Cocktail For Note 4

Cocktails for Medical Officers
By Dr. Muhammad Bilal Sharif
1.Gastrohepatology
Hepatits C:
Tab. Velpaget 100/400mg 1 x OD 6 Months(Sofosubiver+Velpatasvir)
Alt Tab. Hipval 100/400mg 1 x OD
Tab. Ribazole 400mg 1 x BD x 6 Months
DCLD/ Upper GI Bleeding:

Inj. Hemaccel 500cc IV stat (If needed)
Inj. Novapressin 2ml IV x stat then 1ml IV 6h
Or inj. Sandostatin 1amp stat then 4amp in 96cc NS @ 10dpm IV x cont
Inj. Vita k IM x OD
Inj. Transamin 500cc IV TDS
Inj. Titan 1g IV x BD (encephalopathy)
Inj. Risek Inf IV x BD (For stress ulcers and portal gastropathy)
Inj. Maxolon IV x TDS
Transfuse 2 x POB (If needed)
Tab. Carvidelol 6.25mg (once patient hemodynamically stable for prevention of recurrence)
Syp. Duphalac
DCLD/ Hepatic Encephalopathy:

Protein Restriction
Tab. Risek 40mg I x OD (For stress ulcers and portal gastropathy)
Syp. Duphalac (Non DM)
Or/Lacasil(Diabetic)
Tab.Rifaxa 550 mg 1xBD
Inj. Aminoleban Infusion
Tab.Midazolam(Dormicum) 2.5mg x STAT If patient is aggressive and may injure.
Or. Inj.Serenase (Haloperidol) IM x stat
Bowel Enema 3x4 times
Remember: Laisx causes hypokalemia ,Paralytic Ileus, constipation, worsen Encaphlopathy.
DCLD/ Ascites:
Salt Restriction, Bed rest,H2O rest.
Inj. Titan 1g IV x BD (prophylaxis)
Inj. Spironolactone 100mg 1x OD OR Inj. Lasix 40mg stat(SBP >100)
Syp. Duphalac
Tab.Vadil (Carvidelol) 6.25mg (portal hypertension but R/O wheeze or rhochi)
Inj. Salt free albumin 20% 100ml IV OD x 3 days
DCLD/ Hepatic Encephalopathy,Massive Ascites (OPD basis):

Tab. Aldactone 100mg 1x OD (morning) 2weeks
(Note:Or Tab. Lasoride 40mg 1 x BD contains amiloride and furesimde and more powerful than aldactone alone.
Aminoleban Powder 3+3+3 with water)
Tab Rifaxa 550mg 1 BD
Syp. Duphalac 3TSF x TDS
Tab. Siliver (Silymarin) 200mg 1 x BD Or Syp. Liv. 52((In Childerens Syp.Levijon and Syp. Hepa merz
Tab. Carvida 6.25mg 1 x BD
Tab. Novidat 500mg 1.5 x weekly
Tab. Lasix 40mg 1 x OD
Tab. Ipride 50mg 1 x TDS
Spontaneous Bacterial peritonitis:

Inj.Cefotaxime 1g IV x BD x 14-14 days
Or
Inj. Titan 2g IV x BD
Inj. Flagyl 100cc IV x TDS
Anal Fissure:
Sitz Bath
Tab. Novidat 500mg 1 x BD
Tab. Nuberol forte 1 x BD or Tab. Synflex 500mg 1 x BD
Xylocaine gel 2% + GTN oint Use 30 min before going to toilet x BD
Syp. Laxoberon or Skilax x BD
Hemorrhoids:
Sitz Bath. Xylocaine Oint Or Posterisan Forte Oint. (Hydrocortisone + Phenol) Use 30 min before going to toilet x BD
Tab. Daflon 50/450 (Diosmin + Hesperidin) x BD
Syp. Laxoberon or Skilax x BD
Oral Ulcers:
Aphthous Ulcers: (Women, premenstrual, healed in 1-2 weeks)
Bonjella Gel TDS
Listerine Mouth Wash x TDS
Hycortisone Oint x QD (Hyrdocort 2.5% Oint.)
Oral Candiasis (Painful Swallowing + Oral Thrush + White Patch on Buccal mucosa)
Nilstat oral drops QD or Dakatrin oral Gel QD
And
Tab. Spike 200mg 1 x OD (ketoconazole) x 5 days
Somogel x TDS For General Oral Ulcers:
3. Vincet Angina (painful ulcers affecting gums. Poor hygiene and malnutrition)
Listerine Mouth Wash x TDS
Antibiotics.
GERD: (Heart burn on bending, lifting, Straing or lying down at n ight and relieved by sitting and walking, Regurgitation of food while lying flat,
Iron def. Anemia )
1. Syp. Ulsanic 2 tsf x tds OR Syp.Gaviscon 2 tsf x tds 4-6weeks
2. Tab. Maxolon 10mg 1 x TDS
3. Tab. Zantac/Peptinil 150mg x HS x 3 weeks
4. Tab. Omeprazole 20mg 1 x BBF x 12 weeks
H. Pylori EradicationTriple Therapy:
Diffuse Esophaheal Spasm: (Abnormal esophageal motility produce severe retrosternal pain and dysphagia. Retrosternal pain Rad. To back
neck, arm mimicing angina pectoris, ass. e emotions and eating.). COCKSCREW appearance of esophagus.
Eating in relaxed atmosphere with adequate mastication.
Nitroglycerine/Nifidepine relieves pain. (eg. Sustac 1 x BD)
Acid Peptic Disease:

Weight red. Stop smoking, Avoid tea, fatty food, Coffe choclate. Avoid heavy lifting and bending after meals, avoid late
night meals. Elevate head side.
Tab.Omega 40mg 1xBD + Tab.Amoxycillin 1G 1xBD + Tab. Klaricid 500mg 1 x BD x 14 days
Others Measures:
2. Tab. Ganaton 50mg 1 x TDS
4. Tab. Omeprazole 20mg 1 x BBF
Gastritis & Gastropathy: (Etilogy:NAID, Stress, Portal HTN Gastropathy, C/P: Epigastric Pain, heart burn, anemia, hematemesis,melena)
D/d: PUD, GERD, Biliary track Ds, Pancreatic Ds, Functional Dyspepsia, Infection, AGE
IX. Fecal antigen test, Anti- H. pylori antibodies (IgG), Urea breath tests.
Avoid NSAID if use COX-2 inhibtors or misoprostol+Diclo should be used.
2. Tab. Maxolon 10mg 1 x TDS
4. Tab. Omeprazole 20mg 1 x BBF x 12 weeks
Zollinger-Ellison Syndrome: ZES (Ulcers symptoms are fulminant, progressive, persistent respond poorly to Medical tx.
Ulcers located in duodenal bulbs, post bulbar duodenum, jejunum, esophagous
Diarrhea D/t acid hypersecretions, interferring fat digestion and steatorrhea. bleeding, perforation common)
ZES SUSPECTED WHEN NO H/O OF NSAID AND H.PYLORI CAME NEGITIVE.
IX: Fasting Serum Gastrin levels >150ng/L.Serum Ca, Secretin stimulation test >200pg/ml. Endoscopy. Imaging studies.
Tab. Losec 40-120mg/d
Gastrinoma should be resected.
Constipation:
Isphaghul Husk 20-30g x HS x 3 weeks
Syp. Cremaffin 2 TSF x TDS Or Skilax Drops 15 Drops x HS
Or
Tab. Abolitium 100mg 1 x TDS
In DCLD or Hepatic Encaphlopathy cases:
Syp. Duphalac (Non DM)
Or/Lacasil(Diabetic)
Celiac Disease: (Age 6Mon-2Y.O C/P: Irritable,Abd distension, Anemia, Growth retardation, Stool Voluminous.)
In adults C/P: Diaarhea, weight loss, anemia, peripheral neuropathy, vitamin def. hypoprotenemia, edema, bone pain.
Ix. Antigliadin antibodies. IgG sensitive, IgA specific. IgA endomysial a/b. Tiss ue Transglutaminase a/b.jujunal biopsy.
Gluten free diet.Rice potato and maize shoulde be used instead wheat, joe, rye.
Vitamin suppliments.
Clinical response in 6 weeks. In Refactory Spure Give Corticosteroids.
Diverticular Disease: (Old age, Pain in Left Iliac fossa, ass e constipation/Diarrhea )
Remember Acute Diverticulitis = Sever left iliac fossa pain + Fever and constipation + Tenderness on left side of abdomen.
NPO, Bed rest, IV Fluids.
Tab. Metronidazole.
Bulk Laxative in Asymptomatic Patients.
Irratible Bowel Syndrome:

Reassurance, Avoid Fresh fruits and salad in diarrhea. High fiber diet fiberad, ispaghule husk.
Tab. Colofac 135mg TDS Or Tab. No-spa (drotaverin) 80mg 1 x TDS Or Tab. Anafortan + (phloroglucinol) 80mg TDS
Or Tab. Spasmogen 60/30 (P/M + Papaverine + Hyoscine) 1 x BD
Tab. Domperidone (ICO constipation or distension)
Tab. Levopraid 25mg BD (Levosulpride)
Codeine Phosphate 30mg TDS.
Dyspepsia: (Upper abd pain may/may not ass. e food, heart burn, bloating, sense of abdominal distension, flatulence aerophagy, blenching)
R/O Anxiet & Psychogenic Illness. .In young women Pregnancy Should be ruled out, In old R/O I/Abd melagnancy.
Rassurance. Stop Smoking
Syp. Dijex-MP 1 x TDS
Tab. Maxolon 1 x TDS
Tab. Zantc 150mg 1 x HS
Psychogenic Vomiting: (Vomiting in morning or after breakfast. Vomiting for long time but no weight loss .)
R/O Pregnancy.Reassurance.
Tab. Xanax 0.5mg BD
Tab. Maxolon 1 xTDS
Globus Hytericus: (Sensation of lump in thorat not related to swallowing, relieved by swallowing.)
Ix: Barium swallow, endoscopy.
Reassurance, Antideprasants.
Hiccups:
General Measures
Holding breath, having glass of water, Avoid large meal, or eating/ drinking too quickly.
Tab. Maxolon 1 x TDS
Syp. Similone 1 x TDS
Tab. Lisorel 5mg (Baclofen) 1 x TDS
Tab. Chlorotil 2mg 1 x BD (Chlorpromazine )
Tab Serenace 1.5mg (Haloperidol) 1 × HS
Tab. Dormicum 7.5mg (Midazolam) 1 × OD if everything fails.
Chronic Pancreatitis:
Tab. Plasil with enzymes BD or (Chymotrip Forte)
Cholecystits:
Tab. Novidat 500mg BD
Tab. Plasil with enzymes BD
Tab. Synflex 550mg BD
Tab. Levopraid 25mg BD
Ulcerative Coloitis:
Tab. Pentasa 500mg 1 x TDS
Tab. Deltacortil 5mg 3 x TDS ( Tappered 5 mg/wk for 9 weeks
Pancreatitis:
Tab. Plasil with Enzymes 1 x TDS
2.Respiratory
COPD:
Stop Smoking.
Counseling.about LTOT, vaccination, Chest physiotherapy, intermittent use of antibiotics.
Cap. Combivier 6/400mcg 1 x BD with Rotacap
Cap. Tiover 18mcg 1 x OD with Rotacap
Tab. Deltacortil EC 5mg 3 x 3 7days
Tab Theophylline 300mg ½ BD (Bamifix 600mg ½ x BD) or Tab. Ofylin 400mg)
Tab. Moksi 400mg 1 x OD
Inhaler.Ventolin/Foster/Salmicort
Tab.Spiromide 20mg 1x Morning (SBP>100 and corpulmonale) or Tab. Lasix 40mg
Asthma:
Management in Stepwise fashion. In IHD, HTN use Tab. Herbesser 30mg 1 x BD.
Inhaler.Foracort 6/200mcg with spacer Or Inh. Foster ,Seretide,
Tab. Deltacortil EC 5mg 3 x 3 7days
Tab. Montileukast 10mg 1 x HS (Motiget)
Tab. Theophylline 400mg ½ BD (Bamifix 600mg ½ BD)
Tab. Tulobuterol (Bremax) 1mg 1 x BD
Treatment in Acute severe Asthma:(Hosp.)

Oxygen 4l/min via nasal cannula
Neb. Ventolin 1cc + Atem 2cc + N/S x 4hourly
Neb. Clenil 2cc + 2cc N/S x 4 hourly
Inj.Hydrocortisone 250mg IV stat then 100mg IV 6 hourly
Inj.Aminophylline 250 mg in 98cc N/S @ 10 mdpm IV x BD
Inj.Augmentin 1g IV x BD
Inj. Mgso4 1.2g infusion in 20 ml D/W over 20 min.(if not responding to above)
Cough:
Syp. Pacific DM 2TSF x TDS
Syp. Rondec 2TSF x TDS
Syp. Hydryllin-DM/Benylin-DM/Actifed-DM/Cofcol/Cosome/Corex-D/Tussivil
Mucolator Sachet x BD (Alt. Cap. Rhinathiol 375mg x OD)
Acute Beonchitis:
No benefits from Antibiotics
Tab. Unify line 400mg 1/2 BD or Tab. Bamifix 600mg 1/2 BD
Tab. Codogesic 1 x BD (Codeine 20mg x 6H)
Syp. Tussivil 1 x TDS
Interstitial Lung Disease :

Tab.Deltacortil EC 5mg 3 x 3 for 7 days.
O2 therapy and Tab.Spiromide 20 mg 1x OD (if Cor pulmonale:))
Bronchoectasis : (Hemoptysis +Copious Purulent sputum + clubbing)

Bed Rest, Chest Physiotherapy
Cap. Transamin 500mg 1 x TDS
Tab. Moksi 400mg 1 x OD x 5 days Or Augmentin 1g Or Cipro 500 mg 1 x BD
Inhaler. Ventolin 2 Puff x QD
Tab. Brolite 3 mg 1 x HS (or Lexilium)
Lung Abscess:
Postural Drainage
Tab. Augmentin 1g xBD
Tab. Flagyl 400mg 1 x TDS for 4-6 weeks
Symptomatic MX.
Laryngeal Diphtheria:
Isolation, Gentle Examination
Inj. Ampiclox 250mg IM BD x 3Days (ATD)
Tab. Augmentin 1g xBD x 14Days or (Erythromycin, Azithromycin)
Diphtheria Antitoxin (ATD) 20000-40000IU for laryngeal, 80000-120000 for diffuse neck swelling.
3.Infections
Sore Thorat (Pharyngitis, URTI):
Avoid Cold drinks,Sour and Spicy foods.
Tab. Augmentin 625mg 1 x BD Or Tab. Levofloxacin 500mg 1 x BD
Tab. Danzen DS (Serratiopeptidase) 1 x TDS
Tab. Deltacortil EC 5mg 1 x BD x 1 Day
Tab. P/M 2 SoS
Infectious Mononucleous: (Fever, Sore thorat, myalgia, petechial rash on palate,MP rash, Lymphadenopathy,posteriocerviacal chain,
splenomegaly)
Rest, Symptomatic Tx, steroids, Mx of complication eg rupture of spleen.
Scarlet fever:
Influenza:
Tab.Amantadine 100mg 1 x BD x 7 dys
Tab. P/M 500mg x 2 SoS
Tab. Augmentin 625mg 1 x BD (for Secondary Infectoins)
Pneumonia (LRTI):
Adequate Hydration, O2
Tab. Nims 100mg 1 x TDS
Tab. Moksi 400mg 1 x OD x 5 days (Staxin/Izilon/Mofest/Occunet/Xefacta) Best.
(Others Antibiotics are Augmentin, Levofloxacin, Azomax)
Measles: (Koplik Sign,3Cs)

