Professional Documents
Culture Documents
presentation
patient said he is asthmatic
complain of chest allergy ..
dyspnea and chest wheeze..
by examination.. bilateral diffuse sibilant ronchi
*********
bronchial asthma
* management
250
NB cardiac patient
ventolin
,bisolvon avil
.
nebulizer 6 :
(farcolin (salbutamol
2 salin
anti muscrinic
atrovent to relif bronchial spasm in vials inhalation
solutions
) dexamethasone) solucortef
Renal colic
1
* history Stone
buscopan visceralgine
glucolynamine
spasmofen .
:
loin pain
burning haematuria
250 ) ( stone
CRYstals or pus or other
CRYstals
* urates urosolvin eff
zyloric (200-800) tab Or No-uric (100-300)mg
* oxalate
epimag eff
.
* phoshate
vitacid c tab
pus
* hpf
* 5 30
uvamine retard cap 12
(macrofuran(50-100 6
* 30 50 Quinolones
uti
(Ciprofar 250 or ciprofloxacin or bactiflox (250-500
12
(Kiroll or tarivan(ofloxacin200
12 .
* .
.Antiseptic eff
Coliurinal or proximol 3
Analgesic
Rowatinex cap 8
50
vomiting
*:You should at first exclude that
Appendicitis
Acut abdomen
Insecticides
DKA
*
cortigen
B6 amp
3
MOTILIUM tab
80 60
* 500
effortil 10
urine retention
*
sudden decomprition of bladder wall
haematuria
)(epistaxis
* hypertension
:
nasal truma,dryness of nasal mucosa , bleeding disorders
*bleeding come mainly from kisselbach's plexus at anterior
.nasal septum
first aid
-venous pressure
Hand compress nostrils for 10 minutesLeaning forwardMay use cold compresses on nasal septum and not insidenose
Add amp epinephrine to nasal pack for local use
Afrin adult spray 0.05% 4
pressure nasal pack *
vaselin gauze
(full flexed to avoid aspiration)
haemostop haemostatic *
local.
. ethmasylate)dicynone 250)
: *
Ruta-C tablets 1X3 ,hemostop tablets 1X3 or dicynone
Antihaemorhagic and capillery protective
*
Pt=prothrombin time=10-15 sec
Ptt=partial thromboplastin time=35-45 sec
:
fucidin dressing
10 ) ( velosef 500 86
*
.....
) (
* ....
.
* 6 .
*
* .
hepatic coma
diuretics
Fluid replacement
500 % 5 12 500 24
2ry hyperaldoseronism with salt and water retention
For liver support
Aminoleban
250 12
(Hepamarin Or Legalon tab (silymarin
3
7
Tri-B
Essential forte tab
3
Ammoniacal antagonist
Lactulose syr
3
comatosed NG TUBE
NEOMYCIN 500 8
250 %25 :
hepa merz amp
Nootropil amp 1000
oxybral amp
6 ) 5 + 2
( neomycin
* MEASURES AGAINST HGE
2 KONAKION +2 DICYNONE 8
2 CYCLOKAPRON 12
* CEFOTAX 1gm 12
)( coma
def.:loss of consciousness
causes
:intracranial as*
head trauma &inrta cran. Hge (cerbrovascular strok) with
increased B.P
brain abscess, encephalitis ,meningitis
massive infarction ,hypertensive encephalopathy
brain tumour
all intra cranial causes may &may not come with
: lateralization signs which are
unequal pupil,*facial asymmetry,*unilateral hyper *
or hypotonia
unilateral Babiniski,asymmetrical deep reflexe*
:extra cranial causes*
toxic as co poisoning
diabetic (D.M)may be hypoglycemic ----->treated
with
cm glu 25% or DKA 100
-(uraemic (CHRONIC RENAL FAILURE
MI
-(hepatic (ENCEPHALOPASY
-resp. failure
:diagnosis
history+complete physical exam.+investigations like
*ABG
renal function tests*
complet urine analyssis*
urea &creatinine*
*random blood sugar
glucose & aceton in urine *
*liver functions tests
bilirubin direct, indirect & total*
SGOT &SGPT*
PROTHROMBIN activity*
ECG*
Abdominal U/S*
Brain CT*
:ttt
maintain adequate oxygenation -1
.care of patient during coma
.
