Medical students/ pre-interns/ Family physicians use various notes to guide their general practice at the begining, specially drug doses, common treatments for common diseases etc. These "guides" have been used by many seniors but need to be careful revision before prescribing. Hope to update once I go through them completely.
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Private practice guide for common illnesses
1. Guide to private practice- note 1
Simple way of private practice
There are several illnesses that can be easily treated and cured. But most cases relive
spontaneous. About 30 cases can identify and can be treated.
Allergies Ear infection Cough and cold
UTI Eye & Ear drops Asthma
Vaginal discharge Painful menstruation Motion sickness
Warm treatment Contraceptives Sinusitis
Toothache in child Dermatology (pitriasis) Rhinitis
Hypertension Appetite inducers (LOA) Numbness of distal limb
Oral thrush Diarrhea Abdominal pain & discomfort
Gastritis Migraine Viteligo
Constipation Vertigo Warts plantar
Anemia Acne Wounds
Allergies skin
Hydrocortisone cream (tropical)
Betnovate cream
Betnovate-N-combination with antibiotics- Oozing
Betnovate-C_ only steroid –none oozing
Betnil-N
Dexaquin cream/ointment –use in eczema-Infantile eczema
Oral treatment
1. Prednisolone 10mg stat+tds (initially up to 10-20mg daily. Acute attack of asthma30-
40mgdaily.)
2. Promethazine HCL (phenagan) IM stas 20mg bd / 25 mg noct / 10-12mg tds (1tab=10mg)
2. 3. *Child<2yr phenagan is not recommended*
4. 2-5yr 5-15mg give as divided doses.
5. 5-20yr 10-15mg bd
6. Piriton (chlophenamine)2tab stat/then nocte+1/2 mane (1tab =2/4/mg )
7. Ketotifen also can can beused 1-2mg bd>2yrs
8. Drug allergy: hydrocortisone IV+ piriton/phenagan IM stat or prednisolsne 5 tab +piriton2tab
Paracetamol doses
o <3month 60mg (1/2tsp)6 hrly (10-15mg /kg bodyweight)
o 3-12 month 60mg-120mg6hrly (1/2 -1tsp)
o 1-5yr 120-250mg 6hrly (1-2tsp)
o 6-12 yr 250-500mg 6hrly
o >12yr 500-1000mg 6hrly(1-2tab)
o >15yr 2 tab
*5ml =125mg*
If jaundice reduce dose
Urinary tract infection
a. Nalidixic acid 500mg- 1000mg 6hrly / child 40mg/kg/day
b. Vit C1-2 tab tds.
c. Frusemide 20-40mg mane
d. Probenthine 1tab tds 15mg =1tab
e. PCM 2tab sos
Other antibiotics
a. Nitrofurantion 50-100mg 6hrly or tds
b. Norfloxacin 400mg bd
c. Ciprofloxacin 250mg bd or 500mg bd
Investigation should be done
a. *UFR for protein
b. *USS abdomen for <5yr child
c. *Urine culture /ABST
3. Vaginal discharge
If suspected Candidasis
1. Itraconazole 200mg bd for 1day
2. Nystatin vaginal pessary
3. Candid vaginal tablet v1/v2/v3/v6
4. Metranidazole 1tds or metragel local application can be used.
5. Clotrimazole 500mg vaginal tab stat
If gonorrheal infection is suspected pencillin500mg 1tds1day.
Vitamin
1. VitA,D.E(cod live oil)5ml nocte
2. Vit E evit, evion 200mg , 400mg or tocovt 1tab nocte
3. Polyboin (vit B Complex) syrup 2tsp or 1 tab noct
4. Neuroboin (vitB complex) 1 tab nocte
5. Becsules (vit B with vit C) syrup 2-3tsp or 1cap nocte
6. Neurofle
7. Iburol syrup
8. Vit B12 IM
9. Multi vitamin (multi sanostol) adult3-4 tsp
Warm infection
1. Combantrin-
6/12-2yr 1tab (1/2tsp) nocte or combantrin mixture 1tsp mane.
2-9 yr 2tab (1tsp)nocteor combantrin mixture 2tsp mane.
9-13yr 3tab (1,1/2 tsp) nocte or combantrin mixture 3 tsp mane.