Bed rest, Isolation, Frequent fluid intake.
Vitamin A: (<6Mon. 50000IU/Day PO for 2 Doses, 6-12 Mon. 100000IU/Day PO for 2 doses, >1 year 200000IU/Day PO for 2 doses
Post Exposure Vaccination in Nonimmunized People within 72 h, and Immune serum globulins in pregnant women within 6 days of exposure.
IV Rehydration. Anti-Pyretics, Antibiotics for Secondary Infections(LRTI, SOM)
Chicken Pox:
Calamine Lotion
Menthol
Bacitracin Lotion.
Syp. Acylex 20mg/Kg/Dose 4 times x 5 day
Sinusitis:
Tab. Augmentin 625mg 1 x BD
Tab. P/M 2 SoS
Enteric Fever (OPD): Typhoid (Diarrhea, Vomiting, Abdominal Pain, hepatospleon. Rose spots, Widal, Blood Culture +)
General Measures:
Boiled Water. Maintain Hygiene
Tab. Cipro 750mg 1 x BD 10-14 days Or Tab. Oflobid 400mg BD Or Cap. Cefixime (Carisef) 400mg OD
Tab. Entamizole DS 4oomg 1 x TDS
Supportive Rx:
Cap. Risek 20mg 1 x OD x 7 days
For Childrens:
Syp. Calpol 6 Plus 2 TSF x TDS
Syp. Novidat 250mg/5ml (10mg/kg/Dose/BD) Or Syp Caricef 200mg/5ml (20mg/kg/Day/OD
Syp. Entamizole DS 250mg/5ml (30-50mg/kg/Day) ½ TSF if < 1 year and 1 TSF if > 1 year.
Or
Syp. Flagyl 250mg/5ml (30-50mg/kg/Day) ½ TSF if < 1 year and 1 TSF if > 1 year.
Amoebic Dysentary (Entamoeba hystolytica)(Diarrhea, Mucus in stools, Tenesmus, Ova parasite + in stools)
Tab. Flagyl 500-750mg 1 x TDS x 7 days
Or
Tab. Tindazole 2g 1 x OD x 3 days
For Cysts Tab. Paromyomycin 25-35mg/kg/day x TDS x 7 days
Bacillary Dysentary/ Shigellosis:

Tab.Cipro 500mg 1 x BD x 3 days
Or
Tab. Levo 500-750mg 1 OD x 3 days
Or
Tab.Azomax 500mg 1 x BD x 3 day
Child: Inj. Ceftriaxone 50-75mg/KG/Day x 2-5 days
Cholera:
Adult: 1.Cap. Doxycycline 300mg x 1day
2. Tab. Erythrocin 250mg 1 x TDS x 3 day
3. Tab.Azomax 500mg 1 x BD x 3 day
Child: 1. Tab. Erythrocin 250mg 1 x QD x 3 day (40mg/KG/Day)
Malaria:
Inj. Artem 160mg IM stat then Inj. Artem 80mg IM 1xBD 3days (1amp =80mg)
Or
Tab. Arceva (Armtemether+Lumefantrine) 20/120,40/240,80/480 at 1h,8h,24h,36h,48h 2 Cap OD x 4days
Uncomplicated malaria
Tab. Resochin 250mg 4 Stat then 2 Tab after 6 Hrs then 1 Tab x BD for 2/days, Followed by Primaquine 2 weeks
Complicated Malaria:
Tab. Quinine Sulphate 600mg TDS x 5 days followed by Tab. Fansidar 1.5/75mg 3x stat. Or
Tab. Timequin (dihydroartemisinin+piperaquin) 40/320 3 capsule 3 days.
For Children:
Syp. Nivaquin-P 2TSF x BD x 3days OR Syp. Malarest 25/500mg 2TSF x Stat OR
Syp. Fansidar 25/500 mg 2TSF x Stat
Dengue Fever: (Sudden fever e chills, Sever aching, breakbone, sore thorat, headache, dizziness, Maculo-Papula RASH, first appears on
dorsum of hands feets then spreads to legs, trunk,and neck. Face spraed. Bleeding tendency. O/E Myalgia, Periorbital edema, hypotension,
Tachycardia.)
Ix: Leukopenia, Thrombocytopenia. Non-Structural Antibodies -1 (Viral Detection of blood)
D/d: Malaria, Typhoid, Leptospirosis, shigellosis,
IV Fluids
Inj. Maxolon IV stat
Tab. Panadol 2 x Stat
Monitor Platlets count. Platelet Replacements may be required.
Pulmonary Tuberculosis:
Clinical Severity:
Mild/Minimal: 1 ZoneU/L
Moderate: < 3 Zone U/L
Advanced: >3 Zones B/L
Doses:
>28 Kg: 1 Tab
28-35 Kg: 2 Tab
35-54 Kg: 3 Tab
>54 Kg: 4 Tab
Categories:
Cat.1: New Case, New Sputum +ive.
Cat.2:Relapse, Treatment Failure, Dafault Treatment. (2 months ATT free)
Cat.3:Sputum -ive with limited parenchymal involvement
Cat.4:Extrapulmonary TB, Chronic Cases
Drugs:
Isoniazid (5mg/KG, Max 300mg) 50mg/5ml.
Rifampicin (10mg/KG, Max 600mg) 100mg/5ml.
Ethambutol (15-25mg/KG, Max 2.5g) 220mg/5ml.
Pyrazinamide (15-30mg/Kg, Max 2g) 250mg/5ml.
Streptomycin (15mg/Kg, Max 1g)
Category 1:
Initial Intensive Phase (2Months) 4 Drugs: Isoniazid plus Rifampicin plus Ethambutol plus Pyrazinamide.
Check Sputum after 2 Month:
If Sputum is Negitive Continue 4 drugs for additional 1 month and 2 drugs for 5 months.
If Sputum is Positive then Continue Isoniazid plus Rifampicin for 6 Months
Continuous Phase (6Months) 2 Drugs: Isoniazid plus Rifampicin,
Category 2:
Initial Intensive Phase (2Months) 4 Drugs: Isoniazid plus Rifampicin plus Ethambutol plus Pyrazinamide plus
Streptomycin.
One More Month: Isoniazid plus Rifampicin plus Ethambutol plus Pyrazinamide.
If Smear is Positive: Give 5 drugs for one month more
If Smear is Negitive: Continue Isoniazid plus Rifampicin plus Ethambutol for 5 Months.
Contine Isoniazid plus Rifampicin plus Ethambutol for 4 Months whether the Smear is positive or Negitive. Send C/S
Sputum.
Labelled it a chronic case and Refer to Chest Specialist.
Pulmonary TB in Childrens:
Most cases of Pulm. TB in Children are sputum Negitive and Falls in category 3.
Category 3:
Isoniazid plus Rifampicin plus Pyrazinamide for first 2 Months.
Isoniazid plus Rifampicin continue for next four months.
Without Pyrazinamide, Isoniazid plus Rifampicin MUST be given for nine months.
ICO Positive sputum Smear, add Ethembutol or Streptomycin for first two month.
Drug OD, BBF
Steroids Indication In Pulmonary TB:

Acute Pericardial Effusion.(TB)
Massive Pleural Effusion
Miliary Tb with RF
TB meningitis.
Life threating airways Compression
Doses in Children:
< 2 years = 2mg/Kg
2-12 years = 1.5mg/kg
>12 years = 1mg/Kg
UTIs (Women)
General:
Send Urine C/E then start antibiotics.
Encourage Water intake.
Citro Soda powder x TDS
Cranberry Powder x TDS OR Syp. Citralka 2TSF x TDS
Pharmaceuticals:
Tab. Urixin (Pipemidic acid) 400mg 1 x BD Or Tab. Enoxabid (Enoxacin) 400mg 1 x BD
Or Tab.Cipro 500mg 1 xBD 14-21 days
(In pregnant Inj. Cefuroxime750 mg then Tab. Zinnat 125mg x BD for 10-14 days) Qunilones Contraindicated
Tab. P/M 500mg x 2 SoS
Newly:
Sachet. Monurol (Fosfomycin) 1 x Stat or Tab Focin 500mg 1 x BD
Diaarhea: (Enteric fever,AGE)

Indication of IV Fluids Therapy:
1.Vomiting
2.Severe Dehydration (S BP<100mm/hg)
3.Low UOP
4.Severe Diaarhea
(Loperamide is C/I in Bloody Diarrhea, USE Bismuth Subsalicylate)
Rx:
Inj. R/L 1000ml IV x BD
Inj. Cipro 100cc IV x BD or Tab. Rifaxa 200mg 1 x TDS
Inj. Flagyl 100c IV x TDS
Tab. Entamizole DS 1 x TDS (For Bloody Diarrhea)
Tab. Entox-p (attapulgite) 1 x OD
Inj. Nospa IV x BD
Traveler's Diarrhea :
Tab. Cipro 500mg 1 x Bd Or Tab. Rifaxa 200mg 1 x TDS
Tab Doxycycline 100mg 1 X Stat
Water hygiene
WheatPill poisoning:
NG
O2 2-4L/min via nasal Prongs
Inj. MgSo41g IV stat then 1g IV x 1hourly then 1g 6h for 3-5 days for arrhythmias
OR Inj. CaCo3 10ml in 90 cc N/S @ 20 units IV BD
Inj. N/S 1000ml IV x TDS
Inj. Hemaccel 500cc IV x stat
Inj. Dopamine+Dobutrex Infusion @10DPM (Keep BP above 100/60)
Inj. Hydrocortisone 100mg x 6h (capillary + hypoadrenalism)
Inj. Risek Infusion IV OD
Inj.Maxlone IV TDS
Inj.Titan 1g IV x BD
Inj. Norprin Inf. 100cc N/S @ 10 DPM
Rat Pill Poisoning:

Same as In wheat pill poisoning + Inj. vitamin K IM x OD for 3 days
Meningitis:
Triple Therapy:
Inj. Aclova 500mg IV x TDS (10mg/Kg) for 10 days
Inj. Artem 160mg IM stat then Inj. Artem 80mg IM 1xBD 3days (1amp =80mg)
Inj. Mannitol 150cc iv TDS
Inj. Decatron 2cc IV x 8h
Liver Abscess:
Inj. Flagyl 100ml IV TDS
Inj.Oxidil 1g IV x BD
Tab. Entamizole DS 1 x TDS
Tab. Panodol 2 x SOS
Supportive TX:
Syphilis:
Inj. B. penicillin (Penidure LA) 2.4 MIU IM x Weekly x 3 weeks
Or
Tab. Doxycycline 100mg 1 x BD x 28 days
For neurosyphilis:
Inj. B. penicillin (Penidure LA) 2.4 MIU IM x 4H x 10-14 days
Rabies:
Inj. ARV 1ml IM x 0,3,7,14,28,90
Gynaecology
Infections Of Lower Genital Track:
(Ix: Wet Smear,Smell test, High Vaginal Swab, Gram Staining, Ph test,Culture, Pap Smear )
Bacterial Vaginosis: (No pruritis, Fishy Odor, Inc. Grayish White Disharge, 50%) R/F are Preg. Married, Pre menses. IUCD users
Tab. Fasigyn 2g x OD (Tinidazole) x 2 days is Recommend Or Tab. Secnizaole fore 2g Single Dose OR Flagyl 500mg 1 x
BDS x 7days.
Or
Tab. Dalacin C 300mg 1 x BD x 5 days (even effective during Pregnancy)
Or
Oint. Travocort Vaginal or Oint. Dalacin V 2% Intravaginally HS x 5 days (Alt. Clycin-V oint.)
Trichomonias: (Age in 40, Unprotected Sex, Strawberry Petechia , Yellow Green Dishcharge, Pruritis,25% Dysuria, Dyspareunia)
Tab Flagyl 2g x Single dose (For male Partners)
or Tab. Dalacin C 300mg 1 x TDS
Tab. Fasigyn 500mg 2 x OD x 5 days (Tinidazole)
Vaginal Candidasis: (Prurits, Dysuria, Dyspareunia, Buring Discharge, Thick white, 15%) R/F are DM, OCP,A/B, Steroids,
Preg.Premenstrual Phase. Thyroid and Parathyroid Diseases.
Oint. Hydrozole/Vagizole OD x HS x I/ Vaginally (Gynosporin)
Or Gyno Travogen Pessary, Canesten Vaginal, Clozole Oint, Stiemazol Oint.
Tab. Onlezole 150mg 1 x OD (Single dose) Fluconazole
Chlamydial Infection: (Excessive discharge, P/Coital bleeding, dysuria, Perihepatits, periapendicits)

Tab. Erythrocin 1g x OD 7 Days
Tab. Dalacin C 300mg 1 x TDS Or Tab. Vibramycin 100mg 1 x BD 7 Days
Tab. Azomax 1g Single Dose
Gonorrhea: (Excessive discharge, Arthritis,Pharyngitis,Dysuria)

Tab. Doxy 100mg 1 x BD
Tab. Dalacin C 300mg 1 x TDS
(Others A/B are ciprofloxacin, Spectinomycins, Minocycline, Cefuroxime)
Genital Herpes: (Lesions are at introitus, Labia majora, Perineum, Vagina, Cervix, appears as erythematous Plaque develops into vesicles and
later ulcerates. Extremely Painful and ass. e Dysuria or retention. Often B/L inguinal lymphoadenopathy, Flu like symptoms)
Tab. Aclova 400mg 1 x TDS (Acyclovir)
Analgesics,Antibiotics for Seconndary Infections.
Infections Of Upper Genital Track:

Pelvic Inflammatory Disease:
(Includes Endometritis, Parametritis, Salpingitis, Salpingo-Oophoritis, Pelvic Peritonitis, Pelvic Abscess)
R/F: almost always in Sexually active wom en, Reproductive age, IUCD user, Abortions, postoperative sepsis, Pureperium.
C/P: Fever High grade, Swinging in pattern, Rigors, Nausea Vomiting, Malaise, Lower Abd. Pain both Quad., Vaginal Discharge, Shock.
D/D: EP, Andometriosos, Abortion.
Inj. Cephradin 1g x 6h + MTZ infusion x 6h +Gentamycin IV 8mg x 8h.
Shock Mx.
Hirsutsm:
Tab. Diane-35 1 x OD (for 21 days)
Infertility:
Inj. IVF- C 1000IU 2 x Stat (Mainly used for men)
Inj. Sustanon 250 1 x weekly (Only in Hypogonadism)
Tab. Clomid 1 x BD (starts on 3rd day of menses) x 3 weeks
Cap. Evion 1 x OD
Cap. Gonadil-F 1 x OD
Dysfunctional Uterine bleeding:AUB