ttt of shock if present-2
By insertion of nasogastric tube and feeding the patient*
with 2 liters of fluid
. 2 *Insertion of folley's catheter and estimation of urine in 24h
. 24 12 1 .hospitalization &recording vitalsigns at regular intervals-3
sudden onset onset coma *
INTRACRANIAL HEAMORRAGE
One of cerebrovascular stroke
Patient clinicaly present with History of hypertension, Right
or lift hemiplegia, hemiparesis,facial
deviation,Coma,Slurred speech.
Investigations needed
*For hypertension
-Na,K
10
2 8
cyclokapron amp 8
*flumox 500 mg
* abimol
*if vomiting give primperan
12
antiinflamatory drugs as piroxicam
:Alternatives
(Zantac(tab&) ,Ranitidine(tab&) ,Histac(tab&
(Aciloc(tab) ,Ranitak(tab
Fluid therapy
Fluid assessment
hypovolemia
B.pressure
Systolic 100 or
low
Puls rate&volume Tachycardia&smal
l volume
Cental venous
zero
pessure
tongue
dry
Skin elastisity
Loss of it
haematocrite
Urine out put
increased
little
hypervolemia
High
Normal&big
volume
high
wet
Normal or
peripheral
oedema
decreased
nomal
:Fluid replacement*
Glucose 5% given*
To replace water loss not associated with electolyte
disturbance
As solvent for many iv drugs
*Dextrose ,Glucose (20,25,40,50%) given in
As nutrient to give calories when git feeding isn't accessible
as in deep coma
13
hypertension
more than 150/90 plus headache with or witout
epistaxis
*
,
,
,
24 ,
, ,
Management
14
8 3 lasix *
12 epilat 10mg
cerebral oedema .
8 capoten 25 mg
aldomet 250
atenolol 50
.Combination
*
:
Drug choice
First line in young adult is diuretics & b-blockers
2nd is ACE inhibitors as capoten or Ca channel blockers as
Epilat
In old age
Ist line is Ca channel blocker with or without diuretics
In H.failure
Lasix capoten
Nefidipine & B.blockers
R.failure
Lasix-nefidipine(epilat)-aldomet
(thiazide diuretics & capoten (ACE inhibitors
*:Alternatives
Ca channel blockers*
Epilat , adalat 10 mg soft capsule (nifedipine) in HPN &(unstable angina(coronary & peripheral V.D
-Epilat retad , adalat retard 20 mg
15
*ACE inhibitors
Captopril 25, 50 mg (capoten- capotril) short acting
ramipril 1,25 -2,5-5 mg (tritace ramipril)long acting
*B.blockers
(Atenolol 50,100 mg (atenolol-ateno-atelol
Appendicitise
Presentation
Symptoms
* , fever
* periumblical localised in
R.iliac fossa
* anorexia
* nausea vomiting
Signs
macburny
*
point
* tenderness and rebound tenderness
rigidity
*cross tenerness
*cough tenderness
*
.
Management
16
* %25
: analgisic not mask the
diagnosic
* renal
colic
* neutrophilic W.blood cells
11
* pelvis
mid-cyclic pain history .