2. Mebendazolle-1 tab bd for 3days (threadworm,roundworm, whipworm,hookworm)
3. Albendazole (Zentel )(Albex) adult or >12yr (200mg =1tab )400mg single daily dose
(threadworm ,roundworm,whipworm,hookworm)
Toothache for children 5-14yr
4. 1. Diclofenac Na 25mg tdsfor 3days
2. Metranidazole 1tds for 3days
3. Amoxicillin 250mg tds for 3days
4. Aludrox1tds
Vomiting
a. Maxolone (metaclopramide HCL)
Adult >15yr 10mg tds,
Child
14-9yr 5mg tds,
9-5yr 2.5mg tds,
5-3yr 2mg bd-tds,
1yr 1mg bd
(Vomiting, flatulence, heartbum,reflux)
a. Motilium(domperidone)adult>15yr10mg tds
Child 5mg/kgbody wt (vomiting, flatulence,heart burn,reflux,digestive disrters)
a. Phenergan (promethecine HCL 10mg tab) adult 20mg /nocte ror bd or 10-20mg tds
(Vomiting due to post –op&pregnancy, mortion sickness 1tab before journary)
Children is not recommended
a. Prochloperazine (stametil) adult 1-2tab (5-10mg)3-5time/day(sever nausea,vomiting, vertigo,-
labyrinthin 1tab tds
Oral thrush
Nistatin orals suspension
Datarin cream
Helicobacter pylori infection (eradication)
Omeprozole 20mg bd
Clarithromycine 500mg bd
Tinidazole 500mg bd
Lansoprozole 30mg bd
5. Ranitidine 300mg nocte
Metronidazole 400mg bd
Anemia
1 Fe SO4 1tab nocte for >7 days
2 Folic acid 1tab bd
3 Vit C1tab tds
i. Multi vit 1tab bd
ii. Appetite inducer,
1. Cytecxin 1tsp tds
1. Peritol syrup 1tsp
2. Aperiton 2tsp tds
3. Lysatone 1tsp tds
4. Nutroplex 2tsp daily
Constipation for adult
Bisacodyl tab (SPMC) 5-10mg nocte (5mg tab)
Dulcolax 2 tab nocte for 3 days
(Suppository –aduit 10mg, children 5mg)
1. For chronic constipation dulcolax 1tab nocte 4days/ lactulose 15 ml nocte sos
2. For pregnant mother fybogel 1packet 24 hrs after delivery fybogel packet 24 hrs
Constipation with nausea, vomiting & headache may be typhoid fever *SAT Ix con be done
Can be treat with
1. Domperidon (motilium) 10mg bd 3days
2. Metanidazole
3. Dulcolax
Ear infection
6. Examine ear properly
If wax waxsole not >2night
1. Gentamycine ear drop bd
2. Penicillin250mg 6hrly
3. Diclofenac Na
4. Diazepam 5mg nocte
5. PCM 2tab tds
Eye drops & ear drops
1. Gentamycine eye &ear drops
2. Sofiamicine eye & ear drops
3. Dexona eye & ear drops
4. Betanasol eye &ear drops
5. Tobralex eye &ear drops
6. Ciplox eye &ear drops
7. Garamycine eye &ear drops
8. Chloranpenicol/spersanicol for pain
Painful menstruation/sever clotted bleeding
1. Ponstant (mefanamic acid)500mg tds
2. Tranexamic acid 500mg bd
*Severe abdominal pain with menstruation can treat with above drugs and if no response USS
should be done. & should refer to VOG may be chocolate cysts
Postcoital contraception
1. Postinor -2 1tab 12hr apart 2tab only should be used within 72hr OCP 3tab stat
Should do pregnancy test
*pregnancy test –ve but no menstruation give
7. 2. Premalute-N10mg nocte 14 days or 10mg tds 5days menstruation begin after 2 days of
treatment
*pregnancy test+ve wanted chid give
a. Folate 1tab nocte
b. Vit Cbd
c. Fersolate 1tab nocte
d. Calcium tab mane
*unwanted child <10week of POA
Gynacoside 2tab stat & premalute N10mg nocte 3days.
If not abortion occur patient should be referrel center
***Abortion is illegal in some countries.
Contraceptive pills (overl & trinordiol 28 tab, Nordett& minnler 21 tab)
Dermatologycal treatment
Betnovate cream N or C (if viral, acne, rosea,
Supricort cream apply bd
Inflammational dermatitis
Eczema-infantile, atopic, discoid
Psoriasis
Lichen simplacs/planuas
S. dermatitis
Heat bum
Becnovate cream can be used in above infection
Bactroban ointment applies bd for 10 days.
