1st Edition

A HANDBOOK OF

Drug & OPD Guide

Dr. Faisal Farooq

 PREFACE

In the name of Allah, the Most Beneficent and the Constantly Beneficent

Upon starting of house-job, many young doctors face a critical problem upon
their first encounter with a real patient, i.e. inability to prescribe a
medication. This is not because of a lack of sufficient effort put in during the
medical school training, but a lack of knowledge of the brand names and
their appropriate dosages in various medical conditions. I have written this
handbook in order to cull this problem.

Even though there are other books available in this category, they are usually
either too bulky or contain too much information. This makes it impossible
for a new doctor to finish or quickly refer to them during the hectic work
hours. There are a million brands of every drug out there in the market. So
in order to help the young doctors, this book lists the most common and
popular brand names as standards, with reference to Pakistan. The readers
will find the generic name mentioned in brackets alongside the brand names.
In addition to that, this handbook also states the most common side-effects
and Contraindications of the drugs.

As every work of man is below perfection, this handbook is a work in progress

as well. Even though I have done my best to keep this handbook error free,
there’ll certainly be inaccuracies that went unrecognized. Therefore, I would
like to request the readers to duly point out such errors and email me their
details at faisalfarooq123@hotmail.com.

Finally, I would like to thank Allah, my Master, for allowing me the

opportunity to craft this piece of work in order to help my fellow men.

With best regards,

Dr. Faisal Farooq

Copyright © free

This handbook may be reproduced, distributed, or transmitted in any form

or by any means, electronic or mechanical, including photocopying and
recording, or by any information storage and retrieval system, without any
need for permission in writing from the author.

I have made this handbook copyright free, and I’d like to encourage the
readers to improve it further as per their own learning journey. The PDF and
editable formats are available online for download on the Facebook page
(https://www.facebook.com/DrFaisalFarooq).

ISBN 978-969-23565-0-3
 HOW TO USE THIS HANDBOOK

1. Index is provided at the end of this book.

2. When starting a new drug to a naïve patient, always keep in mind various
factors such as; patient’s weight, co-morbidities, age etc.
3. Several drugs may be listed under the heading of a medical condition e.g.
‘Angina, Post MI’ in the cardiology section. Those lists contain all the
drugs that COULD BE USED for that particular medical condition, and does
not mean that all the listed drugs are to be prescribed simultaneously in
that respective condition, unless indicated otherwise
4. In order to keep this handbook as short as possible, the drugs are listed
in a very concise fashion. Please refer to the diagram and abbreviations
below in order to familiarize yourself with the listing pattern of drugs.

Abbreviations used in this handbook

S/Es Side Effects PO Per Oral

CIs Contraindications P/R Per Rectal
MOA Mechanism of Action L/A Local Application
DOC Drug of Choice IV Intra-venous
Tab Tablet IM Intra-muscular
Cap Capsule tsf teaspoon
Inj Injection tbsp tablespoon
Inf Infusion OD Once Daily
Syp Syrup BD 12 hourly
Susp Suspension TDS 8 hourly
E/D Eye Drops Qid 6 hourly
E/O Eye Ointment HS At Bedtime (hora somni)
S/L Sub-lingual SOS As Needed
S/C Sub-cutaneous STAT Immediately

About the Author

Dr. Faisal Farooq

MBBS (CMH Lahore)

The author is a professional medical doctor, and a researcher in the field of medicine.
Please note that this handbook is copyright free and the readers are encouraged to
improve it further as per their own learning curve.
 CONTENTS

Sr. # Drug Families & OPDs Page #

1. Medical Emergencies 1
2. Painkillers 5
3. Hypertension 6
4. Diabetes Mellitus 7
5. Pulmonology 8
6. Cardiology 11
7. Neurology 12
8. Gastroenterology 13
9. Urology / Nephrology 14
Genital & Sexually Transmitted
10. 15
Diseases
11. Orthopaedics 16
12. Surgery 17
13. ENT 18
14. Ophthalmology 19
15. Dermatology 20
16. Psychiatry 23
17. Antibiotics 25
18. Antifungals 26
19. Antivirals 26
20. Antimalarials 26
21. Antihelminthics / Worms 27
22. Vitamins & Minerals 27
23. Steroids 27
24. Paediatrics 28
25. Paediatric Drugs Formulary 30
 1
MEDICAL EMERGENCIES

Myocardial Infarction

Acute Coronary Syndrome (ACS) Protocol:

• Tab. Dispirin or Loprin 300 mg dissolved or chewed x PO x stat [Aspirin]
• Tab. Lowplat 300 mg x PO x stat [Clopidogrel; Anti-platelet]
• Tab. Angised x 1 x S/L [Nitroglycerin; can repeat if pain persists]
• Analgesia:
o Inj. Morphine x 5/10 mg x I/V x SOS
o Inj. Nalbin x 5/10 mg x I/V x SOS [better than morphine b/c less S/Es]
• Secure I/V access + O2 administration
• Primary Percutaneous Coronary Intervention (Primary PCI), If door-to-
balloon time < 90 min, otherwise SK administration [for STEMI only]
• Inj. Streptase, Akinase (Streptokinase) 1.5 million units in 100 ml
N/Saline over 90 min x I/V
[only in STEMI or ST depressions of post wall STEMI; SK effective for 12
hrs; Alteplase is expensive]

[ST elevation: transmural ischemia; ST depression: subendocardial ischemia]

Asthma Exacerbation
Move onto the next step if no improvement
Step 1:
• O2 administration.
• Nebulise with Ventolin x 5mg x stat [Salbutamol; β-agonist]
Step 2:
• Inj. Solu Cortef, Hy-Cortisone x 1-2 mg/kg x IV x stat
[Hydrocortisone]
Step 3:
• Nebulise with Ventolin (5mg) + Optra (0.5 mg) x stat then every 15
minutes [Salbutamol + Ipratropium]
Step 4:
• Inj. MgSO4 x 2mg x SLOW IV over 20 min [Magnesium Sulphate]

If patient is improving, give salbutamol every 4 hours and prednisolone 40-

50mg for 5 days.

Status Epilepticus
Step 1:
• Inj. Ativan, Tranquil x 4 mg x SLOW IV @ 2mg/min x stat
[lorazepam; CI: respiratory depression, benzodiazepine & opioid use]
• OR Inj. Dormicum x 5 mg x IV x stat
[Midazolam; S/E: Respiratory Depression]
Step 2: If two doses of the above (10 min. apart) have failed, then;
• Inj. Epigran x 10-20 mg/kg x IV @ 25-50 mg/min (loading), then 100 mg
IV or PO x TDS (Tab. Epitoin, Cap. Dilantin) [Phenytoin; 1 inj. Ampoule =
250mg/5ml; S/E: arrhythmias; CI: bradycardia, Heart block]

Step 3: If seizures persist;

• Refer to ICU
• Inj. Phenobarbital x 15-20 mg/kg x IV @ 25-100 mg/min (loading)
[Can repeat after 10 minutes if seizures persist; CI: Pregnancy]
• Intubation
 2
Diabetic Ketoacidosis (DKA)
Diagnosis
HHS
DKA
Hyperglycemic Hyperosmolar
Diabetic Ketoacidosis
Syndrome
(Type I DM, thin lean patient)
(Type II DM, obese patient)
1. pH ≤ 7.3 1. BSR> 600 mg/dl or 33.3 mmol/L
2. HCO3 < 18 mEq/L 2. HCO3 > 15 18 mEq/L
3. BSR > 250 mg/dL or 13.9 mmol/L 3. pH > 7.3
4. Serum ketones > 5 or urinary
4. No serum/urinary ketones
ketones +++
5. Serum osmolality ≥ 320mOsm/kg
6. Altered consciousness

Rule out the factors precipitating DKA/HHS:

• Infection • MI
• Stress • Missed dose

Investigations:
• BSR [raised] • Urine for ketones • ECG [Rule out MI]
[+ve in DKA]
• X-ray chest [in HHS; • Blood Complete • RFTs [uremia,
rule out pneumonia] Picture [infection] nephropathy]
• Blood Gases (Arterial/Venous): • CT brain [only in HHS; if altered
↑ anion gap metabolic acidosis consciousness present]

Rx:
1. Fluid replacement:
• Inj. Normal Saline
- 1000 ml x I/V over 30 minutes (if BP < 90, then over 10-15 minutes)
- then 1000 ml over 1 hour
- then 1000 ml over 4 hours
[Once BSR drops below 280 mg/dl, then use Inj. 5% D/W 1000 ml
instead of Normal Saline]

2. Insulin:
• Infusion Humulin R x 0.1 units/kg/hour in Paeds chamber
• @ 6 µdrops/min when BSR > 280 mg/dl &
• @ 3 µdrops/min when BSR < 280 mg/dl

3. Potassium (K):
• Inj. KCL x 40 mmol in 1000 ml N/Saline over 4 hrs

4. Anti-biotics:
• Inj. Rocephin (Ceftriaxone) x 1 g x OD

5. Prophylactic anti-coagulation:
• Inj. Clexane x 40 mg x S/C x OD
[Enoxaparin, LMWH; CI: Active bleed, heparin-induced
thrombocytopenia]
 3
Hypertension
Emergency treatment needed only if systolic > 160 mmHg or patient
symptomatic e.g. headache. Move onto the next step if no improvement.

Step 1: Tab. Capoten x 25 mg x 1 x PO x STAT

[Captopril; Contraindications: Pregnancy, Anuria, Renal dysfunction,
Angioedema, Hypersensitivity to ACE inhibitors]

Measure BP again after around 30 minutes. If BP not reduced, then either

repeat dosage of Capoten or move to the next step;

Step 2: Inj. Lasix 0.5-1mg/kg x IV over 1-2 min x STAT

[Furosemide; CI: Dehydration, Anuria, Hypokalemia]

Step 3: Inj. Labetalol x 20 mg x slow IV x STAT

[β –blocker (non-selective), Contraindications: Asthma, 2° or 3° heart block,
heart failure, bradycardia, prinzmetal angina]

Step 4: Infusion Isoket x IV @ 1 mg/kg/hour

[Isosorbide Dinitrate; MOA: Arterial & venous vasodilator]

Snake Bite (WHO Guidelines)

Severity: Mild, Moderate & Severe
Snake Types: 1. Haemotoxic. 2. Neurotoxic 3. Myotoxic.
Key Medically Significant Species: Russell’s Viper (85% of bites)
(Haemotoxic) & Monocled Cobra (Neurotoxic)

• Anti-snake venom (ASV) initial dose: (1 ASV vial = 10 ml)

(4 vials- if incoagulable blood, 6 vials- if neurotoxicity signs) in 500 ml
N/Saline x infuse I/V over 01 hour
[Give ASV ONLY if: 1. Incoagulable blood measured by 20-minute Whole
Blood Clotting Test (20WBCT). 2. Visible neurological signs such as
ptosis/ respiratory impairment]
• Inj. Solu cortef x 100 mg x I/V x stat before ASV (steroid to prevent allergic
reaction to ASV)
• Inj. Risek x 40 mg x I/V x stat [Omeprazole]
• Pain killer as needed
• Inj. Augmentin x 1.2 g x I/V x BD (Only for high-risk wounds and if there is
evidence of infection)
• Manage according to the snake type:
o If Haemotoxic; Repeat 20-minute Whole Blood Clotting Test (20WBCT)
every 06 hours; if blood incoagulable, repeat ASV. Maximum 8 vials.

o If Neurotoxic; risk of respiratory paralysis. Single Breath Count (SBC) <

15 indicates resp. muscle weakness. Repeat Single breath count every
10 minutes for 1 hour after Inj. Neostigmine 1.5 mg IM & Inj. Atropine
0.6 mg IV. If improves, can repeat dosage every 30 min. until recovery.
If no improvement, repeat dose of 4 vials of ASV. Maximum 12 vials.

o If Myotoxic, Myoglobin levels and RFTs (Danger of Acute Kidney Injury)

• Monitor: RFTs, urine output, occult bleeds, O2 sats

 4
Dog Bite
History: Dog pet or stray? Pet dog immunized or not? Stray dog captured?

Pet dog:
1. Immunized: Do nothing. Only symptomatic treatment.
2. Not Immunized: IVIG + Observe dog for 10 days for signs of rabies.

