PCU Manual Treatment 1

8/12/2019 PCU Manual Treatment 1

1/209


2/209

1

( ill - defined symptoms) ( clinicaldiagnosis)

( ) ( )

1


3/209

2

3

1. (emergency)2. (specific treatment)

3. (symptomatic treatment)

3.1 (self-limited)

3.2 , , (

2) ()3.3 (incurable)

/

2 1. 2.

3 2 ()

1. (disease) (conditions) 3 ( 1) ( 3.1 )

( 1) ( 3.1) ; ; ()

2. ( 6 ) ( 7 , ) 2


4/209

3

( ) ( ) ( )

() (palliative care)

3.

() 4.

(dynamicity) ( 2 - 3 )


5/209

4

2

s

s

s

s

s

s

s

s

s

s

?

3-7 /1-2

?

- - ?

(, , )

?


6/209

5

/

/

3 1. 2. 3. 4.

1. 35

1. (Cardiopulmonary arrest)2. (Unconsciousness)3. (Shock)

4. (Seizure)5. (Anaphylaxis)6. (Syncope, Fainting)7. (Stroke, Cerebrovascular disease)8. (Drowning and Near drowning)

9. (Massive blood loss)10. (Electrical Injury)11. (Lightning Injury)12. (Falling)13. ( Fracture)14. (Eye emergency)15. (Ear emergency)16. (Throat emergency)

17. (Nasal emergency)18. (Zipper injury)19. (Head Injury) ()20. (Chest Injury)21. (Abdominal Injury)22. (Spinal Injury)23. (Burn) ()24. (Mass casualty)

25. (Toxic substance, Drug over dose)


7/209

6

26. (Human bite)27. (Snake bite) ()

28. (Animal bite) 29. (Bee, Wasp, Hornet String) ()30. (Scorpion string, Centipede and Spider bite)

() 31. (Sea Urchins) () 32. (Jellyfish Dermatitis)

33. (Suicide)34. (Rape) ()

35. (Violence)

2.

1. 7 2. 3. 4.

5. 6. 7. 8. 9. 10. 11. 12. , 13. / 14. 15. ( )16. 17. / 18. 19.

20. 21. /


8/209

7

22. 23. ()

24. 25. Condyloma ()

3.

1. - /

2.

- / /- //3.

- -

4. /- / -

5. - - /

6. -

7. ///- / - /

8. -

4.

1. 2.

3. 4.


9/209

8

5. 6.

7. 8. 9. 10. 11.


10/209

9

3.1

1. (Cardiopulmonary arrest)

:1.

2.

3. 4.

5. , , 6.

3


11/209

10

/ /

1.

2. 3.

1.

2.

3. Head tilt chinlift Jaw thrust maneuver Jaw thrust maneuver

4.

5. mask

Mouth to Barrier device Pocket mask Faceshield Lite Key

6. (Externalcardiac massage) Cardiopulmonaryresuscitation Glide line (CPR 2000) 2

15 1 2 7.

8. bag 1

5 100 / bag

9. (Isotonic Solution)

10.


12/209

11

2. (Unconsciousness)

(Reticular activation system) (Cerebral hemisphere):1. (Structural cause) ,

2. (Metabolic cause) ,

, ketone, carbondioxide

/ /1.

2. 3. 4. 5.

6.

, ABCs

(strip)

(Hypoglycemia) < 70 mg/dl 50% glucose


13/209

12

3. (Shock)

:1. 2. , (Hypovolumic Shock)3. (Septic Shock)4. 5.

/ /

1. BP < 90/60 .Pulse pressure 20. mean arterialpressure < 60 .

2. , ,

3.

1. , ABCs

2. 10-20

3. 4.

(Isotonic Solution) NSS, Lactate RingerSolution

5% D/W5. 6. 7.

8.


14/209

13

4. (Seizure)

(cerebral cortex) , , ,

1. Localization - related (focal, local, partial) Seizure

Simple partialseizure Complex partial seizure

2. Generalized Seizures 2

1. Idiopathic (Primary) 2. Symptomatic

, , 3. Cryptogenic

/ /

1. , ABCs

5 Diazepam 10 mg 5


15/209

14

2.

(Postictal Confusion)

/ /

3.