Tab. Primolut-N 5mg x HS for 21 days or Tab. Orgametril 1 x BD
Cap. Transamine 500mg 1 x TDS
Tab. Vitamin K 1 x OD
Amenorrhea:
Tab. Primolut N 1 x OD x 21 x Dyas
Tab. Estranor 1 x OD x 21 Days
PCOS:
Post-Menopausal Syndrome:
Tab. Livial 2.5mg 1 x OD x 1year
Tab. Efamol Active (Prim Rosa Oil Capsules) 1Year.
Tab. Rocaltrol 0.5mcg 1 x OD (Calcitriol) Most active form of VD3
(Alt. Tab. Bon-one, Bone-care, )
3.Neurology
Subacute Combined Degeneration of Spinal cord (B12 Deficiency):
Inj. Neurobion 1000µg IM x 7-10 days then 1 x weekly for a month then 1 x monthly for whole life.
Tab. Neurobion 1 x OD OR Tab. Bevidox
Migrane:
During Acute Attacks:
Inj. Phlogen IM Stat or Inj. Stemetil IM Stat
Tab. Migril(ergotamine+cyclizine+caffeine) 2mg/50mg/100mg (Avoid in pregnancy or vascular disease) or Tab. Zomig
2.5mg 1 x Stat
Tab. Panadol Extra 2 x Stat and Tab. Maxolon 1 x TDS
Tab. Sumoxen 1 x BD
For Proph ylaxis Purposes:
Cap. Sibelium 5mg 1 x OD (Flunarizine)(1 st DOC for Migraine prophylaxis)
Tab. DivEpival 500mg x BD
Syp.Mosegor 0.25mg/5ml (Pizotifen) x HS
Tab. Inderal 10mg BD
Tab. Tryptanol 25mg x HS
Tab. Calan 80mg x OD
Bell's Palsy:
Tab. Deltacortil EC 5mg x 10days
1-5 days .2+2+2
6 day.2+2+1
7 day.2+1+1
8 day.1+1+1
9 day.1+1+0
10 day.1+0+0
Vertigo:
Tab. Serc (betahistine) 8 mg (16mg for Headache)
Or Tab. Vergo (betahistine)
Tab. Stugeron (Cinnarizine)
Hemorrhagic Stroke:
O2 Inhalation 3L/min
NG, Foley's, Counseling about Posture change, chest physiotherapy, NG feeding.
Inj. R/L 500ml + Inj. Nootropil 1g/ml (2-6) + Inj. Neurobion (2) + Inj. Decadron 4cc + Inj. Neutrocoline 250mg (1amp)
Inj. Mannitol 150cc IV x TDS
Inj. Titan 1g IV x BD (encephalopathy)
Inj. Risek Inf IV x OD Plus Inj. Maxolon IV x TDS
Inj. Nimodipine 30 ml in 70 cc N/S @ 10DPM IV x 6h
Tab. Norvasc 10mg 1 x OD (if SBP is >180)
Sup. Ginbex 1+1+1
Intermittent Claudication:
Tab. Pletaal 100mg 1 x BD (Cilostazole)
Or Tab. Loftyl 150mg 1 x BD (Buflomedil)
Tab. Tonoflex-P 1 x BD
Trigeminal Neuralgia: (Knife like.Electrical pain, lasting seconds at trigeminal nerve distributaion. Associoated with trigger zone eg. Shaving,eating,
talking, touching cold, washing etc.)
Tab. Tegral 200mg 1 TDS x 2weeks. (Alt Tab. Rivotril 2mg 1 x HS)
Tab.Tryptanol 25mg 1x HS
PostHerpetic Neuralgia : (Vesicular Skin eruption, followed by local pain and tenderness at trigeminal nerve distribtion)
Tab. Aclova 200mg TDS (Alt. Cycloz) x 7 days
Tab. Deltacortil 5mg EC 2+2+2 x 2 weeks
For neuralgia:
Tab. Tryptanol + Tab. Motival + Lignocaine Gel locally.
Vestibular Neuronitis : (MCC of isloated vertigo e/o deafness, tinnitis. Ass . e Viral infections. Lasts for weeks.)
Tab.Serc (betahistine) 8 mg x TDS Or Tab. Enier 8mg x TDS (Max up to 48mg/day)
Tab. Stugeron 75 mg 1 BD (Cinnarizine)
Peripheral Neuropathy: Mononeuropathy

Carpal Tunnel Syndrome: (Electrical shock feeling in thumbs and fingers supplied by median nerve,esp at night, B/L, Tinel,s Sign)Dx: NCV
Wrist Splint,
Tab. Nuberol Forte 1 x BD
Tab. Deltacortil EC 5mg 2x2 7days
Surgical Decompression.
Mononeuritis Multiplex: (Involvment of more than one nerve affected in patchy distribution)
D/D:
1. Diabates 5. Hiv
2. Leprosy 6. Malignancy
3. Sarcoidosis 7. Neurofibromatosis
4. Amylodosis
Myopathy:
Duchenne,s Muscular Dystrophy: (age 5, Pt must use their arm to climb uptheir body, pseudohypertrophy of calves . Ix.CPK raised 200
time, EMG shows Myopathic pattern, Muscle biopsy shows fiber necrosis.Death by 20)
Tab. Deltacortil EC 5mg 2+2+2 (In children under 5 years 2 x OD x 10days then off for 10 days then again and cycle
continues)
Syp. Acicion 1x OD
Syp. Haemocare 1 x OD
Very poor Prognosis.
Hypokalemic Periodic Paralysis: (Gen. weakness include. Speech and bulbar muscles after heavy carbohydrate meal or rest after
exertion) Ix. Serum K is low and often respond to KCL.
Similar weakness occurs in Hypokalemia during thyrotoxicosis.
Tab. K-Tab 500mg (KCL @ 60mg/Kg) Or K-Lite
Hyperkalemic Periodic Paralysis:

IV Ca gluconate or Tab. Furosemide or Glucose.
Myasthenia Gravis: (Weakness and fatigability of proximal muscles of shoulder gridle, ocular and bulbar muscles, Women cant undertake
work above the level of shoulder. Severe fatigue towards the end of the day and improvement following rest. )
IX: Serum Ach receptor Ab,
Nerve stimulation shows a decrement in the evoked muscle action potenial.
Other are chest x ray to for Thymoma, ESR is not raised, CPK is normal, muscle biopsy
Tab. Mestinon 60mg TDS (Pyridostigmine)
Tab. Deltacortil EC 5mg 2+2 for 3months then gradually increased upto 1-2 months then tappered off in 6 months.
Polyneuropathy:
Strict Glycemic Control, High protein Diet, Multivitamens. Daily Massage, Passive movement, hot packs,
Inj.Neurobion 500mcg IM x 7 Days
Tab. Deltacortil 2+2 for 3 Days
Tab. Tofranil 25mg (Imipramine in case of Diabetic Neuropathy)
4.Endocrinology
Hypothyroidism:
Tab.Thyroxine 100µg 1xOD (Young + No cardiac issue)
Tab.Thyroxine 50µg 1xOD (Elderly + No cardiac issue)
Tab.Thyroxine 25µg 1xOD (Heart Disease) If IHD exacerbates then thyroxin should be stopped and coronary surgery
should be considered.
Note:Half Life of Thyroxin is 2 weeks.TSH is monitored at 6-8 Weeks.

Adrenal failure often associated e Hypothyroidism and exacerbates it. If Patient develop hypotension nausea
vomiting after thyroxin therapy, thyroxin should be started and steroids should be started.
Subclinical Hypothyroidism (T4 normal but TSH is raised) Not required therapy but repeat TFT after 6 month
because patient may develop OVERT hypothyroidism.
Hyperthyroidism:
Tab. Neo-mercazole 5mg 1 x TDS (0-3 weeks 40mg in divided doses and 4-6 weeks 20mg in divided doses)
Tab. Inderal 50mg 1 x TDS
Diabates Mellitus:
Diet, Weight Loss, Exercise
1. Tab. Metformin 500mg 1 x BD
If not controlled then Tab. Getformin 2/500 1 x BD (Or. Tab. Trevia Plus 50/1000, Tagipmet, Or)
If not controlled then add Tab. Glitazone or Switch to Insulin.
Diabetic Ketoacidosis: (Hyperglycemia, Urin ary Ketones, Metabolic acidosis(PH<7.3,NaHCo3 <15meq/L))

Urine Osmolarity = 2 x Na + RBS/18 + Urea / 6
1. General:NG,Foley,RBS 1h for 8Hour, Electrolytes 2h for 8 hours, Maintain IOP.
2. When RBS is >250mg/dl

Inj.N/S 1000ml IV 30min
Inj.N/S 1000ml IV 1h + KCL (1amp=25mmol) Monitor ECG
Inj.N/S 1000ml IV 2h + KCL (1amp=25mmol) (Monitor HR,BP,Pulse,UOP,JVP,PCWP)
Inj.Insulin R 24 units in 100cc N/S @24µdpm (6units/h)

OR
In case of HONK
3. When RBS is <250mg/dl

Inj. D5W 1000ml IV cont.

OR
4.Bicarbonate Deficit Can be calculated as:

Bicarbonate Deficit = 0.5 x Weight x (24-HCO3) eg. 0.5 x 70kg (24-15) = 315 mEq/2 = 158mEQ
1 amp of HCO3 Gives 44 mEQ.
Half of Bicarbonate Deficit will be given in first 8 h and next half in 24 hours.
Inj.NaHCo3 4amp of in 1L of 5 % D/W 500ml x 8h and 4 amp in 24 hours.
(give NaHCo3 when pH <7.1 or severe hyperkalemia.
Inj . Risek Inf. IV x BD
Once Patient is out of DKA, Insulin dose should be calculated as:
Insulin (dose) = 0.5-1.0 units x Weight (kg) = Eg. 0.5 x 60 = 30 Units/3 = 10 Units x TDS
Inj. Mixtard 70/30 S/C (2/3rd in morning + 1/3 rd in Evening) Remember Insulin units increased 2 units at a time.
Diabetic Neuropathy: Strict Glycemic control.

Tab. Pregabalin 75 mg 1 x BD (tab Zeegap or Tab Hilin)
Tab. Amyline 25mg 1 x HS
Tab. Duloxetine HCl 30mg 1 x OD
Tab. Lacosamide 10 mg 1 x OD
Diabetic Nephropathy:
Salt, protein restriction
Strict Glycemic control (urine spot for albumin, Hba1c, RBS)
Tab. Zestril 5 mg 1 x OD ( even in normotensive. It reduces proteinuria and dec. renal disease progression)
Inj. Cipro 500mg iv x BD (UTIs)
Treat renal failure accordingly.
Hypoglycemic Shock:
Inj. 25% D/W 4amp IV x Stat
Then Inj. 10% D/W 1000ml IV x Stat
Lower Oral Hypoglycemic.
Obesity:
Tab. Orles 120mg 1 x BD
Metabolic Syndrome: (Diagnosed when FBG > 100mg/dl, BP>130/85, Triglycerides >150mg/dl, HDL-C <40 in men, 50 in women,
Waist Circumference >40in in men, 35in in women )
Lifestyle modification eg Diet, Exercise, Smoking cessation, Low sugar diet
Tab. Co-Extor ½ OD (Maintain BP below 140/90)
Anti-Diabetics Meds
Tab. Asprin 75 mg 1 x OD
NOTE: if Elevated LDL-C levels: Adv. Statins
If Decreased HDL-C levels : Adv. Niacin
If Elevated triglycerides : Adv. O3FA, Niacin, Fibrates
Male Infertility: (Oligospermia = <20Millions sperm count, Azospermia = Absemce of sperm count)
Etiology: Testicular: Testicular tosion, Varicocele, Crytochidism, Trauma
Infections: Mumps Orchitis, Epididmyitis
Systemic: DM<Hernia repair (may damage Vas defrens), Thyroid orm liver disease.
O/E: Scortal exam for size and hydrocele, Palpate vas defrens, Epidimis, Prostate, Hypogonadism (loss of libido,lethargy, Gynaeomastia, ED,
Infertility,Dec. frequency of shaving, delayed puberity, look for secondary sexual features)
Ix: Semen Analysis: Sperm count: > 20-60 millions
Morphology: > 60% sperm should be of normal morpholgy
Motility: > 60% sperm should be motile.
Liquefication of seminal fluid: 15-30 min.
Volume: 1.5- 6ml (<1.5ml may results in buffering of vaginal aciditu. R/O retrograde ejaculation)
If sperm count is low do a Serum Testosterone, FSH, LH and prolactin.
(Rem: FSH and LH (High in primary and low in seconday hypogonadism)
Mx. Etiologically. Testosterone if primary hypogonadism. FSH, LH in seconday hypogonadism.
Tab. Gonadil-F IxOD for 6weeks.
Importence: Aka ED (Depression, Anxiety, Hypogonadism, Hyperthtroidism, Acromegaly, Addison,s )

Drugs: BB, Thiazides diuretics, Antihistamines, Metoclopromide, Tricyclic Antidepressants. Ix:Serum Testosterone, FSH, LH and prolactin
Mx: Testosterone if hypogonadism.
Tab. Viagra 1 x Before intercourse.
Prostaglandin E1 injection by patient.
Nephrology
Chronic Renal Failure :
(HTN,DM,Anemia,IHD,hyperkalemia,hypocalcemia/hyperphostemia)
Protein restriction. K restriction (Tomatoes Coffee), PO4 restriction (Eggs, Diary products, Meat), Salt water restriction
Inj. Espogen 4000 IU 1 x weekly IM

Tab. Bon-one (alfacalcidol) 0.5 µg 1 x OD
OR
Tab. Qalsan-D (CaCO3 + cholecalciderol=Phosphate binder) 1 x BD (Maintain Phosphate levels between 4-5mg/dl)
Tab. Ketosteril 1 PO x OD OR Tab. Iberet Folic 500 Gradumet 1 x OD
Tab. Lasix 40mg 2+2+2
Tab. Lophos 667 mg 1 x OD
Cap. Risek 40mg 1+0
Tab. Ipride 50mg 1+1+1
Tab. Onset 8mg 1+1+1
Syp. Cremafin 2 TSF x TDS
Tab. Diamicron MR 30 mg 1+1
Tab.Zestril 10mg 1 x OD
Sach. Citrosoda (NaHCO3, Na citrate)
Hospitilized:
Inj. NaHCo3 150cc + 5% D/W 150cc @12dpm in 2h (severe acidosis)
Inj. Tanzo 2.25mg IV x TDS
Inj. CaCo3 10% in 10ml N/S IV x 20 min
BPH:
Tab. Tamsulosin HCL 0.4 mg (Tab.Uriflow,Maxflow) 1 x OD
Tab. Solfy 5mg 1 x OD (Solifenacin Succinate)
Or
Tab. Hytrin 1 mg 1 x OD (Terasocin)
Tab. Finasteride 5mg (Proscar)
Urinary Incontinence:
Tab. Tamsolin 0.4mg 1 x OD (Tamsulosin HCl)
Tab. Fenaso 10mg 1 x TDS (Solifenacin Succinate)
Tab. Citanew 5mg 1 x BD
Nephrotic Syndrome: (Proteinuria>3, Hypoalbuminemia, Edema, Hyperlipdemia, Hypercoaulability)

Clinical: (Periorbital edema, ascites, Hydrothorax, Anorexia,Diarrhea, Malnutrtion, Infections,)
Ix: (Urine D/R, 24h Urinary Proteins, Serum Albumin, LDL, Raised ESR, ANA, HBV antibody)
General Mx: Bed Rest, Low Salt Diet, Protein Restriction,
Edema: Diuretics: Tab. Lasix 40mg OD
Hyperchloestermia: Tab. Atorva 5mg 1 x HS
Specific:
Minimal Change Disease:
Tab. Deltacortil 5mg EC 60mg/day x 8 weeks
Tx continued for weeks upto complete remission of proteinuria)
In steroids resisteant cases Cyclophosphomide 3mg/kg x 6-8 weeks
H2 blocker Antagonists eg, Zantac 150mg
Membranous GN:
Prednisolone + Cyclophosphomide x 8 weeks
Nephritic Syndrome: (Hematuria, Proteinura, HTN, Edema, Oliguria, Uremia)