Fucidin cream apply bd or tds
Metrogyl gel apply bd
Soframycine cream (burn,scalds,wound,cut,ulcers,otitis externa,eczema)
Foban cream apply bd
Scabies
Scoboma (lindain1%benzocain 2%lindans) apply in body.
8. Tetmosoluse as soap when bath and wash
Fungle infection (taenea infectin, pityriasis versicolor, yeast)
Candid (clotrimazole)apply bd for 2-4 week
Candiplas (micnazole) apply bd/tds for1-2 weeks.
Mycrol cream (ketocanozole 2% onse –bd for 2-3 week
Grisefulvin (fungal, grisvin- FP, (syntofulvin) 125mg-500mg adult 500mg-1000mg/daily
(Tania infection, candidal infection)
Children *>23kg 125-250mg bd
*14-23kg 62.5-125mg bd
Infants *5mg /kg body wt/bd
o Nizoral shampoo
o Beterdine shampoo
o Selsun shampoo
o 10% cetrimide shampoo
Loss of appetite
For childrenperitol syrup dosage 1tsp 30min before meal
For adult cytexin syrup 1tsp before meal
This syrup can be used 2times per day
Diarrhoea for adult
Probenthinebuscopan (10mg tab) 20mg 6hrly (children 6-12 yr 10mg tds
Loparamine (lomutil) 2tab stat
Furoxone 1/2tab <1 yr
1. Tab for child (5mg /kg/body wt
2. Tab for adult (10mg 6hrly)
Flagel 400mg tds
9. Domperidon 1tab bd
Oral rehydration should be introduce
Migraine attacks
Brufen 200mg to 400mg or flunarizine (sibelium) 5mg 1-2tab nocte
Maxalon or domperidone 1bd
Propanalol 20mg bd
Artane 1tds
Migranil 1tab stat or sos
Other prophylactic drugs for migraine attacks
o Amitryptiline 50mg nocte
o Propanalol 40mg bd or tds
o Nifidipine
Vetigo (vestibular neuritis)
Stametil 1 tds for 5days or betasera (betahistine di HCL 8mg)1-2 tab tds
PCM 2tab 6hrly
Piriton 1 nocte
Dexa 1tds 3days
Olternative drug for stemitil /cinnaracine 25mg tds5days /silium 5mg per day
Treatment for acne
Erytop 3% cream apply bd
Tetracycline cream L.A
Doxycycline 100mg 1 nocte 2 week
Folic acid 1bd 3 days
Other cream
Retin-A cream apply bd
Albiotin cream
10. Cough and Cold
For adult PCM 2tab tds
Brufen 1tds /1bd
Dexamethazone 1tds
Piriton 1tab nocte /1/2tab mane <4mg>
Cimitidine 200mg if mild heart burn
If severe heart burn 400mg bd
If no gastritis other plasibo bco 1tds or VIT-C1 tds
Antibiotics if sputem suspected- Amoxillin 250mg qds 3days
If rhonchi is found should add dexa/ salbutamol or Deriphylin salbutamol 2mg tds/Deriphylin
1tab tds.
Cough syrup
Dry cough –cough syrup corex- D
Benadryl junior 6y- 12y 1tsp tds. 1-6y1/2 tsp tds
Avil expectorant
Cerycough
Rasindal expect
Ascoril expectorant (no piriton)
Actifan expec….
Actipass expec..
Piriton expec…
Dosages
Adult 10ml tds
Children 5-10ml
<6yr 5ml tds
*if baby is <9month do not give cough syrup
Cetricine 5mg bd given
Allergic rhinitis
Decongestant decon 1-2 drops tds
Epherdrine 1-2 drops
Nasivin
11. If patient has cought add
PCM/Brufen 4000mg bd or tds
Digin /alludrox 2tds
Dicolofenic Na 50mg tds/ 25mg tds
Piriton /vit C/bco 1tds/dexa 1tds
Cough and cold in small children
<1yr 3 days can be prescribed
Piriton syrup <6month 1/2tsp tds>1yr 1tsp bd
PCM syrup <6month 1/2tsp tds>1yr 1tsp tds
Ventolin (salbutamole) <6month 1/2tsp tds> 1yr 1tsp tds
Antibiotic syrup
1. –Erythromycin 125mg (1tsp) tds *1yr to 5yr 1tab tds
2. _Cephelexin syrup decacep/ sprideex/ selecxin/ceporex*<1yr 125mg bd
3. _Amoxycillin- decamox/blumox/moxarin/amoxil
Asthma
1. –Asses to severity, if patient difficult to speech it should nebulizer.