*
appendectomy
laparoscopy or laparotomy
peritonitis,septicemia
and septic shock
) (typical
.
analgesic acute abdomen mask
diagnosis
gastritis hcl
Myositis
.or back pain due to muscle spasm or myalgia
caTaflam 50 or ketofan 50 or antiflam 50,adwiflam*
50,rheumaren 50,rheumafen 50,voltaren 50(anti
(inflammatory & anti rheumatic
felden gel or olfen gel *
(Neurovit amp or neuroton or tri B(vitamin B complex*
.
organophospherous poisoning
Presentation
organophospherous poisoning
pin point pupil, bradycardia ,hypotension
secretion
salvitation, sweeting ,diarrhea
nausea, vomiting, dizziness
:management
for a case of acut intoxication 4 broade lines should be*
.done
first aid or supportive care-1
which is life saving to maintain patent air way And.removing secretions and insertion of oropharyngeal tube
prvention of further absorption of poison here by-2
removing contaminated clothes and washing skin Also by insertion of ryle tube 16 and performing stomach wash
18
500 clear
)) charcoal tab 10 300
methods to increase elimination of poison-3
use antidote Here we use -4
atropine 2 ampule in one injection every 15 min* 15 pupil fully dilated or pulse
reaches120
secretion
dry tongue
(parlidoxime (protopan chloride* )(choline estrase reactivatore
2 15
- zantac
spasmodigestin tab
gastrofait(sucralfate)mucosal protective
common cold
+
Treatment
flumox cap 500
19
Cough
coflin syr
3
mucophyline syr
phenadone syr
antihistaminic)
( corticosteroid
Farcolin(salbutamol) tab
20
Alternatives
Coflin contain(cough supressent ,decongestant ,anti
allergic),codilar,tussilar,neo pulmolar,selgon,siloma
Mucophyline,neominophyline,mucosin,mucovent,farcosolvi
n,trisolvin,ambroxol,Koffex,Actifed,solvex
Phenadone,vendexine,apidone syp
Farcolin,ventolin,bronchovent,salbovent tab
gastroenteritis
vomiting, diarrhea, abdominal pain with or without
fever
avil
adolor
dehydrated
antinal cap or diax
8
spasmocin tab or nu-spasm or viscralgine
3
flagyle 500 tab or amrizole
( )
21
uncontrolled DM
HEADACHE ,malaise ,blurring of vision
history of DM or patient on anti DM treatment
pin prick the finger tip ,put a blood drop on the the tape
mark ,put the tape in the device,wait and read the resulting
:number ,if random blood sugar is
-250- 200
-250-300
-350- 300
-350 400
400 25
25 500 20
* 500
* 12
3*
22
* 150
* neuritis
200
200 250
250 300
300 350
350 400
400 25
correction of potassium
potassium chloride two ampule on 500 cc ringer
correction of acidosis
250 12
porphylactic of DVT
500
Blood glucose level
motilium,zantac,tri-B,prempran
hypoglycemic coma
24
intestinal obstruction
abdominal distension and colic ,vomiting ,absolute
constipation
x ray show multiple air fluid level
anaphylactic shock
and hypersensitivity reaction
clinical picture
sudden and important fall of blood pressure
,tachycardia,frequent cautanous manifestation
erythema, urticaria ,quincke' oedema
inconstant respiratory manifestations as dyspnea or
even bronchospasm
12 fortacorten
kenacort vial
Or claritine ) allergex tab avil
(or tavegyl
Topical corticosteroid betaderm
hematemesis
25
first or recurrent attack-amount of blood
history of liver dis, DM, hypertension, analgesicabuse
do general and local examination,comment on neckvein, LL oedema hepatosplenomegaly, ascitis ,vital
sign pulse bp temp, consciousness
treatment
- 500 %5
cyclokapron
)(tranexamic acid antifibrinolytic
haemostop
antihaemorrhagic and capillary protective
ranitidine
amri-k or konakion or haemokion
) 10-9-7-2
)(hyperkalemia
electrolytes
)(hyperkalemia
26
3.5 5
asystole
*
100 10
direct iv .
Acidosis
ph HCO3 deficit
* 100 %25 5 10
VI Intracelluar shift of K ion
*
* beta agonist
tachycardia cardiac
.
-1
2 -3 ACEI
Beta blockers spironolactone
-4
Acidosis-5
-6
.
27
Other prescriptions
Impotance
pregnyl 5000 10 /
proctan cap /
Anderiol cap / 12
vasotal tab 400 12 /
......................................... ..............................................