3.1 3.1.1 3.1.2 3.1.3 15 3.1.4 3.1.5

Simple

Febrileconvulsion

ABCs

-- -- Clear airway

-- -- Positive Breathing

3.2 3.2.1 (Meningitis)- (Neck stiffnesspositive)- Kernigs sign positive

- Babinskrs sign positive

/

3.2.2 1 6 3.2.3 3.2.4 3.3

15


16/209

15

0-5

- ABCs- air way - 6-10 5% D/NSS 5%D/NSS/2 50% glucose 2 ml/kg 25% glucose 2 ml/kg 10-30 Diazepam 0.2 mg/kg/dose 10 Gardinal

Na 10-15 mg/kg/dose rate 50 mg/min.

/ /

5. (Anaphylaxis)

(sensitized) (local) (systemic)

:1. antibiotics penicillin, sulfonamide group, NSAIDS,

Immunoglobulin2. -, 3. , , , 4. ,

/ /

1.

2.

3.

4. 5.

, ABCs

(Cardiopulmonary re-suscitation )

adrenaline 1:1000 0.3 -0.5ml IM, IV0.01 ml /kg/dose ( standing order)

Isotonic solution


17/209

16

6. (Syncope, Fainting)

:1. 2. 3. 4. - 5.

6. 7.

/ /

1. 2.

3. 4.

5.

, ABCs

(Cardiopul-monary resuscitation )

6.


18/209

17

7. (Stroke, Cerebrovascular disease)

1. (Cerebral ischemia)

- Transient ischemic attack (TIA)- Cerebral infarction

2. (Cerebral hemorrhage)3.

-

- - -

/ /

1. 2.

3.

4. 5.

6.

7. 8.

, ABCs

(Cardiopulmonary resusci-tation)

(Isotonic solution ) NSS,Lactate Ringer solution

5% D/W maintenance

maintenance ** ** x 21

x 35 fluid 1


19/209

18

Holiday and Segar

~ 10 . 100 ./ . ~ 10 . 50./ . 20 . 20 . / . increase intracranial

pressure iv fluid rate KVO (Keep Vein Open)

/ /

8. (Drowning and Near drowning) 24 . Near

drowning 24 . :

/ /1. , 2.

3.

, ,

4. ,

, 5. (aspiration)

, ABCs , ,


(Spinal injury) (Head injury)


20/209

19

9. (Massive blood loss) 40 %

(Hypovolumic shock) (Organ failure) :1. (External hemorrhage) 2. (Internal hemorrhage)

/ /

1.

2. 3. ()4.

Isotonicsolution Lactate Ringer solution Normal

saline


21/209

20

/ /

1. , 2.

, 3.

4.

5.

, ABCs (Cardio pulmonary resusci-tation)

(Spinal injury) (Head injury)

6.

10. (Electrical Injury) :

1. 2. 3.


22/209

21

11. (Lightning Injury):

1. Nervous system 2. Hearing system 3. Skin 4. Heart 5. Vascular system

/ /

1. 2.

3. 4. ,

, ABCs (Cardiopulmonary resusci-tation)

fracture


23/209

22

1. 2. 3. 4. ,

, 5.

6.

7.

12. (Falling):

(Multiple injury)

/ /

, ABCs (Cardiopulmonary resus-citation)

** (

) **


24/209

23

13. (Fracture)

1. (Incomplete fracture) 2. (Complete fracture) 1. (Close fracture)2. (Open fracture)

1.

2. 3.

4.

5. 6.

/ /

,ABCs .

(Splint)

normal saline


25/209

24

14. (Eye emergency)

1. 2. 3. (Chemical burn)

/ /

1. (Blunttrauma)1.1

1.2 Fracture

1.3 anteriorchamber (hyphema)

Absolute bed rest 30 - 45

2

2. 2.1

()

2.2 -

3. (Chemicalburn) ( )

NSS 1/2 NSS 2 ()

4. (Subcon-

junctival hemorrhage)

2


26/209

25

15. (Ear Emergency)

1. 2. 3.

/ /

5.

(Circumcorneal injection)

/ /

1.

2. C.S.F

Absolute bed rest

3. 3.1

ear forceps

3.2

4.

70% glycerine borax

( )


27/209

26

6. -

/ /

5.

3-7 discharge

valsalva decongestant

16. (Throat emergency):

/ /

1.

/

Heimlich maneuver Abdominal Thrust

ABCs

2.

()

laryngealmirror

3.


28/209

27

17. (Nasal emergency)

1. (Epistaxis)2.

/ /

1.

5-8

2. anterior septum

1 adrenaline 1 : 1,000 10 (HT)

3.

nasal forceps

18. (Zipper injury)

/ /1.

1. towel clips 2

2.


29/209

28

19. (Head injury)

1. 2. 3.

2 Primary brain injury

concussion, contusion, epidural hematoma, intracerebral hematoma Secondary brain injury primary brain injury

/ /

1. 2.