Stray dog:
1. Dog captured: HRIG (Human Rabies Ig) + Observe dog for 10 days for
signs of rabies.
2. Not captured: HDCV (Human Diploid Cell Culture Vaccine; Route:
Intramuscular; adults-deltoid, children- Anterolateral thigh) + HRIG
• Inj. HRIG x half into and around the wound (given anatomical
constraints) & half I/M away from wound site (gluteus or deltoid)
• Inj. HDCV x 1 ml x I/M on days: 0, 3, 7, & 21 days (if non-immunized);
0, 3 (if immunized) and 0, 3, 7, 14 & 30 (if immunocompromised)
• Inj. TT (Tetanus Toxoid) x I/M x stat
• Prophylactic anti-biotics: only for high-risk wounds (deep wounds,
advanced liver disease, immunocompromised, asplenic patient)

Organophosphate Poisoning
(Insecticides, Nerve Gas)
S/S: History of exposure, miosis, bradycardia, sweating, lacrimation, muscle
twitches/fasciculations followed by paralysis, bronchoconstriction.

• Secure Airway, Administer O2

• Inj. Atropine x 2 mg (mild to moderate S/S), 6 mg (Severe S/S) x IM

[if no effect, can repeat 2 mg dose 10-15 minutes after first dose.
Monitor heart rate]

• Inf. P-Doxime (Pralidoxime) x 200mg/10ml ampoule

Dosing: Loading: 30 mg/kg IV over 20 minutes (IM or S/C if no IV access.
Maintenance: 4-8 mg/kg/hour

ER Painkillers
Anti-spasmodic:
• Inj. Nospa x IV x STAT
[Drotaraverine; 40 mg/2ml, ONLY FOR abdominal spasmodic pain]

Anti-pyretic + Analgesic:
• Inf. Falgan, Provas x 1 g x STAT [Paracetamol/Acetaminophen]

NSAIDs:
Contraindications (CI): Gastritis, Renal dysfunction, Asthma, low platelets
Increase risk of: GI ulcers & cardiovascular thrombotic events e.g. MI,stroke
• Inj. Dicloran x IM x STAT [Diclofenac Na; NSAID]
• Inj. Toradol x 30 mg x IV x STAT [Ketorolac; NSAID]

Opioids: (Inject D2 antagonist anti-emetic with opioids to prevent vomiting)

• Inj. Campex, Tramal x IV x STAT [Tramadol-weak opioid]
• Inj. Nalbin, Kinz x 5/10/20 mg x slow IV x STAT
[Nalbuphine-strong opioid]
• Inj. Morphine x 5/10 mg x slow IV over 5 min [Strong opioid]
 5
PAINKILLERS

Paracetamol
• Tab. Calpol, Panadol x 500 mg x 2 x BD/TDS
• Tab. Nuberol forte x 1 tab x TDS
[Orphenadrine: 50 mg, Paracetamol: 650 mg]
• Cap. Diagesic-P x 1 x TDS
[Caffeine-70mg, Paracetamol-500mg, Thioridazine-3mg]

NSAIDs

Contraindications (CI): Gastritis, Renal dysfunction, Asthma, low platelets

Increase risk of: GI ulcers & cardiovascular thombotic events e.g. MI, stroke.

• Tab. Aspirin, Loprin x 300 mg x 1-2 tabs x SOS (Max 4g/day)

[Acetylsalicylic Acid; Additional Cis: Hemolytic anemia, hemophilia]
• Tab. Artifen x 25 or 50 mg x TDS/BD [Diclofenac-Na; CI: HTN]
• Tab. Caflam, Dolo K x 50 mg x TDS [Diclofenac-K]
• Tab. Rotec x 50 mg BD/TDS [Diclofenac Na(50mg)+Misoprostol(200mg)]
• Tab. Toradol x 1 or 2 x TDS [Ketorolac 10 mg]
• Tab. Brufen x 200, 400, 600 mg x PO x TDS [Ibuprofen; Max= 3.2 g/d]
• Cap. Celbexx x 100/200 mg x 1 x BD
[Celecoxib; selective NSAID], No need for risek]
• Tab. Neoprox x 250/500 mg x 1 x BD + cap. Risek [Naproxen]

Neuropathic Pain & Migraine

• Tab. Gapaben x 300 mg x HS

[Gabapentin: Neuropathic pain, S/E: induces sleep]
• Tab. Zeegap, Gabica x 75 or 150 mg x HS
[Pregabalin; HS b/c its induces sleep]
• Tab. Amitin or Tryptanol x 1 or 2 x HS
[TCA, Amitryptyline: migraine prophylaxis, Tension headache, depression]
• Tab. Imigran x 50 or 100 mg x TDS (50 mg) / BD (100 mg)
[Sumatriptan; Migraine, Cluster headache]
• Tab. Limigzol x 2.5 mg x 1-2 tabs x BD or SOS (max. 10 mg/day)
[Zolmitriptan; use: migraine esp. acute attacks]
Muscular Pain (Skeletal)

• Tab. Movax x 2 or 4 mg x TDS/BD

[Tizanidine; alpha-2 agonist, Skeletal muscle relaxant, sk. muscle spasms]
• Cap. Muscoril, Thiosid x 4 mg x 1 x BD OR Inj. Muscoril x 4 mg x IM x
OD [Thiocolchicoside;
skeletal muscle relaxant; backache, neuralgia, sciatic pain]
• Tab. Mits x 7.5 or 15 mg x 1 x TDS
Meloxicam(NSAID); joint pains e.g. OA, RA, Anklyosing spondylitis]

Spasmodic Abdominal Pain

• Tab. Nospa OR Nospa forte x 1 x TDS

[Drotaraverine: 40/80mg; Smooth muscle spasmodic pain, stone formation]
• Tab. Buscopan x 1 x TDS [Hyoscine; anti-spasmodic]
• Tab. Buscopan plus x 1 x TDS [Hyoscine+Paracetamol 10/500 mg]
• Tab. Colofac x 1 x TDS [Mebeverine-135 mg, Anti-spasmodic for GIT]
 6
HYPERTENSION

ACE Inhibitors (ACEIs)

Side Effects (S/Es): dry cough, increases K+, ARF, skin rash
CIs: Pregnancy, Anuria, Renal dysfunction, Angioedema, Hypersensitivity
• Tab. Capoten x 25/50 mg x 1 x BD [Captopril]
• Tab. Zestril, Lispril x 5/10/20 mg x 1 x OD [Lisinopril]
Angiotensin Receptor Blockers (ARBs)
• Tab. Eziday x 25/50/100 mg x 1 x OD [Losartan]
• Tab. Advant x 8/16 mg x 1 x OD [Candesartan]
• Tab. Diastolic x 16 mg x 1 x OD [Candesartan]

Calcium Channel Blockers (CCBs)

S/Es: non-dipines: heart block; -dipines: peripheral edema
• Tab. Sofvasc x 2.5/5/10 mg or Norvasc x 5/10 mg x 1 x OD
[Amlodipine; HTN. Angina]
• Tab. Calan x 40/80 mg x TDS [Verapamil]
Diuretics
Thiazides S/Es: inc. K+, uric acid, glucose, met. alkalosis
• Tab. Lasix x 20/40 mg x 1 x OD [Furosemide]
• Tab. AZM x 250 mg x [Acetazolamide; CA inhibitor, removes
HCO3 from body, Uses: Met. alkalosis, Acute mountain sickness]
• Tab. Co-eziday x 12.5+50 mg OR 25+100 mg x 1 x OD
[Hydrochlorothiazide + Losartan]
• Tab. Co-lispril x 12.5/10 mg OR 12.5/20 mg x 1 x OD
[Hydrochlorothiazide + Lisinopril]
• Tab. Triforge x 5,12.5,160 mg/10,25,320 mg x OD
[Amlodipine + Hydrochlorothiazide + Valsartan]
B-blockers
S/Es: dec. HR (β1), bronchospasm(β2), CI: Asthma, DM, PVD, Acute HF
• Tab. Inderal x 10/40 mg x 1 x OD-BD-TDS [Propanolol]
• Tab. Labetalol x 100 mg x 1 OD or BD
• Inj. Labetalol x 20 mg x IV
• Tab. Concor x 2.5/5/10 mg x 1 x OD [Bisoprolol]
(NB: Lasix and Beta-blockers can ppt. encephalopathy in at-risk patients)
α-Blockers
S/E: α1: orthost. hypoTN, urine incont; α2: +ve coombs, depression(↓NE)
• Tab. Aldomet x 250 mg x BD [α2 Methyldopa; HTN, HTN in pregnancy,
opiate withdrawal]
• Tab. Cardura x 2, 4 mg x OD [Doxazosin; HTN, BPH]
 7
DIABETES MELLITUS
[For DM type 1 → Inj. Humulin 70/30]
For DM type II (NICE Guidelines)
Step 1 Dietary modification, smoking/alcohol
cessation, exercise.
Step 2: (If HbA1c ≥6.5%) Tab. Neophage, Glucophage (Metformin)
Step 3: (If HbA1c ≥7.5%) Tab. Neophage, Glucophage (Metformin)
Dual Therapy PLUS Tab. Sita (Sitagliptin)
OR Tab. Getryl (Glimepiride)
OR Tab. Piozer (Pioglitazone)
Step 4: (If HbA1c ≥7.5%) Tab. Neophage, Glucophage (Metformin)
Triple Therapy PLUS Tab. Getryl (Glimepiride)
PLUS Tab. Sita (Sitagliptin)
OR Tab. Piozer (Pioglitazone)
Step 5: (If HbA1c ≥7.5%) Inj. Humulin 70/30
Insulin Therapy (see listing below for dosing etc.)

Contra-indicated in DM: α2 agonists e.g. methyldopa (↓ insulin release), β

blockers (cause fasting hypoglycemia).
Individualised prescription is based on: Patient’s needs, comorbidities, and
risks from polypharmacy. Measure HbA1c levels 3/6 monthly.

• Tab. Neophage, Glucophage (Metformin) x 500, 850, 1000 mg x BD, TDS

[DOC overweight type II DM. S/Es: GI discomfort, CI: Creat > 150; if
estimated GFR < 45 -> reduce dosage; if eGFR < 30 -> Discontinue]
Dosing: initial 500 mg BD or 850 mg OD e meals, then 500 mg TDS for
maintenance. Max 2550 mg/day.
• Tab. Getryl (Glimepiride) x 1, 2, 3, 4 mg x 1 x OD with breakfast [a SFU.
S/Es: Hypoglycemia if renal impairment, weight gain, sulfa allergies]
• Tab. Sita (Sitagliptin) x 25, 50, 100 mg x 1 x OD [a DPP4 inhibitor. DM II
only b/c acts by ↑insulin secretion via incretin & GLP1. S/Es: Headache,
URTI, Pancreatitis, Heart failure. If CKD: ↓ dosage to 25 mg OD]
• Tab. Sitamet, Sitaglumet x 50/500, 50/1000 mg x BD
[Sitagliptin/Metformin. DM II only. CI: CKD]
• Tab. Piozer (Pioglitazone) x 15, 30, 45 mg x 1 x OD [MOA: ↑ insulin
receptors. S/Es: weight gain, edema, risk of CA bladder, heart failure,
and bone fracture. No longer prescribed B/C of assoc with Ca Bladder.
CI: heart failure. Safe in renal impairment. Only for patients who have
been taking it already for a long period]
• Tab. Repag (Repaglinide) x 0.5/1/2 mg x 1 x before each meal [A short
acting hypoglycemic. Safe in renal impairment.CI: liver impairment.
Combine with metformin/Pio/Rosi]
• Inj. Humulin 70/30 x _ u in morning & _ u in evening x S/C [Insulin
isophane NPH/Insulin R 70/30] BSF determines morning dose & BSR
determines evening dose
Dosing: DM 1: start at 0.5 u/kg/day divided as BD;
DM 2: start at 1 u/kg/day divided as BD then adjust acc to
blood glucose levels.
Administer 15 min before or immediately after a meal. Store in
refrigerator and not freezer.
Routine self-monitoring of blood sugar only if:
1. On insulin. 2. Pregnant 3. Previous Hypoglycemic episode. 4. Risk of
hypoglycemia with oral hypoglycemic.
 8
PULMONOLOGY