Urine D/R,ASO Titer:1:3000, S. Complements, BuN S, Cr. Daily Intake output Chart)
Bed Rest, Low Salt Diet, Protein Restriction,
Edema+HTN: Diuretics: Tab. Lasix 40mg OD
Daily Intake output Chart
A/B if Culture Positive
Ranal Calculi:
High Fluid intake > 2L/day, Bed rest, application of warmth to site of pain.
Low Salt Diet, Protein Restriction.(Avoid animal protein)
Inj. R/L 1000ml + Inj. No-spa (@fast rate) After 500ml give Inj. Lasix IV 2 Amp (not in Drip)..
Inj. Phlogen IM Stat or Inj.Buscopan/Spasler IV Stat
Tab. Tamsolin 0.4 mg 1xOD (Medical expulsive Therapy)
Tab. Mebever 135 1 x TDS
Tab. Hiflox 750mg 1 x BD (Alt. Urixing 400mg x BD) ICO UTI
If Hyper calcemia/Hypercalcuria then:
Avoid Vit.D prep. Avoid high Calcium foods eg Milk
Give Thiazides Diuretics
If hyperuricosemia/uricosuria then
Protein restriction and Allopurinol
If Hyperoxaluria:
Increased Fluid intake
Add Ca carbonate.
(For Ureterral Stones <6mm. Observe for 6 weeks with Analgesic. Pass spontaneously. If no the ESWL/ Uretroscopic
Stone Extraction)
Acute Pyelonephritis: (Loin pain, dysuria,fever, Tenderness at renal angle )

Ix: Blood C/E, Urine D/R, Urine C/S, RFT,Micturiting Cystourethrogram,IVP, Renal USD
D/D.Ac. Appendicits, Salpingitis, Cholecystits, Diverticulitis, Perinephric Abscess.
High fluid intake, Maintain personal Hygiene and proper cleaning after defecation.
In Pregnancy Inj. Zinacef (Cefuroxime )750mg x IV 3 Days Then Tab. Zinacef 250mg x BD x 10-14Days
Inj. Ciprofloxacin 400mg /100ml IV BD (In sever Cases)
Tab. Novidate 750mg x BD x 21 days.
Tab. Panodol 1 x BD
Syp, Citralka
Remove obs, vesicoureteric Reflux disappears in adult age.
In Relapses Give Tab. Septran DS BD x 2-4 Weeks (Or 1 Tab. After Coitus In married)
(Small Scalding Cloudy urine d/t associated Cystits)
LUTI: (Urethritis, Cystitis):

(inc. Frequency of micturation, Scalding pain felt in urethra during micturation, Suprapubic Pain during & after Micturation in cystits, intense desire
to pass more urine after bladder empitied d/t spasm of inflammed walls, Urine have unpleasent odor and cloudy look )
Tab. Novidate 750mg x BD x 3 days
Tab. Panodol 1 x BD
Syp, Citralka
Acute Prostatis:
(Perineal Pain, Dysuria, Fever and tender prostate on P/R exam. )
Ix. Urine D/R, Urinalysis (S hows Pyuria, Bacturia, Hematuria) Urine C/S
Inj. Ampicillin + Amikacin
Tab. Novidate 750mg BD for 4-6 weeks
Urinary Catheterization or Percutaneous Spurapubis puncture is required.
Cardiovascular System
Hypertension:
Counseling, Weight loss, Exercise, Salt restricts. Stop smoking,
1.) Age >55. Non-DM . First choice: CCB or Thiazides Second choice: ACEI or ARBs
2.) HTN + DM= Target <130/80 First choice: ACEI or ARBs. Avoid BB and Dihydropyridine (CCB like Diltiazem or
verapamil decreases proteinuria so can be used but Dihydropyridine eg amlodipine increase proteinuria.BB may cause
hypoglycemia by autonomic interference)
3.) HTN + HF= First choice: Diuretics (if fluid overload) ACEI or ARBs. Avoid BB and Dihydropyridine.
Age<55. First choice: Second choice:
Note: Amlodoine (24h) should be given at night but diuretics should be given in morning…
Atenolol (Longest acting BB) Inderal (shortest acting BB)
Amlodopine (Longst acting CCB)
Telmisartan (Longst acting ARBs)
Capoten (8h)
Tab. Avsar, Valtec AM, Co Valtec, Co eziday
4)HTN+Pregnancy= BB,ACEI,DIURETICS ARE C/I in Pregnancy.
Tab. Aldomet 250mg BD
5)HTN+Dyslipidemia= Avoi BB and Diuretics which worsens lipid profile.
Tab. Zestril 10mg 1 x OD
Tab. Xavor 50mg x OD
5) HTN+STROKE=
Tab. Corace Plus 12.5mg/10mg OD
6)HTN+REANL FAILURE =
Tab. Lasoride 1 x OD
Tab. Tenormin 50mg 1x OD
7)HTN+Asthma=AVOID BB
Tab. Herbesser 30mg x BD
Or Tab. Xavor 10mg or Tab. Zestril 5mg x OD
HTN + Comorbidites:
MI = BB
CHF = BB, ACEI,ARB
Migrane = BB, CCB
Hyperthrodism = BB
Asthma = No to BB
Depression = No to BB
Pregnancy = Alpha Methyldopa 250-500mg PO
BPH = Alpha Blocker
DM = ACEI / ARBS
Hypertensive Emergency: eg 240/170mmhg

Tab. Capoten 25mg S/L 1 x OD
Inj. Isoket 0.1% in 90 cc N/S @20 µDPM IV x stat (1amp=10ml)
Tab. Norvasc 10mg 1 x OD
Inj. Lasix 60mg IV x Stat
Or
Inj. Labetolol 4cc infusion IV infusion in 30-60 min.
MI:
Tab. Loprin 75mg 1 x OD (Alt Lowplat 75mg or Lowplat 75/ 75mg)
Tab. Rovista 10mg 1 x HS
Tab. Concor 5mg 1 x OD
Tab. Zestril 10mg 1 x OD
Cardiogenic Shock:
Inj. Dopamine 5cc in 95cc N/S IV x Stat (1amp =5ml(5 x 40mg = 200mg)
Inj. Dobutamine 5cc in 95cc N/S IV x Stat (1amp =20ml(20ml x 12.5mg = 250mg)
Complete heart Block:

Inj. Atropine 1cc IV x Stat (Max upto 3cc)
Some Prescriptions:
Congestive Cardiac Failure:LVF
1. Inj. Lasix 40mg 1 x BD 2. Tab. Digoxin ½ x Bd 3. Tab. Zestril 5mg 1 x OD 4. Tab. Aldactone 100mg 1 x OD
5. Tab. X-plended 10mg 1 x HS 6. Tab. Ascard Plus 75mg 1 x OD and Deponit Patch x BD
IHD (T2DM): (KMTH)

1. Tab. Sustac 2.6mg 1 x BD 2. Tab.Ascard 75mg 1 x OD 3. Inj. Mixtard 70/30 26U M & 14U E (Wt=68Kg)
4. Tab. Eziday 50mg 1 x OD 5. Tab.Hilin 50mg 1 x HS 6. Tab. Esso 20mg
IHD (HTN: (FIC)

1. Tab. Ascard 75mg 1 x OD 2. Tab. Lowplat 75mg 1 x OD 3. Tab. Concor 2.5mg 1 x OD 4. Tab. Atorva 20mg 1 x HS
5.Tab. Eziday 50mg 1 x HS 6.Tab. Spiromide 40mg ½ x OD 7. Tab. Angised 0.5mg x SOS 8. Tab. Losartan 20mg 1 x BD
Rheumatology
Arthritis: Swollen Joint,Hot,Tender,Movements Restricted,Painfyl,Effusion Present
MonoArthritis:
Osteoarthritis: Wt bearing Joint,Pain e Movements, H/O Morning Stifness,Joint DEFORMED,CREPITUS,Muscle around WAS TED.
X-Ray Shows Osteophytes,Cyst Formation,Periarticular Sclerosis.
Pyogenic Arthitis: Knee MCC,Acute Onset e Severe Pain,Fever,Joint RED HOT Swollen,TENDER,Movement are painful,
Leukocytosis high,Blood Culture Positive X-Ray has no value.
Gonococcal Arthitis: Gradual Onset,Joint Swollen Tender, Movements restricted and Painful, Leukocytosis high,URETHRAL
DISCHARGE.
Tuberculous Arthitis: Knee & Hip MCC,Onset Gradual,Joint Swollen Tender, Movements restricted and Painful,ESR High,X-Ray
Shows TB,Tuberculosis Test Positive.
Gouty Arthitis: MEN,M etatarsophalangeal Joint of big toe MCC< Severe Pain,Joint Swollen,Red, Hot, Extremely Tender,TOPHI
PALPABLE in cartilage of ear, UA is HIGH,
Neuropathic Arthitis: Ankle Joint,Painless Deformed JointSENSORY LOSS D/T NEUROLOGICAL DISORDERS.
Hemathrosis: Joint Swollen after Minor Injury.
Pyrophosphate Arthopathy:
Poly Arthritis
Rheumatoid Arthitis: Symmetrical PA,Multiple Painful Joints,WINTER,MORNING STIFFNESS,Joint Swollen,Hot,Tender,PIP
Joint,ESR HIGH< CRP,RA Positive.
OsteoArthritis:
SLE:
Gout:
Ankylosing Spondylitis:
Reiter's Syndrome :
Enteropathic Arthitis:
Bechet's Syndrome:
Gonococcal Arthitis:
Psoriatic Arthitis:
Backache:
Sprain : Common,Pain after injury,Local Tenderness,Movements are Painful
Sciatica/IDH: Common,Low back radiates to leg, worse on walking,leg become weak, STRAIGHT LEG RAISING Poistive, Root
compression Sympotome positive, Ankle Jerk Absent in S1 compression, X-Ray Shows Reduced Disk space, MRI
Osteoarthritis of Spine: On X-Ray Osteophytes
Tuberculosis of spine: T/L Spine,Back Pain, Cold Abscess in Lower Abd/Thigh,Weakness of Legs, ESR Raised, Paraplegia, Local
Spinal Deformity
Osteoporosis: Old Age,P/Menopause,Steroid Therapy,Prolonges inactivity,Kyphosis,Lose Height,Local Tenderness S.Ca,PO4,ALP XRay
wedge fractures of spine
Spondyloarthitis:
Traumatic vertebral Fracture:
Matastases:
PID: MCC in Child bearing age.
OsteoMalacia: Bone Pain,Difficulity in Standing up from sitting Pos. Local Bone Tenderness, Proximal Muscles Weakness, S. Ca,Po4,
low,ALP high X-Ray shows Looserzones(Pseudo fractures Common Sites Ribs, Long Bones)Tx: Tab. Calcivit 3-4 x weeks
Neck Pain D/D:

Ankylosing Spondylitis
Rheumatoid Arthritis.
Cervical Spondylitis
Cervical disc prolapse.
Soft tissue Rheumatism
Fibrositis
OsteoMalacia
Tab. Osomin- D 1 x OD
Tab. Calcivit 3-4 x OD/Weeks
Or
Cap Sunny D3 200000IU 1x Wk
Gout:
Acute: 1. Tab.Indocid 25mg 1 x BD
2. Tab. Deltacortil 5mg EC 2 x 2 7-10 days (Tapered slowly)
Chronic: 1. Tab Allopurinol (Zyloric) 100mg 1 x OD gradually increased to 300mg/day.
(2-4weeks. Maintain Uric acid below 5mg/dl.). Febuxostat 40mg is more effective Than allupurinol
2.Tab. Colchicine 0.5mg 1 x BD
Osteoarthritis:
Periods of rest. Heat. Local Exercises. Weight Reductions. Physiotherapy
Tab. Zultracet 37.5/325mg 1 x TDS (P/M + Tramadol)/
Tab. One Alpha 0.5Mcg 1 x OD (Alfacalcidol)
Tab. Cartigen Plus 600/750mg 1 x BD (Glucosamine + Chondrotin)
Capsaicin Oint. BD
Total Joint Replacement.
Rheumatic Arthritis: (Same Mx for Seronegitive RA)
Tab. Sinaxomol 1 x OD
Tab. MTZ 2.5mg 3 OD weekly (Cytotrexate 10mg) + Tab. Sangobion 1 x OD
(Indication to MTZ therapy is active disease not responding to NSAID and erosive arthritis. Response occours in 4-8 weeks,if no respone in 8 weeks
then increase dose 2.5mg every other week until improvement upto a maximum of 25mg. Maximum improvement in 6 months. Monitor CBC AST
ALT serum Albumin every 4weeks. Macrocytosis is indicator of serious BM toxicity)
Tab. Cara 20mg 1 x OD (Lumide 20mg)
(Response occours in 4-8 weeks. Maximum improvement in 4-6 mon. Initial 100mg daily for 3 days followed by 10-20mg daily.Effective
contraception should should be practiced during and after TX for at least 2 years. Monitor CBC AST ALT serum Albumin every 4weeks. )
Tab. Deltacortil 5mg EC 2+2 x 6-24 months or Inj. Triamcinolone every 6-8 weeks IM
Fibrositis: (Musculoskeleta pain in pts e Depression and anxiety. Tenderness over Trapezius,Second Costochondral Junctions, Post. Cervical
muscles and upper gluteal area)
Not respond to Analgesics.
Tab. Tryptanol 25 mg x HS
Physiotherapy
Polymyalgia Rheumatica : (S udden onset,severe pain and stiffness of shoulders neck hips lumbar spine.WORST IN MORNING
PERSISTS 30 MIN . Pts troubled combing their hair, putting on a coat, getting up a chair. Pts is ALWAYS 50 ABOVE. Ix. ESR very
high.Anemia always present.)
Tab. Deltacortil 5mg EC 2+2+2 for 6-12 Mon.
Geriatric Pain Management:

Tab. Lacolep 100mg 1 x OD
Tab. Mits 15mg 1 x OD
Tab. Movax 4mg 1 x BD
Tab. Thiolax 4mg 1 x OD
Osteoporosis :
Tab. Rocaltrol 1 xOD
Fibromyalgia: (pain, Stiffness, Fatigue, IBS, GAD, Non restorative sleep)

Enhanced Sleep, Aerobic Exercise.
Tab. Lyta 60mg 1 x OD
Systemic Lupus Erythematosis: Fever+arthragia+Rash+Young female is SLE UPOW)

Avoidance of UV light, Use Sunblocks (eg. Sun Screen UV 90) Reassurance, Use Anti HTN, And Anti Hyperlipidemics.
Inj. Soul Medrol 500mg IV BD X 3 Days Then Start Tab. Deltacortil 5 mg 2 x BD (For Glumerulonephritis)
Tab. HCQ 200 1 x OD (For Skin Lesions and systemic Symptoms)
Tab.
Psychiatric Diseases:
Gen. Anxiety Disorder:
Tab. Buspar 5mg 1 x BD
Tab. Lexilium 4mg 1 x HS
Tab. Inderal 50mg 1 x TDS
Depression
Tab. Citanew 5mg 1 x BD Or Tab. Seroxat 12.5mg 1 x OD
Tab. ALP 0.5mg 1 x HS
Tab. Pentoxol-M 1 x BD
Parkinson,s Disease:
Tab Sinemet 25/250mg 1/2bd (Levodopa+cabidopa)
Tab. Kempro 5mg 1 x OD (procyclidine)
Schizophrenia
Tab. Tiapine 100mg 2 x HS(queitapine)
Tab. Surbex- Z 1 x OD
Tab. Chlorotil 25mg 1 x OD (chlorpromeziaine)
And if needed
Tab, Rivitril 2mg 1 x HD (Clonozepam)
Dementia:
Inj. R/L 500ml + Inj. Nootropil 1g/ml (2-6) + Inj. Neurobion (2) + Inj. Decadron 4cc
Tab. Ceregin 4 mg 1 x BD(Co-Dergocrine Mesylte)
Syp. Ginbex 1 x OD
Insomina:
Tab. Tenzil 0.5mg 1 x Hs (Loratidine)
Tab. Noctamid 0.5mg 1 HS (Lormetazepam, a Hypnotic drug)
Hematology
Iron Def. Anemia:
Identify Etiology and treat.
Concomitant Vit. C improves Fe Absorbtion. Antacids decreases Fe absorption. Ferrous Gluconate/Fumarate OD with meals then Gradually increases
dose. Hb rises 1%/day.Retic count peaks on 10 days.Therapy continued for 6-12 months after Hb Becomes Normal.
Cap. Bisleri 100mg 1 x OD or Syp. Bisleri 50mg/5ml or Tab. Tri-Hemic 600 1x OD Or Syp. Maltofer Fol 1 TSF x TDS
OR
Tab. Fefol spansule 150mg or Tab. Iberet Folic 500mg Graduamet
Inj. Venofer 20mg/5l (IM/IV)
B12 Def. Anemia:

Tab. Neurobion/Triedox/Surbex-T 1 x BD
Syp.Vidaylin/Multibionata 1 x OD
Tab/Inj. Neuromet 500mg 1 x TDS/IM
Vitamein D Deficency:
Diagnosed by Serum 25 Vitamen D level (<8ng/ml means Severe Def., 8-20ng/ml means moderate deficiency)
Indrop-D e milk x weekly.
Tab. Qalsan-D 1 x OD (CaCO3+Cholecalciferol)
Tab. Cac-1000 plus Lemon 1 x OD
Tab. Caltrate/Chewcal/AboCal/Fenocal/Osso Plus 1 x OD
Intravenous Fluids:
1. Ringer Lactate:
Nacl: 6g/L
KCl: 0.3g/L
Na Lactate: 3.1 g/L
2. Hemaccel :
Hydroxyethyl Starch 3g/500ml
3. 5 % Dextrose Water:
Dextrose 50g:
4. Plabolyte-M:
Dextrose 50g:
KCL: 1.5g/L
NaCl: 0.216g/L
Na acetate: 3.13g/L
CaCl:0.22g/L
5. N/S:
Nacl: 9g/L
Intravenous Fluids in Paeds:

Sign Of Dehydration:
Hr, SBp, U.output, Tears, Mucus Membranes, Skin Tugidity, Anterio frontaelle
Dehydartion:
1: Mild: Encourage oral Fluid.
2: Moderate: 50ml/Kg/Day
Eg. 50 x 10kg = 500ml/3 = 166ml x TDS
3: Severe: 70ml/Kg/Day
Eg. 70 x 10kg = 700ml/3 = 233ml x TDS
How to Calculate IV Fluids:

A:Push (Only Given In shock Patients) i.e 20ml/Kg
B.Maintanance: 1-10Kg = 100ml/Kg/24h
11-20Kg = 50ml/Kg/24h
>20Kg = 20ml/Kg/24h
E.g: 15Kg Baby = 1000+250 = 1250/24h
: 25Kg Baby = 1000+500+100 = 1600ml/Kg/24h
C. Deficit: % of Dehydration x Wt x 10 ( Formula Coefficent)

(i.e 5%(Mild) 10%(Moderate) 15%(Severe) )
1st half is Given in 8 Hour
2nd Half is Given in 16 Hour
Example: 10Kg Baby Wt with 10% Dehydration

Maintanance = 1000ml/24h
Deficit = 1000ml/24h (10 x 10 x 10)
Total = 2000ml/24 h
2000ml/2 = 1000ml
Remember only Deficit will be divided in 2 halfs But Maintaince Fluids will given in 24h.
So Deficit is 1000ml/24h Divided by 2 and
1st Half (8h) = 500ml/8h (62.5ml/h) + Maintanance (41.6ml/h) = 104.1ml/h in 1st 8h.
2nd Half (16h) = 500ml/16h (31.2ml/h) + Maintanance (41.6ml/h) = 72.6 ml/h in 2nd 16h.
Remember:
R/L should be given in Stat
Then 1/5th Dextrose Saline(0.45%Nacl) should be given as maintaince dose.
Miscellaneous Diseases:
Psoriasis:
White Petroleum jelly + Liquid Paraffin + Betasalic Oint (Mix and Applied)/Novasalic/Provate-S
Tab. Atarax 25mg 1 x HS (Hydroxyzine)
Cap. Acitrelex 25mg 1 x BD (Acitretin) for severe Psoriasis.
Tab. Qalsan D 1 x OD
Cap. Omega 20mg 1 x OD
Scabies;(Severe nocturnal itching,Family H/O,Typically @interdigital clefts,ulnar borders of hands,wrists,elbows,axillae,

buttocks,penis,umbilicus. FACE NOT AFFECTED)
Malin Lotion or Lotrix Lotion (5% permethrin) Single Application.(TOC) Once Weekly for 3 weeks.
Scabrid Lotion Or Sabfree Or Scabion Lotion (Applied below neck for 3 days then 1 weekly) boiled garments.
Tab. Ivermite 6mg 1 x Wk.
Pediculosis Capitis !Scalp itching,Preauricular R, Hair may be matted with pus)

Lotrix Lotion/Oint (5% permethrin) Single Application.(TOC)
Pediculosis Corporis !Old men/women,itching, secondary infection common)

Calamine lotion
Topical Antibiotics
Pediculosis Pubis: (Intense itching at pubic hair,eyebrows,axillae,rarely scalp,Secondary infections,blue grey macules
Lotrix Lotion/Oint (5% permethrin) Once Weekly for 3 weeks.
Tine Capitis:
Tab.Grisol 1 x OD (BD for Child) Griseofulvin
OR Tab. Terbisil/Cutis/Terbiderm/Lamisil (Terbinafine) 125mg 1 x BD
Betaderm-NN
Scalp Brushing After 1 month of Tx.
Seborrhoeic Dermatits: (Marked Scaling at scalp R,with eczema, greasy discharge)

Nizoral Sclap Gel OR Stieprox Liquid OR Selsum Blue Shamp&Cond
Betaderm NN Oint BD x 1Month (Hydrocort 2.5%)
Spike Oint 2 %/ Conaz Lotion (Ketoconazole) 1 Month.(aka Extina, Ketopike, Nizoral,)
Hepers Simplex Labialis:

Tab. Aclova 400mg 1 x TDS (Acyclovir)
Polyfex eye Ointment
Enziclor + Xylocaine + Glycerine mixed and applied in mouth x TDS
Healit Oint.
Herpes Ophthalmica:
Tab. Aclova 800mg 5times(at 6am,10am,2pm,6pm,10pm) (Acyclovir)
Tab. Synflex 500mg 1 x BD
Tab. Amyline 25mg 1 x HS (Amitriptyline)
Tab. Gabica 75mg 1 x HS
Polyfex Plus Oint. TDS
Healit Oint.
Vigamox Eye drops x BD (moxifloxacin)
Sycosis Barbae:
Clycin-T Lotion x TDS
Tab. Zinacef 250mg 1 x BD
Tab. Danzen DS 1 x TDS
Tab. Fexet-D 1 x TDS
Napkin Dermatits:
Curazole Oint x BD (Alt. Diprocort-C Oint x BD)
Melasma:
Mometaderm Oint x BD Or Hydroquin cream
Miliaria : Aka Sweat Rash, Prickly Heat

Calamine Lotion
Vicks Vaporub Balm, or Wilson Vapur Rub or Sarna or Pacifics j&j Rub
Pytriasis Versicolor:
Sun block
Travocort Oint x BD
Oral Zinc
Pytriasis Alba:
Stienoide oint x BD (Desonide)
Pruritis Ani:
Avoid hot and spicy Food, maintain proper hygiene, Use cotton Underwear.
Cabedin Oint. BD ( Prednicarbate) Alt zemagis
Erythema Carbuncle:
Tab. Velosef 500mg 1 x BD (Cephradine)
Tab. Amyline 25mg 1 x HS (Amitriptyline)
Healit Oint.
Tinea Corporis:
Terbisil Oint BD
Tab. Terbisil 250mg 1 BD
Tinea Unguium:
Tab. Griseofulvin 1g OD x 6months - 1 year
Or Tab. Terbisil 250mg OD x 3-6 Months
Or Tab. Onlezole 150mg once (Itreconazole)
Pompholyx: Chronic vesicular eruption of palms and soles.

Spontaneous resolution 2-7 weeks.
Clobederm-N Oint x BD
Soak the affected areas in 1:1000 KMnO4 soultion QD
Acne (Nodular or Vulgaris):

Tab. Erythrocin 500mg or Tetracycline 500mg BD
Tab. Zantac 300mg 1 x HS
Acdermin Gel at night only (Because tretinoin causes irritation under light) 12 weeks.
(Alt. Clinda T/Cleret Oint (Clindamycin +trentoin) (Applied for 2 hours only causes burning so 2 hrs only)
(Alt. Adapco forte oint. at night only for 12weeks then adapco gel is for maintainace)
Glycerin-D at day
Cap. Isotretinoin 20mg 1 x HS (only in Acne Vulgaris)
Never Use Bazaare Creams.
Hair loss:
Minoxy Plus 5% int.
Eczema (Dermatits):
Reassurance,Avoid soap,wool.
Betaderm-N Oint x 2 weeks (Mild cases) and Dermovate/Clobederm-N Oint (Severe cases)
Antibiotics,Antihistamins
Warts (aka Verrucae): warts are cauliflower like discrete papules conglomerating into large masses. Common on back of hands fingers, back.
Plane Warts: On face Knees and back of hands. D/d LP:
Duofilm Gel x BD (5% salicyclic acid & 5% lactic acid in flexible collodion)
Or Retina-A x BD (Tretinoin 0.05%)
Premature Ejaculation:
Tab. ALP 1 x HS
Tab. Everlong 1 x HS
Peridentitis/Gingivitis:
Tab. Contymycin 100 1 x BD
Tab. Fasigyn 500mg 1 x BD
Citacol Mouthwash TDS
Gramex Plus Gel x BD (Alt. Revomet Plus gel)
Prosalz Paste BD
Wound Care:
Tab. Zinacef 250mg 2 x BD
Oxoferone Soln. (Tetrachlorodecaoxide) Alt. Sufre Tulle Dressing.
Healit oint.
Smoking Cessation:
Tab. Chantix 0.5mg 1 x 28 days (Varenicline)
Tab. Wellbutrin-XL 150mg x OD (Bupropion)
Urinary Incontinence:
Tab. Detrusitol 2 mg 1 x OD (Tolterodine)
Onychomycosis:
For Finger toes:
Tab. Terbiderm 250mg 1xOD 6 weeks (<20kg 1/2 Tab. OD and >20kg 1 Tab OD)
For Foot toes:
Tab. Terbiderm 250mg 1xOD 12 weeks
Note: Terbinafine are fungicidal while all Azores are fungistatic.
Nocturnal Enuresis:
Tab. Minirin 0.2 mcg 1 x OD (Desopressin)
Chronic Fatigue Syndrome: (CFS)

Tab. Arcalion 200mg TDS (Sulbutiamine)
E.N.T:
1. Tonsillitis: (Sore throat, T, Earache, Difficulty in swallowing, hyperemia & edema of pillars, soft plate, Uvula, yellow spots on tonsils)
Bed Rest, plenty of fluids, warm saline gargles, and voice rest.
Tab. Levofloxacin 500mg 1 x BD 7-10 days
Tab. Panodol 2 x SOS
Enziclor Mouth Wash x TDS
2. Pharyngitis: (Throat discomfort, foreign body sensation, tiredness of voice, posterior pharyngeal wall thick, edematous, congested)
Bed Rest, plenty of fluids, warm saline gargles, and voice rest.
Avoid Cold drinks, Sour and Spicy foods.
Tab. Levofloxacin 500mg 1 x BD Or Tab. Augmentin 625mg 1 x BD (Leflox, Foxcil, Qumic, Neumo, Azomax, Klarricid,
and In children Syp. Calamox, Synocef, E-clar 125/5ml, Klaribact, Klaricid, Rithmo Caricef)
Tab. Nims 1 x BD
Tab. Danzen DS (Serratiopeptidase) 1 x TDS
Tab. Deltacortil EC 5mg 1 x BD x 1 Day
Tab. P/M 2 SoS
3: Laryngitis: (Hoarseness, Dry cough worse @ night, Epiglottis erythema & edema, vocal cord appear white)
Voice Rest, Avoid Smoking, and Steam inhalation with Tincture Benzoin.
Tab. Levofloxacin 500mg 1 x BD 7-10 days
Tab. Nims 1 x BD
4. Allergic Rhinitis: (Paroxysmal sneezing, b/l nasal obs. Ocular signs,Eustachian tube blockage, Pharyngeeal signs, )
Avoidance of Allergens (Pets, Dust, Smells, food allergens)
Tab.Fexet-D 1 x BD (Telfast-D, Sizzle-D, Genfix-D, e.g Antial (loratidine) 10mg, Lexidex 10mg, M Plus (levocetrizine+ monteleukast)
Spray Hivate (mometasone furoate), Ticovate (Fluticasone),
Nasal Drop Deltarhinol, Betnesol, Vegatob, Dexcip, Gentycin,
Tab. Levofloxacin 500mg 1 x BD
5. DNS:
6. Epistaxis:
Tab. Transamine 500mg 1 x TDS x 3 days
Liquid Paraffin 15 drops on each nostril
7. Chronic SOM:
Avoid Feeder, ear sticking, oil massages, Never Put cotton
Tab. Levofloxacin 500mg 1 x BD Or BD (Leflox, Foxcin, Neumo, Azomax, Klarricid, and In children Syp. Calamox,
Synocef, E-clar 125/5ml, Klaribact, Klaricid, Rithmo Caricef)
Nasal Drop Deltarhinol Or Betnesol nasal drops Or Syp. Arniac
Tab. Froben 1 x TDS
Ear Toilet with Soda Glycerin or wax-Aid ear drops x TDS x 3 days followed by syringing.
8. Otitis Externa:
Topical Antibiotics (Gentycin, vegatob)
9. Tinnitis:
Tab.Serc (betahistine) 8 mg x TDS (16mg for Headache)
Or
Tab. Enier 8mg x TDS (Max up to 48mg/day)
Tab. Vergo (betahistine)
Tab. Stugeron 75 mg 1 BD (Cinnarizine)
10: Nasal Polyps: (Polyps are white, cause cont. nasal obstruction, attached to medial wall)
Warm water + Sodium bicarbonate + Salt +Pathkari x TDS
Liquid Paraffin 15 drops on each nostril.
Tab. Fexet 60mg 1 x TDS
Tab. Deltacortil 5mg EC 2+2 (Ony Short Course)
Polypectomy
11. Maggots/Myiasis: (Larval forms, attracted by atrophic rhinits, syphilis, leprosy, infected wounds and lay eggs, abt 200 at a time which in
24hrs hatch into eggs, seen in nose nasopharynx, Sinuses causing extensive destrucion to nose eyeball softtissues of face, sinuses plate.. Clinically
Blood stained discharge from nose or epistaxis, eyes and lips puffiness or foul smelling)
Isoloation and Mash nets.