3.

4. 5. 6. 7.

8.

, ABCs (Cervical spine)

(Stroke) Hypotension

NSS Lactate Ringers Solution

Cervical collar

1. 2. Glasgow coma score

15

3.

24 .

1.


30/209

29

20. (Chest injury) 2

1. Blunt injury 2. Penetrating injury

- (Fracture ribs)- (Flail chest)- (Pneumothorax)- (Open pneumothorax)

- (Hemothorax)- (Cardiac temponade)- (Massive bleeding)

/ /

1. ,

2. 3. ,

4. 2 ,

5.

6. 2 (flail chest)

, ABCs

Open pneumothorax

sterile occlusivedressing

Flail chest Flail pressure dressing


31/209

30

21. (Abdominal injury):

2 1. Blunt abdominal injury

2. Penetrating injury

/ /

1.

2.

3. (guarding)-

- ,

, ABCs

. Isotonic solution

normal saline


32/209

31

22. (Spinal injury)

/ /

1. 2.

3. 4.

5. 6. 7.

-

, ABCs

- -

Cervical collar


33/209

32

23. (Burn)

(Rules of nine) Lund and

Browder ( 1 1% )

1. (First degree burn)

2. (Second degree burn) 3. (Third degree burn)

/ /

1.

15% 2.

3. 5%

4.

5.

6. 7.

8.

, ABCs

, 20%

Hypovolumic shock Parklan

20%

NSS


34/209

33

24. (Mass casualty)

1. 2.

/ /

(

10% Hypothermic shock )

9.

-

/ /

1.

, 2.

3.


35/209

34

25. (Toxic substance, Drug over dose) (Toxic substance)

(Drug over dose)

1. (ingestion)2. (inhalation)

3. (absorption)4. (injection)

-

/ /

- - - ()

/ /

1.

2. - 3.

4.

, ABCs


1.


36/209

35

26. (Human bite)

Aerobic Anaerobic bacteria HIV Hepatitis B

/ /

2.

3.

3-5

4. (activated charcoal)

5.

6.

/ /

normal saline

Amoxycillin Ampicillin Cloxacillin, Penicillin


37/209

36

27. (Snake bite) 2

1. 3 1. (Neurotoxin) , , ,

2. (Hematotoxin) , , 3. (Myotoxin) , ,

2. , , ,

(), , , , , , ,

,

/ /

1.

2. -

3. 4. 5. 1.

2. , ,,

3. 4. 5.

6. 7.

1. , ABCs2.

(Cardiopulmonary resuscita-tion)

3. 4.

5. 6.

7.


38/209

37

/ /

-

1.

2. 3.

4. 5.

()6.

8.

9. 10. 11.

-

Penicillin, Amoxycillin, Cotrimoxazole

5 - 10


39/209

38

28. (Animal Bite)

/ /

1.

()

2.

(

)

3. -

4.

: 1.

2.

70%


40/209

39

3. 3 - 4

4. 5.

1. 2. 2 2 3.

3 10

3 / 10

29. (Bee Wasp Hornet String) , ,

/ /

1. 2. 3.

4. ,

()

, ABCs

(Cardiopulmonaryresuscitation)

Anaphylaxis

-


41/209

40

30. (Scorpion string, Centipede and Spider bite) ,

/ /

1. 2. Anaphylaxis3. 4.

5.

6.

()

,ABCs


Anaphylaxis


42/209

41

31. (Sea Urchins)

/ /

1. Systemic reaction Anaphylaxis

, ABCs


Local presentation ()

2. Local presentation


43/209

42

32. (Jellyfish Dermatitis)

/ /

1. Fatal reaction anaphy-laxis, cardio pulmornaryarrest

ABCs-

2. systemic reaction

local heat 39

( )

Anaphylaxic

systemic infection

3. local reaction / 1 - 4


44/209

43

33. (Suicide)

- 80%

- 20% schizophrenia

/ /

1.

2.

3.

4. 5. 6.

1.

2.

3.

4.

5.

6. 7.


45/209

44

34. (Rape)

/ /

1. 2.

3. 4.


46/209

45

35. (Violence)

:- (Alcoholic intoxication)

(Alcoholic withdrawal)- (Personality disorder)- (Paranoid psychosis)

(Mania)-

- , , ,

/ /

1.

2. 3. 4. 5. 6. 7.

8.

8

1.

2.

3.