Cough

• Syp. Pulmonol x 1 - 2 tbsp x TDS [multiple compounds; relieves cough,

expectorant, soothes throat]
• Syp. Hydryllin x 1 – 2 tbsp x TDS [Each 5 ml contains: Aminophylline-
32mg (theophylline derivative; a bronchodilator), NH4Cl-30mg
(expectorant), Diphenhydramine-8mg (anti-histamine, drowsiness +),
Menthol-0.98mg (coolness); use: wet cough]
• Syp. Hydryllin DM x 1.5 - 2 tbsp x TDS [Diphenhydramine 5mg/5ml,
Dextromethorphan (cough suppressant) 6.25 mg/5ml; use: dry cough]
• Syp. Acefyl x 1 – 2 tbsp x TDS [Acefylline-125 mg/5ml, a theophylline-
derivative- bronchodilator; use: Bronchitis, asthma]
• Syp. Acefyl Cough x 1 – 2 tbsp x TDS [Acefylline 45mg/5ml,
Diphenhydramine 8mg/5ml, use: cough in chronic bronchitis or
asthma, allergies]
• Muconyl Expectorant x 2 tsp x TDS/Qid [Terbutaline/Guaiphenesin
1.5/66.5 mg/5ml]

Anti-Biotics

• Tab. Augmentin x 625 / 1000 mg x BD x 7-10 days [Amoxicillin +

Clavulinic Acid; Uses: URTI, LRTI]
• Cap. Cefim x 400 mg OD x 5 days [3rd gen-cefixime; URTI, LRTI]
• Tab. Azomax x 500 mg once then 250 mg OD for next 4 days
[Azithromycin; LRTI]
• Tab. Claritek x 500 mg x BD x 7-10 days [Clarithromycin]

Pulmonary Tuberculosis

Initiation Regimen: (for initial 02 months)

• Tab. Myrin-P x OD
[35-45 kg → 2 tabs, 45-60 kg → 3 tabs, > 60 kg → 4 tabs]
Isoniazid 60 mg; S/Es: Hepatitis, peri. neuritis, sideroblastic anemia,
hemolysis in G6PD deficiency]
Rifampicin 120 mg; S/Es: Hepatitis, red-orange metabolites
Ethambutol 225 mg, S/Es: Neurotoxic, retrobulbar neuritis
Pyrazinamide 300 mg; S/Es: Hepatitis, Hyperuricemia]
Ethambutol is nephrotoxic, so in CKD goal is to ↓ ethambutol dosage:
1. Tab. Rafinah x 300/150, 450/300 mg x 1 x OD for 4 days a
week – days alternated with [Rifampicin + Isoniazid]
2. Tab. Myrin-P x 4 tabs x OD for 3 days a week

Continuation Regimen: (for next 04 months)

• Tab. Myrin x OD [Isoniazid + Rifampicin]

Combine the following with Anti-TB medication:

• Tab. Vita 6 x 1 x OD [Pyridoxine (vit. B6) 50 mg,
prevents peripheral neuritis and sideroblastic anemia-S/Es of Isoniazid]
• Tab. Motilium x 10 mg x 1 x TDS [Domperidone]
• Cap. Risek x 20 mg x BD [Omeprazole]
 9
Asthma
SABA=Short acting β-agonist, LABA=Long acting β-agonist, ICS: Inhaled
Corticosteroid
• Salbo, Ventolin inhaler x 2 puffs x TDS [Salbutamol (SABA) 100 mcg]
• Xaltide inhaler x 2 puffs x BD [Salbutamol(=albuterol); a SABA /
beclomethasone 100/50 mcg; S/Es of inhaled steroids: sore throat,
candidiasis, horseness (use a spacer in inhaler & rinse mouth after use]
• Flixotide inhaler x 50, 125, 250 mcg x 2 puffs x BD [Fluticasone]
• Salmicort, Seretide inhaler x 25/50, 25/150, 25/250 mcg x 2 puffs x BD
[Salmeterol (LABA) / Fluticasone]
• Tab. Myteka x 5, 10 mg x HS [Monteleukast; drops & sachet- 4 mg]
• Tab. Theograd x 1 x BD [Theophylline 350 mg; Uses: asthma, COPD]
• Inj. Xolair x S/C x [omalizumab 150 mg/ml; for severe persistent
asthma treatment when ↑ IgE levels]

Step up regimen for Asthma (NICE guidelines)

Move on to the next step if asthma uncontrolled for at least 1 month
Step # Formulation Prescription
1. SABA only Salbo, Ventolin inhaler x 2 puffs x TDS
2. SABA Salbo, Ventolin inhaler x 2 puffs x TDS
+ Low dose ICS + Flixotide inhaler 50 mcg x 2 puffs x
BD
3. SABA Salbo, Ventolin inhaler x 2 puffs x TDS
+ Low dose ICS + Flixotide inhaler 50 mcg x 2 puffs x
+ LTRA BD + Myteka Tab. x 5, 10 mg x HS

4. SABA Salbo, Ventolin inhaler x 2 puffs x TDS

+ Low dose ICS + Flixotide inhaler 50 mcg x 2 puffs x
± LTRA BD ± Myteka Tab. x 5, 10 mg x HS +
+ LABA Salmicort/Seretide inhaler x 25/50 mcg
x 2 puffs x BD
5. SABA + moderate- or Salbo, Ventolin inhaler x 2 puffs x TDS
high-dose ICS + Flixotide inhaler 50 mcg x 2 puffs x
± LTRA BD ± Myteka Tab. x 5, 10 mg x HS +
+ LABA Salmicort/Seretide inhaler x 25/150 or
+ Theophylline 25/250 mcg g x 2 puffs x BD + Tab.
Theograd x 1 x BD

COPD

• Smoking cessation, exercise, chest physiotherapy

• Optra, Atem inhaler x 2 puffs x TDS [Ipratropium; anti-cholinergic 40
mcg]
• Cap. Tiovair 18 mcg x OD via inhaler [Tiotropium; COPD]
• Others: Inhaled β2-agnoists, corticosteroids, Theophylline
• Anti-biotics: for acute exacerbations
Vaccines

• Inj. Influvac x S/C x ONCE (influenza virus- inactivated surface antigen)

• Inj. Prevenar 13 x I/M x ONCE (Pneumococcal conjugate, 13-valent)
• Inj. Menactra x I/M x ONCE (Meningococcus; Grp A, C, Y, and W-135)
• Inj. Hiberix x I/M x ONCE (Hemophilus influenzae Type b)
 10
Pneumonia

Community Acquired Pneumonia (CAP):

Mild/No Comorbids: Cap. Amoxil 500 mg TDS for 10 days
[Amoxicillin] OR
Tab. Azomax 500 mg OD on day 1, then 250
mg OD for next 4 days [Azithromycin]
Moderate/Comorbids [I] Tab. Avelox 400 mg 1 tab OD
present (COPD, DM, [Moxifloxacin]
other lung/liver/renal [II] Cap. Amoxil 500 mg TDS for 10 days
disease): [Amoxicillin] OR
2 regimen options [I,II] Tab. Augmentin 625 mg TDS for 10 days
(Amoxicillin + Clavulinic Acid)
PLUS
Tab. Claritek 500 mg BD 10 days
[Clarithromycin] OR
Tab. Azomax 500 mg OD on day 1, then 250
mg OD for next 4 days [Azithromycin]
Severe/Inpatient/non- [I] Inf. Avelox, Moxiget 400 mg IV OD
ICU: [II] Inj. Rocephin 1 g IV OD
2 regimen options [I,II]
PLUS
Inf. Zithrax, Azitma (Azithromycin) 500 mg
IV
Severe/ Inpatient, Inj. Rocephin 1 g IV OD
ICU: PLUS
Inf. Avelox, Moxiget (Moxifloxacin) 400 mg
IV OD OR
Inf. Zithrax, Azitma (Azithromycin) 500 mg
IV
Aspiration Pneumonia:
→ Add Metronidazole to the above regimens
Pneumocystis jirovecii (carinii) Pneumonia
Tab. Septran, Cotrim (Trimethoprim/Sulphamethoxazole) 80/400, DS
160/800 mg
Treatment Dosage: TMP 20mg/kg/day divided BD or TDS
Prophylaxis: DS tab x 1 tab on alternate days

Pulmonary HTN

Diagnosis: If PAP >25 mmHg (at rest), >30 mmHg (on exertion)

Idiopathic:
• Tab. Bosmon x 62.5/125 mg x 1 + 1 [Bosentan]
• Tab. Revatio x 20 mg x TDS [Sildenafil; PDE inhibitor; CI: nitrates]
Non-idipathic (e.g. CKD):
• Nitrates and CCBs.
 11
CARDIOLOGY

• Tab. Loprin x 75 mg x 1 x OD
[Aspirin-S/Es: Gastritis, salicylism, bronchoconstriction, Reye syndrome
(if aspirin is prescribed to a child with viral infection)]
• Tab. lowplat x 75 mg x 1 x OD [Clopidogrel; CI: peptic ulcer,
hemorrhage]
• Tab. lowplat plus x 75/75 x 1 x OD [Aspirin/Clopidogrel]
• Tab. Atorva x 10/20/40 mg x 1 x HS [Atorvastatin: statin S/Es: Myopathy,
myalgias, rhabdomyolysis, hepatotoxic; statin CI: Deranged LFTs, RFTs,
pregnancy, lactation]
• Tab. Rosuva x 5/10/20 mg x 1 x HS [Rosuvastatin]
• Tab. Zopent x 40 mg x 1 x OD [Pentoprazole, a PPI, preferred over Risek]

Heart Failure
• Tab. Carveda x 6.25/12.5/25 mg x 1 x OD [Carvedilol, a β-blocker]
• Tab. Zestril x 5/10/20 mg x 1 x HS [Lisinopril; dec. preload and afterload]
• Tab. Sacvin x 24/26,49/51,97/103 mg x BD [sacubitril/valsartan; ↓
mortality in CHF (NYHA II-IV) & reduced EF; S/Es: hypoTN, hyperkalemia;
CI: if already on ACEI, for shifting to this allow washout period (36 hrs)]
• Tab. Ivaset x 5 mg or sivab x 5/7.5 mg x BD [Ivabradine: CHF; may
precipitate atrial fibrillation]
When is CHF decompensated?
1. BNP > 150pg/ml or Pro-BNP (newer marker) > 300
2. Dyspnea (R/O COPD)
• Tab. Digoxin/Linoxin x 0.125/0.250 mg x OD [Digitalis- an inotrope]

Angina, Post-Myocardial Infraction

• Tab. Sustac x 2.6/6.4 mg x 1 x (1+1+0)
[Glyceryl Trinitrate; S/E: ortho. HypoTN, Tachyphylaxis]
• Tab. Isoket x 10 mg x (1+1+0) [Isosorbide dinitrate; use: chronic angina
S/E: hypovolemia, raised ICP, Low CO]
• Tab. Monis x 20/40 mg x 1 x (1+1+0) [Isosorbide mononitrate; use:
angina chronic use]
• Tab. Vastarel MR x 1 x TDS [Trimetazidine 35 mg; Uses: angina, ischemia
of neurosensorial tissues]
• Tab. Rancard XR x 500/1000 mg x OD [Ranolazine; use: Angina; CI: long
QT syndrome]
• Tab. Nicoget x 10/20 mg x BD [Nicorandil (nicotinamide derivative)
Arterial + venous vasodilator use: angina]

Atrial Fibrillation (ER)

• Inf. Cordarone (Amiodarone) x 150 mg x I/V x stat over 10 min, then
@ 1 mg/min (360 mg) over next 6 hrs, then
@ 0.5 mg/min (540 mg) over next 18 hrs
 12
NEUROLOGY

Anxiolytics
• Tab. Serenace x 5/10 mg x 1 x OD [Haloperidol]
• Inj. Serenace x 5 mg x IV x OD
• Tab. Dormicum x 7.5 mg x 1 x OD [Midazolam]
• Inj. Dormicum x 5 mg x IV x OD
• Tab. Valium x 2, 5, 10 mg x 1 x HS-insomnia, BD-agitation, alcohol/opioid
withdrawal [Diazepam-BZ; CI of BZs, BBTs, ethanol: sleep apnea]
• Tab. Lexotanil x 1.5, 3, 6 mg x HS- insomnia, BD-anxiety
[Bromazepam-long-acting BZ; use: insomnia, anxiety]
• Tab. Ativan x 2 mg x 1-2 tabs x HS- insomnia, BD- Anxiety
[Lorazepam-BZ]

