PH 3.
1 PRESCRIPTION WRITING
1. Anaphylactic shock
A 22-year-old male presents to the emergency department with sudden onset of shortness
of breath, generalized itching and swelling of lips and eyes. He gave history of symptoms
began about 15 minutes after eating seafood. On examination BP is 80/50mmHg, HR is
120/min.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 22 years Sex: M
Address: Address:
Phone:
Diagnosis: Anaphylactic Shock
Rx:
1. Maintenance of airway, breathing and circulation.
2. Inj. ADRENALINE 0.5 mg (0.5ml of 1 in 1000 solution) IM Stat.
(To be repeated after 5 to 10 minutes if the patient does not improve)
3. Inj. HYDROCORTISONE 100mg IV Stat.
4. Inj. CHLORPHENIRAMINE 10mg IM Stat.
Advice:
• Recognize symptoms:
Know the signs of anaphylaxis, which include skin rashes, difficulty breathing, rapid
heartbeat, dizziness, nausea, abdominal cramps
• Allergy testing:
Consider undergoing allergy testing to identify specific allergens that trigger your
anaphylaxis.
• To avoid exposure to known allergens (seafood, pollen, nuts)
• Stay informed:
Allergy history to be informed to the friends, family and treating physician.
XYZ
Doctor’s Signature
Reflection of the Learner
2. Type 2 Diabetes Mellitus
A 50-year-old male weighing 80 kgs presents to the OPD with complaints of increased
thirst, frequent urination and fatigue for the past 3 months. He gives a family history of
diabetes mellitus. His fasting blood glucose is 132 mg/dl.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 50 years Sex: M
Address: Address:
Phone:
Diagnosis: Type 2 Diabetes Mellitus
Rx:
1. Tablet. METFORMIN 500 mg…………….28
One tablet to be taken orally two times daily after food for 14 days.
Advice:
• Adhere to the medication schedule.
• Healthy diet: Follow a balanced diet that's low in sugar, salt, and unhealthy fats. Focus on
whole foods like vegetables, fruits, whole grains, lean proteins, and healthy fats.
• Regular exercise.
• Weight management: Aim for a healthy weight, as excess weight can worsen insulin
resistance.
• Stress management: Practice stress-reducing techniques like meditation, yoga, or deep
breathing exercises.
• To review after 2 weeks.
XYZ
Doctor’s Signature
Reflection of the Learner
3. Acute Angina
A 50-year-old male presented to the emergency department with C/o sudden tightness and
severe discomfort over chest after exertion. He is a chronic smoker and a known
hypertensive. His resting ECG was normal, but stress test was positive.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 50 years Sex: M
Address: Address:
Phone:
Diagnosis: Acute Angina
Rx:
1. Tablet. GLYCERYL TRINITRATE 0.5mg sublingual stat.
(should be placed under the tongue).
2. Tablet. METOPROLOL 50 mg stat.
3. Tablet. ASPIRIN 300 mg stat.
Advice:
• Lifestyle modifications:
Healthy Diet: Follow a balanced diet that's low in saturated fats, cholesterol, and sodium.
Regular Exercise: Engage in regular physical activity, such as brisk walking, to help
manage stress and improve overall health.
Stress Management: Practice stress-reducing techniques like meditation, yoga, or deep
breathing exercises.
• Avoid Triggers: Avoid triggers that can exacerbate angina, such as heavy meals, stress, or
extreme temperatures.
• Stop any physical activity and rest immediately in case of development of similar
symptoms.
XYZ
Doctor’s Signature
Reflection of the Learner
4. Acute Convulsions
A 25-year-old male brought to the emergency department with the history of generalized
seizures involving all four limbs. On examination, patient was unconscious, actively
convulsing with laboured breathing. His BP was 130/80 mmHg, heart rate 120/min, SPO2
– 89%.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 25 years Sex: M
Address: Address:
Phone:
Diagnosis: Acute Convulsions
Rx:
1. To maintain patent airway.
2. Nasal oxygen.
3. IV line.
4. Inj. LORAZEPAM 4mg IV stat (at the rate of 2mg/min)
To be repeated after 10 minutes if seizures recur.
Advice:
• Take medications as prescribed.
• Do not miss any doses of your medication, as this can increase the risk of another
convulsion.
• Safety Precautions: avoid driving motor vehicles, swimming and working near fire and
machineries.
• Lifestyle Modifications: Get enough sleep, reduce stress & avoid triggers that can cause
convulsions.
• Always to have ID card & details of drug intake.
• Regular follow-up with the physician.