47/209

46

3.2 /

1. 1.1 : ()

/ /

1. 1.1

1.2 1.3

(crepitation)

(ABCs)

2. 2.1 2.2 7

24

3. 1 23.1

Paracetamol

-----------------------------------------------------------------------------------------------------------------3.2

5 2 Chlorpheniramine 2-3 2-3


48/209

47

1.2 /

/ /

3.3

3.4 4 24

(Amoxycillin Erythromycin)3 5-7 ( 10 )

3.5 7 1 2

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

/ /

1. 1.1 1.2

1 .1.3

1

2. 12.1 / Chlorpheniramine


49/209

48

/ /

2.2

24

(Amoxycillin Erythromycin)3

5-7

2.3 ( )

Chlorpheniramine

2.4 / 1

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

1.3 :

/ /

1. 1.1 1.2

1.3

(ABCs)

O2


50/209

49

3. 3.1

/ /

2.

2.1 7 2.2 2.3 2.4

(crepitation) (wheezing)

24

(Paracetamol)

(Amoxycillin Cotrimoxazole Erythromycin) 3

5-7

3.2

Chlorpheniramine 1

4.

4.1 ,

4.2

4.3

4.4 7 , 3

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


51/209

50

1.4 :

/ /1.

1.1 1.2 1.3 1.4

1.5 1.6

(ABCs)

NSS N/2

2. 12.1

Wheezing

1

2.2

- - 30

2.3

/

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

1.5 : / / /

/ /

1.

(ABCs)


52/209

51

2. 2.1 :

:

/ /

2.

2.1 3 2.2

3

3. 1 2

,

5 2 Paracetamol

(Pen V Amoxycillin Erythomycin) 3 5 - 7

1. 3 2. 3

3. 1

/ /

1. 1.1 1.2 1.3

1.4 2


53/209

52

/ /

2.

1

3. 1 23.1

2

3.2

1

3.3

1

2.2 : / / /

/ /

1.

Chlorpheniramine

1. 3 2. 3.

Chlorpheniramine /

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


54/209

53

2.3 / :

/ /

2.

Chlorpheniramine

3

3. 1 2

( ) /

Chlorpheniramine 3

/ /

1. 1.1 1.2

-

2. 12.1

/

(Pen V Amoxycillin)

-

3-5

1. 3 2. 3.

4.

-----------------------------------------------------------------------------------------------------------------


55/209

54

2.4 / : /

/ /

2.2

1-2

/ /

1. 1.1 1.2

2.

24

- 3. 1 2

3.1

2

Aspirate I/C () /

Cloxacillin Erythromycin 3-5 3

3.2

3.3

2 3

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


56/209

55

4.2

/ /

3.4

Paracetamol

Amitriptyline10 .

1. 2. 3 3. 40 4. SBP 140 DBP

90 .

3.5

(Amoxycillin Cotrimoxazole

Erythromycin) 3 - 5 14

4.

4.1 ,

1. 2. 3. 3

( )

3

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


57/209

56

1. 1.1

/ /

2.5 : ( )

(ABCs)

2. 1 . 3

1

3. ()

(Penicillin V Erythromycih

Amoxycillin) 3 7

4. ()

(Penicillin V Erythromycin Amoxycillin)3-5

24 5. 1-45.1

1 10- 15 3


58/209

57

2.6 // : 2

/ /

1. 1.1

()1.2

1.3 1.4

1.5 1.6

ear forceps

2. 2.1 2.2

ear wax impact

1

3. 1 23.1

(Cloxacillin Erythromycin) 3 5 - 7

3


59/209

58

3. 3.1 :

/ /

1. 1.1 1.2 1.3

1.4 1.5

24

2. 1 2.1 2.2 2.3

(Penicillin V

Erythromycin Amoxycillin) 3-5

3.2 :

/ /

1.

(gingivitis)

(Penicillin V Erythromycin

Amoxycillin) 3-5

2. 1 .

TA oral paste 3 1


60/209

59

/ /

3. 1 - 2

acyclovir cream 5

1

4. ( )

antibiotic cream 2 1

5. (

(clotrimazole)

6.

Mycostatin oral suspension

7

7.

1 - 6

1

3.3 :

/ /

1. 1.1 1.2 1.3 1.4 1.5

1.6

(ABCs)


61/209

60

3.4

/ /

2.

2.1 2.2 2.3 2.4 2.5

3

Dimenhydrinate

3. 1 2

3.1

3.2

/

1. 24

2.

3.3 ()

Dimenhydrinate 30

3.5

24

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


62/209

61

3.4 :

/ /

3.5

Dimenhydrinate

1. 24 2. 3. 4.

/ /

1.