Anti-Epileptics
• Tab. Lerace x 250/500/750 mg x BD
• Inj. Lerace x 500 mg x BD [Levetiracetam; myoclonic & partial seizures
Cis: Breastfeeding]
• Tab. Hitop x 25/50/100 mg x 1 x BD [Topiramate; seizures]
• Tab. Tegral x 200 mg x BD [Carbamazepine]
• Tab. Lamictal x 100 mg x BD [Lamotrigine]

Vertigo

• Tab. Stemetil x 5 mg x 1-2 tabs x TDS [Prochlorperazine; Use: emesis,

vertigo, Meniere’s disease, psychosis; CI: depression, S/E: bone
marrow suppression]
• Tab. Serc x 8/16 mg x 1 tab x BD
[Betahistine (histamine analogue-vasodilator)]

Multiple Sclerosis

• Tab. Imuran x 50 mg x TDS [Azathioprine; immunosuppressant]

• Tab. Toldin x 2 mg x BD [Tolterodine-an anti-cholinergic: for urinary
incontinence]
• Tab. Imidol x 25 mg x BD [Imipramine- a TCA; Antidepressant]
Parkinsonism
Dopamine agonists: improve bradykinesia; Muscarinic blockers: improve
muscle rigidity and resting tremors
• Tab. Pk Merz x 100 mg x OD initially, BD after 1 week, Max. 400mg/day
[Amantadine-antiviral; MOA: blocks Ach receptors and ↑ dopamine
release. S/Es: atropine-like, livedo reticularis, depression. CI:
breastfeeding, hypersensitivity, untreated narrow angle glaucoma]
• Tab. Sinemet x 1 x TDS [Carbidopa/Levodopa 25/250 mg, Prodrug
converted to dopamine. S/Es: Dyskinesias, psychosis, hypotension, CI:
use of non-selective MAO inhibitors, narrow angle glaucoma,
hypersensitivity. Avoid in Pregnancy.]
• Tab. Kempro x 5 mg x BD [Procyclidine- an anti-cholinergic]
• Tab. Requip x 1 x BD [Ropinirole- Dopamine receptor agonist]
• Tab. Selgin/Jumex x 5mg x 1 tab at breakfast & 1 tab at lunch. Can
taper off levodopa by 30% 3 days after selegiline therapy depending
on patient’s response [Selegiline-MAOB inhibitor. S/Es: dyskinesias,
insomnia, psychosis]
 13
GASTROENTEROLOGY

Antacids
• Syp. Dijex-MP x 2 tsf x TDS [Hydoxides of Al & Mg, and Simethicone:
Acidity, indigestion, dyspepsia, heartburn, gastric bloating, flatulence]
• Syp. Mucaine x 1-2 tsf x TDS [Antacid; oxethazaine, AL & Mg
oxides/hydroxides; oxethazaine-topical anesthetic]
• Citro Soda sachet x 1g x TDS [NaHCO3/Citric acid/Na-citrate; use:
heartburn, acidity, indigestion]
• Cap. Risek x 20 or 40 mg x OD/BD x 30 min. before meal
• Inj. Risek x 40 mg x STAT or OD
• Tab. Zopent x 20/40 mg x BD/OD [Pentoprazole]
• Cap. Nexum x 20/40 mg x BD/OD [Esomeprazole]
• Susp./Tab. Ulcenil 20/40 mg x BD/OD [Famotidine]
• Inj. Zantac x IV x STAT or BD [50 mg/ 2 ml] [Ranitidine]
• Tab. Masacol x 400/800 mg x 1 x TDS [Crohn’s, ulcerative colitis]
Anorexia
• Syp. Trimetabol x 1 tsp x BD [Metopine 2.75 mg/ 15 ml]

Anti-emetics
H1 antagonists: [Anti-histaminic; other Uses: motion sickness]
• Tab. Gravinate x 1 or 2 x TDS
• Inj. Gravinate x 50 mg in 10 ml N/S x IV x TDS [Dimenhydrinate]
• Tab. Phernergan/Avomine x 25 mg x 1 tab x SOS/TDS [Promethazine]

Serotonin Receptor Antagonist [5HT3]: Use: CA chemotherapy

• Tab. Onset x 8 mg x 1 x TDS
• Inj. Onset x 8 mg x IV x TDS [Ondansetron]

Dopamine D2 anatagonists:
• Tab. Maxolon x 10 mg x 1 x PO x TDS
• Inj. Maxolon x 10 mg x IV x TDS [Metoclopramide, other Uses: CA
chemotherapy, GIT prokinetic]
• Tab. Stemetil x 5 mg x 1 x TDS
• Inj. Stemetil x IV x TDS [Prochlorperazine]
• Tab. Motilium, Pelton x 1-2 x TDS
• Inj. Motilium, Pelton x 10 mg x TDS [Domperidone]
Diarrhea
• Cap. Loperam, Imodium x 2 mg x 2 tabs initially then 1 tab after each
stool. Max. 8 tabs/day. [Loperamide]
• Biflor, Enflor sachet x 1 x BD
[saccharomyces; diarrhea, indigestion, colitis e.g. pseudomembranous]
Constipation
• Syp. Lilac, Duphlac x 2 or 3 tsf x TDS [Lactulose: An osmotic laxative]
• Lilac, Duphlac enema x 1 x P/R

• Skilax drops x 10 – 15 drops in water x Once x PO x HS

• Tab. Skilax, Laxoberon x 5 mg x 1 or 2 x HS
[Sodium Picosulphate; A stimulant laxative]
• Cremaffin emulsion x 1-1.5 tbsp x PO x BD
[Paraffin + Al/Mg hydroxide: A lubricant laxative]
• Kleen enema x 1 x P/R [Phosphate enema; CI: gut paralysis]
 14
H. Pylori Gastritis

• BMTO regimen:
o Tab, Bismol x 1 x Qid x 14 days (Bismuth subsalicylate)
o Tab. Flagyl x 400 mg x BD x 10 days (Metronidazole)
o Cap. Tetracycline x 250 mg x 2 caps. X Qid x 10 days
o Cap. Risek x 20 mg x BD x 14 days (Omeprazole))
• CAO regimen:
o Tab. Claritek x 500 mg x BD x 14 days (Clarithromycin)
o Tab. Amoxcil x 1 g x BD x 10 days (Amoxicillin)
o Cap. Risek x 20 mg x BD x 14 days (Omeprazole)
• Sequential (MEAL) regimen:
o Tab. Flagyl x 400 mg x BD x 10 days[Metronidazole]
o Tab. Nexum x 20 mg x BD x 4 weeks [Esomeprazole]
o Tab. Amoxil [Amoxicillin]x 1g x BD for 5 days, then tab. Leflox
[Levofloxacin]x 500 mg x OD for next 5 days

UROLOGY / NEPHROLOGY

Benign Prostatic Hyperplasia

• Cap. Tamsol, Maxflow x 0.4 mg x HS
[Tamsulosin (α1-blocker); Uses: BPH, nocturnal enuresis]
• Cap. Tamsol D x 0.4+0.5 mg x 1 x HS
[Tamsulosin + Dutasteride (dual 5α-red. Inhibitor; BPH]
• Tab. Cardura x 2, 4 mg x OD [α-blocker Doxazosin mesylate 2mg]

Urinary Tract Infection

• Syp. Citralka x 2 tsf x TDS [Na acid citrate; burning micturition]
• Tab. Nitrofurantoin x 50 mg Qid for 3 days (females) and 7 days (males)
• OR Tab. Leflox x 250 mg x BD OR 500 mg x OD for 03 days
[levofloxacin]
• Cran Max juice x 15 ml x PO x BD [Cranberry extract, uses: prevents UTI]
Overactive Bladder, Urge Incontinence
• Tab. Solifen x 5 mg x HS [Solifenacin succinate]
• Tab. Detrusitol, Toldin x 2 mg x BD
• [Tolterodine; anti-cholinergic: urinary incontinence; Max. dose in
renal/hepatic impairment: 1 mg BD]
• Tab. Genurin (100 mg) or Genurin Forte (200 mg) x BD [Flavoxate HCl;
relaxes detrusor muscle]

Chronic Kidney Disease (CKD)

• Inj. Lasix x 40 mg x 2 + 2 + 0 [Furosemide, loop diuretic]
• Tab. Lophos x TDS [Calcium-acetate 667 mg]
• Tab. Bon one x 1 x on alternate days [Alfacalcidol- active vit. D3, 0.5 mcg]
• Cap. Iberet folic x 1 x BD [Multivitamin]
• Inj. Epokine x 4000 IU x Mon/Fri every week [Erythropoietin]

Miscellaneous
• Tab. Androcur x 50 mg x ½ x OD
[Cyproterone Acetate (hormone)-antiandrogenic; uses: Prostate Ca,
Sexual disorders (Male), Hirsutism & acne (Female)]
 15
GENITAL & SEXUALLY TRANSMITTED INFECTIONS

Vaginal Candidiasis
• Canesten, Dermosporin, Clotrim cream (Clotrimazole 1%) L/A x HS for 1-
2 wks OR
• Cap. Fungix, Diflucan (Fluconazole) x 150 mg x 1 tabs ONCE
(uncomplicated), 1 tab 72 hourly for 3 doses (complicated)

Bacterial Vaginosis
• Tab. Flagyl (Metronidazole) x 400 mg x 1 tab BD for 7 days OR
• Metni V gel (metronidazole 0.75%) x L/A for 5 days BD or HS

Trichomoniasis
• Tab. Flagyl (Metronidazole) x 400 mg x 1 tab BD for 7 days OR 4 tabs
ONCE

Cervicitis (Chlamydia)
• 1st line: Cap. Supramycin, Vibramycin (Doxycycline) 100 mg BD x 7 days
• 2nd line/Pregnant: Cap. Azomax (Azithromycin) 1g PO ONCE

Cervicitis (Gonorrhoea)
• Inj. Rocephin (Ceftrixone) 250 mg IM OR
• Tab. Novidat (Ciprofloxacin) 250 – 500 mg BD for 1-2 weeks

Pelvic Inflammatory Disease (PID)

1st line:
• Inj. Rocephin (Ceftrixone) 250 mg IM +
• Tab. Flagyl (Metronidazole) x 400 mg x 4 tabs ONCE +
• Cap. Supramycin, Vibramycin (Doxycycline) 100 mg BD for 7 days
2 nd line:
• Tab. Flagyl (Metronidazole) x 400 mg x 1 tab BD for 14 days +
• Tab. Oflox (Ofloxacin) x 400 mg x 1 tab x BD for 14 days

Syphilis
(single painless genital ulcer)

• Inj. Benzathine (Benzathine Penicillin G) 0.6, 1.2 MILLION IU

Usual: 2.4 MIU x IM x ONCE
Pregnant: 2.4 MIU x IM x weekly for 2 weeks
HIV+, Neurosyphilis: 2.4 MIU x IM x weekly for 3 weeks
• Cap. Supramycin, Vibramycin (Doxycycline) 100 mg BD for 2 weeks (if
syphilis for < 1 yr), for 4 weeks (if syphilis for> 1 yr)

Genital Herpes (HSV)

(multiple painful genital ulcers)

• Tab. Acylex, Zovirax (Acyclovir) 200, 400 mg

Initial: 200 mg PO 4 hourly while awake (5 times daily)
Recurrence prophylaxis: 400 mg BD for 1 year
 16
ORTHOPAEDICS

Painkillers
Refer to the section ‘Pain Killers’.
However, most commonly prescribed painkillers in Ortho OPD are:
Paracetamol, Nuberol forte, Artifen, Dolo K, Rotec, Celbexx, Mits, Nise,
Neoproxx + Risek/Nexum, Thiosid, movax

Osteoarthritis

• Tab. Qalsan D x 500 mg x OD [Calcium + Vitamin D3]

• Cap. Dulan x 30 mg x HS [Duloxetine Hydrochloride; Use: advanced OA]
• Inj. Indrop D x 1 x PO x weekly [Cholecalciferol 5mg/ml] OR
Cap. Sunny D 1 x weekly
Rheumatoid Arthritis

