- Methotraxate, rituximab, Chloroquine

Ranitidine

Gastroeosophageal reflux disease

50mg twice a day for 6-8 weeks

Gastric Ulcer

150 mg PO 12hourly or 300 mg PO at bedtime

Erosive Esophagitis

150 mg PO 6hourly or 50 mg IM/IV 6-8hourly

Hypersecretory Conditions

150 mg PO 12hourly

 

Adverse Effects: Headache, abdominal pain, constipation, diarrhea, alopecia, dizziness, nausea, vomiting, anaemia, pancreatitis, thrombocytopenia, arthralgia, myalgia

Drug Interactions: Serous-Itraconazole, Atazanavir, Ketoconazole. Monitor Closely-Cefuroxime, cyclosporin, amiodarone, ferous sulphate, glipizide, lopinavir, metformin

ReSoMal

Malnutrition

5-10ml/kg/hr every 30minutes for 4-10 hours

Rifampicin

TB in paediatrics

15  mg/kg/day  (10  to  20  mg/kg/day)

Leprosy

600mg  once a month  6 months  (Paed = 10-15mg/ kg*) 

Neisseria Meningitidis Carrier

600 mg 12hourly for 2 days

 

Adverse Effects: Elavated liver function test results, nausea, vomiting, diarrhea, rash, epigastric distress, fever, headache, numbness, dizziness, flushing, ataxia, behaviral changes, muscle weakness

Drug Interactions: Contraindicated- Apixaban, artemether/lumefantrine, atazanavir, lumefantrine, ritonavi, voriconazole. Serious-Atorvastatin, amiodarone, BCG vaccine, carbamazepine, colchicine, diazepam, dexamethasone, erythromycin, lopinavir, midazolam, pyrazinamide, predinisolone, quinidine, ritonavir, verapamil, warfarin. Monitor Closely- Azithromycin, amlodipine, atorvastatin, carvedilol, digoxin, efavirenz

Risperidone

Non-Psychosis

1-3 mg 2 times a day continual

Organic-psychosis

5mg as a test dose then after monthly

Schizophrenia

2 mg po daily initially; may increase in increments of 1-2 mg/day at intervals ≥24 hr

Bipolar Mania

2-3 mg/day initially may be increased if necessary in increments of 1 mg/day at intervals of 24 hours to 6 mg/day

Tourette Syndrome

0.5-1 mg/day po may be increased or decreased in increments of 0.5 mg 12hourly at intervals >3 days; not to exceed 6 mg/day

Post Traumatic Stress Disorder

0.5-8 mg/day po

 

Adverse Effects: Somnolence, agitation, insomnia, headache, rhinitis, akathisia, drooling, urinary incontinence, anxiety, increased appetite, increased weight, constipation, dyspepsia, abdominal pain.

Drug Interactions: Serious- Amiodarone, methyldopa, quinidine. Monitor Closely- Amytriptyline, amiodarone, atracurium, atorvastatin, baclofen, atropine, carbamazepine, clotrimazole, clozapine, efavirenz, dobutamine, fentanyl, erythromycin, fentanyl, glimepiride, insulin, itraconazole, levofloxacin, metformin, nifedipine, phenytoin.

Kanamycin

Ophthalmia neonatorum

25mg/kg once single dose

Empyema/lung abcess

7.5mg/kg 12hrly 14 days

Mastoiditis

7.5mg/kg 24hrly 12 hrly

Urethral discharge,vaginal discharge

2g[1g  into  each buttock] one  dose  only

Adverse effects

agranulocytosis, anorexia, diarrhea, dyspnea, muscle cramps, nausea, vomiting, nephrotoxocoty,pruritus, arsh, tinnitus, thrombocytopnea, tremor, vertigo , weakness

Drug interactions

contraindicated- BCG vaccine live, typhoid vaccine live

serious-amphotericin B, actracurium, furosemide, neomycin, quinidine, vecuronium, torsemide

monitor closely- acyclovir,amikacin, amiodarone, cisplastin, cyclosporine, digoxin, estradiol, gentamycin, ketoconazole, rifampin, ritonavir,tenofovir, warfarin

minor- adefovir, aceclofenc, acemetacin, aspirin, calcium carbonate valcium gluconate, fluconaxole, ketorolac, mivonazole, pyridoxin, thiaine, vancomyocin,voriconazole

Ketamine

Sedation

1-2mg/kg iv

4-8mg/kg im (onset30-90sec)10-20min    

(maintenance = serial doses 50% of induction iv dose or 25% of im dose. analgesic dose = 0.25 – 0.5mg/kg)

Adverse effects

tachycardia, visual hallucinations, vivid dreams, diplopia, increased intraocular pressure, tonic-clonic movements, nystigmus,anaphylaxis, cardiac arrythmia, hypersalivation, hypertonia, laryngospasms

Drug interactions

contraindicated-doxapram , norepinephrine, phenylephrine, memantine, doxapram

serious-epinephrine, fentanyl, isocarboxazid, phenelzine, sodium oxybate, hydrocodone, ivosidenib, apalutamide, benzhydrocodone

monitor closely-acebutolol, amisulpride, amitriptyline, atazanavir, baclofen, bisoprolol, carbinixamine, chlorpromazine, darunivir, desipramine, diazepam, ethanol, haloperidol, lorazepam, metoprlol

minor-desipramine, doxepin, lofepramine, imipramine, lofepramine, maprotiline, nortriptyline, trazodone, trimipramine

Ketoconazole

Histoplasmosis

200mg Twice a  day Months

Systemic fungal infections

200-400mg po daily x 2weeks

Adverse effects

nausea, vomiting, pruritus, abdominal pain, alopecia, dizziness, somnolence, fever, chills, bulging fontanelles,gynecomastia, leukopenia,hemolytic anaemia, hepatoxicity, photophobia