1.1 :

1.2 / 6

1.3

1.4

1.5 ,

(ABCs)


63/209

62

1.6

3-5

1.7 ()

/ /

2. 2.1

7 2.2 2.3 2.4 2.5

24

3. 3.1

() /

()

1 (antispas-

modic) ,

3.2

antispasmodic

1. 2. 3. 1 , 2

4. 25

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


64/209

63

/ /

-----------------------------------------------------------------------------------------------------------------

3.3

antispasmodic

6

1, 2

4.

4.1

/ cimetidine 1

1 - 2

1. 2. 3.

4.2

1

5.

5.1

Amoxycillin

Cotrimoxazole 3


65/209

64

5.2

-----------------------------------------------------------------------------------------------------------------

/ /

antispasmodic

1. 2. 1, 23. 25

5.3 5.1 5.2

6.

1,2

1 2

3.5 :

/ /

1. 1.1 1.2 1.3

1.4

(ABCs)

2.

2.1

2.2 7 2.3 2.4

24


66/209

65

3. 7

/ /

1

4. 1 - 3

ORS Amoxycillin 500 . 6

. Tetracycline 2 6 . Cotrimoxazole 2 2 / 5

Nofloxacin 400 . 2 3

Cotrimoxazole 5

1. 2 2. 3. 1-2

5.

2-4 .

ORS absorpbent

kaolinpectal activated clacole

1. 48 .2. ORS 3. 1-2


67/209

66

3.6 :

/ /1.

1.1 1.2 1.3

2.

2.1 2.2 1

2.3

3

3. 123.1

()

()

3.2

-

- - -

-----------------------------------------------------------------------------------------------------------------


68/209

67

3.3

/ /

(

milk of magnesia bisacodyl) 1

3.7 :

: ( )

1. 5% 10

/ /

1

2. 12.1

1. 1 2. 3.

-----------------------------------------------------------------------------------------------------------------

2.2 digitalis

propanolol, codeine

2.3

1

-----------------------------------------------------------------------------------------------------------------


69/209

68

4. / 4.1 / : () ( 1- 10 .)

( )

/ /

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

1. 1.1 1.2

1.3

4.2 :

24 (Hematocrit)

2. 12.1

/ 48

2.2

1

2.3

3

/ /

-----------------------------------------------------------------------------------------------------------------

1. 1.1 1.2 1.3 1.4

1.5 100 /

(ABCs)


70/209

69

4.3 :

/ /

-----------------------------------------------------------------------------------------------------------------

2.

2.1 2.2 2.3 2.4

2.5 2.6

3

3. 1 23.1

()

Folic acid

3.2

1 Mebendazole 3 2

/ /1.

1.1 1.2 1.3 1.4

(ABCs)


71/209

70

3.

/ /

1.5

1.6

3 - 5

2.

2.1 7 2.2 2.3 2.4

3

Cimetidine 1

1 -2

1.

2. 3. 4.

4.

3


72/209

71

/ /

5.

() 1-4

Diazepam ()()

1. 7 2. 1-2

4.4 :

/ /

1. 1.1 1.2 1.3 1.4

1.5 1.6 1.7

(ABCs)

< 70 % 50% glucose

2. 2.1 2.2

2.3 2.4 100 /

3

3. 3.1


73/209

72

1. 1.1 1.2

1.3

1.4 1.5

1.6

/ /

3.2 ,

, , ,

6

4. 1 -34.1

100 /

1 -----------------------------------------------------------------------------------------------------------------

4.2

1

5. 5.1 :

:

/ /

1


74/209

73

5.2 :

/ /

2. 1

2.1

,, ,

,, 1

2.2

1

2.3

1

/ /

1. 1.1 1.2 1.3

24

2. 2.1

2.2

3

3. 1 23.1

3

-

-

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


75/209

74

5.3 :

/ /

3.2

Amoxycillin Cotrimoxazole3

2

/ /

1. 1.1 1.2 1.3

24

2. 1

[clotrimazole] 1 6 clotrimazole cream

1

3. 1

2-

1


76/209

75

5.4 / :

/ /

1. 1.1

16

1 Paracetamol Hyoscine

1.2 1.1

16

2. 2.1

2.1.1 2.1.2 2.1.3 2.1.4

3

2.2 2.1

2.2.1

2.2.2 / /

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


77/209

76

6. 6.1 :

/ /

2.2.3 45

*

*

3. 2.1 2.2

* -* 6

/ /

1. 1.1 7 1.2

1.3 1.4

1.5

1.6 (

)1.7 1

3

2. 12.1

Chlorpheniramine 1- 2 7

Calamine lotion


78/209

77

- 7 - Chlorpheniramine

/ /

2.2 , ,

( )

