PRESCRIPTIONS
Prescribe for acute watery diarrhea for 2yrs child
(1) Sachet. Oral rehydration salt
Dispense: 4 sachets
Dissolve 1 sachet in 1L of boiled and then cooled water. Drink as much as
possible and one glass after each defecation. Do not refrigerate. Finish 1L
within 24hrs
(2) Tablet. Zinc sulfate 20mg
Dispense: 14 tablets
Take 1 dispersible tablet and dissolve it in water and take it once a day for 14
days
ADVICE:
Take more fluids
Maintain good nutrition
Prescribe for acute gastroenteritis (AGE)
(1) Sachet. Oral rehydration salt
Dispense: 4 sachets
Dissolve 1 sachet in 1L of boiled and then cooled water. Drink as much as
possible and one glass after each defecation. Do not refrigerate. Finish 1L
within 24hrs
(2) Tablet. Metronidazole 400mg
Dispense: 21 tablets
Take one tablet at a time three times a day (8 hours apart) after food for 7
days
(3) Tablet. Ciprofloxacin 500mg
Dispense: 10 tablets
Take one tablet at a time two times a day (12 hours apart) after food for 5 day
1
Prescribe an anti-emetic drug to a 4 years old child of 20kg who is
going for 2 days journey by bus
(1) Transdermal patch. Scopolamine 1.5 mg
Dispense: 1 patch
Apply the patch behind the pinna 1 hour before starting the journey
Prescribe an anti-emetic drug to a patient going on a journey who has a
disorder of motion sickness
(1) Tablet. Promethazine 25mg
Dispense: 1 tablet
Take 1 tablet 30 minutes before the start of the journey
Prescribe a laxative for a patient of 60 years who has undergone
transurethral surgery & now he is severely constipated
(1) Tablet. Docusate sodium 100mg
Dispense: 9 tablets
Take 1 tablet at a time 3 times a day (8 hours apart) after food for 3 days
ADVICE:
Increase fluid intake
Eat fiber rich diet
Avoid straining
2
Prescribe a laxative for a patient with myocardial infarction who is
severely constipated
(1) Tablet. Docusate sodium 100mg
Dispense: 9 tablets
Take 1 tablet at a time 3 times a day (8 hours apart) after food for 3 days
ADVICE:
Increase fluid intake
Eat fiber rich diet
Avoid straining
Prescribe for a patient suffering from amoebic dysentery
(1) Sachet. Oral rehydration salt
Dispense: 4 sachets
Dissolve 1 sachet in 1L of boiled and then cooled water. Drink as much as
possible and one glass after each defecation. Do not refrigerate. Finish 1L
within 24hrs
(1) Tablet. Metronidazole 400mg
Dispense: 42 tablets
Take 2 tablets at a time 3 times a days (8 hours apart) after food for 7 days
(1) Tablet. Diloxanide furoate 500mg
Dispense: 21 tablets
Take one tablet at time 3 times a day (8 hours apart) after food for 7 days
ADVICE:
Maintain personal hygiene
Wash hands after defecation
3
Prescribe for a patient suffering from gastroesophageal reflux disease
(GERD)
(1) Tablet. Omeprazole 20mg
Dispense: 28 tablets
Take 1 tablet at a time once a day before breakfast for 28 days
ADVICE:
Avoid spicy food
Eat regularly in small proportions
Drink plenty of water
Avoid alcohol/smoking
Prescribe for a patient suffering from chronic constipation
(1) Sachet Ispaghula husk 3g
Dispense: 6 sachets
Take 1 sachet and freshly mix with cold drink, fruit juice or water and take it 2
times a day just after meals for 3 days
ADVICE:
Do not take it at bed time
Do not swallow dry
Prescribe for a patient suffering from chemotherapy induced vomiting
(1) Injection. Ondansetron 8mg
Dispense: 6 ampules
Infuse 8mg i.v. slowly over 15mins ½ an hour before chemotherapy followed by
two similar doses 4 hours apart
4
Prescribe for a patient suffering from acute diarrhea
(1) Sachet. Oral rehydration salt
Dispense: 4 sachets
Dissolve 1 sachet in 1L of boiled and then cooled water. Drink as much as
possible and one glass after each defecation. Do not refrigerate. Finish 1L
within 24hrs
ADVICE:
Drink plenty of fluids
Maintain personal hygiene
Wash hands after defecation
Prescribe for NSAID related ulcer
(1) Tablet. Omeprazole 20mg
Dispense: 14 tablets
Take 1 tablet at a time one a day 30 minutes before food for 14 days
ADVICE:
Avoid spicy food
Eat regularly in small proportions
Drink plenty of water
Avoid alcohol/smoking