. . ....
(pregnyl 5000 I.U ( Human chorionic gonadotrophin
profasi 5000 ) )
: 10
2nd testicular failure
undescending testis 1500
:
proctan ST cap
Impotance
FOR SEXUAL POWER IMPROVMENT
:
:
28
Premature ejaculation
Prozac disp or anfranil 25 or 75 mg cap
(Antidepressent (delay ejaculation
(Xylocaine jelly (local anathetic
Or lignocaine spray
2
* :
:
: 40
: -
29
Rx
Ciprobay 500(-Ciprofloxacin-) tab
(Alter.(cipromax-ciprofar-bactiflox 250,500,750
Diprofos- (betamethasone) amp
Alter(decadron,dexamethason,solu cortef,kenacort
(A
Colostop-( piperment+anise oil) caps
Alter(gastrocare-master gest)digestant
Mucogel-( AlOH3+MgOH3- )susp
(Alter(epicogel,magsilon,sedo-mag
3
* " "
"ciprofloxacin
" " Mucogel ""antiacid
.
30
interaction ciprofloxacin
.
* interaction ciprofloxacin
Ca ... Fe
- - - -
multivitamins
-
- - ciprofloxacin
ciprofloxacin
quinolones )macrolids) azithromycin
Rx
Zithromax 250 -azithromycin- caps(azalide
cap250,500,susp200)azrolid 500
Xithrone-zisrocin zithrokan
250 3
500 3
Susp 200 single dose 3
Mineravit- multivitamins- caps
31
* betamethsone amp
:
...
...
) .
:
....
:
quinolones
rifampicin -
"
"
cephalexin
* 12 8
12 .
32
Septazol tab
) (Sulphamethoxazole+ Trimethoprim
....................
formadehyde urine
sulphathiazole
insoluble sulphamethizole
preciptate
)
formaldehyde and ammonia
he acidic pH of the urine
)
pH
urinary excretion of the sulphamethoxazole
crystalluria
.,,,,,,,,,,,,,,,.................................. ................,,,,,,,,,,,,,,,,,,,,,,,
33
: 4
-
Rx
Aspegic (Lysine Acetyl asalicylic acid ) vial
12 2 5
Mucosol (carbocysteine ) 125 mg syrup
3
Michaelon ( pseudoeph. + paracetamol +
chlorpheniramine) syrup
3
Gripe water ( dill seed oil) syrup
3
.................. i it is Aspegic
Anaphylactic shock has been reported in patients given
lysine aspirin by injection.
Lysine aspirin, like aspirin, should not generally be given to
children because of the risk of Reye's syndrome
:
...
Reye's syndrome
34
Salicylic acid
16
..........
Reye's syndrome is a potentially fatal disease that causes
numerous detrimental effects to many organs, especially
the brain and liver. It is associated with aspirin
consumption by children with viral diseases such as
chicken pox.
The disease causes fatty liver with minimal inflammation,
and severe encephalopathy (with swelling of the brain). The
liver may become slightly enlarged and firm, and there is a
change in the appearance of the kidneys. Jaundice is not
usually present
Early diagnosis is vital, otherwise death or severe brain
damage may follow.
Hostacortin - prednisone - 5 mg tab
12
10
Ranitidine 150 mg
3
auto immune disease
.................................................. ...........................................
....... ............................
prednisone 60
60 = 12
35
!
/
" "
adrenal glands atrophy
Ranitidine
............................................
vioderm
vioderm
.................................................. ...........................................
....... .................
mixderm
.
babycare&baby cream&rash o_z lotion
stop&calme skin&hi_panthen
.
36
.................................................. ...........................................
....... ...............
pandermal kenacomb polyderm triderm mixderm
.
.................................................. ...........................................
....... ...........................
vioderm
.
.................................................. ...........................................
....... ..............................