, ,

2 -

3

2.3 , , 2

Benzyl benzoate Chlorpheniramine Amoxicillin., Erythro-

mycin, Cloxacillin 1

2.4

1 - 2

3 - 4 1 - 2

2.5 2.5.1

2.4

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


79/209

78

2.5.2

/ /

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

1 - 2

2.6 ( )

(Ketoconazole)

3 () 1 - 2

2.7 I/D, Wet dressing /

2.7.1

,Impetigo

(Pen V Cloxacillin) 3 5 - 7 1 - 2

2.7.2

2

(PaederousDermatitis)

10 2

- - ()-

2.8 2.8.1

2 - 3

Paracetamol Calaminelotion 2 - 3

1. ,

2. 3.

-----------------------------------------------------------------------------------------------------------------


80/209

79

2.8.2

1 - 3 . (

) ()

/ /

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

Wet dressing Normal Saline 3% Boric acid

Acyclovir 5

1. 2. 3. 1

2.9

2.9.1

,

keratolytic agent (40 %) 2

2.9.2

6.2 : : 1.

2. 3.

/ /

-----------------------------------------------------------------------------------------------------------------

1. 1.1

1.2

3 Chlorpheniramine

Calamine lotion

2. 12.1 2.1.1

Benzyl benzoate

2.1.2

2


81/209

80

2.1.3

/ /

1

Ketoconazole shampoo 2

2.1.4

2.2.3

2

2.2 2.2.1

3

2.2.2

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

Mebendazole

2

2.3 ()

2.3.1 ()

-----------------------------------------------------------------------------------------------------------------

Mebendazole

-----------------------------------------------------------------------------------------------------------------

2.3.2

1

2.4 ()

Calamine lotion Chlorpheniramine

1. 3

2. 3.

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


82/209

81

7. ///7. :

( )

1. 1.1 1.2 ()

1.3 1.4 1.5 /

1.6

/

1.7 SBP

210 DBP 120.

/ /

2. 2.1

40

2.2 3

2.3

2.4 SBP 160 DBP100 .

3 Paracetamol


83/209

82

3.

3.1

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

/ /

, (Chlorpheniramine) (Amoxycilin Cortimoxazole Eryth-

romycin 3 )

3.2

(Amoxycillin Cotrimoxazole

Erythromycin) 3 2

3.3 ( 2

)

Paracetamol

1. 2. 3 3. 4. 40 5. SBP 140 DBP 90

.

3.4

Paracetamol

1. 2. 1-2

-----------------------------------------------------------------------------------------------------------------


84/209

83

7.2 :

/ /1.

1.1 1.2 1.3 1.4

1.5 1.6 1.7 1.8 SBP 210

DBP 120.

(ABCs)

2.

2.1 2.2 2.3 2.4 2.5 2.6

1

2.7 SBP 140 DBP 90 .

24

(Dimenhydrinate)

3. 1 2 3.1

(Dimenhyrinate)

1. 3

2. 3.


85/209

84

-----------------------------------------------------------------------------------------------------------------

/ /

3.2

3.3

,

24

/

3.4 3.1 - 3.3

(Dimenhydrinate)

1

7.3 :

/ /

1.

2. 2.1 2.2 SBP

140 DBP 90

.2.3

2.4 2.5

2.6

,

1 1

-----------------------------------------------------------------------------------------------------------------


86/209

85

2.7

2.8

/ /

3. 1 2

1 2

7.4 :

/ /

1. 1.1 1.2

1.3 ()1.4 (

)1.5

2. 2.1

/

2.2

-----------------------------------------------------------------------------------------------------------------

()


87/209

86

7.5 :

/ /

3. 1 2

3.1 2

(Hyperventilationsyndrome)

30

3.2

-----------------------------------------------------------------------------------------------------------------

/ /

1. 1.1

ABCs

(Splint)

1.2

24

-----------------------------------------------------------------------------------------------------------------


88/209

87

2.2

/ /

1.3 7

1

2. 1.1 -1.32.1

( 40

)

: ( ) ,

Paracetamol

1. 2. 3.

48 .

1. 2. 1

2.3

Paracetamol

1. 1 2. 1.2 - 1.3

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


89/209

88

7.6 :

/ /

1. 1.1 1.2 1.3

(ABCs)

2. ,

24 ,

3.

3.1 3.2 3.3

3.4 3.5 7

24

4. 1-34.1 4.2

//

! Paracetamol NSAID (

)


90/209

89

7.7 / :

: 1.

2. 3.

/ /

1. 1 2. 3.