Drug interactions

contraindicated-alfuzosin, alprazolam, cisapride, disopyramide, dronedarone, isoniazid, midazolam, quinidine, simvastatin, verdenafil

serious-almotriptan, amiodarone, amoxapine,atorvastatin, buspirone, chlorpromazine, clarithromycin, cortisone, dexamethasone, erthromycin, esomeprazole, fentanyl, haloperidol, prednisolone, ritonavir sildenafil

monitor closely-amlodipine, atazanivir, azithromycin, calcifediol, carbamazepine, carvedilol, efavirenz, cimetidine, codeine, dapsone, diclofenac, diltiazim, gentamicin, itraconazole, kanamycin, levofloxacin

minor-cortisone, efavirenz, fluconazole, ibuprofen, indinavir, losartan, metronidazole, neomycin, phenytoin, piroxicam, prednisolone, streptomycin, verapamil

Venlafaxine

Depression

75mg po once daily in the morning with food continual

Generalized Anxiety, Panic Disorder

Extended release:37.5-75 mg PO once daily initially; may be increased by 75 mg/day every 4-7 days; not to exceed 225 mg/day

 

Adverse Effects:Headache, Nausea, Insomni, Dizziness, Ejaculation disorder, Dry mouth, Diaphoresis, Weight loss, Hypertension, Tremors, Nervousness

Drug Interactions:Serious-Apixaban, Amytriptilline, entanyl, Mefloquine, Quinidine, Warfarin. Monitor Closely-Asprin, Carvedilo, Clopromazine, Clozapine, Clopidogrel, Diclofenac, Ibuprufen, Lopinavir,Mefenamic Acid, Piroxicam, Ritonavir

Warfarin

Anticoagulation, Arrhythmias after myocardial infaction,

10mg po once or twice a day for 3 days then adjust according to INR

 

Adverse Effects

Cholesterol embolus syndrome, Intraocular hemorrhage, Abdominal pain, Flatulence, Alopecia, Rash, Pruritus, Taste disturbance, Tissue necrosis, Headache, Lethargy, Dizziness, Hematuria, Anemia, Hepatitis

Drug Interactions

Contraindicated- Apixaban, Mifeprestone, Defibrotide. Serious- Abciximab, Allopurinol, Amiodarone, Azithromycin, Carbamazepine, Ceftriaxone, Cefuroxime, Clotrimazole, Dabigatrin, Erythromycin, Heparin, Itraconazole. Minor - Fluconazole, Isoniazid, Acetaminophen, Doxycycline

Xalacom [latanoprost 5mcg, timolol maleate 5mg/ml]

Chronic Open Angle Glaucoma

1 drop daily continual

Adverse Effects: Ocular burning, conjunctival hyperemia, Dry eye, Itchiness, Ocular discomfort, Increased iris pigmentation

Drug Interactions: Serious- Atenolol, Bisoprolol, Artemether/Lumefantrine. Monitor Closely- Amiodarone, Asprin, Atazanavir, Bupivacaine, Celecoxib, Chloroquine, Diclofenac, Epinephrine, Phenobarbitone, Nifedipine. Minor- Adenosine, Ciprofloxacilin, Neostigmine

Xalatan

Chronic Open Angle Glaucoma

eye drops 1 drop daily continual(Ophthalmic Solution?emulsion)

Adverse Effects: Increase in brown pigmentation of the iris, blurred vision, foreign body sensation, itching, conjunctival hyperemia, upper respiratory tract infection, tearing, eye pain, dryness, photophobia, conjunctivitis

Drug Interactions: Serious- Bimatoprost. Monitor Closely- Diclofenac Ophthalmic, Ketorolac Ophthalmic, Travoprost Ophthalmic

 

Magnesium sulphate

Imminent Eclampsia

4g iv over 20 minutes plus 5g in each buttock as loading dose then 5g in alternate buttocks 4 hourly for 24 hours  post deliverly

Eclampsia

4 gm iv in 20mls of Normal Saline over 20 minutes plus 5 gm in each buttock as the loading dose, followed by 5gm in  alternate buttocks every four hrs until 24 hours after delivery, or 24 hrs after the last fit whichever is the later.

Acute asthma attack

1.2-2g slow IV over 20-30 minutes once

Adverse effects

circulatory collapse, respiratory paralysis, hypothermia, depresed reflexes, flushing, drowsines, diaphoresis, hypocalcemia, hypophosphatemia, hyperkalemia,visual changes

Drug interactions

contraindicated-eltrombopag

serious- demeclocycline, doxcycline, minocycline, oxytetracyline, tetrcycline, baloxavir marboxil

monitor closely-abobotulinumtoxin A, actracurium, ciprofloxacin, cisatracurium, delafloxacin, fleeroxacin, gemifloxacin, levofloxacin, pancuronium, penicillamine, rocuronium, succinylcholine, vecuronium

minor- amikacin, amiloride

 

Magnesium trisilicate

Acute Liver Failure

40ml po 6 hourly until diarrhea is induced

Burns

20ml po 6 hourly then review

Indigestion

10-20ml po as required

Adverse effects

constipation, calky taste, fecal impaction, stomach cramps, vomiting, aluminum intoxication, hypomagnesmia, hypophosphatemia, osteomalacia, dirrhea, nausea, dizziness, lethargy, drowsiness,  lightheadedness

Drug interactions

contraindicted- raltegravir

serious-atazanavir, baloxavir marboxil, pazopanib, ponatinib

monitor closely-budesonide, debrafenib, ethambutol, nilotinib, omadecycline, rifampin, riociguat, serecycline, sofosbuvir/velpatasvir, vismodegib

 

Medroxyprogesterone acetate

Family Planning

150mg im once every 3 months

Amenorrhea, uterine bleeding

5-10mg per day for 5- 10days from day 16 or 21 of menstrual cycle

Endometrial carcinoma, recurrent, metastatic(adjunctive/palliative therapy)

400-1000mg IMI per week

Endometrial hyperplasia reduction

5-10mg po a day for 12-14 conssucutive days eqch month from day 1 or day 16 of the cycle

Endometriosis

104mg SC every 3 months forr 2 years

Adverse effects

amenorrhea, brealthrouh bleeding, change in menstrual flow, spotting, edema, anorexia, weakness, angioedema, depression, weight change, hedache, dizzines,somnolence,galactorrhea