2. Nebulize with Salbutamol 1ml and water 1ml (children Sal- 5mg and water 1.5ml)
3. Hydrocortisone IV 200mg given
4. –Prednisolone 60mg /Salbutomole 4mg start
Continue
1. –Salbutamol 2mg tds or bd
2. –Prednisolone 2 tab/10mg tds 3days /then 5mg tds 2 days
3. –Deriphyline 1tab bd 3days also given
Patient suffer from fever should add Antibiotics Amoxicillin 250mg 6hrly, Amoxi
Type>see later pages
Antibiotics
12. 1. –Amoxycillin types
1. Decamox for adults 250mg cap /500mg tds
2days 4Rs /7.5Rs for
2. Blue mox 125mg tab for child<5yrs
3. Amoxil 250/5000mg tds 10Rs for cap
4. Amoxil tab 125mg 6hrly
5. Axilsy/250/500mg 3.50Rs
2. –Cloxacillin 500mg
3. Cephalexin
1. Blucep 125mg/500mg tab 5Rs for 1 tab
2. Decacef 250mg /500mg cap
3. Sporidex sy/tab 10Rs for 1 cap
1. –Ciprofloxacin, 250mg/maximal daily dosage- 1mg
2. –Co-trimoxol bactrim for children 1 tab bd/5-10Rs
3. –Augmentin,IV
4. –Nitrofurantoin 50/100tds/for prophylaxis50mg nocte1/52
5. _Doxacyclin 100mg nocte 1/52 for prophylaxis
6. _Erythromycin 250/500mg
Antibiotics syrup
1. Amoxicillin syrup 1 tsp bd/tds 1tsp=125mg
o Decamox syrup
o Amoxil
2. Cephlexin syrup
o Decacef
o Blucef
3. Clocxacillin syrup
13. 4. Erythromycin syrup
5. Bactrm syrup
Antibiotics dosage
1-2month 1/5tsp tds 4-5 days
2-4 month ¼ tsp tds 4-5 days
6-10 month ½ tsp tds 4-5 days
11>month 1tsp tds 6-7 days
Sinusitis
1. Amoxicillin 500mg tds for 3days
2. Piriton 1 tab bd or stemiz (astemizole) 10mg nocte
3. Vit C1tab tds
4. Brufan /PCM 2tab tds with steaming 3-4 times per day
Rhinitis
Astemizole (stemiz) 1tab daily for 1-2 weeks
Citrizine 10mg 1tab daily for weeks. Less than 12yrs not recommended.
Motion sickness
1. Scopdem- hyocin butyl bromide.300mg 30min before travel and continue 6hrly 3 doses
adequate 4-5 yr 75 150mg 10yr 150-300 mg
2. Promethaazine HCL (phenergan) 1 tab 30min before journe
3. Avomine 1tab 30 min before journey
Hypertention
1. If Systlic BP 140Hgmm diastolic bp 100Hgmm Not treat give dieatary
2. Systolic Bp>160Hgmm diastolic Bp> 100Hgmm start Rx
3. Diastolic>100Hgmm mild
HCT (50mg- 100mg ) 25mg mane max 100mg
Lasix (frusimide ) 40mg mane with KCI
14. If lasix with captopril no need KCI
Moderate
Propanalol 40mg (B blocker) 20mg tds. Max40mg tds
Atenalol 50mg daily or mane or nocte
Captopril 12.5mg or 25mg start 6.25 bd After 1 week 12.5mg. then after 1 week25mg bd.
(postural hypertention can occur therefore at bed time )
Immediately hypertention reduce by
ISD (1sosorbide dinitrote 10mg & 20mg ) 10mg tds.
GTN 2.6mg (0.1mg,0.5mg)
Anticoagulant aspirin 100mg or 300mg 150mg nocte.
Risk factor investigation
1. Lipid profile
2. ECG
3. Blood urea
4. Serum Electrolytes
5. Serum Creaternine
6. Chest X ray
If cholesterol high
Dietary high fibre diet. Reduce fatty acid
Drug lovastatin 10mg or 20mg 20mg nocte.
Lipid profile
Favorable Standed risk Risk Indication
Total cholesterol <200mg /dI 200-260mg/dI >260mg/dI 6mmmoI/I
HDL >55mg/dI 35-55mg/dI <35mg/dI 0.9mmoI/I
LDL >150mg/dI 150-100mg/dI >190mg/dI 4.2mmoI/I
Total TG >250mg/dI 2.8mmoI/I
Gastritis