/ /

1. 1.1

1.2 1.3 3

1

2. 12.1

Paracetamol

NSAID ()

1. 1 2.


91/209

90

8.

8.1 :

/ /

2.2

Paracetamol

1. 1 2.

/ /

1. 1.1

1.2 (crepitation)

1.3 6

1.4

(ABCs)


92/209

91

2. 2.1 (

)

2.2

2.3 7

/ /

24

2.4 (eschar)

2.5 -

2.6 (R/OPyelonephritis)

2.7 (R/O DHF)

-----------------------------------------------------------------------------------------------------------------

3. 3.1

3.2

Cellulitis (Penicillin V, Amoxycillin Erythromycin) 3

7

3

-----------------------------------------------------------------------------------------------------------------


93/209

92

3.5 ( 4 ) ( 4 )

/ /

3.3

24

3.4 3.3

1

CalamineLotion

1

3.6 -

Paracetamol

1. 4

2. 1 2

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


94/209

93

8.2 : -:

/ /

1. 1.1 1.2 1.3

3

2. 12.1 (

)

1 Mebendazole 3 2

2.2

2.3

1

2.4

1

2.5

1

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------


95/209


96/209

:

: 110000-2590-1637-8

0-2590-1631http://www.203.157.3.100 ()

1 : 2546 12,000

:

200/198 ISBN 974-465-271-3


97/209

( 2545 - 2546) / 6

..2545

2546


98/209

1 1

2

4

3 93.1 9

(Cardiopulmonary arrest) 9(Unconsciousness) 11 (Shock) 12

(Seizure) 13 (Anaphylaxis) 15 (Syncope, Fainting) 16 (Stroke, Cerebrovascular disease) 17 (Drowning and Near drowning) 18(Massive blood loss) 19 (Electrical Injury) 20 (Lightning Injury) 21

(Falling) 22( Fracture) 23 (Eye emergency) 24(Ear emergency) 25 (Throat emergency) 26 (Nasal emergency) 27 (Zipper injury) 27 (Head Injury) () 28 (Chest Injury) 29 (Abdominal Injury) 30


99/209

(Spinal Injury) 31(Burn) () 32(Mass casualty) 33 (Toxic substance, Drug over dose) 34 (Human bite) 35 (Snake bite) () 36 (Animal bite) 38 (Bee, Wasp, Hornet String) () 39

(Scorpion string, Centipede and Spider bite)() 40 (Sea Urchins) () 41 (Jellyfish Dermatitis) 42 (Suicide) 43 (Rape) () 44 (Violence) 45

3.2 46

46 51 58/ 68 72 76/// 81 90

3.3 94 94 96 98 100 102 103 105 108

111 112


100/209

114 116 117

119 126

129Paracetamol 129Ibuprofen 130Acetylsalicylic acid (Aspirin) 131

132Chlorpheniramine maleate 132

133Adrenaline (Epinephrine) 133

134Dextromethorphan 134Mixt. Tussis 135Mist. Scill. Ammon 136

137Salbutamol 137

138Sodium bicarbonate : sodamint 137Mixture Carminative 139

140Antacid 140Cimetidine 141

142Dimenhydrinate 142Metoclopramide 143

144Hyoscine-n-butyl bromide 144Atropine sulfate 145

146Milk of Magnesia (MOM) 146

Bisacodyl 147


101/209

147ORS 147 148

Absorbent : Kaolin 148 149

Vitamin B6 149Vitamin B complex 150Multivitamin 150

151Ferrous Fumarate 151Ferrous sulfate 152

153Albendazole 153Mebendazole 154

155Amoxycillin 155Penicillin V (Phenoxymethyl Penicillin) 156

Erythromycin 157Co-trimoxazole 158Doxycycline 160Cloxacillin Sodium 161Norfloxacin 162

163Benzyl Benzoate 163Gentian violet 164

Clotrimazole cream 165Calamine lotion 165Methyl salicylate 166Salicylic acid ointment 40% 166Triamcinolone acetonide 167

168Chloramphenical eye drop/ointment 168Hista-oph 168

169Antiviral cream : Acyclovir cream 169


102/209

170 170 170 170

171Lidocaine HCI 171

172

Ethyl alcohol 172Povidone iodine 10% 173Cresol (Lysol) 174Glutaraldehyde 2% 175Sodium triazine-3-one (virkon) 176

176Glucose 50% 176D 5% NSS (5% dextrose + 0.9% NaCl) 177D 5% N/2 (5% dextrose + 0.45% Nacl) 178Lactate ringers solution 178

179 179

Methylergometrine 179 180

Cinarizine 180 181

Diazepam 181

182Thiazide 182

183Mycostatin oral Suspension 183

184 187 190 191

192 195


103/209

196 196

198

.. 2543 199

200


104/209

94

3.3

(Diabetes Mellitus)

1.