Drug Interactions

serious-acitretin, darunavir, ivosidenib, nelnavir, saquinavir, voriconzole, lesinurad

monitor closely-albiglutide, atzanivir, axinib, clarythromycin, dexamethazone, efvirence,etravirine, insulin, isoniazid, itraconazole, lopinavir, metformin, nevirapine, quinidine, rifampin

minor- maitake, taurine

Metformin

Overweight type 2 diabetes

500-1000mg(increase gradually, maximum dose 2g/day) twice a day long term

Normal weight type 2 diabetics

500-850mg 2-3 times a day indefinitely

Adverse effects

asthesia, diarrhea, flatulence, weakness, myalgia, hypoglycemia, nausea, vomiting, lctic acidosis, chills, dizziness, contipation, heeartburn, dyspepsia

Drug interactions

contraindicated-contrast media(iodinated), ethanol, ioversol

serious-methylene blue, ranolazine, selegiline, tafenoquine, tedizolid, tranylcypromine

monitor closely-acetazolamide, amiodarone, amlodipine, atazanavir, betamethasone, captopril, chlopromazine, ciprofloxacin, darunavir, dolutegravir,enalapril, estradiol, glucagon, indinavir, insulin, isoniazid, lopinavir,nifedipine, ofloxacin, phenytoin, ranitidine, tenofovir, trimethoprim 

minor-agrimony,amitriptyline, chlorothiazide,clomipane, clonidine,cortisone, desipramine, folic acid, hydrochlorothiazide, ibuprofen, imipramine, nifedipine, oflaxicin, predinisolone

Methotrexate

Rheumatoid Arthritis

5-25mg po once a week review

Throphoblastic neoplasms

15-30mg po per day for 5 days

Burkitt lymphoma (stage I/II)

10-25mg / day po for 4-8 days

Adverse effects

hyperurecemia, glossitis, gingivitis, nausea, vomiting, diarrhoea, anorexia,leukopnea, intestinal  perforation, thrombocytopnea, renal failure, azotemia, nephropathy, alopecia

Drug interactions

contraindicated- acitretin, ethanol, anthrax vaccione, typhoid vaccione, yellow fever vaccine, zoster vaccine, varicella virus vaccine live, smallpox vaccine live, pneumococcal vaccine 13 valent

serious-aspirin, bacitracin, BCG live, celecoxib, diclofenac, ibuprofen, ketoprofen, mefenamic acid, naproxen, sulfamethoxazole, trimethoprim

monitor closely-allupurinol, amoxicillin, ampicillin, caffeine, cholera vaccine, ciprofloxacillin, cisplatin, dicloxacillin, digoxin, lansoprazole, minocycline, omeprazole,phenytoin

minor-adalimumab, colestipol, folic acid, hydrochlorothiazide, methyclothiazide, methylfolate, golimumab

Methyldopa

Hypertension in pregnancy

250-500mg po 3-4 times a day

Adverse effects

angina, bradycardia, depression, dizzziness, lethargy, sedation, rash, gynecomastia, impotence, nausea,vomiting,arthralgia

Drug interactions

contraindicated-aripiprazole, chlopromazine, clozepine, haloperidol, iloperidone,loxapine, metoclopramide, promethazine, ziprasidone

serious-iobenguane, lofexidine, tranylcypromine

monitor closely-apomorphine, cabergolin, dopamine, epinephrine, ferrous gluconate, levodopa, nadolol, norepinephrine, propranolol, timolol, xylometazoline

minor-lithium

Methylphenidate

Attention Deficit Hyperactivity Disorder

10-60mg po daily in 2-3 divided doses continually with regular reviews

Narcolepsy

20-30mg po  3times a day(30-45minutes before meals)

Adverse effects

insomnia, decreased appetite, mood swings, affect labiility, nasophryngitis, contusion, back pain, headache, hypertension, nausea, seizures, cardiac arrhythmia, anxiety, agitation, iriitability, vertigo

Drug interactions

contraindicated-benzphetamine, carbegolin, ergotamine, isocarboxid, linezolid, rasagiline, selegiline, tranylcypromine

serious-doxapram, ethanol, ether, lofepramine, methoxyflurane, sevoflurane

monitor closely-albeterol, mitrrptyline, amlodipine, amoxapine, amphetamkine, apomorphine, aripiprazole, aspirin, bambuterol, bromocriptine, caffeine, calcium carbonate, captopril, cocaine, desipramine, enalapril,epinephrine, famotidine, haloperidol, levodopa, loxapine, methyldopa, nifedipine, olanzepine, oxytocin

minor-amantadine, desmopressin, guarana, ginseng,

Metoclopramide

Emesis

10mg 3 times a day review

Chemotherapy induced nausea and vomiting

2mg/kg IV infused over 15minutes , 30 minutes before chemotherapy tgen repeat 2 more times

Diabetic gastroparesis

10mg IV/IM/PO  6hourly 30minutes before meals and at bedtime

Gastroesophageal reflux disease

10-15mg po 3 times a day 30minutes before meals and at bed time

Drug Interactions

contraindicated-carbegolin, dopamine, methyldopa, pramipexol, ropinirole

serious-citapopram, duloxetin, fluoxetin, paroxetin, rivastigmine, setraline, venlafaxine, vilazodone

monitor closely-amoxipine, apomorphine, aripiprazole, clozapine, digoxin, haloperidol, levodopa, olanzepine, pimozide, sulpiride, thiothixine, ziprasidone

minor-acetaminophen, ethanol, meperidine, nitrofurantoin,fosfomycin, atovaquone

 

Metoprolol Succinate X1

Chronic heart failure

12.5-200mg once a day long term

Hypertension

25-100mg po once a day

Acute Myocardial Infarction

5mg rapid IV every 2 minutes upto 3 doses then 15 minutes after last IV, 50mg po 6hourly for 48hours then 50-100mg po twice a day

Angina

100mg per day initially twice a day

Adverse effects

dizziness, headache, tiiredness, depression, diarrhea, pruritus, bradycardia, rash, dyspnea, constiaptation, nausea, flatulence, wheezing, broncospams

Drug interactions

contraindicated-chlorpromazine, thioridazine, thiothixine, 

Serious-acebutolol, atenolol, betaxolol, artemether/ lumefantirine, carvedilol, clonidine, digoxin, diltiazem, fluoxetine, labetalol, nadolol, propranolol, quinidine, verapamil

monitor closely-acemetacin, albuterol, amiloride, amiodarone, asenapine, aspirin, atazanavir, atenolol,bupropion, carbidopa, carvedilol, cimetidine, celecoxib, digoxin, dobutamine, ephedrinem, esmolol, gentamicin, haloperidol, ibuprofen, ketamine, levodopa, losartan, mefenemic acid, nadolol, naproxen, nifedipine, salmetorol, rifampin, verapamil

minor-adenosine, brimonidine, ciprofloxacin, cocaine, diazepam, melatonin, pilocarpine, treprostinil