• Tab. Methotrexate x 2.5 mg x 3 tab once a week + Tab. Folic acid x 5 mg

x OD except on day of Methotrexate [CI: Renal or hepatic dysfunction,
Cytopenia, Lung disease, Ulcerative colitis, Pregnancy, alcohol intake]
• Tab. Cara x 20 mg x OD [Leflunomide] + Tab. Folic acid x 5 mg OD
• Tab. Salazidine x 500 mg x BD [Sulfasalazine]
• Tab. HCQ 200 x 1 x BD [Hydroxychloroquine 200 mg]
• Tab. Deltacortil EC x 5 mg x BD
Gout

• Tab. Zyloric x 300 mg x OD [Allopurinol- XO inhibitor]-for 3 to 6 months

• Tab. Gouric x 40/80 mg x OD – for 02 months [Febuxostat- XO inhibitor,
Use: chronic hyperuricemia, CI: Renal/Liver dysfunction]
• Cap. Indomethacin x 25mg [NSAID; CI: heart failure, Liver/Renal disease]
• Dietary advice – fluids 8-10 glasses/day, avoid- Palak, Daal, Eggs, & Red
Meat)
Miscellaneous

• Pcam gel x L/A x BD [NSAID;Piroxicam 0.5 %]

• Tab. Methycobal x 500 mcg x BD/TDS [Mecobalamin, vit. B12 coenzyme]
• Tab. Bless x 20 mg x OD [NSAID: Piroxicam]
• Lumbosacral support belt x small/medium/large
• Knee support
 17
SURGERY

Peripheral Vascular Disease (PVD)

• Tab. loprin x 75 mg x OD [Aspirin]
• Tab. Lowplat x 75 mg x OD [Clopidogrel]
• Tab. Lipiget x 10 mg x BD OR 20 mg x OD [Atorvastatin]
• Tab. Pletaal x 100 mg x BD [Cilostazole, vasodilator and anti-platelet]

Deep Venous Thrombosis (DVT)

• Tab. Xarelto, Xcept x 15 mg x BD x 03 weeks; then 20 mg x OD x 03

months if provoked DVT and 06 months if unprovoked DVT
[Rivaroxaban; CI: Tanscatheter aortic valve replacement, active bleeding,
risk of pregnancy-related hemorrhage]
• Inj. Clexane;
o For prophylaxis: 40 mg x S/C x OD
o For Treatment: 1 mg/kg x S/C x 12 hourly
[Enoxaparin, LMWH; CI: Active bleed, heparin-induced
thrombocytopenia]

Anal Fissure
• GTN 0.2 % ointment + Lignocaine gel x L/A x BD
• Sitz batch x BD (Add 1 tbsp baking soda + 1 tsp Salt into warm water 3-4
inches high, in a clean bathtub, and soak perineum in it for 15 minutes)
• Oral painkiller
Hypothyroidism
• Tab. Thyroxine x 1 ½ tab x 02 weeks then 2-3 tabs for maintenance [1
tab=50 µg] [hypothyroidism or post thyroidectomy]

Hyperthyroidism, Graves’ Disease

• Tab. Procarbizole (Propylthiouracil) 50 mg
Loading: 2-3 tabs TDS (Hyperthyroidism), 1-3 tabs TDS (Graves)
(load until initial response)
Maintenance: 1 tab BD/TDS (Reassess after 1.5 months (TFT + LFT), then
either ↑ or ↓ dosage)
[DOC in Pregnancy; Warning: Risk of liver failure, Assess LFT before and
after starting PTU periodically, taper off & stop when euthyroidism
restored)
• Tab. Tapazole/Northyx (Methimazole) 5, 10 mg
[CI: Pregnancy (1st trimester), breastfeeding; taper off & stop when
euthyroidism restored]

Dosing Hyperthyroidism Graves

Loading Mild: 15mg/day divided TDS 10-20 mg OD
Moderate: 30 mg/day divided TDS
Severe: 60 mg/day divided TDS
Maintenence 5-30 mg/day divided TDS 5-10 mg OD
x 12 months
Epididymo-orchitis
STI-associated: (age < 35 yr, sexualy active, urethral discharge)
• Inj. Rocephin (Ceftriaxone) 250 mg IM ONCE, PLUS
• Cap. Azomax (Azithromycin) 1g PO ONCE OR
Cap. Supramycin/Vibramycin (Doxycycline) 100 mg BD for 7-14 days
 18
UTI-assocaiated: (>35 yr, less sexual activity, recent UTI or instrumentation)
• Tab. Leflox (levofloxacin) x 500 mg x OD for 10 days OR
• Tab. Augmentin 625 mg TDS for 10 days (Amoxicillin + Clavulinic Acid)

Prepubertal Boys: (entreric organisms)

• Tab. Augmentin 15-20 mg/kg BD for 10 days (Amoxicillin + Clavulanate)

ENT

Oral Thrush / Candidiasis

• Habits: Stop smoking, if using inhaled corticosteroids → use good

inhaler techniques and a spacer device, and rinse mouth with water
after inhaler use
• 1st line: Daktarin gel x L/A x BD x 14 days [Miconazole]
• If severe: Cap. Diflucan x 50 mg x OD x 07 [Fluconazole]

Rhinitis
• Rino-clenil Nasal/Spray x 1 mcg x TDS [Beclomethasone]
• Xynosine Nasal/Spray x TDS [Xylometazoline]
• Tab. Fexet 60/120 mg x BD [fexofenadine]
• Oxycrom Nasal/Spray x TDS [Na-cromoglycate]

Epistaxis

• Sit upright and leaning forward

• Pinch cartilaginous soft part of the nose for 10-20 min.
If still bleeding after 20 min. then
• Nasal cautery followed by nasal packing
[If you cannot visualise the heavy bleeding then just use nasal packing]

Tonsillitis

• Symptomatic - Paracetamol and NSAIDs

• Antibiotics
o Cap. Amoxil 500 mg (adult), 50mg/kg/day (child) BD/TDS for 10 days
[Amoxicillin]
o Tab. Claritek x 250 mg x BD x 10 days
[Clarithromycin, if Penicillin Allergic]
• Tonsillectomy, if:
o > 7 episodes/year for 1 year
o > 5 episodes/year for 2 years
o > 3 episodes/year for 3 years

Pharyngitis

• Symptomatic - Paracetamol and NSAIDs

• Antibiotics
o Cap. Amoxil 500 mg (adult), 50mg/kg/day (child) BD/TDS for 10 days
[Amoxicillin]
o Tab. Claritek x 250 mg x BD x 10 days
[Clarithromycin, if Penicillin Allergic]
 19
OPHTHALMOLOGY
E/D = Eye Drops, E/O = Eye Ointment

Anti-biotics

• Ofly V E/D x TDS [Ofloxacin]

• Nebra E/D x TDS or E/O x HS [Tobramycin]
• Moxigan E/D x TDS [Moxifloxacin]
• Blephamide E/D x TDS OR E/O x HS [Phenylephrine (decongestant) +
Prednisolone (anti-inflammatory) + Sulphacetamide (antibiotic); Uses:
blepharitis etc.]
• Deximox E/D x TDS [Dexamethasone + Moxifloxacin]
• Eyebradex/Tobradex E/D x TDS [Tobramycin + Dexamethasone]
Eye Lubricants

• Tears Natural E/D x 2 drops x TDS [Hydroxymethylcellulose]

• Blink fresh E/D x TDS [Polyvinyl Alcohol, Povidone Iodine]
• Curine E/D x TDS (Multiple lubricating compunds)
Glaucoma

• Blotim E/D x BD [Timolol]

• Synigan E/D x BD [ Dorzolamide (CA inhibitor) + Timolol (B-blocker)]
• Latep E/D x TDS [Latanoprost, for ocular HTN]
• Lumigan E/D x HS [Bimatoprost]
• Alphagan E/D x BD [Brimonidine (α2 agonist); open-angle glaucoma-
decreases ocular HTN)]
• Hypertonic saline E/D x TDS [decreases edema]
Ocular Decongestant

• Histazolin E/D x TDS [Na-Cromoglycate, tetrahydrozoline; Use: relieves

ocular redness by causing vasoconstriction]
NSAIDs

• Barinep, Nevafenac, Nepanac E/D x TDS [NSAID; Nepafenac]

Steroids

• FML E/D x TDS [Fluorometholone; weak steroid]

• Pred forte E/D x TDS [Prednisolone; strong steroid]
• Deximox E/D x TDS [Dexamethasone + Moxifloxacin]
• Eyebradex/Tobradex E/D x TDS [Dexamethasone + Tobramycin]
• Lotepred forte E/D x TDS [Loteprednol; conjunctivitis, keratitis, uveitis]
• Lotepred-T E/D x TDS [Loteprednol + tobramycin]
 20
DERMATOLOGY
[If dry lesion: ointment; wet lesion: cream; large area: lotion]

Steroids

Mild:
• Advantan cream/ointment (Methylprednisolone)
• Hydrocortisone

Moderate:
• Cutivate cream/ointment (Fluticasone)
• Synalar (Fluocinolone)

Potent:
• Provate, Betnovate ointment/cream/lotion [Betamethasone]

Super-potent:
• Clobevate, Clobederm x ointment/cream/lotion [Clobetasol]

Anti-biotics

• Fucidin, Zudic cream [Fusidic Acid]

• Fucidin H cream [Fusidic Acid 20 mg + Hydrocortisone 10 mg]
• Cicatrin powder/cream [Bacitracin, Neomycin]
• Provate-G ointment/cream [Betamethasone + Gentamicin]
• Spectrazole G [Betamethasone + Clotrimazole + Gentamicin]
• Betnovate N [Betamethasone + Neomycin]
Bacterial Skin Infections

• Topical: Fusidic acid or Mupirocin x L/A x BD or TDS

• Oral: 1st line: Tab. Flucloxacillin 500 mg Qid; 2nd line: Clarithro/erythro
[e.g. furuncle]
• I/V: Ceftriaxone, Vancomycin, Linezolid
Acne
Types:
1. Papulopustular (Rx: topical anti-biotics if mild acne, oral Anti-biotics in
moderate to severe acne)
2. Comedonal (Rx: Retinoids)

Severity:
Mild: Papulopustular or Comedonal acne only (<30 in quantity);
Moderate: Papulopustular or comedonal acne (30-125) and/or nodules;
Severe: Papulopustular or comedonal acne (>125) and/or cyst

• Clinagel gel x L/A x BD [Clindamycin; papulo-pustular acne]

• Dalacin T lotion x L/A x BD [Clindamycin]
• Cap. Supramycin, Vibramycin x 100 mg x 1 tab x PO x BD on first day
then OD for 03 months [Doxycycline- broad spectrum tetracycline;
moderate to severe acne]
• Brevoxyl cream x L/A x BD [Benzoyl peroxide; both pp & cmd. acne;
kertolytic, dec. sebum production, mild bleaching]
 21
• Skin A cream x L/A x BD [Retinoid-Tretinoin; decreases keratinocyte
turn-over]
• Isotrex gel x L/A x BD [Retinoid- Isotretinoin]
• Adapco gel, cream x L/A x BD [Adaplene: a Retinoid-like compound]
• Fusidic cream, ointment x L/A x BD (in acne for super-added bacterial
infection)
• Tab. Androcur x 50 mg x ½ x OD
[Cyproterone Acetate (hormone)-antiandrogenic; uses: Prostate Ca,
Sexual disorders (Male), Hirsutism & acne (Female)]
Melasma

• Sunblock Uveil forte x spf 65 x L/A x daytime [1st line]

• Petroleum gel x L/A x SOS [2nd line + Don’t use scented/pigmented
cosmetic products]
• Derma Clin x L/A x TDS x 30 days [3rd line, Hydroquinone + glycolic acid:
bleaching agent, for hyper-pigmented skin]
Scabies

• Counselling [application, clothes, contacts]

• Scabree cream x L/A x once for 24 hours [Permethrin 1%]
• Scabene x L/A x once for 24 hours [Lindane 1%]
• Scabicure lotion x L/A x once for 24 hours [Benzyl Benzoate 25%]
• Tab. softin, Rhilor x 10 mg x 1 x HS [Loratadine:anti-histamine; for night
itching]
• Tab. Ivermectin x 3 mg x 3 x PO x weekly for 02 weeks [Anti-helmintic;
for severe crusted scabies]
Tinea