Nasal Hygiene.
Manual removal of Maggots by Forceps
Chloroform Water and Oil x BD
Warm Saline to remove Sloughs, crusts and dead maggots.
12.
Paediatrics:
AGE:
Hosp: (7Mo,6Kg)
Inj. Maverick 500mg x OD
Inj. Novidat 15ml IV x BD
Inj. P/M 150ml IV x BD
Inj. R/L 250ml IV x Stat
OPD:
Syp. Caricef 100mg/5ml 1 TSF x OD (Dose Cefixime 10 mg/kg/day x OD/BD x 5 days)
Syp. Zincat 10mg/5ml (Dose Zinc: <6 Month is ½ TSF x OD, >6 Month 1 TSF x OD x 4 Days onl y)
Syp. Brufen 100mg/5ml (Dose Brufen 10 mg/kg/ Dose x OD/BD x 5 days)
Low Osmolar ORS (under 1 year children)
Biflor Sachet (Dose Biflor: <6 Month is ½ sachet x BD, >6 Month 1 Sachet x BD x 3 Days onl y), Mix 2 ounc wi th milk or water.
Syp. Metodine DF ½ TSF x TDS
Chronic Diarrhoea:
Syp. Osiris 1x OD
Syp. NT-Tox 1/2 BD
Low Osmolar ORS (under 1 year children)
Biflor Sachet (Dose Biflor: <6 Month is ½ sachet x BD, >6 Month 1 Sachet x BD x 3 Days onl y), Mix 2 ounc wi th milk or water.
Syp. Metodine DF ½ TSF x TDS
Vitamen A defeicency: (Bitot sign )

Tab/Syp/Inf Multibionta (5500IU)
Tab. Fertin (30000IU) 1 x OD
Acute Laryngotrachitis (Croup): (under 4yo,Flu like symptome, Brking coughwith stridor,horse voice,chest indrwing)
Mist therpy,Nebulization or steam
Tab. Dexa 0.5 mg (or Inj. Dexa)
A/B
Symptomatic treatment
Mumps:
Supportive,Antipyretics,Semisolid Liquid Diet,Bed Rest,
Orchitis:Scortum suspended, ice bags applied, Analgesics, Inj. Solo-cotef 100mg IV 6h.
URTI:
Green Tea with honey, Qahwa, Joshanda
Syp. Brufen 100mg/5ml (Dose Brufen 10 mg/kg/Dose x OD/BD x 5 days)
Syp. Klaricid 125mg/5ml ½ TSF x BD (Dose Clarithromycin 15 mg/kg/day x BD x 5 days )
Panadol Drops
Constipation:
Encourage water intake, Fiber Diet, Breast Milk,
Micronema
Infantile Colic:
Syp/Drops Infacol x TDS
Colic Drops xTDS or Syp. Spasler-P 1/2 x TDS
Injections doses in Paeds:

Some Prescriptions:
1 day (Wt 2.8kg) NNU.
Inj. Ampiclox(ATD) 500mg+5cc D/W Give 1.5cc IV 8H
Inj. Cefotax 500mg + 5cc D/W Give 1.5cc IV x 8H
Inj. Decadron 0.2cc IV x 8H
Inj. 10% D/W 40cc + Inj. Ca Gluconate 0.8cc IV x 8H
Inj.Vitamen K 0.1ml IM x Stat
O2 inhalation, Suction, Warmer Care
7 Mo (Wt 6Kg)
Inj. Maverick (ATD) 500mg IV x OD
Inj. R/L 250ml IV Stat
Inj. P/M 150ml IM BD
Syp. Zincat 1 TSF OD
Syp. Q-Plex ½ TDS
ORS
Syp. Pandol ½ TDS
4 Y.O (Wt 15Kg)
Inj. Oxidil 500mg + 5cc D/W Give 1 vial IV x BD
Inj. Provace 30ml IV Stat
Inj. Decadron 0.5cc IV TDS
Neb. e Clenil Composite 0.7cc + 2cc N/S x TDS
1Y.O (Wt 10Kg)
Inj. Maverick 500mg IV x BD
Inj. P/M 250ml IV BD
Inj. Decadron 0.8cc IV TDS
Inj. Provas Inf 30ml IV Stat
Syp. Vomilux 1 TSF TDS
Syp. Pandol ½ TDS
AGE
Inj. Novidat 10ml IV BD
Inj. Flagyl 7ml IV TDS
Inj. 1/5th D/Saline 150cc IV TDS
Inj. Ulcerex 0.3cc IV BD
Enflor Sachet ½ BD
Syp. Zincat 1 TSF OD
Syp. Q-Plex ½ TDS
1Y.O (Wt 9.2Kg) Bronchial Asthma
Inj. 2Sum (500mg + 5ccD/W) 4.0cc x BD x 5 Days
Inj. Apoclox (ATD) (500mg) 1 x TDS
Neb. e Clenil Composite 0.3cc + 2cc N/S x 6H x 4 days
Syp. Britanyl ½ BD
Syp. Tempramin 1 x TD
1M.O(Wt 3Kg)
Inj. Oxidil 1g + 10cc D/W Give 7cc IV OD
Inj. Klaricid 500mg + 10cc D/W Give 1.2cc + 20cc N/S in Burette IV OD
Inj. 1/5th D/Saline 150cc + Inj. KCl 3cc IV TDS
Neb e Clenil A 0.7cc + 2cc N/S x 6H
Syp. Pandol ½ TDS
3.5Y.O (Wt 14 Kg)
Inj. Maxcef 500mg IV BD
Inj. Provas 25ml IV 6h
Inj. P/M 250ml + Inj. Gravinate IV Stat
Inj. Decadron 0.5cc IV stat
Syp. Arceva 1 TSF x TDS
1Y.O(Wt 8.3kg)
Inj.Novidat inf 17ml (ATD) IV BD
Inj. Flagyl inf 14ml IV TDS
Inj. Ulcerex 0.3cc IV BD
Inj. R/L 250ml +Inj. Gravinate ½ IV Stat
Inj. P/M 200ml IV TDS
Syp. Zincate OD 1 TSF x TDS
Amybact Sachet 1 x BD x 3 Days
7 Mo (Wt 6.7Kg)
Inj. Maverick 500mg IV x OD
Inj. Hyzonate 100mg + 3cc N/S Give 1 cc x BD
Inj. P/M 150ml IV BD
Neb e Ventolin 0.5cc + 3cc N/S x 4H
Neb e Clenil A 0.5cc 3cc N/S x 6H
Neb.e Atem 0.5cc +3cc N/S x 8H
Inj. Provas 6cc IV 8H
Antibiotics with Drug of Choices

S/N Disease Drug of choices
1 Neonatal sepsis Ampicillin + Gentamycin

2 Newborn Gonococcal Conj. Topical Erythromycin + inj. Ceftriaxone
3 Infant with Chlamidia Conjunctvitis Topical + Oral Erythromycin
4 Meningitis < 30 Days old Ampicillin + Gentamycin
5 Meningitis 30-60 days Old Ampicillin + Cefotaxime
6 Meningitis > 2Years Vancomycin + Ceftriaxone/Cefotaxime
7 Streptococcal Pharyngitis Oral Penicillin or Inj. B. Penicillin (Single1.2MU >27Kg , 0.6MU if
< 27kg
8 Dental Infections Oral Penicillin
9 AOM Amoxicillin 90mg/Kg/24h
Cefdinir 14mg/kg/24h
Ceftriaxone 50mg/kg/24h 3days
10 Acute Mastoiditis Vancomycin + Ceftriaxone/Cefepime
11 Pneumonia Amoxicillin/Ampicillin 90mg/Kg/24h
Ceftriaxone
12 Pneumonia (Mycoplasm) Azithromycin
13 UTI (E.Coli MCC) TMP/SMX (Not use for 1st 2 Months)
Cephalexin
Amoxicillin+Clavulanic
Cefixime
Ciprofloxacin
14 Tissue Cellulitis (MSSA) Cephalexin, Cefazolin
15 Tissue Cellulitis (MRSA) TMP/SMX, Clindamycin, Linezolid
Antibiotics Ass. Diaarhea MTZ, Vancomycin
Pediatrics Medicine and Doses.
S/N Drugs Strengths Doses Indications
1 Syp. Amoxil 125mg/5ml 30-50 mg/kg/day TDS URTI
250mg/5ml
2 Syp. Augmentin 156mg/5ml 30-50 mg/kg/day TDS URTI
312mg/5ml
400mg/5ml
3 Syp. Caricef 100mg/5ml 10 mg/kg/day OD URTI
200 mg/5ml 20 mg/kg/day OD Typhoid fever
4 Syp. Klaricid 125 mg/5ml 15 mg/kg/day BD Acute Tonsilits
250 mg/5ml Bronchial Asthma
5 Syp. Acefyl Cough 125 mg/5ml ½ TSF TDS < 1 Year Wheezy Cough
1 TSF TDS > 1 Year Productive Cough
6 Syp. Hydryllin DM ½ TSF TDS < 1 Year Dry Cough
1 TSF TDS > 1 year
7 Syp. Britanyl 2.5 mg/5ml ½ TSF TDS < 1 Year Bronchodilator
1 TSF TDS > 1 year Bronchial Asthma
8 Syp. Zincat OD 20 mg/5ml ½ TSF TDS < 6 Months Diarrhea
1 TSF TDS > 6 Months
9 Syp. Gravinate 12.5mg/4ml ½ TSF TDS < 6 Months Vomiting
1 TSF TDS > 1 year
10 Syp. Entamizole 100 mg/5ml ½ TSF TDS < 1 Year Infectious diarrhea
(30-50mg/Kg/day) 1 TSF TDS > 1 year
11 Syp. Flagyl 250 mg/5ml ½ TSF TDS < 1 Year Infectious diarrhea
(30-50mg/kg/day) 1 TSF TDS > 1 year
12 Syp. Brufen 100 mg/5ml 10 mg/kg/day TDS Fever
13 Syp. Panodol 100 mg/5ml 10 mg/kg/day < 6 Months Fever
14 Syp. Ponston 20mg, 40mg 10 mg/kg/day TDS High Grade Fever
15 Cap. Omega APD
16 Syp. Mucaine ½ TSF TDS < 1 Year Abdominal Pain
1 TSF TDS > 1 year
17 Syp. Colic ½ TSF TDS < 1 Year Abdominal Pain
1 TSF TDS > 1 year
18 Syp. Vidalin L ½ TSF OD < 1 Year Appetizer
1 TSF OD > 1 year
19 Syp. Trimetabol ½ TSF OD < 1 Year Appetizer
1 TSF OD > 1 year
20 Syp. Sangobione 5-10 mg/kg/day OD/BD Appetizer
21 Syp. Rifampicin-H 100 mg/5ml 10 mg/kg/day BBF (9Mon) TB
22 Syp. INH 50 mg/5ml 5-10 mg/kg/day BBF (2M) TB
23 Syp. PZA 250 mg/5ml 25 mg/kg OD BBF (2Mon) TB
24 Syp. Epival 250 mg/5ml 20-60 mg/kg OD/BD Epilepsy
25 Tab. Vita 6 ½ OD < 1 Year TB
1 OD > 1 year
26 Tab. Myrin-P For Every 10Kg 1 Tab. OD BBF TB
(2 Months)
27 Tab. Myrin For Every 10Kg 1 Tab. OD BBF
(Next 7 Months)
28 Tab. Novidat 250mg, 500mg 10 mg/kg/Dose BD Typhoid fever
29 Syp. Novidat 250 mg/5ml 10 mg/kg/Dose BD Typhoid fever
30 Montika Sachet 4mg 1 HS < 4years Acute bronchial Asthma
31 Tab. Montika 5mg 1 HS > 4years Acute bronchial Asthma
32 Tab. Artem DS 20/120 (Children) 5-15 Kg 1 BD Malaria
15-25 Kg 2 BD
25-35 Kg 3 BD
>35 Kg 4 BD
36 Tab. Artem EZ 80/480 >45kg 1 BD Malaria
34 Tab. Delacortil 5mg, 10mg 1 mg/kg OD Acute bronchial Asthma
60mg/day MAX OD Nephrotic Syndrome
35 Hi Flora Probiotic 1 Pack BD Diarrhea
36 Inj. Ampicillin 500mg + 5 cc D/W 100 mg/kg/day TDS Birth Asphyxia, Pneum.
(ATD) 200 mg/kg/day TDS Sepsis
300 mg/kg/day Meningitis
37 Inj. Cefotaxime 500mg + 5 cc D/W 100 mg/kg/day TDS Birth Asphyxia, Pneum.
150 mg/kg/day TDS Sepsis
200 mg/kg/day TDS Meningitis
38 Inj. Ceftriaxone 1gm + 10 cc D/W 50 mg/kg/ OD Diaarhea
(Cefxone) 75 mg/kg/ OD Pneumonia
85 mg/kg/ OD Enteric Fever
100 mg/kg/ OD Meningitis
39 Inj. Flagyl 1.5 mg/kg/dose TDS Diarrhea, AGE
40 Inj. Novidat (ATD) 200mg/100ml 10 mg/kg/dose BD Enteric Fever
41 Inj. Grasil 50mg/ml 15 mg/kg/day BD GIT Sepsis, Gr -ive Sepsis
In Preterm 7.5mg/Kg OD dose
42 Inj. Ulcerex 100mg/ml 15 mg/kg/day TDS Bloody Aspiarte
43 Inj. Ceftazidime 500mg + 5 cc D/W 100 mg/kg/day TDS Hospital Acq. Sepsis
(Fortum) 150 mg/kg/day TDS Meningitis
44 Inj. Vit.K cc IM OD Birth Asphyxia,
0.5 cc IV Diluted OD HDN, Liver Failure
45 Inj. Decadrone 4mg/ml 0.6 mg/kg/day TDS Meningitis, Sepsis
46 Inj. Artem 80mg/ml 3.2 mg/kg/ OD IM for 3 Days Malaria
47 Inj. Vancomycin 500mg + 5 cc D/W 60-80 mg/kg/day TDS diluted in Resistant Steph. Aureus
Burette + 20 cc N/S in Inf. Inf.
40 mg/Kg/Day TDS Dec. Dose in Renal Fail.
48 Inj. Ampiclox (ATD) 500mg + 5 cc D/W 200 mg/kg/day TDS Sepsis
300 mg/kg/day TDS Meningitis
49 Inj. Aclova 500mg + 10 cc D/W 30 mg/kg/day TDS diluted in Encephalitis
Burette + 20 cc N/S in Inf.
50 Inj. B. Penicillin 1 M Unit + 5 cc D/W 1-2 Lac/Kg/Day TDS Pneumonia
3-4 Lac/Kg/Day TDS Meningitis
51 Inj. Solu Cortef 250mg + 2.5 cc D/W 10mg/kg Stat and then Acute bronchial Asthma
5mg/kg/dose 6Hrs.
52 Inj. Diazepam 5mg/ml 0.2-0.5mg/kg/dose Fits
53 Inj. Phenobarbitone 200mg/2ml 15-20mg/kg loading dose Fits
5mg/kg/dose OD/BD
Maintainance
54 Inj. Cefepime 500mg + 5 cc D/W 100 mg/kg/day TDS Sepsis
(Maxipime) 150 mg/kg/day TDS Meningitis
55 Inj. Klaricid 500 + 10 cc D/W 30 mg/kg/day diluted in 20 cc Atypical pneumonia
N/S in burette IV BD
56 Neb. Ventolin Initially 0.5 mg/kg Stat then Acute bronchial Asthma
0.15mg/kg 3 times 5mins apart
57 Neb. Atem ½ Amp 6 Hrs Acute bronchial Asthma
Eye:
Ophthamia Neonatorum: (Chlamydial= Presentation 5-14 days, Gonorrhea = 2-5 days)
Topical Antibiotics eg.
Conjunctivitis:
Cortisol rim Eye Oint or Trimin Eye Ointment
Sup. Augmentin 1 x OD
Chalazion: (Painless Swelling At eyelid, O/P small Nodule, Blurry Vision )