 

 

 

Metronidazole

Necrotising Enterocolitis

7,5mg/kg IV for 10 days

Dysentery

10mg/kg three times a day for 5 days, if the diarrhea is chronic 7,5mg/kg for 7 days

Vaginal Discharge, Mild to moderate PID

400mg po three times daily for 7 days

Post Miscarriage Sepsis

400mg po three times a day for 10 days

Severe PID

1g PR 12 hourly for 72 hours

Prolonged Rupture of Membranes

500mg IV 8 hourly until delivery, switch to 400mg po three times daily after delivery for 7 days

Urethral Discharge In Men, vaginal discharge

2g po one dose only

 Lung Abscess

400mg po three times daily for 6 to 8 weeks

 Empyema

400mg po three times daily for 10-14 days

H Pylori Eradication

400mg po three times daily for 2 weeks

Amoebic Dysentery

800mg po three times daily for 5 days

Pyogenic Abscess

500mg IV three times daily for 4 to 6 weeks

Giardiasis

400mg po three times daily for 5 day

Intestinal Obstruction

500mg iv tds

Adverse effects

appetitte loss, dizziness, diarrhoea, , headache, ataxia, dark urine, hypersensitivity, neutropnea, metallic taste, neuropathy, seizures, encephalopathy, decreased libido, xerostomia, nausea

Drug interactions

contraindicated- BCG vaccine live, cisapride, disulfiram, dronabinol, lomitapide, terfenadine, typhoid vaccine, propylene glycol

serious-axitinib, cholera vaccine, cisapride, ergotamine, erythromycin, fentanyl, ivabradine, naloxigol, simvastatin, warfarin

Monitor closely-accalabrutinib, almotriptan, amiodarone, aripiprazole, avanafil, cannabidiol, carvedilol, clopidogrel, clozapine, cortisone, digoxin, estradiol, ethanol, hydrocortisone, indinavir, losartan,maraviroc, prednisoloone, predinisone, quinidine, saquinavir, sulfamethoxazole,tacrolimus, verapamil,

Minor-acetaminopnine, alosetron, amitriptyline, amlodipine, atazanavir, celecoxib, diclofenac, efavirenz, ethanol,ibuprofen, imipramine, itraconazole, nifedipine, piroxicam, quinine,thiamine, vincristine, zolpidem

Mianserin

Depression

15-40mg po once at bedtime continual

Adverse effects

constipation, dry mouth, drowsiness, tremor, headache, dizziness, vertigo, weakness, increased appetite, tiredness, vivid dreams, weight gain

Drug interactions

apraclonidine, brimonidine, sibutramine, artemether/lumefantrine,carbamazepine, phenobarbital, diazoxide, hydralazine, nitroprusside, apraclonidine, brimonidine, sibutramine

Miconazole

Oral Thrush/ Oral candidiasis

2% gel topically 4 times a day for 7 -14 days, 2,5ml po after feeds for paeds

 Tinea Corporis, Tinea Pedis

2% gel topically 2-3 times a day for 7 days after recovery

Adverse effects

diarrhea, naausea, vomiting, dysgeusia, upper abdominal pain, vomiting, allergic reactions

Drug interactions

phenytoin, insulin, warfarin, coumadin, jontaven, dihydroergotamine, ergotamine, ergonovine

Midazolam

Sedation

7.5-10mg po.Onset less than 10 mins, duration 2-6 hours

Adverse effects

decreased respiratory rate, apnes, drowsiness, seizures, nausea, vomiting, cough, headache, sedation, euphoria, delirium, hypotension, nystagmus, apnea, desaturation

Drug Interactions

contraindicated- atazanavir, darunavir, itrconazole, ketoconazole, ritonavir, cobicistat, fosamprenvir, nelfinavir

serious-apalutamide, brigatinib, carbamzepine, cimetidine, erythromycin, clarithromycin, hydrocodone, ketoconazole, rifampin, valerian

Monitor closely-albuterol, alprazolam, amitriptyline, apomorphine, aripiprazole, azithromycin,baclofen, butabarbital, caffeine,chlorpheniramine, chlopromazine, cortisone, desflurane, dexamethasone, diazepam, droperidol, isoniazid,lorazepam, metronidazole

minor-armodafinil, ciprofloxacin, esomeprazole, gemifloxacin, ofloxacin, rifabutin, ruxolitinib, sage, vinpocetine

Misoprostol

Prolonged Rupture of membranes, Cervical Ripening

50mcg PV 24 hourly(maximum 1 dose) OR 25mcg po 4 hourly(maximum 3 doses)

Active Management of third stage of labour

600mcg PR once only

Induced Abortion, Missed Abortion(first trimester)

600mcg PV 12 hourly (maximum 2 doses)

Incomplete Abortion

600mcg po once only

Induced abortion, intrauterine fetal death 13-17 weeks(second trimester)

200mcg PV 12 hourly  (maximum 4 doses)

Intrauterine fetal death 18-27 weeks

100mcg PV 12 hourly (maximum 3 doses

Adverse effects

diarrhea, abdominal pain, headache, anaemia, chestpain, anaphylaxis, flatulence, hearing loss, nause, vomiting, myocardial infarction, gastrointestinal hemorrhage

Drug interactions

monitor closely-crofelemer, eluxadoline

Morphine

Post operative pain

5-15mg IM 4 hourly, review

Severe pain in children

< 6months =0.02mg/kg, >6months =0.04mg/kg po 4 hourly Review OR 0.025mg/kg sc/IV 4 hourly review

Acute Pulmonary Edema

5-10mg IV slowly over 1-2 minutes, repeat every 15 minutes if required

Severe Pain in labour

5mg im 4 hourly as required

Adverse effects

pruritus, vomiting, constipation, headache, somnolence, astheni, depression, dyspnea, fever, insomnia, rash, anxiety, dizziness, hiccups, syncope, respiratory depression, anaphylaxis