• Lamisil cream x L/A x BD x 02 weeks [Terbinafine]

• Travogen cream x L/A x BD [Isoconazole]
• Conaz sloution x L/A x twice weekly [ketoconazole]
• Dermosporin lotion/cream x BD [Clotrimazole-broad spect AF]
• Daktarin, Candistat oral x L/A x OD x 02 weeks [Miconazole oral gel; oral
candidiasis]
• Tab. Terbisil x 125, 250 mg x 1 x OD x 02 weeks [Terbinafine-Anti-fungal:
<20 kg: 125 mg ½ tab; 20-40 kg: 125 mg 1 tab; >40 kg: 250 mg 1 tab;
hepatotoxic-check LFTs periodically]
• Cap. Icon x 200 mg x BD x 04 – 06 weeks [Itraconazole; Get LFTs before
prescribing, hepatotoxic]
Seborrheic Dermatitis
• Sunlight exposure
• Conaz solution x L/A x twice weekly [Ketoconazole]
• Provate lotion x L/A x BD
• Anti-dandruff shampoo
Cutaneous Leishmaniasis

• Tab. Rifampicin x 300 mg x OD

• Tab. Zyloric x 300 mg x 1 x OD [Allopurinol}
• Inj. Stibotim x S/C x twice weekly [Na-Stibogluconate (anti-protozoal): In
04 quadrants around the lesion. If multiple lesions, then I/M]
• Cryotherapy
 22
Pruritis / Itching

• Calamine lotion x L/A x SOS [soothing agent]

• Sarna lotion x L/A x SOS [Camphor + Menthol + Phenol]
• Logel gel x L/A x SOS [Lignocaine-local anesthetic; may cause local allegic
rxn]
• Anti-histamines:
o Tab. Atarax 10, 25 mg x 1 x HS [Hydroxyzine: antihistaminic, CNS
depressant. Uses: Anxiety, insomnia, pruritis, urticaria]. Others: H1
blockers: Fexet, Softin/Rhilor, Rigix; H2 blockers (if H1 resistant):
Cimetidine.
• Zinc/Paraffin cream x L/A x TDS [Pruritis ani]
Eczema

• Emollients: Vaseline, Petroleum gel x L/A x TDS [Use moisturizing soaps

e.g. lux, dove rather than anti-bacterial soaps]
• Topical Steroids: Fusidin, Cutivate, Provate [according to severity]
• Eczemus ointment x 0.03% (02-15 yr) or 0.1% (adults) x L/A x TDS
[Tacrolimus-immunomodulator]
• Immunosuppression: [Methotrexate (+ folic acid), Ciclosporin,
Azathioprine] – [Severe eczema]
• Phototherapy [severe eczema, S/E: risk of cancer]
• Infected eczema:
o Topical: Fucidin, Silvate/Dermazin (Silver sulphadiazine), Neomycin
o Oral: Augmentin, Erythrocin, Ciproxin
Urticaria (Hives)
Skin rash with red, raised and itchy bumps

• Identify & remove the offending agent (latex, insect bites, foods, drugs
such as aspirin, NSAIDs)
• Anti-histamines (Non-sedating; Loratadine, Cetirizine, Fexofenadine)
• Calamine lotion x L/A x SOS [soothing agent]
• Prednisolone x PO/IV (in severe cases)
Psoriasis

• 1stline: Emollients: Vaseline, Petroleum gel x L/A x TDS

• 2nd line: topical Steroids [acc. to severity]
• 3rd line: Vit. D analogues [Inj. Indrop D or Cap. Sunny D x 1 x weekly]
• Phototherapy/Immunosuppression
 23
PSYCHIATRY

Insomnia / Anxiety

• Tab. Alp x 0.25, 0.5, 1 mg x 1 x HS for 5 days [Alprazolam-BZ; for 5 days

max, otherwise dependance and tolerance develops]
• Tab. Melonia x 2 mg x 1 x HS 3 to 4 hours before sleep [Melatonin; a
hormone that regulates sleep cycle; use: insomnia]
• Tab. Valium x 2, 5, 10 mg x 1 x HS-insomnia, BD-agitation, alcohol/opioid
withdrawal [Diazepam-BZ; CI of BZs, BBTs, ethanol: sleep apnea]
• Tab. Lexotanil x 1.5, 3, 6 mg x HS- insomnia, BD-anxiety [Bromazepam-
long-acting BZ; use: insomnia, anxiety]
• Tab. Ativan x 2 mg x 1-2 tabs x HS- insomnia, BD- Anxiety [Lorazepam-
BZ]
• Tab. Serenace x 5/10 mg x 1 x OD [Haloperidol]
• Inj. Serenace x 5 mg x IV x OD
• Tab. Dormicum x 7.5 mg x 1 x OD [Midazolam]
• Inj. Dormicum x 5 mg x IV x OD

Anti-depressants
1st line: SSRI, 2nd line: SSRI + Mirtazapine (Nassa), 3rd line: SSRI + Nassa +
SNRI or low-dose anti-psychotic (Risp), 4th line or if suicidal intent: all +
ECT

SSRIs: (Selective Serotonin Reuptake Inhibitors)

Uses: Major depression, OCD, Bulimia. S/Es: anxiety, bruxism, sexual
dysfunction (anorgasmia), GI ulcers, weight loss, serotonin syndrome (e
excess SSRI or SSRI+MAO Inhibitor]

• Tab. Citanew, Es-pramcit x 5, 10, 20 mg x 1 x OD [Escitalopram; use;

anxiety, low mood]
• Tab. Preloft x 50, 100 mg x 1 x OD [Sertraline; for Depression in multiple
comorbidities e.g. IHD, HTN, epilepsy. Safe in pregnancy]
• Cap. Oxetin/Galaxy/Depricap x 20 mg x 1-4 tabs x OD [Fluoxetine; if
depression + psychomotor symptoms. If Depression at <18 yrs e.g.
lethargy. CI: Pregnancy/Lactation. Don’t increase dosage more than 10-
20 mg per month if required]
• Tab. Paraxyl x 20 mg x OD [Paroxetine]
TCAs: (Tricyclic Antidepressants)
Uses: Major Depression, OCD, Neuropathic pain (Amitryptyline), enuresis
(imipramine). S/Es: muscarinic and α-blockade, toxicity: 3Cs
(cardiotoxicity, convulsions, coma).

• Tab. Clomfranil x 10, 25 mg x 1 x OD [Clomipramine; use: Major

Depression, OCD]
• Tab. Imidol x 25 mg x BD [Imipramine; enuresis]
• Tab. Amitin or Tryptanol x 1 or 2 x HS
[TCA, Amitryptyline 25 mg: migraine prophylaxis, Tension headache,
Neuropathic pain (post-herpetic Neuralgia: 3-4 tab OD x 3 weeks),
depression (start at 1-2 tabs OD then ↑ by 25 mg weekly to 100 mg OD]

SNRIs: (Serotonin-Norepinephrine Reuptake Inhibitors)

 24
• Cap. Dulan x 30 mg x 1 x BD [Duloxetine SNRI; Uses: Major Depression,
pain (chronic neurpathies (e.g. DM), fibromyalgia]
• Cap. Efexor XR x 75, 150 mg x OD [Venlafaxine SNRI]

Other Anti-depressants:
• Tab. Deprel x 100 mg x 1 x HS [Trazodone; anti-depressant]
• Tab. Nassa x 30 mg x 1 x OD [Mirtazapine; if depression + anorexia OR
depression e use of warfarin/aspirin/NSAIDs; S/E: weight gain]
• Tab. Wellbutrin XR x 150 mg x 1 x OD [Bupropion-antidepressant: uses;
Depression, smoking cessation (start XR @ 150 mg OD for 3 days 1 wk
before quit date, then @ XR 150 mg BD for 7 weeks ± nicotine patch)]

Anti-psychotics

• Tab. Olanzia, Olepra x 5, 10 mg x 1-2 x HS [Olanzapine]

• Tab. Risp, Raze, Vepridone x 3 mg x 1 x HS [Risperidone-atypical]
• Tab. Qusel, Evokalm XR x 300 mg x 1 x HS [Quetiapine; use:
schizophrenia, Mania of bipolar disorder]
Anti-epileptics

• Tab. Tegral (200 mg) [Carbamazepine]

Dosing: start at 1 tab BD, then increase 1 tab weekly to maintain at 1 tab
TDS or Qid
S/Es: allergic reactions, aplastic anemia. Warning: may lead to fatal
dermatologic reactions e.g. Toxic epidermal Necrosis & Steven Johnson
Syndrome, CI: Hypersensitivity]
• Tab. Lamictal x 2, 5, 25, 50, 100 mg x BD [Lamotrigine, S/Es: allergic
reactions, CI: Hypersensitivity]
Dosing: first 2 weeks: 50 mg OD, next 2 weeks: 50 mg BD, week 5 and
beyond: increase by 100 mg/day to maintain at 150-250 mg BD

Miscellaneous

• Tab. Neurolith SR x 400 mg x BD [Li-carbonate; Uses: DOC Bipolar

disorder, along-side an anti-depressant (for depressed phase) and anti-
psychotic e.g quetiapine (for mania); S/Es: tremors, seizures,
hypothyroidism, Nephrogenic Diabetes Insipidus]
• Tab. Inderal x 0.5 mg x BD [Propranolol]
• Tab. Buspar x 5 mg x 1 x TDS [Busiprone; use: GADs (non-sedative)]
• Tab. Valium x 2, 5, 10 mg x 1 x HS-insomnia, BD-agitation, alcohol/opioid
withdrawal [Diazepam]
 25
ANTI-BIOTICS
BC=Bactericidal, BS=Bacteriostatic, ATD= After Test dosage

Penicillins [BC]
S/Es: Hypersensitivity. Administer ATD.
• Inj. Benzathine (Benzathine Penicillin G) 0.6, 1.2 Million IU x IM
• Cap. Amoxil x 500 mg x TDS for 10 days [Amoxicillin]
• Tab. Augmentin x 1 g x BD [Amoxicillin + Clavulinic acid]
• Inj. Augmentin x 1.2 g x BD

Caphalosporins [BC]
S/Es: Hypersensitivity. Administer ATD.
• Cap. Cefim/Cefspan x 400 mg OD x 5 days [Cefixime-3rd gen; URTI, LRTI]
• Inj. Rocephin 500 mg, 1g x IV OR 250 mg x IM x ONCE (Ceftriaxone-3rd
gen)
Imipenem/Meropenem [BC]
↓ dose in renal dysfunction, S/Es: seizures with overdose
• Inj. Meronem x 500 mg, 1 g x I/V [Meropenem]
• Inj. Cilapen x 250, 500 mg x I/V [Imipenem]

Aztreonam [BC]
[Uses: Gram -ve rods e.g. Pseudomonas, Klebsiella, Proteus, Serratia]
• Inj. Azactam x 500 mg, 1 g x IV

Vancomycin [BC]
Uses: MRSA, Enterococci, back-up drug for Clostridium difficile.
S/Es: Red man syndrome, Nephrotoxicity, Ototoxicity
• Inj. Vancomycin/Vinjec x 500 mg, 1 g x I/V

Aminoglycosides [BC]
[Uses: Gram -ve rods e.g. Pseudomonas, Klebsiella, Proteus, Serratia. Don’t
use for anaerobes.
S/Es: Nephrotoxicity, Ototoxicity, Neuromuscular Blockade. ↓ dose in renal
dysfunction. CI: Pregnancy, Pneumonia. Administer ATD.
• Inj. Amikin x 100,250,500 mg x I/V [Amikacin, Dosing: 15mg/kg/day-
divided as BD or TDS]
Tetracyclines [BS]
CI: Children, Pregnancy. S/Es: tooth dysplasia, ↓ bone growth,
phototoxicity
• Cap. Supramycin/Vibramycin (Doxycycline) 100 mg OD/BD

Macrolides [BS]
S/Es: GIT prokinetic, ↑ QT interval, cholestatic hepatitis in pregnancy
• Tab. Erythrocin x 250 Qid or 500 mg x BD [Erythromycin]
• Tab. Azomax x 500 mg x OD [Azithromycin-Macrolide]
• Tab. Claritek 500 mg BD 10 days [Clarithromyciin-Macrolide]