Prescribe a drug for patient suffering from ascariasis
(1) Tablet. Albendazole 400mg
Dispense: 1 tablet
Take 1 tablet single dose on empty stomach
ADVICE:
Low fat diet
Drink boiled water
Eat hygienic and well cooked food
5
Prescribe for relapsing ulcer
(1) Tablet. Lansoprazole 30mg
Dispense: 56 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) 30 minutes before food
for 28 days
(2) Tablet. Amoxicillin 1000mg
Dispense: 28 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 14 days
(3) Tablet. Clarithromycin 500mg
Dispense: 28 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 14 days
ADVICE:
Take light meals
Avoid spicy food
Avoid smoking/drinking
Avoid stress/tension
Prescribe a drug for patient suffering from hookworm infestation
(1) Tablet. Albendazole 400mg
Dispense: 1 tablet
Take 1 tablet single dose STAT
(1) Tablet. Ferrous sulfate
Dispense: 90 tablets
Take 1 tablet at a time once a day for 3 months
ADVICE:
Avoid walking barefoot
Maintain hygiene
6
Prescribe a drug against Taenia solium
(1) Tablet. Praziquantel 500mg
Dispense: 1 tablet
Take 1 tablet as a single dose after food in the morning
Prescribe for a patient for induction of labor
(1) Injection. Oxytocin 5IU
Dispense: 2 ampules
Mix 1 ampule of oxytocin in 500ml of normal saline and give by continuous i.v.
infusion. Start the drip 15 drops per minute and gradually can be increased up
to 60 drops per minute depending upon maternal uterine contraction and fetal
heart rate
Prescribe a hormonal contraceptives for a lady
(1) Tablet. Norgestrel 0.3mg
Tablet. Ethinyl estradiol 0.03mg in combination
Dispense: 1 strip
Start the 1st pill on 5th day of menstruation and continue to take 1 tablet once a
day at the same time and take continuously as indicated and after completion
of 1st strip start the next
ADVICE:
If one tablet is missed, take two tablets on the next day. If 2 tablets are missed stop the
medication and use other methods of contraception and next course started on 5 th day
of menstruation.
Prescribe for a 50kg lady with insulin dependent diabetes mellitus
(1) Injection. Insulin 25IU
Dispense: 30 ampules
Inject s.c. 15IU before breakfast and 10IU before dinner
ADVICE:
Decrease sugar intake
Take the doses regularly
Do not miss meal
Always carry a sweet
7
Prescribe for a patient with diabetes mellitus (IDDM) who has a blood
glucose level <300 mg/dl
(1) Injection. Insulin 25IU
Dispense: 30 ampules
Inject s.c. 15IU before breakfast and 10IU before dinner
ADVICE:
Decrease sugar intake
Take the doses regularly
Do not miss meal
Always carry a sweet
Prescribe an anti-diabetic drug to a very obese NIDDM patient
(1) Tablet. Metformin 500mg
Dispense: 90 tablets
Take 1 tablet at a time once a day for 3 months
ADVICE:
Decrease sugar intake
Exercise regularly
Follow up after 3 months
Prescribe patient suffering from type-II diabetes mellitus
(1) Tablet. Metformin 500mg
Dispense: 90 tablets
Take 1 tablet at a time once a day for 3 months
ADVICE:
Decrease sugar intake
Exercise regularly
Follow up after 3 months
8
Prescribe for a patient suffering from thyrotoxic crisis (thyroid storm)
(1) Injection. Propranolol 2mg
Dispense: as required
Inject 2mg i.v. slowly STAT
(2) Tablet. Propranolol 40mg
Dispense: as required
Then take 1 tablet at a time 4 times a day (6 hours apart)
(3) Tablet. Propylthiouracil 200mg
Dispense: as required
Then take 1 tablet at a time 4 times a day (6 hours apart)
(4) Tablet. Iopanoic acid 0.5g
Dispense: as required
Then take 1 tablet at a time once a day
(5) Injection. Hydrocortisone 100mg
Dispense: as required
Inject 8mg i.v. 8 hourly
Prescribe for a patient suffering from type-I diabetes mellitus
(1) Injection. Insulin 25IU
Dispense: 30 ampules
Inject s.c. 15IU before breakfast and 10IU before dinner
ADVICE:
Decrease sugar intake
Take the doses regularly
Do not miss meal
Always carry a sweet
9
Prescribe for a patient suffering from hypothyroid goiter
(1) Tablet. L-thyroxine sodium 50mcg
Dispense: 14 tablets
Take 1 tablet at a time once a day after food for 14 days
ADVICE:
Avoid cabbage and cauliflower
Use iodized salt
Prescribe for a patient suffering from insomnia