Self Resolution.
Topical Steroid e antibiotics drops.
Anti-inflammatory Drops
Local steroid Injections.
Surgery
Hordeolum Externum (Cyst): (Pain/tenderness at eyelid, Eyelid margins becomes red and oedematous. Pus points towards lid
margins)
Tab. Augmentin 1g 1 x OD
Tab. Tonoflex-P 1 x BD
Betadrop-N 2 x BD
Warm Compress
Evacuation of pus
Blepharitis: (Chronic Irritation, itching, lacrimation, gluing of eye lashes and Photophobia, eyelid Margins are red, oedematous,
inflammed)
Eyelid Hygiene: Mainstay of Tx. Crusts and toxic Products are removed by scrubbing with 25% baby shampoo lotion
twice daily.
Antibiotcs Ointments. Eg
Topical Steroids
Artificial Tears.
Pregnancy: Drugs During Pregnancy and Lactations:
1.NSAID:
1.Paracetamol:
Is the analgest and antipyretic of choice
Can be used at any stage of pregnancy at usual doses
2.Aspirin (Acetysalicylic Acid)
2nd DOC in pregnancy
In 3rd trimester should nt be taken.
3. Ibuprofen and Diclofenac:
Can be considered in first 2 trimesters only
After 28 weeks its C/I.
4.Codeine:
May be used as an analgesicfor pregnant woman if P/M is nt sufficient.
Used as an antitussive
Use near to term may lead to withdrawal sympotoms
Long term use may lead to withdrawal symptoms.
5.Morphine:
If compellingly indicated, morphin may be use during pregnancy.
Use near to term may lead to withdrawal sympotoms
Long term use may lead to withdrawal symptoms.
2. DMARD:
1. Sulphasalazine:
1st DOC during pregnancy
Azathioprine, Cyclosporine, Pencillamine are reserved Mx options
3. Gout:
Probenecid is the DOC to achieve elimination of uric acid.
Calchicine is the 2nd DOC.
ALLOPURINOL IS C/I.
4. AntiHistamine (H1 Blockers) In Pregnancy:

First Generations:
CPM
Dexahlarpheniramine
Clemastine
Dimetindent
Mebhydraline.
Second Generation:
Loratidine: 1st DOC
Cetrizine: 2nd DOC
5. AntiAsthmatic and cough Medicatations:

Selective B2 adrenergic agonists:
Salbutamol Metaproterenol and Terbutaline (short acting) is the 1st DOC.
Formeterol and Salmeterol should be used if ther are essential to an optimal treatment. (long acting)
Corticosteroids:
Inhaled Corticosteroids:
Beclomethasone and Budesonide are 1st DOC.
Systematic corticosteroids:
Prednisolone and its metabolites are indicated only in acute exacerbation of asthma or SEVERE ASTHMA.
Intranasal corticoids:
For Allergic rhinitis.
Anticholinergic Drugs:
Ipratropium bromide inhaler are 1st DOC.
Theophilline:
indicated only in acute exacerbation of asthma or SEVERE ASTHMA.
Sodium Cromoglycate:
Can be used for the prophylactic Tx of Allergic Disease.
Expectorants and Mucolytics:

N-Acetylcysteine , Bramhexine, Ambroxol are 1st DOC mucolytic during pregnancy if oral therapy and other non
medical Tx is not effective.
Antitussive:
Codeine and Dextramethorphan can be given in all trimesters of pregnancy.
Antibiotics During Pregnancy:

Remember:Penicillins, Cephalosporins,Erythromycin, Nitrofurantain are OTC drugs in
Pregnancy.
Penicillins:
B- Lactam Antibiotic.
1st DOC at usual doses.
Cephalosporins:
B- Lactam Antibiotic.
Can be used if needed.
Macrolids:
Erythromycin 1st DOC.
Erythromycin estolae and troleandomycin should not be given in 2nd and 3rd trimester.
Azithromycin, clarithromycin, Josamycin, Roxithromycin are 2nd drug choice.
Lincomycin and clindamycin:
Lincomycin and clindamycin are only indicated when penicillins and cephalosporin are not effective.
Quinolones:
Not indicated in first trimester.
Cipro and norfloxacin shoul be used in complicated resistant UTIs.
Aminoglycosides Chloramphenicol Polypeptides eg Vancomycines, and SMP are C/I in pregnancy.
Pregnancy Problems and their save medications
Problem Save Medicine
Antibiotics Penicillins,Cephalosporins,Erythromycin,Nitrofurantain, clindamycin

Rashes Benadryl Cream, Caladryl lotion, hydrocortisone cream/Oint.
Cuts and Scrapes Polysporin
Heart Burn, Gas Upset Antacids,Simethicane
Constipation, Diarrhea Psyllium, polycarbophil, methycellulosem Lopreamide,
Insomina Diphenhydramint
Vomiting Doxylamine,Metoclopromide Meclizine(DOC) A/histamines 1st and 2nd Gen.
Pyrexia Of Unknown Origin

Causes: Infections:
Malaria: Fever(Cold,Hot,Wet stage)Vomiting, Severe Headache,Pt Anemic,Splenomegaly,Herpes Simplex of
Mouth,Anemia,Jaundice,Thick Thin Smear
Enteric Fever: Stepwise Rise of Temp,Fever continuous,Headache Drowsiness,Cough/Epistxis,Constipaation/Diarrhea ,RELATIVE
BRADYCARDIA,RASH,Hepatosplenomegaly,LEUKOPENIA,BC positive throughtout
TB: High Grade,Remittent,Intermittnet fever with NIGHT SWEATS ,Anorexia,Wt LOS S,Anemic,TACHYCARDIA,Crepitations+ /-,
Hepatosplenomegaly,NN Anemia,TT Positive
Brucellosis:
Amebiasis: Fever,Mildly Tender Hepatomegaly
Absces (Intraabdominal, Dental): H/O Abdominal Surgery,Fever
Infective Endocarditis:
Fungal Infections:
Malignancies:
Leukemias:
Lymphomas:
RCC:
HCC:
Colonic Cancers:
Others:
Connective Tissue Diseases:
Drugs: Any drug,Discontinue and Observe.
PE:
Hyperthyrodism:
Sarcoidosis:
Factitious Fever:
Brands Leaders in Pharmaceutical Companies of Pakistan

S/N Generic Brand Leader Price 2nd Best 3rd Best 4th Best 5th Best
Antibiotics
1 Ciprofloxacin Ciproxin 504 Novidat Lucid Cipval
**Hiflox 750 *Cipesta XR Algocin Axcin *Cyrocin
2 Norfloxacin Noroxin 200
3 Ofloxacin Tarivid 296 *Oflobid
4 Cefixime Cefspan 286/512 Caricef *Cebosh *Cefiget Magnett
Fixitil **Maxima Maxpan
5 Cephalexin *Keflex 59/200
6 Cephadrin Velosef 75/212 **Vercef Monocef
7 Clarithromycin Klaricid XL 314/245 Klaribact Claramed Claritek Megaclar
Rithmo
8 Levofloxacin Levoquin 671 ^Leflox *Levomerc Effiflox *Locus
Aerobay 416 Pfiziflox (390) Levofin **Qumic
9 Amoxicillin+Clavulanic Acid Augmentin 75/120 Calamox *Zamoclav
625mg,1g,457mg
10 Azithromycin 250mg Zithromax 190 Azomax Azour(Mer) *Zetro Azitma
11 Moxifloxacin Avelox 800 Moksi *Mofest Moxiget **zefecta
12 Doxycycline 100mg Vibramycin Supramycin Dotur ^Contymycin
13 Ampicillin+Sulbatem 750m Unasyn 440 Ambac
14 Lincomycin 600mg Lincocin HFC 115

15 Clindamycin 300mg Dalacin C 320 Bendue Clinda
16 Nitrofurantoin Furadentin 162
17 Cefaclor Ceclor Slate
18 Cefuroxime Zinacef 286 Zinnat Kefrox Cefuzin Zecef
19 Metronidazole Flagyl Metodine
20 Fosfomycin Mifos Focin
Gastrointestinal Track
1 Omeprazole Losec 688 *Noctis Risek/Insta *Xerosec Benzim
Selanz 70 *Omega Rpd **Teph-20 Rabecid Promoto
1a Esomeprazole Esso-20 Axid Neo Esofil Nexum **Novoteph
Lansoprazole Zoton Inhibitol Lanzit Lanzol
Rabeprazole
1b Pantoprazole Zopent Protium
1c Cinitapride Dynetic Cinita
2 Antacid Ulsanic **Dijex-MP Mucane Semilone

Mylanta-2 Gaviscon
3 Antiemetics Motilium **Gravinate **Maxolon Ganaton Onset
**Dompedone Maxolon Domel **Pelton-C
4 AntiDiarrheals Dependal-M Imodium Entamizole DS Enflor Lomotil
5 H2 Antagonists Ulfam 20 120 Zantac Tagamet Peptinil Ranax

6 Constipation *Laxoberon **Skilax **Cremaffin Lilac Duphalac
7 Anti Spasomedics ^**Spadix Colofac 135 No spa Anafortan + *Spasmogin
Multivitamens and Minerals
1 Calcium **Qalsan-D 122 Abocal Cac-1000 + Chewcal
3 Multivitamens Surbex-Z 130 Centrum Multibionta- *Unicap-T Optilets-M
Pramet-FA 122 Iberet Folic Sangobion Supradyn-N Dayalets
Revitale-M Theragran-
4 Iron Hydroxide Poly Maltose Polymalt FA 105 Maltofer drops **Bisleri *Ferosoft Acefer
Complex Ferricure 70 *Tri-Hemic 600 Ferfix 60ml **Rubifer Polyfer FA
4 Iron Protein Succinylate 400 *^Heamocare Iropal Iropas 800/15ml
5 Mecobalamin Methycobal Hicobal Incobal **Elgin **Mylaxon

Neuromet **Mabil *Nervon Vicopin
6 Cyanocobalamin Neurobion Sangobion Bevidox Triedox Surbex-T
7 Cholecalciferol Miura Indrop-D *Sunny-D3 Droplet-D D-tres
8 Ossein Mineral Complex *Êsegrow Forte Osnate-800 Osmin-D3 ^Bonmin
9 M/Vit Sachets Aqua Vit

Calcee Plus
Ointments
1 Steroids
Clobetasol Proprionate 0.05% Clobederm Dermovate Clobevate
Clobederm-S Dermovate-S
Clobederm- NN Dermovate- NN
Betamethasone Dipr. 0.05% Betaderm **Provate **Diprocort Diprogenta Saloderm
Provate-C Diprocort-C Spectrazole-G Mysoderm
Lotricort
Provate-G Diprocort-G
Lotricort-G
Provate-S Diprocort-S Novasalic
Betamethasone Vale 0.1% Betaderm-N Betnovate Betagenic Betacort-N Betacin
*Betaderm- NM Betnovate-N Betasalic Betacin Plus
Mometasone Furoat Momevate Hivate
Fluticasone propio 0.05% Cutivate Ticovate Flutinate
Triamcinolone Acet 0.02% Kenacomb Kenalog N
Hydrocortisone 1% Hydrocort 2.5% Hydrocort 1.0%
2 Antibacterial
Mupirocin Bactroban
Fusidic Acid Fusil A/B Fosedic Melas FU-Skin
Fusil-H Zudic **Melas-H
Wounds Healit Polyfax + Corticosporin Polyspore- HC Xyloaid
3 Antifungal
Miconazole **Daktacort Daktarin Gyno Daktarn
Ketoconazole **Conaz Stieprox Spike **Ketowin Ketagen

Terbinafine 1% Tersil **Lamisil Terbiderm *Cutis
^Terbisil Terbiwood (Lotion)
Griseofulvin Grivin ^Gryso
Isoconazole+Diflucorto. Travacort Acort
4 Antiacne
Isotretinoin **Isotrex **Isotrexin
Tretinoin **Retina-A Cromentin-A Skin-A
Clinda + Tretinoin **Cleret Acsolve **Acdermin
Fluocino+Tret+hydroquin **Trimelasin **Siton plus Hyderquin +
Clinda+ Benzoyl Peroxide Duac **Clinda Plus
Benzoyl Peroxide Crozyl **Panoxyl
Adaplene **Pimpal Adapco
5 Psoriatic Movelat **Oilatum +
6 Vaginal Creams
Clindamycin Dalacin-V *Clycin-V
Clotrimazole **Hydrozole **Canesten-V Cremazole-H Vagizole Gynosporin
7 Anti-Scabies
Permethrin **Lotrex Scabfree 5% On Skab Scabrid ^Mitonil
^Lice-o-mite
Crotamiton + Sulpher Scabion Forte Scabion
8 Isoamyl-P-N-Dimethyl *Spectraban
9 Burn Dermazin Silvate
Anti-Hypertensive
1 HydrochloroThiazid + ^*Xavor-Forte Co-Eziday
Losartan 25/100mg/ Xavor-DIU
2 Amlodipine + Valsartan Avsar *Valsan-AM Valtec AM
10/160mg Extor (10/320mg)
3 Amlodipine + Co-Extor Tri-Valsan **Triforage *Valam-H
Hydrochlorothiazide +
Valsartan (10/12.5/160mg)
4 Amlodopine + Telmisartan *AM-Telsan **MISAR-AM AMTAS
10/40mg
A Telmisartan 40mg *Telsan **Misar Tasmi
B Hydrochlorothiazide + *Co Telsan **Misar-H Co-Tasmi
Telmisartan 12.5/40mg
5 Amlodopine 10mg Norvasc Ampress *Lodopin
6 Amiloride + Furosemide *Lasoride
5/40mg
7 Spironolactone + Spiromide
Furosemide 50/20mg Spiromide-40
8 Spironolactone 25,100mg *Aldactone *Aldactone-A 25mg
9 Furosemide **Lasix
10 Lisinopril Zestril **Corace Ziscar Novatec
11 Lisinopril + HcT 10/20mg Corace Plus Co Ziscar Co-Trupril
12 Bisoprolol 5mg Concor **Actim
13 Atenolol 100mg Tenormin *Blokium
14 Captopril 25mg Capoten **Capril
Anti-Diabetics
1 Glimepride 4mg Amaryl 640 ^Gluconorm Gliride Agpride
*Getryl 400 *Gpride
2 Glimepride+Metformin **Getformin 195 Evopride Plus
3 Glimepride+Pioglita 2/15mg Zoliget 150 Piozer G
4 Metformin Glucophage **Glucophage XR Neophage
5 Metformin+ Pioglitazone Prefair Piozer Plus
6 Met4min+Sitagliptin 50/1g Sitaglu met Treviamet **Jentin met **Tagipmet Itaglip Plus
7 Sitagliptin Sitaglu Trevia Gliptin *Tagip
8 Gliclazide 30,60mg ^DiamicronMR Getzid-MR **Prozide
9 Metformin+Glibenclamide **Glucovance Glibomet Daonil
Miscellaneous
1 Anti-Allergic
Fexofenadine Telfast-D *Fendina Fexet Xadine Fexo D
Desloratadine Neo-Antial ^*Destina Larinex
Cetirizine *Gixer *Incidal-Neo Actilex-CTZ Zyrtec Xyzal
Rigix Cezine *Sedil Neo-Sedil *Syp.T-Day
Loratadine ^*Exigentin Antial Lorefect *Senergy OD Xylor
Chlorpheniramine Cofcol Pectus Piriton Corex-D Sancos
Clemastine ^Tandegyl-D
2 Analgesics
Diclofenac Caflam **Artimov-k **Mobikare Maxit Catafen
Voltral SR Klic Declam Diclorep
Diclo + Misoprostol Artho plus Arthotec-50 Cytopan *Dyclo-M Osteotec
Tector Plus *Rotec *Esmart
Ibuprofen Brufen Plus
Piroxicam Feldene **Proxim Brexin
Cyclobenzaprine Hcl 10mg Flexagil
Tramadol 50mg Tramal Plus *Tonoflex Merlon **Tamadol
P/M + Caffei + thioridazine **Sinaxamol Diagesic-P Nuberol Plus
P/M + Tramadol Tonoflex-P **Zultracet
P/M+ Orphenadrine Nuberol Forte Sinaxamol Extra Norgesic Wilgesic Samerol forte
Aceclofenac Acemed **Airtal ER Acenac Alkeris Pefree
Celecoxib Ecoxib Celbexx Celart Rheuoxib Moveryl
Meloxicam Mellow *Xobix Melor Melfax Micam
Lornoxicam *Zafon Rapid *Xika Rapid Loricam
Thiocolchicoside Thiolax **Myosoft
Ketorolac Toradol
Pregabalin Cap 75mg **Hilin Gabica Zeegap Lyrica *Prelin
Gabapentin Cap 300mg **Neupentin Duogab Gabix Neogab
Amitriptyline Tryptanol Amyline
Nortriptyline + Fluphenazine Motival
Lignocaine Healit Mycitrracin Plus Polytracin **Xylocaine
Diclofenac Mobikare *Artifen Topiical Fenac Diclozaf
Voltral Fist *Sofac
3 Appetite Stimulants Trimetabol Mosegor-V Orex Plus *Cestonil Plus