Drug interactions

contraindicated-alvimopan, safinamide

serious-artemether/lumefantrine, cimetidine, citalopram, clonidine, fentanyl, fluoxetine, isocarboxid, linezolid,paroxetin, phenelzine, quinidine, rasalagiline, tramadol, valerian

monitor closely-albuterol, alprazolam, amitriptyline, apomorphine, aripiprazole, baclofen, bupropion,caffeine, captopril, celecoxib, chloroquine, desipramine, diazepam, dopamine, epinephrine, ethanol, haloperidol, imipramine, ketamine, lorazepam, maraviroc, melatonin, norepinephrine, olanzapine, ritonavir, tenofovir, tramadol, yohimbine

Minor-benazepril, brimonidine, celandine, dexatramphetamine, eucalyptus, lidocaine, rifabutin, rifampin, sage, ziconotide

 

Multivitamins

Severe Alcohol Dependance

2-4 tablets once to 3 times a day then review

 Nutritional Supplements

2 tablets upto 3 times a day as required

Adverse effects

constipation, dark stools, nausea, vomiting, abdominal pain

 

 

Para-amino-benzoic acid cream/lotion

Albinism, Vitiligo

apply daily in the morning as required

 

Adverse Effects: Anorexia, nausea, fever, rash, hepatotoxicity

Drug Interactions: Serious- Sulfadiazine, sulfamethoxazole. Monitor Closely- Omadacycline

Paracetamol

Small surface area burns,Mild pain in adults

500mg-1g po 4 to 6 hourly(maximum dose 4g/day) paeds 10-15mg/kg 4 to 6 hourly as required

Back and neck pain

1g po three times a day

Migraine headache

1g po 6 hourly as required

 

Adverse Effects: Angioedema, disorientation, dizziness, rash, urticaria, pancytopenia, liver failure, nephrotoxicity, pneumonitis, steven johnson syndrome, toxicic epidermal necrolysis, gastrointestinal hemmorhage

Drug Interactions: Monitor Closely- Isoniazid, warfarin, dapsone. Minor- clonazepam, diazepam, carbamazepine, enoxaparin, ethosuximide, heparin,lorazepam, rifampin, phenobarbital, valproate

Permathrin

Scabies

5% cream apply from neck down once and wash off after 8-12 hours once only

 

Adverse Effects: Itching, skin redness, skin swelling, rsh, numbness and tingling, burning sensation

Pethidine

Post Operative pain

1-2mg/kg im 3 hourly

Severe Pain In Labour

50-100mg im 4-6 hourly (maximum 3 doses)

 Large surface area burns

1mg/kg im 4 hourly review

 

Adverse Effects: agitation, angina, constipation, dry mouth, faintness, cardiac arrest, coma, nausea, palpitations, sedation, seizures, shock, syncope, tachycardia, pruritus, weakness.

Drug Interactions: Contraindicated-isocarboxazid. Serious- Amitriptylline, fentanyl, tramadol. Monitor Closely- albuterol, baclofen, shlorpromazine, diazepam, efavirenz, dopamine, isoniazid, ketamine, midazolam, morphine, ritonavir

Phenobarbitone

Neonatal Tetanus

2,5-5mg/kg iv/im/nasogastric 12 hourly as long as required

Convulsions

10mg/kg iv over 5-10minutes, repeat after 30minutes if still Convulsing

 Epilepsy

120mg (paeds 5mg/kg)po nocte for 2 weeks then review side effects and compliance

Status Epilepticus

10-15mg/kg iv infusion over 10 minutes

Insomnia

100-200 mg po twicw daily

 

Adverse Effects: Ataxia, dizziness, drowsiness, fatigue, headache, irritability, nystigmus, vertigo, nausea, vomiting, diarrhea, constipation, rash, hepetotoxicity, hepatotoxicity, steven johnson syndrome

Drug Interactions :Contraindicated- Atazanavir, Atazanavir, Praziquantel. Serious- Apixaban, Cyclosporine, dabigatran, Enoxaparin, fundoparinax, heparin, rivaroxaban, sildenafil, simvastatin, warfarin. Monitor Closely-  Albuterol, amikacin, amiodarone, azithromycin, baclofen, atenolol, azithromycin, bisoprolol, carvedilol, clopidogrel, colchicine, digoxin, gentamycin, haloperidol, ketamine, lopinavir

Phenylepherine

Cataract

2.5% eye drops 1-3 drops pre-op

Phenylephrine hydrochloride

Acute hypotension

100-500mcg IV repeat 5-15minutes Repeatedly as necessary

 

Adverse Effects: Hypertension, reflex bradycardia, anxiety, headache, burning, sneezing, pulmonary edema, metabolic acidosis, nausea, gastric irritation, decreased renal perfusion, reduced urinary output. 

Drug Interactions: Contraindicated- Isocarboxazid, linezolid. Serious- Amitriptylline, isoflurane, propofol. Monitor Closely- Albuterol, Bromocriptine, Chlorpheniramine, Chlorpromazine, clonazepam, haloperidol, hydralazine, insulin, methyldopa, morphine, midazolam, phenobarbital, oxytocin

Phenytoin

Epilepsy

300mg at bed time review

Status epilepticus

15-20mg/kg iv at a rate of 50mg per minute 6 hourly

 

Adverse Effects: drowsiness, fatigue, ataxia, irritability, headache, restlessness, nervousness, dizziness, vertigo, rash, parasthesia, pruritis, nausea, vomiting, diarrhea, constipation, hypocalcemia, hepatotoxicity, rash.

Drug Interactions: Contraindicated- apixaban, artemether/lumefantrine, darunavir, praziquantel. Serious: Cyclosporine, egortamine, erythromycin, itraconazole, lidocaine, nifedipine, sildenafil, simvastatin. Monitor Closely- Albendazole, amikacin, azithromycin, amiodarone, bleomycin, carbamazepin, ciprofloxacin, clopindogrel, cyclosporine, colchicine, diazepam, heparin, itraconazole, lopinavir, metformin, nevirapine

Pilocarpine

Acute Glaucoma, Chronic Open Angle Glaucoma

4% eye drops 1 drop in each eye 6 hourly continual

Hepatic Impairment

Moderate impairment: 5 mg PO 12hourly

 

Adverse Effects: Sweating, headache, flushing, dizziness, chills, nausea, urinary frequency, nausea, rhinitis, vomiting, hypertension, lacrimation, hypotension, tachycardia, bradycardia, pain.