-1 :
, , , , ,
2-
- - -
3-
.. 2-1
3
, , , , , , ,
,
, , , ,
37
4-
6
, , , , , ,
, ,
5-
, , , , ,
( ) - ( , , , ( ,
) )
6-
3
, ,
7-
.. 1-
.. 2-
3-
500 4-
5-
, , , , .. 3
*
6
38
1-
- 26 - - - - - - - 1
- - 1 -
30 *
*
2-
- 2 - - 2 - - -
- 2 2
4 3-
-
...
-
L F ...
- - - -
-
A R 6-
L B W
7-
39
- - - - - -
- -
:
!!
ciprofloxacin 250 tab
12
uti 12
.
- 18
) (gout
.(plantar fascitis).....
non ...... 1 ...
steroidal like voltaren or ketofan(but no mobic or
celebrex)if there is ulcer ..
allopurinol(zyloric or no urea 3
))ph+sedementation+puscell s 3
:colchicine +++ sedementation
or allopurino 3times daily..........
ph ph acidic
40
:
Aquacid syrup
Spasmotal drops
+
My sweet baby
41
42
: Mead jhonson
: Temporal
) ( 250mg/5ml
Unasyn
: ampicillin + sulbactam
penicillinase inhibitor
vials
:
) pharco ( salbin ( ( : unictam
Rhinostop
: pseudoephdrine ( decongestant) +
) carbinoxamine ( anti-histaminic
: relief nasal congestion
... :
: ) ( 3 1-3
: 3 3-6
: 3 6-9
: ) ( 3 9- 24
43
Motilium
...
2007
) : domperidone ( D2 receptor antagonist
upper gasto-eoseophageal reflux
abdominal pain
: 30-15
...
:
) ( Motinorm
) ( domperidone
........
Diakan m syp
8
Entofar syp +5 cap diax
8 4
ceforan 500 mg vial
12 1/2
.....................>>>>>>>>>>>>>>>.............. .................
^_^....................
Diakan
44
: kaolin + kanamycin
.................................................. .........
Entofar
: metronidazole
antiprotozoal and for anaerobic bacteria
.................................................. .........
ceforan
: cefotaxime
45
cephalosporin
Claforan
:
Neuroton tab.
Arcalion 200 tab.
2
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
>>>>>>>>>> >>>>>>>>>>>>>>
46
B1 : salbutiamine
) ( asthenia in all its forms :
. -
2
: Servier
) ( : Activate 200
>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>
>>>>>>>>>>> >>>>>>>>>>>>>>
tonsilitis
:
ceftriaxone 1gm
12 3
BBC spray
3 2
sedamol supp
8
larypront tab
5-4
) )
penadur long acting penicillin 1200000
15
aspirin tab 320 mg
2x3
47
2x2
epicogel susp
3
kiddi syp
5
.................................................. ...........................................
) ) ceftriaxone
) ) bbc spray
sedamol
larypront
___
reacurrence
rheumatic fever
15 peniciilin
epicogel
ASOT
ESR
INFLAMATION
diagnostic tests
positive
ESR=200
........
48
.....
.....
tonsilictomy pre
10 1- never give antibiotic
bacterial flora
vitamin k
2-never give NSAID
NON STROIDAL ANTI INFLAMATORY
CLASS
10
Abimol extra
paramol
_______________________ ______________________________
?????????????????? tosilitis
red flages
fever >38
recurreent>5times per year
unilateral tonsilitis
1.
2.
3.
.................................................. ...........................................
....... ..............................
:
56 :
Osteomyelitis
49
Rx
Indications
50
Osteomyelitis
Flucloxacillin or clindamycin if penicillin-allergic (or
vancomycin if resistant Staphylococcus epidermidis or
meticillin-resistant Staph. aureus)
Treat acute infection for 46 weeks and chronic infection
for at least 12 weeks; combine vancomycin with either
fusidic acid or rifampicin if prostheses present or if lifethreatening condition
fluxacillin
) broad )
Q5-Can we give the remaining half of the 500 mg injection
for the next dose
(i.e. is it stable for the next dose )?
no
stability of injections after
reconstitution
Q6-If ampicillin is given orally, what advisory labels should
be given to the patient?