XYZ
Doctor’s Signature
Reflection of the Learner
5. Acute Severe Bronchial Asthma
A 55-year-old female with a history of asthma presented to the emergency department
with severe shortness of breath, wheezing and chest tightness which progressively
worsened. On examination, she was tachypnoeic with RR – 34/min, HR – 118/min, SPO2
– 88% and bilateral rhonchi present.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 55 years Sex: F
Address: Address:
Phone:
Diagnosis: Acute Severe Bronchial Asthma
Rx:
1. High flow oxygen inhalation (4 litres/min).
2. Inj. HYDROCORTISONE 100mg IV stat.
Followed by 100mg as infusion for 8 hours.
3. Nebulised SALBUTAMOL (2.5 - 5 mg) in 3 ml saline hourly.
Advice:
• Adhere to the medication schedule.
• Regular follow-up with the physician.
• Avoid triggers that can exacerbate asthma, such as dust, pollen, or pets.
XYZ
Doctor’s Signature
Reflection of the Learner
6. Urinary tract infection in Pregnant female
A 25-year-old Primi gravida at 24 weeks of gestation, presented to the antenatal clinic
with complaints of burning micturition, increased urinary frequency and lower abdominal
discomfort for the past three days. Her urine analysis showed significant bacteriuria.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 25 years Sex: F
Address: Address:
Phone:
Diagnosis: Urinary Tract Infection in Pregnancy
Rx:
1. Tablet. CEFIXIME 200 mg…………….10
One tablet to be taken orally after food, two times daily for 5 days.
Advice:
• Adhere to the medication schedule.
• Complete the full course of antibiotics as prescribed, even if symptoms resolve.
• Drink plenty of water throughout the day.
• To maintain personal hygiene.
• Monitor for signs of preterm labour, such as contractions, back pain, or vaginal discharge.
XYZ
Doctor’s Signature
Reflection of the Learner
7. Pulmonary Tuberculosis - (Drug Sensitive)
A 45-year-old male weighing 38 kgs presented to the OPD with complaints of persistent
cough for 4 weeks associated with low grade evening fever and weight loss for 2 months.
His chest x-ray showed right upper lobe cavitary lesion and sputum smear for AFB was
positive. CBNAAT confirms Mycobacterium tuberculosis and shows no resistance to
rifampicin.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 45 years Sex: M
Address: Weight: 38 kgs
Phone: Address:
Diagnosis: Drug Sensitive Pulmonary Tuberculosis
Rx:
Intensive phase:
Fixed dose combination (FDC) of
Tablet. ISONIAZIDE 75 mg +
Tablet. RIFAMPICIN 150 mg +
Tablet. ETHAMBUTOL 275 mg +
Tablet. PYRAZINAMIDE 400 mg ……………. 120 tablets
Two tablets to be taken orally once daily after food for 60 days
Continuation phase:
Fixed dose combination (FDC) of
Tablet. ISONIAZIDE 75 mg +
Tablet. RIFAMPICIN 150 mg +
Tablet. ETHAMBUTOL 275 mg ……………. 240 tablets
Two tablets to be taken orally once daily after food for 120 days
Advice:
• Adhere to the medication schedule.
• Regular follow-up with the physician.
• Do not miss any doses of your medication. It can lead to treatment failure or drug
resistance.
• Eat a balanced diet that includes plenty of fruits, vegetables, whole grains, and lean
protein sources.
• Take adequate rest to help your body recover.
• Avoid close contact with others.
• Cover your mouth and nose with a tissue when coughing or sneezing.
XYZ
Doctor’s Signature
Reflection of the Learner
8. Treatment of Vivax malaria
A 25-year-old male presented to the OPD with history of intermittent fever associated
with chills, rigors and sweating for 5 days. On examination, he is febrile (Temp – 102.4
F), HR 98/min. Peripheral blood smear showed schizonts of Plasmodium vivax.
Doctors Name: XYZ Patient Name: XXXX Date:
Registration number:12345 Age: 25 years Sex: M
Address: Address:
Phone:
Diagnosis: Vivax Malaria
Rx:
1. Tablet. CHLOROQUINE PHOSPHATE 500 mg (500mg = 300mg base) …………….5
Two tablets stat. One tablets to be taken after food after 8 hours, 24 hours & 48 hours of stat
dose.
2. Tablet. PRIMAQUINE 15 mg…………….14
One tablet to be taken once daily after food for 14 days.
Advice:
• Adhere to the medication schedule.
• Complete the full course of antibiotics as prescribed, even if symptoms resolve.
• Do not miss any doses of your medication. It can lead to treatment failure or relapse.
• Wear protective clothing, such as long-sleeved shirts and pants, to prevent mosquito
bites.
XYZ
Doctor’s Signature
Reflection of the Learner