Drug Interactions: Monitor Closely-Amytriptylline, atropine, atracurium, imipramine, ipratronium, neostigmine, physostigmine, succinylecholine. Minor-Atenolol, carvedilol, bisoprolol, timolol, sotalol

Platelet concentrate

Disseminated Intravascular Coagulation (platelets <30 x10^9 and patient is bleeding)

6 bags/dose cryoprecipitate then review

Thrombocytopenia

Transfusion of 5-10 mL/kg should raise the platelet count by 50,000-100,000/u

 

Adverse Effects: Henolytic transfusion reactions, septic reactions, febrile nonhemolytic reactions, circulatory overload, allergic reactions, transfusion related acute lung injury

Podophyllin paint

Genital Warts

20% wash off after 4 hours once a week then review

Potassium chloride

Chronic Cardiac Failure(on spironolactone)

600mg -1.2g po 1-2 times a day long term

Potassium Replacement

20mmol in every litre, after the first litre increase to 40mmol/litre given over 8 hours, recheck potasssium

Hypokalaemia Prophylaxis

20-40 mEquivalence twice daily

 

Adverse Effects: Arrythymias, bleeding, diarrhea, dyspepsia, hyperkalemia, nausea, vomiting, rash, abdominal pain, perforation, gastro intestinal obstruction, ulceration and perforation.

Drug Interactions: Serious- Amiloride, Spironolactone, potassium sulphate, Eplerenone, triamterene. Monitor Closely- Asprin, Albuterol, atenolo, bisoprolol, captopril, carvedilol, diclofenac, digoxin, frusemide, indomethacin, ibuprufen, gentamycin, mefenamic acid, propranolol.Minor: Metformin, Glimepiride, insulin

 

Povodine iodine

Herpes Zooster, Burns

Topical daily on wound as required

Oral Ulcers

1% povidone iodine 4 times a day

 

Adverse Effects :Hypothroidism in neonates, pruritus, erythema, rash, irritation

Drug Interactions: Serious- Collagenase

Acetazolamide

Acute glaucoma

250-500mg po stat then 8 hourly review (If intraocular pressure >40mm: 0.25-1g divided doses/day for a few weeks)

Adverse effects -confusion,convulsions,drowsiness, flacid paralysis,malaise,parasthesias

Drug interactions

serious-cisapride, methanamine

significant-asprin,amantadine,carbamazepine

 

Acetic acid       

Otitis externa

Ear drops 3 drops twice a day for 7 days

Adverse effects 

stinging/burning sensation upon instillation, local irritation

Drug Interactions

other ear medicine

 

 

Acetylcysteine

paracetamol poisoning

iv infusion in dextrose 5% 150m/kg in 200ml over 15 mins then 50mg/kg over 4 hrs then 100mg/kg in 1000ml over 16 hrs

Adverse effects

flushing,edema,urticaria,pruritus,nausea,pharyngitis

drug interactions

significant-activated charcoal

minor-isosorbide dinitrate, nitroglycerin, isosorbide monotritrate

Activated charcoal

Swallowed poisons

50g added to 400ml water repeat after 4-6 hours, children 0.25 – 0.5 g/kg

Adverse effects

common-black stool,constipation

rare-slowing of intestines, dehydration, regurgitation n the lungs, blocking of intestinal tract

Drug interactions

significant-acetylcysteine, digoxin, theophylline, methotraxate

minor-acarbose, miglitol,leflunomide

Acyclovir

Genital ulcers

200-400mg times a day for 5 days

Herpes simplex virus

400mg po twice a day fot 4weeks then review

Adverse effects

nausea, vomiting , diarrhoea,headache,abdominal pain

Drug interactions

serious-amphotericin B, bacitracin, neomycin,

significant-amikacin,amoxicillin, gentamicin, flucloxacillin, tenofovir

minor--asprin,celecoxib,diclofenac,ibuprofen, mefenemic acid

Acyclovir eye ointment

coneal ulcers

1cm ointment 5 times a day for 14 day

Adverse effects

burning/stinging sensaion,pruritus,rash,

drug interactions

other eye ointmets

Adrenaline

Anaphylaxis

0.5 – 1ml  [= 10mg/kg] Repeat as necessary every 10mins until improvement occurs. 

children >5yrs-0.5ml

4 years-0.4ml

 3 years-0.3ml

 2 years-0.2ml 

1 year    0.1ml

Severe allergic reaction:

1ml slow [1-5yr =0.1ml/kg] repeat every minute  until satisfactory clinical response 

Adverse effects

anxiety, dizziness, dyspnea, flushing, hypertention,palpitations

Drug interactions

quinidine, pentamidine,linezolid, amiodarone,amitryptyline

Albendazole

Neurocysticercosis

800mg Twice a day 14 days

Severe acute malnutrition

≥2 years    400 mg Single dose On discharge from SC/ direct admission to OTP

 Hookworm

<2yrs 200mg one dose only    

 >2yrs 400mg

All Roundworms except Strongyloides

400mg  one dose only  

<2yrs = 200mg

Tapeworm and Strongyloides

400mg(2yrs = 200mg)  once a day 3 days   (Note: If not cured after 3 weeks, repeat the course.)

Cutaneous larva migrans (“sandworm”) 

400mg (<2yrs=200mg) once a  day 7 day

Hydatid Disease

3mg/kg 3 times a day 30 days, then   wait 15 days (medicine free). Then repeat the cycle 4 times.