44 :
Otitis media
Rx
Amoxicillin 500mg cap.
1 cap t.i.d for seven days
Note: the patient was start to take Allopurinol for
hyperuricaemia in the last week.
Q7-What are the difference between amoxicillin and
ampicillin (spectrum, dosing frequency and absorption)?
Amoxicillin has a similar antibacterial spectrum
Amoxicillin has longer duration of action, so it is usually
given 3 times daily, while ampicillin is given 4 times daily
53
54
Sinusitis
Rx
Co-Amoxiclave 625mg(500/125) tab
1 tab t.i.d for 1 week
Q9-What is the idea behind amoxicillin/calvulanic acid
combination?
Co-amoxiclav consists of amoxicillin with the betalactamase inhibitor clavulanic acid. Clavulanic acid itself
has no significant antibacterial activity but, by inactivating
beta-lactamases, it makes the combination active against
beta-lactamase-producing bacteria that are resistant to
amoxicillin. These include resistant strains of Staph.
aureus, E. coli, and H. influenzae, as well as many
Bacteroides and Klebsiella spp. Co-amoxiclav should be
reserved for infections likely, or known, to be caused by
amoxicillin-resistant beta-lactamase-producing strains
Q10-Can you dispensed 2 tablets of augmentin 375 mg
(250/125) instead of the 625 tab which is unavailable in
your pharmacy?
no
250 375
Why?
55
Q11- the patient had been improved, but 2 days after the
completion of Augmentin course, the patient return to your
pharmacy complaining of dark urine, yellow eyes, and
pruritis ( symptoms of cholestatic jaundice)
What is the most likely cause?
Cholestatic jaundice can occur either during or shortly after
the use of co-amoxiclav. An epidemiological study has
shown that the risk of acute liver toxicity was about 6 times
greater with co-amoxiclav than with amoxicillin. Cholestatic
jaundice is more common in patients above the age of 65
years and in men; these reactions have only rarely been
reported in children. The duration of treatment should be
appropriate to the indication and should not usually exceed
14 days
Is it fatal?
Jaundice is usually self-limiting and very rarely fatal
56
synergistic effect.
culture
:
imipenem broadest spectrum antibiotic
58
beta-lactamase inhibitors
clavulanic acid, salbactam, tazobactam
beta-lactamase inhibitors
Staphylococcus aureus
Clavulanic acid
Augmentin
jaundice
Suspension - Amoxicillin/clavulanic acid
Augmentin 156 - 125/31.25mg
Augmentin 312 - 250/62.5mg
Tablet - Amoxicillin/clavulanic acid
Augmentin 375 - 250/125mg
Augmentin 625 - 500/125mg
Augmentin 1000 - 875/125mg
59
250
) ) 125
625 375
500 250
375 250
compination
:
:
) + )
+
+
G+ve broad spectrum
Staph. aureus G-ve
penicillinase resistant narrow spectrum
antistaphylococcal
4
3
4
4-3
Pulmoclox
60
6
22 :
Lower UTI
Rx
Cefalexin 500mg cap.
1 cap q.i.d
Q17-To which generation of cephalosporin, cefalexin
belong?
First generation
Q18-If the patient is fasting ( in Ramadan), could you
recommend cefadroxil as an alternative?
yes
Why?
Because it is belong to the same generation and it can be
used twice daily only
62
8
1 :
10:
chest infection
Rx
Cefotaxime(claforan) 500mg inj.
1 inj. B.i.d for 5 days
Q25-To which generation of cephalosporin, cefotaxime
belong?
third generation
What is the antibacterial spectrum of it ?
greater activity than the second generation'
cephalosporins against certain Gram-negative bacteria.
However, they are less active than cefuroxime ( a second
generation ) against Gram-positive bacteria, most notably
Staphylococcus aureus
64
66
67
68
No
what is the alternative?