(1) Tablet. Alprazolam 0.25mg/ Tablet. Zolpidem 5mg
Dispense: 5 tablets
Take 1 tablet at a time once a day at bedtime after food for 5 days
ADVICE:
Regulate sleeping pattern
Sleep at the same place
Take food 2hrs before sleep
Avoid sleeping during the day
Avoid shift work
Prescribe for an elder patient with depression
(1) Tablet. Moclobemide 150mg
Dispense: 60 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 30 days
ADVICE:
Sleep well
Exercise regularly
Follow up after 1 month
10
Prescribe for grand mal epilepsy
(1) Tablet. Sodium valproate 300mg
Dispense: 90 tablets
Take 1 tablet at a time 3 times a day (8 hours apart) after food for 30 days
ADVICE:
Take medication correctly
Get enough sleep
Take care near water: do not swim alone
Do not drive
Caution with flash photography
Prescribe for an anxiety neurosis
(1) Tablet. Diazepam 5mg
Dispense: 10 tablets
Take 1 tablet before bed and ½ tablet in the morning and afternoon after food
for 5 days
Prescribe for petitmal epilepsy
(1) Tablet. Sodium valproate 15mg/kg
Dispense: 30 tablets
Take 1 tablet at a time once a day after food for 30 days
ADVICE:
Take medication correctly
Get enough sleep
Take care near water: do not swim alone
Do not get near fire
Inform child’s teachers and coaches
Follow up after 1 month
11
Prescribe drug for a child suffering from febrile convulsions
(1) Suppository. Diazepam 5mg
Dispense: 1 suppository
Insert 5mg suppository per rectally STAT
(1) Syrup. Paracetamol 160mg/5ml
Dispense: 1 bottle
Take 15mg/kg 6 hourly for 3 days
ADVICE:
Give the child adequate fluids
Maintain temperature by sponging
Prescribe for myoclonic seizure
(1) Tablet. Sodium valproate 200mg
Dispense: 60 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 30 days
ADVICE:
Take care near fire and water
Do not swim or drive
Follow up after 1 month
Prescribe a drug for patient in manic state (not decided answer)
(1) Tablet. Aripiprazole 15mg
Dispense: 30 tablets
Take 1 tablet at a time once a day after food for 30days
(1) Tablet. Lithium carbonate 300mg
Dispense: 60 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 30days
ADVICE:
Sleep well
Exercise regularly
Follow up after 1 month
12
Prescribe a drug for induction of anesthesia
(1) Injection. Thiopentone sodium 1g
Dispense: as required
Inject 3 mg/kg i.v. as a 2.5% solution
Prescribe a drug for performing tracheal intubation
(1) Injection. Midazolam 1mg
Dispense: as required
Inject 0.02 mg/kg/hr as a continuous i.v. infusion
Prescribe for status epilepticus
(1) Injection. Lorazepam 4mg
Dispense: as required
Inject i.v. at a rate of 2mg/min and repeat once after 10 minutes if required
(2) Injection. Fosphenytoin 50mg/ml
Dispense: as required
Infuse 15 mg/kg i.v. at a rate of 100mg/min under continuous EEG monitoring
Prescribe for a patient suffering from acute uncomplicated
pyelonephritis
(1) Tablet. Ciprofloxacin 500mg
Dispense: 28 tablets
Take 1 tablet at a time 2 times a day (12 hours apart) after food for 14 days
ADVICE:
Drink plenty of water
Maintain hygiene
13
MANAGEMENT
Management of myxoedema coma
1. Ensure patent airway
2. Provide respiratory support, oxygen
3. Maintain blood pressure and correct hyponatremia and hypoglycemia by fluid
infusion and use of vasopressors
4. Levothyroxine 200-500µg i.v. followed by 100 µg i.v. OD until oral therapy can be
instituted
5. Determine initial cortisol level and administer corticosteroids for adrenal
insufficiency as hydrocortisone 5-10mg/hr
6. Supportive therapy such as gradual warming with blankets (no external heating
source should be applied)
7. Antibiotic prophylaxis for the precipitating cause
Management of diabetic ketoacidosis
1. Ensure patent airway
2. Provide respiratory support and maintain blood pressure and electrolyte balance
3. Insulin administration to rapidly correct the metabolic abnormalities:
A bolus dose of 0.1-0.2 IU/Kg i.v. followed by 0.1IU/Kg/hr infusion
4. Intravenous fluids to correct dehydration:
Normal saline is initially infused i.v. at a rate of 1L/hr and progressively reduced
to 0.5L/4hr depending on volume status.