Neurocysticercosis

800mg Twice a day 14 days

Severe acute malnutrition

≥2 years    400 mg Single dose On discharge from SC/ direct admission to OTP

Adverse effects

headache, abdominal pain, nausea, vomiting,alopecis,raised intracranial pressure

Drug interactions

significant-phenytoin,grapefruit,fosphenytoin,altretamine

minor-dexamethasone, praziquantel

 

Allopurinol

Chronic gout

300mg once a day continual

Adverse effects

rash, nausea, renal failure, arthralgias, bronchospasm

Drug interactions

serious-captopril,enalapril,theophylline, protamine, warfarin

significant- amoxicillin,calcium carbonate, methotraxate, hydroxyurea

minor-ampicillin, tacrolimus, cyclosporin

 

Aminophylline

Broncospasms

6mg/kg over 20 minutes unless the patient has taken aminophylline in the past 8 hours then  aminophylline in dextrose 5% slow infusion 12mg/ kg in one litre over 24 hours slow iv bolus 6mg /kg over 20mins

Adverse effects

headache, insomnia,diarrhoea, exfoliative dermatitis, skeletal muscle tremors, tachycardia

Drug interactions

serious- allopurinol, carbamazepine, ciprofloxacin, ketoconazole, erythromycin

monitor closely-activated charcoal, atenolol, artemether/lumefantrine, carvediolol, efavirenz

minor-amiodarone, clarithromycin,  pyridoxine, omeprazole, lithium,

 

 

Amitriptyline

Neuropathic Pain

25mg not later than 8pm at night increasing    to 75mg before 8pm at night,  review

Tension headache

25-150mg at night 3 months

Migraine

25mg at night minimum 3 months

 Peripheral neuropathy

25-75mg at  night, review(the  lower  dose  is  usually  sufficient)

Major depression

Start at 50mg and increase by 25mg every 2 nights up to 150mg Once at night, 1 hour before sleep. Assess progress after 2 weeeks

Depression with psychomotor agitation

50 –75mg once at night 14- 21days then review Amitriptyline po 50mg then increase by 25mg every 2 nights upto 150mg once at night for 2 weeks then assess

Sedative/hypnotic

12.5mg  at night intermittently

Adverse effects

agitation, alopecia, blurred vision, constipation, dizziness, palpitaions, parasthesia

Drug interactions

serious-amiodarone, artemether/ lumefantrine, clarithromycin, dopamine, fluconazole

monitor closely- atazanivir, artovarstatin, carbemazepine, diazepam, efavirenz

minor-atropine, dexamethasone, ethanol, griseofulvin, hydrocortisone, isoniazid

Amlodipine

Hypertension

5-10mg once a day long term

Coronary artery disease

5-10mg once a day long term

Adverse effects

pulmonary oedema, headahce, fatigue, flushing, dizziness, abdominal pain

Drug interactions

serious-dialtiazem, simvastatin, idelalisib, ivacaftor, ivosidenib

monitor closely- acebutolol, atenolol, carbidopa, isoniazid, ketoconazole, metformin

 

Amoxicillin and clavulinic acid

Acute otitits media

500mg   40mg /kg in paeds 3 times a day 8 days

Acute tonsillitis

80mg/kg;7mg/kg 2 times a day 7 days

Adverse effects

diarrhoea, nausea, rash, naphylaxis, anaemia, hepatotoxicity, thrombocytopnea, agranulocytosis

Drug interactions

serious- BCG vaccine, cholera vaccine, doxycycline, tetracycline, typhoid fever vaccine

monitor closely-acyclovir, allupurinol, asprin, methotraxate, warfarin

minor-azithromycin, chloramphenicol, erythromycin, pyridoxine, clarythromycin

Amoxicillin

Surgical prophylaxis

500mg 3 times a day 7 days

Pneumonia, acute ear infection

4-<6kg =62.5mg  3 times a day for 5 days

 6-<14kg =125mg

 14-19kg =250mg

Sore throat 

<3yrs =125mg 3 times a day 10 days

>3yrs=250mg

 >12yrs =500mg

 Urinary tract infection in pregnancy

500mg 3 times a day for 7 days

Post miscarriage sepsis

500mg 3 times a day 10 days

Pelvic inflammatory disease

500mg  3 times a day 7 days

Prolonged rupture of membranes

500mg 3 times a day 7 days

Typhoid fever

2g 3 times a day 14days

Adverse effects

anaphylaxis, anaemia, diarrhoea, headache, nausea, vomiting

Drug interactions

serious- BCG vaccine live, cholera vaccine, doxycycline, tetracycline, typhoid vaccine live

monitor closely- acyclovir, asprin,  methotraxate, warfarin, sulfasalazine

minor- azithromycin, chloramphenicol, clarythromycin, pyridoxine, erythomicin

 

 

Ampicillin

Pyrexia of unknown origin

2g 4 times a day Review

Severe pneumonia

50mg/kg 6hourly 5 days

Pelivic inflammatory disease

500mg 6 hourly 48-72hrs

Pyogenic abcess

1g 4 times a day 4 - 6 weeks

Peritonitis

1g 4 times a day 5-10 days

Acute cholecystitis

500mg 4 times a day 

Pyrexia of unknown origin

2g 4 times a day Review

Severe pneumonia

50mg/kg 6hourly 5 days

Pelivic inflammatory disease

500mg 6 hourly 48-72hrs

Pyogenic abcess

1g 4 times a day 4 - 6 weeks

Peritonitis

1g 4 times a day 5-10 days

Acute cholecystitis

500mg 4 times a day 

Adverse effects

erythema multiforme, exfoliative dermatitis, urticaria, fever, seizures, diarrhea

 Drug interarctions

serious- BCG vaccine, Cholera vaccine, doxcycycline, tetracycline, typhoid fever vaccine

monitor closely-asprin, ibuprofen, methrotraxate, omeprazole, sulfasalazine, warfarin,clarythromycin, 

minor- allopurinol, atenolol, chloramphenicol, rifampin, hydrochlorothiazide

 

Aqeous iodine solution

Toxic Nodular Goitre

0.1 – 0.3ml diluted in water 3 times a day 10-14 days before surgery  

Adverse effects

nausea, vomiting, metallic tatse in mouth, fever , headche, diarrhea

Drug interactions

captopril, losartan, spironolactone, lithium, epleronone

Aqueous cream

As a soap substitute

Aspirin

tension headache

600mg 4 hourly prn no longer than one week continuously (risk of analgesic rebound headache)

migraine

600mg 4 hourly as required

Stroke prophylaxis

150mg once daily long term

 Pain in adults

300-900mg (<4g/day) every 4-6hrs as long as required

Joint/bone pain

600-900mg every 4-6hrs review

Adverse effects

angioedema, bronchospams, hepatotoxicity, hearing loss, , rash ,tinnitus

Drug interactions

serious-captopril, enalapril, ibuprofen, methotraxate, probenecid

monitor closely-acetazolamide, amoxicillin, atenolol, dexamethasone, diclofenac

minor

acyclovir, celecoxib, furosemide, gentamicin, hydroclorothiazide

 