Amoxicyclin or Erythromycin
see table 1
12
33 :
Acne
Doxycycline 100mg cap.
1 cap. Daily
Q35- What counseling should be given to the patient about
oral intake of Doxycycline?
Counselling Capsules should be swallowed whole with
plenty of fluid during meals while sitting or standing
Why ?
Side effect: dysphagia, and oesophageal irritation
and what are the advisory labels of it?
Do not take indigestion remedies or medicines containing
iron or zinc at the same time of day as this medicine
Take at regular intervals. Complete the prescribed course
unless otherwise directed
. . . with or after food
69
13
55:
UTI
Rx
Gentamicin 80mg inj.
1 injection t.i.d
Q38-What is the antibacterial spectrum of
Aminoglycosides?
These include amikacin, gentamicin, neomycin, netilmicin,
streptomycin, and tobramycin. All are bactericidal and
active against some Gram-positive and many Gramnegative organisms. Amikacin, gentamicin, and tobramycin
are also active against Pseudomonas aeruginosa;
streptomycin is active against Mycobacterium tuberculosis
and is now almost entirely reserved for tuberculosis
Q39-What are the most important side effects of
Aminoglycosides?
Most side-effects of this group of antibiotics are doserelated therefore care must be taken with dosage and
whenever possible treatment should not exceed 7 days.
The important side-effects are ototoxicity, and
nephrotoxicity
And when they occur commonly?
they occur most commonly in the elderly and in patients
with renal failure
71
72
14
Rx
Tobramycin Nebuliser solution 300 mg every 123 hours for
28 days
Q43-what is the indication for the Nebulised tobramycin?
It is for the treatment of chronic pulmonary Ps. aeruginosa
infection in cystic fibrosis
15
Mycoplasma pneumonia
Rx
Erythromycin 500mg cap
1 cap q.i.d
74
76
77
79
Rx
sodium fusidate - Fucidin
250mg tab.
two tab. T.I.d
Q55-What is the main indication of fusidic acid?
The only indication for their use is in infections caused by
penicillin-resistant staphylococci, especially osteomyelitis,
as they are well concentrated in bone; they are also used
for staphylococcal endocarditis
Q56-what is the *****alent dose of fusidic acid suspension?
sodium fusidate 500 mg = fusidic acid 480 mg
why?
sodium ******* in salt
and what advisory labels should be given with suspension?
Take at regular intervals. Complete the prescribed course
unless otherwise directed
with or after food
20
34:
Endocarditis caused by methicillin resistant staph. MRSA
80
Rx
Vancomycin 1gm injection
1gm every 12 hours for 28 days
Rifampicin 300 mg cap
1cap t.i.d for 28 days.
82
UTI
Rx
Co-trimoxazole (Metheprim) 240mg/5ml susp 2.5mltwice
daily. For seven days
Q61-what is cotrimoxazole?
It is a combination sulfamethoxazole (sulphamethoxazole)
and trimethoprim
What is the problem in this Rx.(hint. check the age )?
6
which of the following could be used in this age
(Nitrofurantoin, Nalidixic acid, or ampicillin)
ampicillin
83
22
33:
Bacterial vaginosis
Rx
Metronidazole (flagyl) 500mg tab
One tab B.i.d for 5 days
Q22- What is the antimicrobial spectrum of Metronidazole
Metronidazole is an antimicrobial drug with high activity
against anaerobic bacteria and protozoa
Q23-What are the most common side effects of
Metronidazole?
84
No
The last three notes are not recommended
Flagyl suspension is to be taken on empty stomach
*******/
23
30 :
Bacterial vaginosis
Rx
85
Rx
Norfloxacin 400mg tab
One tab B.i.d for 28 days
Q29- to which group Norfloxacin belongs ?
Fluoroquinolones
what are the main indications for it?
uncomplicated urinary-tract infections
What counseling and advisory labels should be given to
patient taking it?