After blood glucose level reaches 300mg/dl, 5% glucose in ½ normal saline is
infused
5. KCl:
After 4hrs 10-20mEq/hr can be added to the i.v. fluid to prevent hypokalemia
6. Sodium bicarbonate:
50mEq can be added to the i.v. fluids if the arterial blood pH is less than 7.5
and not corrected spontaneously when ketosis is controlled
7. Phosphate: 5-10mmol/hr of Na/K phosphate if it is in the low normal range
8. Antibiotics: to treat the underlying infection
9. Paracetamol: to treat the fever
14
Management of hypoglycemia
If the person is conscious and cooperative:
1. Administer 10-20g of glucose orally. Measure serum glucose level after 15min. If
it is below 70mg/dl, administer another similar dose of glucose.
2. Repeat these steps until the plasma glucose level reaches 70mg/dl. Once it
does, the patient should be advised to take a meal. This is to stabilize the
plasma glucose level and to restore the glycogen stores which might have been
used up during the hypoglycemic period.
If the person is unconscious or uncooperative:
1. Hospitalize the patient
2. Ensure patent airway
3. Provide respiratory support and maintain blood pressure and electrolyte
balance
4. Administer 75-80ml of 20% glucose i.v.
If i.v. glucose is unavailable, 0.5mg glucagon i.v. or 0.2mg adrenaline s.c.
maybe given.
5. Once patient regains consciousness administer 10-20g glucose orally either in
liquid form or as granulated sugar (2tsp).
6. Monitor the blood glucose level
7. In prolonged hypoglycemia (hypoglycemia lasting for more than 5 hours):
IV mannitol and dexamethasone with constant glucose monitoring and IV
glucose to keep serum level 5-10 mmol/L
15
Management of acute barbiturate poisoning
1. Ensure patent airway
2. Provide respiratory support, oxygen and maintain blood pressure and electrolyte
balance by fluid infusion and use of vasopressors such as dopamine
3. Gastric lavage: leave a suspension of activated charcoal in the stomach, to prevent
absorption of drug from the intestine
4. Alkaline diuresis: with sodium bicarbonate 1mEq/Kg i.v. with or without mannitol in
case of long acting barbiturates
5. Hemodialysis and hemoperfusion
6. There is no specific antidote for barbiturates
Management of methanol poisoning
1. Keep the patient in a quiet, dark room. Protect the eyes from light
2. Ensure airway is patent
3. Provide respiratory support, oxygen and maintain blood pressure and electrolyte
balance by fluid infusion and use of vasopressors
4. Gastric lavage with sodium bicarbonate if patient is brought within 2hrs of ingesting
methanol
5. Combat acidosis by i.v. sodium bicarbonate infusion
6. Introduce a nasogastric tube and administer ethanol 10% volume by volume at a
loading dose of 0.7ml/Kg followed by 0.15ml/Kg/hr drip
Alcohol blood level needs to be measured repeatedly
Treatment has to be continued for several days until no methanol is detected
in blood
7. Hemodialysis to clear methanol and formate and hasten recovery
8. Fomepizole: loading dose of 15mg/Kg injected i.v. followed by 10mg/Kg every 12hrs
till serum ethanol falls below 20mg/dl
9. Folate therapy as an adjuvant: helps to reduce blood formate levels by enhancing its
oxidation
Folinic acid 30mg i.v. every 8 hourly should be given to increase fomic acid
metabolism to prevent patient from tissue and retinal damage
16