Linezolid [BS]
Uses: Vancomycin Resistant stah. Aureus & enterococci, drug resistant
pneumococci.
S/Es: Bone marrow suppression (↓ platelets), Serotonin syndrome if taken
with an SSRI. Monitor CBC weekly.
• Tab. Nezkil x 600 mg x BD for 10-14 days
• Inf. Nezkil x 600mg x BD for 10-14 days
 26
Trimethoprim / Sulphamethoxazole
Uses: Pneumocystis jirovecii Pneumonia, G –ve infections (E. coli,
Salmonella, Shigella, H. influenzae), G +ve infections (Staph. Aureus, MRSA,
Streptococcus), Toxoplasma gondii, DOC in Nocardia, backup for listeria.
S/Es: Bone marrow suppression (leukopenia), Kernicterus in Neonates. CI:
Pregnancy (3rd trimester)
• Tab. Septran, Cotrim 80/400, DS 160/800 mg
Treatment Dosage: TMP 20mg/kg/day divided BD for 10-14 days

Quinolones [BS]
Uses: UTI, STDs, G –ve infections of skin, soft tissues, and bones, Diarrhea
(shigella, Salmonella, E. Coli, Campylobacter).
S/Es: Tendonitis, ↑ QT interval (torsades risk), phototoxicity, insomnia.
CI: Pregnancy and Children (↓ chondrogenesis)

• Tab. Ciproxin, Novidat x 250, 500 mg x 1 tab x BD [Ciprofloxacin-2nd gen]

• Inf. Novidat, Quinolflox x 200, 400 mg x I/V x BD, TDS [Ciprofloxacin]
• Tab. Avelox x 400 mg x 1 tab x OD [Moxifloxacin-3rd gen]
• Tab. Leflox x 500 mg x OD or 250 mg x BD [Levofloxacin-3rd gen]
Other uses of 3rd gen: strepto-, pneumo- & entero-cocci, anaerobes

Metronidazole [BC]
S/E: Metallic taste
• Tab. Flagyl x 400 mg x TDS [Metronidazole]
• Inf. Flagyl x 500 mg x IV xBD/TDS
ANTI-FUNGALS
[-azole S/Es: ↑LFTs (AST, ALT), ↓ steroid synthesis (↓libido, gynecomastia)

• Cap. Diflucan x 50, 150, 200 mg x OD

[Fluconazole; candidiasis, cryptococcal meningitis]
• Susp. Diflucan x 50mg/5ml x OD
• Tab. Vorif x 40, 200 mg (100 mg if <40 kg, 200 mg if ≥ 40, 2 hourly)
[Voriconazole; aspergillosis]
• Cap. Icon x 100 mg x 2 tabs x BD x 02 weeks [Itraconazole; anti-fungal;
use for Aspergilloma/ABPA]
ANTI-VIRALS

• Tab. Zovirax x 200 mg or Acylex x 200/400/800 mg x 4 hourly

[Acyclovir; Uses: HSV, encephalitis, chickenpox, CMV]
• Zovirax E/O, Cream x L/A
• Tab. Velpaget x 1 x OD for 03 months
[Sofosbuvir 400 mg, Velpatasvir 100 mg; use: chronic HCV]
ANTI-MALARIALS

• Tab. Artem Plus x 20/120, 40/240, 80/480 mg x ___ tab x BD for 03 days
[Artemether/Lumefantrine; wt=5-<15 kg: 1 tab 20/120 mg, wt=15-
<25kg: 1 tab 40/240 mg, wt=25-<35kg→ 1.5 tab 40/240 mg, wt. >
35kg→1 tab 80/480 mg]
• Tab. HCQ 200 [Hydroxychloroquine 200 mg]
Dosing: Start at 13mg/kg stat (max. 800 mg), then continue at 6.5 mg/kg
after 6 hours (max. 400 mg), 24 hrs, and 48 hrs of initial dose
 27
ANTI-HELMINTHICS/WORMS
• Tab. Zentel x 200 mg x BD for 03 days [Albendazole]
• Tab. Vermox x 100 mg x BD for 03 days [Mebendazole]
• Tab. Combantrin x 250 mg x ONCE [Pyrantel Pamoate]

VITAMINS & MINERALS

• Tab. Cecon x 1 x OD [Vit. C - chewable]

• Tab. Drate x 35mg (for prophylaxis), 70mg (for treatment) x once weekly
[Alendronate-bisphosphonate; inhibits osteoclasts]
• Tab. Qalsan D x 1 x OD [Calcium carbonate, vitamin D 1250/125 mg]
• Tab. Cac-1000 x 1 x OD [Calcium gluconate 1000 mg, Ascorbic Acid (vit.
C) 500 mg]
• Tab. CAC-1000 Plus x 1 x OD [Ca 1g, Ca-carbonate 327mg, vit. C 500mg,
vit. D3 4mg, vit. B6 10 mg]
• Tab. Osnate 800 x 1 x BD [Ossein mineral complex]
• Tab. Revitale B x 1 x OD [Vit. B1, B2, B3, B5, B6, B7, B9 & B12]
• Tab. Revitale M x 1 x OD [ Vit. B complex, vit. C, vit. D, vit. E + minerals
Ca, Mg, Zn, Se, Fe, Mn, I]
• Cap. Fefol x 1 x OD [Fe-sulphate/Folic acid 150/0.5 mg]
• Tab. Neo K x 1 x OD [Potassium Supplement]

STEROIDS

Chronic Use Side-Effects: Cataracts (regular fundoscopy), Osteoporosis (add

bisphosphonates), GI ulcers (add PPI/H2 blockers)

• Tab. Delta cortril EC [Prednisolone 5mg]

USES:
o Crohn’s Disease: 5 mg BD
o Rheumatoid Arthritis: 5 mg OD or 7.5 mg OD
o Acute exacerbation of COPD: 30 mg OD x 14 days
o Bell’s Palsy: 60 mg OD x 5 days, then dec. 10 mg every day for
5 more days
o Polymyalgia Rheumatica: 15 mg daily e gradual tapering
o Temporal Arteritis: 60 mg daily e gradual tapering + aspirin 75
mg OD
• Inj. Decadron x I/M or I/V [Dexamethasone]
• Inj. Solu Cortef, Hy-Cortisone x 1-2 mg/kg x IV x stat Hydrocortisone]
 28
PAEDIATRICS

Respiratory Distress
Assess the following;
1. Respiratory Rate: Tachypnea if RR in 0-2 mo > 60/min, 2 mo – 1 yr >
50/min, 1 yr – 5 yrs > 40/min.
2. Work of breathing: Recessions, Nasal flaring, Head Nodding
3. Auscultation: wheeze, crepitations

• Normal RR = symptomatic treatment only (cough syrup, Calpol, etc.)

• ↑ RR + exp. wheeze = RAD (reactive airway disease). Management: Neb.
with ventolin, oxygen inhalation, steroids
• ↑ RR + crepts = Acute bronchiolitis, Pneumonia, ARI. Management:
Neb. with atem + clenil, Oxygen, Anti-biotic, CXR, CBC, CRP
• ↑ RR + ↓ air entry = Pneumonia. Management: Oxygen, Anti-biotic,
Chest X-ray, Blood Complete Picture, CRP

General Danger Signs:

1. Not drinking/breastfeeding.
2. Vomits everything.
3. Fits/convulsions present. (Inj. Diazepam x stat)
4. Lethargic/unconscious.
If any of the above: very severe disease
Treatment:
1. If having seizures - give diazepam.
2. Check blood sugar.
3. Any supportive treatment.
4. Urgent referral/review by consultant.

Pneumonia
Signs of pneumonia:
i. RR ↑
ii. Chest indrawings.
iii. Stridor.
iv. Wheezing.

1. Cough or difficult breathing + stridor/any general danger sign → severe

pneumonia
Treatment: Antibiotic + urgent referral.
2. Cough or difficult breathing + ↑ RR or chest indrawings → pneumonia.
Treatment:
a. Oral Amoxicillin x 5 days.
b. If wheezing → Inhaled bronchodilators x 5 days
c. Sooth throat & relieve cough
d. TB/Asthma assessment if cough/wheeze > 14 days.
e. F/U in 3 days.
3. Cough or difficult breathing only (none of the 4 signs of pneumonia) →
Cough/Cold
Treatment:
a. If wheezing → Inhaled bronchodilators x 5 days
b. Sooth throat & relieve cough
c. TB/Asthma assessment if cough/wheeze > 14 days.
d. F/U in 5 days.
 29
Diarrhea

1. Two of the following:

Lethargic/unconscious, sunken eyes, not drinking/poor drinking, skin
pinch goes back > 2 sec → Severe dehydration → Plan C
2. Two of the following:
Restless/irritable, sunken eyes, drinks eagerly/thirsty, skin pinch goes
back < 2 sec → Some dehydration → Plan B
3. Not enough signs to classify → No Dehydration → Plan A
4. Diarrhea > 14 days → Persistent diarrhea. Treatment: Feeding advice,
multivitamins, zinc
5. Diarrhea > 14 days + dehydration → Severe persistent diarrhea.
Treatment: admit, Treat dehydration.
6. Blood in stools → Dysentery. Treatment: Ciprofloxacin for 3 days, F/U in
3 days.
Plan A
1. Zinc supplements (2 mo-5 yrs). 2 ≤ 6 mo = ½ tab x OD, ≥ 6 mo = 1 tab x
OD x 14 days.
2. Continue feeding.
3. Give extra fluid;
a. If exclusively BF = ORS or clean water in addition to BF.
b. Not exclusively BF = ORS solution, soup, yoghurt drink e.g. lassi, clean
water.
How much fluid: 0 < 2 yrs – 100 ml after each stool, ≥ 2 yrs – 200 ml after
each stool.
4. Counsel when to return (general danger signs).
Plan B
1. ORS. Amount of ORS to be given in first 4 hrs= weight(kg) x 75.
Reassess after 4 hrs and re-classify;
2. Extra fluids.
3. Zinc.
4. Continue feeding.
5. Counsel when to return.
Plan C
1. I/V fluids. R/L or N/S = 100 ml/kg.
Age First 30% fluid Next 70% fluid
< 12 mo 1 hour 5 hrs
12 mo – 5 yrs 30 min 2 ½ hrs
2. Start ORS as soon as the child can drink PO or via NG tube.
If I/V fluid given → ORS @ 5 ml/kg/hr
If I/V fluid not given → ORS @ 20 ml/kg/hr
 30
PAEDIATRIC DRUGS FORMULARY

1 standard teaspoon = 5 ml, 1 standard tablespoon = 15 ml

DRUG DOSE 10kg Crack
Cough
Coferb drops (herbal) 2-3 drops x TDS …….
if child in <3 mon old
Coferb syrup (herbal) 1 teaspoon x TDS …….
if child in <1 year old
Acefyl Cough syrup 0.5 – 1 teaspoon x …….
If child > 1 year old TDS
(Acefylline,
Diphenhydramine)
Hydryllin DM syrup 4-6 yrs: 15 mg BD (6 ml x TDS)
(Dextromethorphan, 6-12 yrs: 30 mg BD (12 ml x TDS)
Diphenhydramine) > 12 yrs: 60 mg BD (24 ml x TDS)
Fever
Susp. Calpol Paediatric 10-15 mg/kg TDS 1 teaspoon x
(Paracetamol) 120mg/5ml TDS

Susp. Calpol Paediatric 6 10-15 mg/kg TDS 0.5 teaspoon x

plus TDS
(Paracetamol) 250mg/5ml
Susp. Brufen 10 mg/kg TDS 1 teaspoon x
(Ibuprofen) 1tsf (5ml) =100mg; TDS
100mg/5ml Children >3 mo