4 Anti-Tussive Hydryllin-DM Benylin-DM Corex-D Pacific-DM Rondec
Actifed-DM Cofcol Cosome-E Triaminic-
Combinol-E Pulmonol
Anti-Pyretics Febrol *Cofcol Nicor Hydryllin A/F Disprol Peds
Calpol paeds Triaminic Flue Flucol Sermol Fort Tempramine
Epinol-CF Sermol Temprol
5 Anti-Protozoal
Tinidazole Fasigyn Trichogin
Secnidazole *Gentizole Secnidal Forte
Clotrimazole Gynosporin Canesten Vag. Gynosporin
6 Anti-Depressant
Bromazepam Brolite *Lexilium Relaxin Sambro
Escitalopram Citanew *Prodep Prolexa Zavget Seradep
Sertraline 100mg **Sert Freedep
Alprazolam (HS) **ALP Lampro Xanax
Paroxetine Seroxat CR 12.5
Quetiapine (HS) 100mg Qusel *Qutyl *Tiapin Evokalm
Risperidone (HS) 2mg Risp
Clonazepam (HS) 0.5mg Rivotril Magura
Chlorpromazine 25mg Largactil **Chlorotil Pregesic
7 Lipid Lowering Agents
Rosuvastatin Rovista ^X-plended **Vaptor *Rosubar Rosulin
Atorvastatin (HMG CoA red.In) *Lipiget Atorsan *Lochol Amotrin **Cadwin
HS
Amostin Lipiget EZ Vastor-AM *Co-Atorap
Simvastatin (HS) *Atrocard Silser Simezet Synimax
Gemfibrozil (Fibrates) Lopid
300mg x BD
Fenofibrate Fenoget Fenogal Zibrate TS
Nicotinic Acid
Cholestyramine (Chole ster ol resins)
8 Eye Drops
Dexa. + Tobramycin *^Bracin-D *Eyebradex Bromycin-D
Cholram + M.cellulose Chlormax Prednicol Optachlor
Beta + Neomycin Probeta-N Betnesol-N
Antiseptic drops Trimin ^Polyspore-Hc Cortisporin
Ketotifen ^Deketofin Ketolerg
Lodoxamide Inlod
Moxifloxacin A-Mox *Ôxcin-D Ômox Ocumox
9 Anti-Malarials
Lumefantrine+Artemether Ârceva Artem plus DS **Artelum Malera *Artheget Jr
Chloroquine Nivaquin-P ChloroQuine Resochin
Pyrimethamine+Sulfadox Fansidar Malarest
Di-OH-Artemisinin+Piper Timequin ^Dipip
10 Acyclovir Zovirax **Cycloz Aclova Zoraxin
11 Anti-Hyperurecemic Zurich 40 Zyloric
12 Psyllium Husk *Fibrocol Powde r Ispogel **Mebipas

Mouth Wash Solophar *Benzid Spray Enziclor *Pyodine (MW)
Infant Colic Drops Colic (digas) Colibid(Lactase) Laczyme

Supplements 4 Pregnants Pregnacare Morinaga BF- Myfol
^Supplement-M Mama Q-folic
Formula Milk in Diarrhea Meiji Lactoless ^Nestle Recover Morinaga NF-33
Formula for LBW Nestle NAN 1
Formula Milk Meiji FM-T Meiji Pro (LBW) Lactogen-1 BF-1 Pediasure
Cow & Gate
Injections
1 Ampicillin + Cloxacillin Ampiclox Apoclox Amplus
2 Ampicillin + Sulbactam Unasyn Ambac
3 Cephradin Velosef Infexin Ceftrinex *Cephagen
4 Ceftriaxone Rocephin Oxidil Sonnet Maverick Maxcef
Cefin Inocef Mercefex *Cefxone
5 Cefotaxime Cefotaxime Cefotax Claforan Exef *Yorker
Cefomerc
6 Cefoperazone + Sulbactam Sulpron 2Sum Cebac Ceflactam
7 Amikacin Grasil Amkay
8 Ceftazidime Fortum 415 Fortazim Cefosel Nivador *Cefcom
9 Cefoperazone Cefobid 329 Dardum
10 Metronidazole Flagyl
11 Clarithromycin Klaricid
12 Ciprofloxacin Novidate 165 Lucid ^Cipesta
13 Gentamicin Gentic
Injections Other than Antimicrobals:

13 Paracetamol Provas *Bofalgan
14 Cimetidine Ulcerex 15 Altramet Tagamet
15 Ranitidine Zantac Nulcer Ranitide
16 Dimenhydrinate Gravinate Devom
17 Metocloprimde Clopan
18 Ketorolac Toralac
19 Dexamethasone Decadron Dexamex
20 Diazepam Valium 25
21 Sodium Valporate Epival IV
B12+FA+Sorbitol Jectosol plus
Nicotinamide+Betaine+ Jetepar
Ethanolamine
22 Cyanocobalamin Neurobion Cyanocob Cytamen Bevidox Jectosol +
Theragran-N Trividox Vitrobion
23 Iron Sucrose Sangobion *Bisleri-S Ive Fer Rubiject
Venofer Ferosoft-S *Neufer
24 Diclofenac Phlogen Maxit-S
25 Tramadol Mictra Tramal
26 Artemether Qmetem-P
27 Testosterone **Testoviron **Sustanon 250
Generic Drugs with their Trade Names

S.No Generic Trade Name Excretion Comments
1 Antibiotics
Ciprofloxacin Ciproxin Neofloxin
Norfloxacin Noroxin Floxin
Ofloxacin Tarivid Tariflox
Levofloxacin Levaquin Iquix
Cravit
Cephradin Velocef Intracef
Cephalexin Keflex Ceporex
Cefuroxime Zin acef Ceftin
Cefixime Cefspan
Cefaclor Ceclor Biocef
Keflor Distaclor
Clarithromycin Klaricid
Azithromycin Zithromax Azithrocin
Moxifloxacin Avilox Vigamox
Doxycycline Vibramycin
Fosfomycin Monurol
Amoxicillin + CA
Clindamycin Dalacin Cleocin
Clinacin
Erythromycin Erybron
2 Injections
Ampicillin+Cloxacillin
Ampicillin+Sulbactam Unasyn
Cephradin
Ceftriaxone Rocephin
Cefotaxime Claforan
Ceftzidime Fortum
Cefoperazone+ Cefobid
Sulbactam
Metronidazole Flagyl
Amikacin Amikin
Gentamycin Genticin Garamycin
Ciprofloxacin
Levofloxacin
Moxifloxacin
3 PPI
Omeprazole Losec
Esomeprazole
Pantoprazole Protonix
Rabeprazole
Lansoprazole Zoton Prevacid
4 H2 Anatagonists
Ranitidine Zan tac
Famotidine Nocid Pepcidine
Antacid Mylan ta
5 Antiemetic
Domperidon Motilium
Cinitapride
Cyclizine Marzine
Promethazine Phenergan
Metoclopromide Maxolon
6 Anti-Diabetics
Glimepride Amaryl
Glimepride+Metformn
Metformin Glucophage
Met4min+Glimepride Janumet
Gliclazide Diamicron
Met+Glibenclamide
Sitagliptin Januvia
7 Analgesics
Diclofenac
Pentazocine Sosegon
Piroxicam Feldene
Cyclobenzaprime Hcl
Tramadol
P/M + Thioridazine
P/M+Tramadol
Thiocolchicoside Muscoril
P/M+Orphenadrine
Aceclofenac Acenac
Ketorolac Toradol
Celecoxib
Meloxicam Mobic
Pregabalin Lyrica
Amitriptyline
Nortriptyline+
Fluphenazine
Lignocaine Xylocaine
Duloxetine Cymbalta
Naproxen Apranax Naprosyn
8 Anti-HTN
Hct + Enalapril Co-Renitec
Hct + losartan Hyzaar Cozaar
Hct+AML+Valsartan Exforge HCT
Hct+ Telmisartan
AML + Valsartan Exforge
AML + Telmisartan
Amlodopine Norvsac
Telmisartan
Amiloride+ Furosemid Lasoride
Spironolactone Aldactone
Spironolactone+Furo. Aldactazide
Lisinopril Zestril
Lisinopril+Hct Zestoretic 20 Co-Novatec
Bisoprolol Concor
Atenolol Tenormin
Captopril Capoten
Captopril+Hct Capozide
Furosemide Lasix
9 Anti-Allergic
Fexofenadine Telfast
Desloratidine
Cetrizine Zyrtec
Levocetrizine Xyzal
CPM Piriton
Loratidine
Clemastine
10 Statins
Rosuvastatin
Atorvastatin Lipitor Atorva
Simvastatin Zocor
Gemifibrozil
Fenofibrate Lipofen
Nicotinic Acid
Cholestyramine
11 Spasmolytics
Mebeverine Colofac
Drotaverine No-S pa
Phloroglucinol
Hyoscyamine Anapaz
Baclofen Lioresal
Tizanidine Zan aflex
12 Anti-Depressant
Bromozepam Lexotanil Lexilium
Rekotnil
Escitalopram Cipralex Lexapro
Paroxetine Seroxat Paxil 20
Paxetin
Alprazolam Xanax
Risperidone Risperdal
Clonazepam Rivotril
Chlorpromazine Largactil
Quetiapine Seroquel
Sertraline Zoloft
Fluoxetine Prozac
TCA
Amitriptyline Tryptanol
Imipramine Tofranil
Clomipramine Clomfranil
Nortriptyline Motival
Dothiepin
13 Ointments
Clobetasol Dermovate
Betamethasone D
Betamethasons V
Fluticasone Cutivate
Triamcinolone Ken alog
Hydrocortisone
Mupirocin Bactroban
Fusidic Acid Usidin-H Fudic H
Usibet
Miconazole Daktrin Daktacort
Gyno-Daktrn
Ketoconazole Nizoral
Terbinafine Lamisil
Griseofulvin Grifulvin
Isoconazole+Diflucort Nerisone-C
Isotretinoin
Tretinoin Retin A
Clinda + Tretinoin
Fluocino+Tret+
hydroquin
Clinda+ Benzoyl Duac Panoxyl
Peroxide
Benzoyl Peroxide Ascabiol
Adaplene
Clindamycin Dalacin
Clotrimazole Canesten
Crotamiton Scabion
Permethrin Lotrex
Crotamiton
Silver sulfadiazine Dermazin Silvate
14 Anti-Maigraine
Valporate Epilim
Topiramate Topamax
Metoprolol Lopressor
Sumatriptan Imigran
15 Sprays
Triamcinolone Nasacort-AQ Nosolone-AQ
Mometasone Hivate
Fluticasone Ticovate
16 LRA
Monteleukast Singulair
17 Mast Cell Stabilizers

Ketotifen Zatofen

Cocktail For Note 4

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Cocktail For Note 4

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Cocktails for Medical Officers

By Dr. Muhammad Bilal Sharif

DCLD/ Upper GI Bleeding:

DCLD/ Hepatic Encephalopathy:

DCLD/ Hepatic Encephalopathy,Massive Ascites (OPD basis):

Spontaneous Bacterial peritonitis:

Acid Peptic Disease:

Irratible Bowel Syndrome:

Treatment in Acute severe Asthma:(Hosp.)

Interstitial Lung Disease :

Bronchoectasis : (Hemoptysis +Copious Purulent sputum + clubbing)

Measles: (Koplik Sign,3Cs)

Bacillary Dysentary/ Shigellosis:

Steroids Indication In Pulmonary TB:

Diaarhea: (Enteric fever,AGE)

Rat Pill Poisoning:

Chlamydial Infection: (Excessive discharge, P/Coital bleeding, dysuria, Perihepatits, periapendicits)

Gonorrhea: (Excessive discharge, Arthritis,Pharyngitis,Dysuria)

Infections Of Upper Genital Track:

Dysfunctional Uterine bleeding:AUB

Peripheral Neuropathy: Mononeuropathy

Hyperkalemic Periodic Paralysis:

Note:Half Life of Thyroxin is 2 weeks.TSH is monitored at 6-8 Weeks.

Diabetic Ketoacidosis: (Hyperglycemia, Urin ary Ketones, Metabolic acidosis(PH<7.3,NaHCo3 <15meq/L))

2. When RBS is >250mg/dl

Inj.Insulin R 24 units in 100cc N/S @24µdpm (6units/h)

3. When RBS is <250mg/dl

Inj.Insulin R 24 units in 100cc N/S @16µdpm (4units/h)

4.Bicarbonate Deficit Can be calculated as:

Diabetic Neuropathy: Strict Glycemic control.

Importence: Aka ED (Depression, Anxiety, Hypogonadism, Hyperthtroidism, Acromegaly, Addison,s )

Inj. Espogen 4000 IU 1 x weekly IM

Nephrotic Syndrome: (Proteinuria>3, Hypoalbuminemia, Edema, Hyperlipdemia, Hypercoaulability)

Nephritic Syndrome: (Hematuria, Proteinura, HTN, Edema, Oliguria, Uremia)

Acute Pyelonephritis: (Loin pain, dysuria,fever, Tenderness at renal angle )

LUTI: (Urethritis, Cystitis):

Hypertensive Emergency: eg 240/170mmhg

Complete heart Block:

IHD (T2DM): (KMTH)

IHD (HTN: (FIC)

Neck Pain D/D:

Rheumatic Arthritis: (Same Mx for Seronegitive RA)

Geriatric Pain Management:

Fibromyalgia: (pain, Stiffness, Fatigue, IBS, GAD, Non restorative sleep)

Systemic Lupus Erythematosis: Fever+arthragia+Rash+Young female is SLE UPOW)

B12 Def. Anemia:

Intravenous Fluids in Paeds:

How to Calculate IV Fluids:

C. Deficit: % of Dehydration x Wt x 10 ( Formula Coefficent)

Example: 10Kg Baby Wt with 10% Dehydration

Scabies;(Severe nocturnal itching,Family H/O,Typically @interdigital clefts,ulnar borders of hands,wrists,elbows,axillae,

Pediculosis Capitis !Scalp itching,Preauricular R, Hair may be matted with pus)

Pediculosis Corporis !Old men/women,itching, secondary infection common)

Seborrhoeic Dermatits: (Marked Scaling at scalp R,with eczema, greasy discharge)

Hepers Simplex Labialis:

Miliaria : Aka Sweat Rash, Prickly Heat

Pompholyx: Chronic vesicular eruption of palms and soles.

Acne (Nodular or Vulgaris):

Chronic Fatigue Syndrome: (CFS)

Isoloation and Mash nets.

Vitamen A defeicency: (Bitot sign )

Injections doses in Paeds:

Antibiotics with Drug of Choices

5 Mecobalamin Methycobal Hicobal Incobal Elgin Mylaxon

Ketoconazole Conaz Stieprox Spike Ketowin Ketagen