Atenolol

 hypertension

50mg once a day long term

Angina

25-100mg once a day long term

 Acute myocardial infarction

50-100mg once a day long term

Arrhythmia

25-50mg once to twice a day review

Adverse effects

postural hypotension, bradycardia, depression,fatigue, nausea

Drug interarctions

serious-carvedilol, digoxin, verapamil, metoprolol, diltiazem

monitor closely-amlodipine, asprin, carbidopa, diclofenac,epinephrine

minor-ampicillin, atropine, cocaine, neostigmine, dipyridamol

 

 

Atropine sulphate

Cataract

Atropine 0.5% or 1%  1-2 drops 2-3 times/day 1 week

Organophosphate poisoning

2-4mg  [Paed=0.02-0.05mg/kg every 10 mins [Paed every 10-15mins], until signs of atropinisation appear, repeat to maintain atropinisation* [hot dry skin, dry mouth, widely dilated pupils, fast pulse]

 Antimuscarinic drugs

0.6-1.2mg (paeds: 10-20mcg/kg)  2-10 min 1-2 hours

Adverse effects

ataxia, coma, delirium, dizziness,headache, hallucinations

Drug interactions

serious-eluxodoline, macimorelin, recefenacin, secretin

monitor closely-amitryptyline, actracurium, chlopromazine, digoxin, fentanyl

minor-atenolol, chlopromazine, levodopa, promethazine, 

Azithromycin

Cholera (second line)

1g Single dose after correction of severe dehydration

Urethral discharge in men, vaginal discharge in women

1g one dose only

Typhoid fever

250-500mg Once a day 7

Adverse effects

diarrhea, nausea, vaginitis, agitation, flatulence

anaemia, anorexia

Drug interactions

serious-BCG vaccine live, typhoid vaccine,digoxin, antihtrombin III, heparine,quinidine

monitor closely-amiodarone, amityptyline,,clotrimazole,epinephrine, fluconazole

minor-amoxicillin,penicillin G,ofloxacin,foscarnet, flucloxacillinm levofloxacin

 

Chlorhexidine topical

cleanser and antiseptic

Surgical scrub

scrub for 3mins ,rinse and wash for another 3mins

Preoperative skin cleanser

apply to suyrgical site and swab for 2mins allow to dry, repeat once

Wound cleaning

rinse with water, apply to wound area, wash gently and rinse thoroughly

Hand sanitizer

rub for 15sec, wash for 15sec and rinse

Adverse effects

irritation, sensitisation, allergic reactions, dyspnea, facial oedema

 

 

Tetracycline

Chronic Bronchitis, Acute Exacerbation

500 mg PO twice daily or 250 mg PO four times daily (ie, 1000 mg/day)

Moderate-to- Severe Acne

1 g/day PO in divided doses (based on the judgement of the clinician)

Brucellosis

500 mg PO q6hr for 3 weeks accompanied by streptomycin

Syphilis

Patients allergic to penicillin

  • Early syphilis (duration <1 year): 500 mg PO 6hourly for 15 days
  • Syphilis (duration >1 year [except neurosyphilis]): 500 mg PO 6hourly for 30 days

 

Adverse Effects: Permanent discoloration of teeth, enamel hypoplasia, gastrointestinal effects like( vomiting, diarrhea, glossitis, esophagitis, esophageal ulceration, black hairy tongue, dysphagia, enterocolitis), rashes, dermatitis, hepatotoxicity, bone marrow suppression, renal toxicity, hypersensitivity

Drug Interactions: Serious- Amoxycillin, Ampicillin, Atracurium, Calcium chloride/carbonate, ferous sulphate, Penicillin, Magnesium Citrate/hydroxide Monitor Closely- Ceftriaxone, Cefroxime, Digoxin, Efavirenz, Estradiol, Methotraxate

Salmeterol/Fluticasone

Asthma

50/150mcg once or twice daily as required (inhaler)

 

Advesre Effects: Upper respiratory tract infections, headache, pharyngitis, candidiasis, throat irritation, cough, nausea, vomiting

Drug Interactions: 

 

Juxtapid

Homozygous Familial Hypercholesterolemia, Renal Impairment

5mg po 6 hourly(Not to exceed 60mg/day)

 

Adverse Effects: Gastrointestinal disorders, diarrhea, nause, dyspepsia, vomiting, abdominal pain, chest pain, constipation, flatulence, influenza, GERD, defecation urgency, fever, headache

Drug Interactions: Contraindicated- Amiodarone, Atazanavir, cimetidine, clarithromycin,clotrimazole, doxycycline, efavirenz, erythromycin, haloperidol. Use Alternative- Lovastatin, simvastatin. Monitor Closely-Acetaminophen, Acetazolamide, atorvastatin, carvedilol, ciprofloxacin, diazepam

 

 

Ulipristal Acetate

Emergency Contraception

30mg po as soon as possible within 5 days

Uterine Fibroids

5-10mg po once daily for 3 months preoperatively

 

Adverse Effects: Headche, abdominal pain, nausea, dysmenorrhea, intermenstrual bleeding, fatigue, dizziness

Drug Interactions: Use Alternative- Carbamazepine, efavirenz, dexamethasone, nevirapine, phenytoin, rifambin, smoking. Monitor closely-Dabigatran, digoxin

Yohimbine

Impotence

5,4mg po three times a day

 

Adverse Effects: Anxiety, Irritability, Headache, Sweating, Nausea, Tachycardia, depression, erectile dysfunction, dry mouth, chest pain

Drug Interactions: Contraindicated- Isocarboxazid, linezolid. Serious- Amitriptyline, desipramine, ergotamine, isoflurane, imipramine. Monitor Closely-Albuterol, caffeine, clonazepam, codein, dopamine, haloperidol, methyldopa, olanzapine

Zinc Oxide

Diaper Rash

Topical ointment 10%, 20%, 40%

Topical cream 11,3%

Paste 16%, 20 %

Apply as needed