Anti-Emetics
DOMPERIDONE 0.3mg/kg/dose x 3ml X TDS
(MOTILIUM/DOMEL) Susp TDS (10kg)
5mg/5ml, (Wt X
Tab 10mg 0.3=ml/dose)
(Dopamine antagonist)
DIMENHYDRINATE 1.25 mg/kg/dose 4ml x TDS PO
(GRAVINATE) IV/IM/PO X (10kg)
Inj.50mg-1ml, TDS/QID Inj = Wt in
Liquid 12.5mg/4ml, (Anti-histamine) kg=dose in mg
Tab. 50mg
Contraindication: Neonates
Multivitamins & Minerals
Zinc (Syp. Zincat <6months ½ tsf OD Zinc (Syp Zincat
(20mg/5ml) >6months 1tsf OD (20mg/5ml)
Maltofer syrup [Iron at 3 Maltofer syrup (50 3 mg/kg per day
mg/kg per day, On Day 14] mg/5 mL) 10kg (On Day 14)
= 3ml x OD
Maltofer Drops (50
mg/mL) 5kg =
0.3ml x 0D
Multivitamin syrup (Syp. 5ml xOD Multivitamin
Vidaylin M/lysovit) syrup
 31
Anti-Virals & Anti-Biotics
ACYCLOVIR (ACYLEX) Susp ≥2 yr: 20 5ml x QID
200mg/5ml mg/kg/Dose x QID
AMPICILLIN 50-100 mg/kg/day 10ml x 6 hrly
(AMPILITE/ZAMPICILLIN) PO divided QID (125mg/5ml)
Susp 125mg/5ml,
250mg/5ml
AMOXYCILLIN (AMOXIL) 25-50mg/kg/day 8ml X BD (Susp
Drops 125mg, divided BD/TDS 125mg)
Susp 125mg), 5ml X TDS
250mg
CLAVULANIC 25-50mg/kg/day 7ml X BD
ACID+AMOXICILLIN divided BD (Susp 156.25)
(AUGMENTIN) Susp Or
156.25mg, 5ml X TDS
312.5mg,
457mg,
Tab. 375mg, 625mg
CEPHALEXIN (CEPOREX) 25-100 mg/kg/day 7ml X TDS (125)
Susp 125mg, 250mg; in divided doses 1.5 dropper x
Drops 100mg/1.25ml TDS/QID TDS
CEFIXIME (CEFIM/ 8 mg/kg X OD 4ml x OD
CEFSPAN)
Susp. 100mg/5ml-30ml
DS susp. 200mg/5ml-30ml
AZITHROMYCIN (AZOMAX) 10 mg/kg X OD for 2.5ml x OD
(macrolide) 3 days
Susp 200mg/5ml
(For >6months)
CLARITHROMYCIN 15 mg/kg/day 3ml x BD
(KLARICID/CLARITEK) divided BD
(macrolide)
Drops/Susp 125mg/5ml,
Tab 250mg
METRONIDAZOLE (FLAGYL) 30 mg/kg/day 2.5ml x TDS
Susp-200mg/5ml; 60ml, divided QID/TDS
Tab. 200mg, 400mg
CIPROFLOXACIN 30 mg/kg/day 6ml x BD
(NOVIDAT) divided BD (125mg/5ml)
Susp 125mg, 250mg (for >1yr) 3ml x BD
Tab 250mg,500mg (250mg/5ml)
ERYTHROMYCIN 30-50 mg/kg/day 2.5ml x TDS
(ERYTHROCIN) divided BD/QID (200mg/5ml)
Granules-200mg/ 5ml, (Anti-microbial)
Drops-100mg/5ml
Tab 250mg
Parasitology / Worms
PYRANTEL PAMOATE 11 mg/kg stat 2.2 ml x Stat
(COMBANTRIN) (repeat after 2wk) Half tablet x
Tab 250mg, stat
Susp. 250mg/5ml -10ml
 32
ALBENDAZOLE (ZENTEL) 400 mg as a single 10ml x stat
Tab 200mg dose; may repeat 2 tab x stat
Susp100mg/5ml-10ml in 2 weeks
MEBENDAZOLE (VERMOX) 100mg twice daily 5ml x BD
Tab 100mg, for 3 days 1 tab x BD
Susp100mg/5ml
Anti-Histamines
PHENIRAMINE MALEATE 0.5 mg-1 1ml x TDS PO
(AVIL) mg/kg/day given
Inj 25mg, Syrup 15mg/5ml every 6 hours.
CHLORPHENIRAMINE 0.25mg/kg 5ml x TDS
(ALLERMINE/PIRITON)
Syp 2mg/5ml,
Tab 4mg
LORATADINE 2-6 years: 5 mg x 5ml x OD
(SOFTIN/SENERGY-OD) OD
Tab 10mg, >6 yrs: 10mg x OD
Syp. 5mg/5ml -60ml
CETIRIZINE (RIGIX) 2-6 years: 5 mg x 5ml x OD
Tab 10mg, OD
Syp 5mg/5ml-60ml >6 yrs : 10mg x OD

SLIDING SCALE INSULIN

(Max 2 units/kg/24 hour) 180-270 = 0.3 u/kg
BSR----------------dosage 270-360 = 0.4 u/kg
60-90 mg/dl = 0.1 u/kg/dose S/C >360 = 0.5 u/kg
90-180 = 0.2 u/kg
Tuberculosis
Syp. Rifapin-H Rifampicin= 10 ml x OD (10
(Rifampicin=100mg/5ml 10-20mg/kg/day kg child)
Isoniazid=50mg/5ml) Isoniazid=
Syrup: 50ml volume 10-15mg/kg/day
Syp: 1ml/kg
STEROIDS
PREDNISOLONE (Deltacortil) Tab 5mg, Syp Steron 15mg/5ml
Inflammation: 0.1-2 mg/kg/day PO OD/ BD
Acute Asthma: 1-2 mg/kg/day in single daily dose or divided q12hr for
3-5 days
Nephrotic Syndrome: Initial 4-6 weeks = 60 mg/m²/day or 2 mg/kg/day
PO
divided q8hr (Max 80mg/day)
Next 4 weeks: 40 mg/m² or 1-1.5 mg/kg PO every other day

HYDROCORTISONE (Solu-cortef) Tab 5mg,10mg Powder for Inj 100 mg

Inflammation: 2.5-10 mg/kg/day PO divided q6-8hr
Status Asthmaticus: 1-2 mg/kg IV q6hr for 24 hr, Maintenance: 0.5
mg/kg/dose q6hr
Physiological Replacement: 8-10 mg/m²/day PO/IV/IM divided q8hr
Acute Adrenal Crisis: 1-2 mg/kg IV bolus, then 25-150 mg/kg/day IV
divided
q6-8 hr (max 250mg/day)
 33
DEXAMETHASONE (Decadron)Tab 1,2mg, Inj 4mg/ml, 10mg/ml, elixir
0.5mg/5mL
Inflammation: 0.1 - 0.3 mg/kg/day IV/PO/IM divided q6hr or q12hr
Airway Edema: 0.5 - 2 mg/kg/day IV/IM divided q6hr, starting 24 hours
before
extubation and continued for 4-6 doses afterward
Croup: 0.6 mg/kg IV/IM once
Meningitis: 0.6 mg/kg/day IV divided q6hr for first 2-4 days of antibiotic
therapy
Cerebral edema with brain tumor: 1-2 mg/kg IV/IM once;
maintenance: 1-1.5
mg/kg/day IV/IM divided q4-6hr
Spinal Cord Compression: 2 mg/kg/day IV divided q6hr

METHYLPREDNISOLONE (Solu-mederol)
Inj. 40mg, Inj 500mg
1-2 mg/kg IV/IM in 2 divided doses
 34
INDEX

A
C
ACE Inhibitors, 6
Acne, 20 Calcium Channel Blockers, 6
Alpha-Blockers, 6 Candidiasis, 18
Aminoglycosides, 25 Caphalosporins, 25
Anal Fissure, 17 Cardiology, 11
Angina, 11 Cervicitis, 15
Angiotensin Receptor Chlamydia, 15
Blockers, 6 Chronic Kidney Disease, 27
Anorexia, 14 Constipation, 13
Antacids, 13 COPD, 9
Anti-biotics, 25 COPD (Steroids), 27
Anti-biotics (Derma), 20 Cough, 8
Anti-biotics (Eye), 19 Cough (Paeds), 30
Anti-biotics (Paeds), 31 Crohn’s Disease (Steroids), 27
Anti-biotics (Pulmonology), 8
Anti-depressants, 23
Anti-emetics, 13 D
Anti-emetics (Paeds), 30
Anti-epileptics, 12, 24 Deep Venous Thrombosis, 17
Anti-fungals, 26 Dermatology, 20
Anti-helminthics, 27 Diabetes Mellitus, 7
Anti-histamine (Eye), 19 DM type I, 7
Anti-histamines (Paeds), 32 DM type II, 7
Antimalarials, 26 Diabetic Ketoacidosis, 2
Anti-psychotics, 24 Diarrhea, 13
Anti-virals, 26 Diarrhea (Paeds), 29
Anti-virals (Paeds), 31 Diuretics, 6
Anxiety (Psych), 23 Dog Bite, 4
Anxiolytics (Neuro), 12
Asthma, 9
E
Asthma Exacerbation, 1
Atrial Fibrillation, 11
Aztreonam, 25 Eczema, 22
Emergencies, 1
ENT, 18
B Epididymo-orchitis, 17
Epistaxis, 18
Bacterial Vaginosis, 15
Beta-Blockers, 6
F
Bell’s Palsy (Steroids), 27
Benign Prostatic Hyperplasia
(BPH), 14 Fever (Paeds), 30
 35
Muscular Pain (Skeletal), 5
G
Myocardial Infarction, 1
Myocardial Infarction (Post
Gastritis, 14 MI), 11
Gastroenterology, 13
Genital Herpes, 15
Genital Tract Infections, 15 N
Glaucoma, 19
Gonorrhoea, 15 Neurology, 12
Gout, 16 Neuropathic Pain, 5
Graves Disease, 17 NSAIDs, 5
NSAIDs (Eye), 19
H
O
H. Pylori, 14
Heart Failure, 11 Ophthalmology, 19
Herpes Simplex Virus, 15 Oral Thrush, 18
Hives, 22 Organophosphate Poisoning, 4
Hypertension, 3, 6 Orthopaedics, 16
Hypothyroidism, 17 Osteoarthritis, 16
Hyperthyroidism, 17 Overactive Bladder, 14

I P

Imipenem, 25 Paediatric Drugs, 30

Insomnia, 23 Paediatrics, 28
Insulin (Paeds), 32 Painkillers, 5
Itching, 22 ER Painkiller, 4
Paracetamol, 5
Parasitology (Paeds), 31
L
Parkinsonism, 12
Pelvic Inflammatory Disease,
Leishmaniasis (Cutaneous), 21 15
Linezolid, 25 Penicillins, 25
Lubricants (Eye), 19 Peripheral Vascular Disease,
17
Pharyngitis, 18
M
Pneumonia, 10
Pneumonia (Paeds), 28
Macrolides, 25
Polymyalgia Rheumatica
Melasma, 21
(Steroids), 27
Meropenem, 25
Pruritis, 22
Metronidazole, 26
Psoriasis, 22
Migraine, 5
Psychiatry, 23
Minerals, 27
Pulmonary Hypertension, 10
Minerals (Paeds), 30
Pulmonary Tuberculosis, 8
Miscellaneous, 14, 16, 24
Pulmonology, 8
Multiple Sclerosis, 12
Multivitamins (Paeds), 30
 36
Q T

Quinolones, 26 Temporal Arteritis (Steriods),

27
Tetracyclines, 25
R Tinea, 21
Tonsillitis, 18
Renal, 27 Trichomoniasis, 15
Respiratory Distress (Paeds), Trimethoprim, 26
28 Tuberculosis (Paeds), 32
Rheumatoid Arthritis, 16
Rheumatoid Arthritis
(Steroids), 27 U
Rhintis, 18
Urge Incontinence, 14
Urinary Tract Infection, 14
S Urology, 14
Urticaria, 22
Scabies, 21
Seborrheic Dermatitis, 21
Sexually Transmitted V
Infections, 15
Skin Infections (Bacterial), 20 Vaccines, 9
Snake Bite, 3 Vaginal Candidiasis, 15
Spasmodic Abdominal Pain, 5 Vancomycin, 25
Status Epilepticus, 1 Vertigo, 12
Steroids, 19, 27 Vitamins, 27
Steroids (Derma), 20
Steroids (Paeds), 32
Sulphamethoxazole, 26 W
Surgery, 17
Syphilis, 15 Worms, 27
Worms (Paeds), 31

THE END

All praise and gratitude is for Allah, The Master of all