Do not take milk, indigestion remedies, or medicines
containing iron or zinc at the same time of day as this
medicine
87
90
27
91
26:
Fungal nail infection
Rx
Griseofulvin 500mg tab
One tab daily
Q39-What is the main indication for Griseofulvin ?
dermatophyte infections of the skin, scalp, hair and nails
where topical therapy has failed or is inappropriate
What counseling and advisory labels should be given for
patient taking it?
May impair performance of skilled tasks (e.g. driving);
effects of alcohol enhanced
Take at regular intervals. Complete the prescribed course
unless otherwise directed
Take it with or after food
ENT
throat 1
Tonsilitis
:
antibiotic
rhumatic fever
penicillin injection
][ reatarpen & durapen & pencitard
12 ospen 1500
severity
: 5 ,,,,,,,,
Tonsiloctomy
______________________________
93
Larypharyngitis
pus
::: .........
........
.
ttt
sulfa drugs
12 ] [septrin D.S
12 sutrin &septazole
carcinoma
94
heavy smooker :
diabetic
n.b
due to insuffient blood supply
:lymph node inflamation
case2::
drolling
fungal infection in tonsilitis
______________________________Nose
-rhinitis1-
vasodilatation
otrivin
afrin
..............
Act as vasoconstrictor
3
dependence
95
Psudoephedrin is C.I in hypertensive:6:
antihistamine e.g claritine vitacid Ca
,muslim prayer position
______________________________
_____________ ______________________________
nose bleedingepistaxis
epinephrin
.
::::::::
Kenakomb cream
mild vaso constrictor
96
__________________ ______________________________
allergic rhinitis
sinusitis
-allergic1 1:::::
. ......
:::mechanism
histamine :
vasodilation in blood vessels
97
:::
) )
ttt
Antihistamin
telfast& cetrac &histafree&claritine&finistil& analarge
& cetrak
98
12 Claritine
2065 Histadine
) (
Flixonase spray 27 ;L.E
Rhinocort spray 38 L.E
::infectious
infection
sputum
amoxicillin calvulinic a
99
Nasal decongestant(otrivin)
______________________________ __
ear
otitis media
ampiciliin+clavulinica
augmentin
otal drops
+
analgesic
antiinflamatory
glycrine ictyol
______________________________ ____
otitis externa
node
excharge<>
ttt
antibiotic
100
quinilones
quinilone drevative 18
_____________ ______________________________
case
swimmer ear
bacterial growth
____________ ______________________________
case
rhinowax drop
glycerin bicarb
,,,,,,,,
wax
,,
________________ ______________________________
n.b
ointment contain antibiotic
oral antibiotic
____________________
101
kenacort-A vial
: triamcinolone acetonide
: claritine tab
) : loratadine (anti histaminic
: dermovate cream
: clobetasone butyrate
4 ]: Kenacort- A vial ( [BLINK
) ]40[/BLINK
: Triamicinolone
: highly effective and versatile corticosteroid
) : )
: SQUIBB
9 : )
)
: Claritine tab
: Loratadine
: Low-sedating Antihistaminic Drugs
low ] ( [BLINK :
)]sedating [/BLINK
: American Schering/Mup
11.90 :
) ( : Dermovate cream
: Clobetasol Propionate
102
104
12
33 :
Acne
Doxycycline 100mg cap.
1 cap. Daily
Q35- What counseling should be given to the patient about
oral intake of Doxycycline?
Counselling Capsules should be swallowed whole with
plenty of fluid during meals while sitting or standing
Why ?
Side effect: dysphagia, and oesophageal irritation
and what are the advisory labels of it?
Do not take indigestion remedies or medicines containing
iron or zinc at the same time of day as this medicine
Take at regular intervals. Complete the prescribed course
unless otherwise directed
. . . with or after food
. . .with plenty of water
Compare it to that of tetracycline?
105
Q36-the patient ask you to give her some antacid tablet for
her GERD symptoms that comes from time to time, What
counseling you will give her ?
Why?
Antacids should preferably not be taken at the same time
as other drugs since they may impair absorption
106