-

- - - -

2.

3.

1. 2. 3. 4.


105/209

95

4.

1.

/

40 4

2 3

1) 10 2) ( 120)3)

3.1 3.2 3.3 (acanthosis

negricans)

(capillary blood glucose) 110 ./.

(capillary blood glucose)

110 ./. 1

3

2.


106/209

96

3.

1 4 4 4

4.

(Hypertension)

1.

140/90.

2.

140/90 .


107/209

97

3.

1.

2. 3.

4.

5.

6. 2-3 7. 8. 10

4.

1. /

40 40 40

1) 2) BMI 25 ./ 3) (130-139/85-89

.)4)

5)


108/209

98

2. 3.

4.

5.

( Asthma)

1.

Asthma

(Bronchial hyper responsiveness) NSIAD, Beta blocker, ,

2.

-

COPD, , ,


109/209

99

3.

1. ( . 1 ,, 3 )

1 2 1 1 2 (Beta 2 agonist nebulizer) 15 3

- -

- -

3-5 -

2. 2 (Beta 2 agonist)

- Salbutamol Ventolin, Butamol, Proventil, Reprtabs 1-2 puff 4-6 . 2-4 mg. (1-2 tablet) 6-8 .

0.1 mg/ 1 Kg. ( 2 mg) 6-8 .- Terbutaline Bricanyl, Ataline, Bucaril, Brethine

1-2 puff 6-8 . 2.5-5 mg. (1-2 ) 6-8 .

0.1 mg./ 1 Kg. ( 2.5 mg.) 6-8 .

Nebulizer 1 ml Normal saline 3 m. 0.01-0.03 ml / Kg. ( 1 ml.) Normal saline 3 ml


110/209

100

3.

4. (pulmonary rehabilitation)

4. 1.

2. 3. ()

1) ()

2) 3) 4) 5)

4. 5.

(Chronic obstructive pulmonary disease, COPD)

1.


111/209

101

2.

barel shape ( APdiameter ) Tuberculosis, carcinoma, bronchiectasis

3.

( acute exac-erbation)

1. ( smoking cessation)

2. (pharmacological)- 2 (Beta 2 agonist) Salbutamo Terbutaline- (Anticholenergic) Ipratropium bromide

3.

3.1

3.2

3.3

3.4

3.5 3.6

purse lip


112/209

102

30 / 110 /

(Pulmonary Tuberculosis)

1.

2.

2-3

3. 1.

/ 2 3-4

2. Isoniazid, Rifampicin,Pyrazinamide, Streptomycin, Ethambutol. 2-3 2 3 4

3.

4. 2 7


113/209

103

5. 2-3

6.

4. 1. BCG 2.

3.

(Gouty Arthritis)

1.

( 3-7 . 100 .)

30

2.

1) ()


114/209

104

2)

3)

3.

1. 2-3 ( ) 1-2 3

2. 1) 2

- (allopurinol)

- (colchicine)

2) 3) ()

( )

()

4) 10-15 5)

3.

4.


115/209

105

4.

1.

2. 3. ()

1) ()2) 3) 4) 5) 6)

4. 5.

(Osteoarthritis Knee)

1.

40

( )

2.

( )


116/209

106

3.

1.

2. 1)

( ) ( ) ( 40 2 )

2)

3) quad-riceps hamstring

3.1) Isometric quadriceps exercise (quadriceps retting)

1 - -

5 20 2

2 - - 45

5 20 2 3.2) Isometric hamstring exercise

5 20 2

3.3) Isotonic quadriceps exercise, ,

90 5 10 2

3.4) Isotonic hamstring exercise, 45 5 20 2

3.5) Progressive resistive exercise 3,4 1 10 10 . 15 .


117/209

107

4)

( )3. 1 - 2

4. 1) 1

2)

3) 4) 5.

( )

6.

4. 1.

2. ( 3 )3.

1) 2) /

3) ( 3 )4)

4. 5. 6.


118/209

108

1. (relaxation exercise)

1.

2. 3.

- 2

1- 3 1-10 -

- 10

-

2. (chest percussion) ,

1. , 2.

( Secretion sound)

1. ()

2. 2

3. cuppedhand 3 ,,

4.


119/209

109

5. , - , , ,

6. 1 - 2 * 30 2 2

7.

8. NSS

1. 2. ,

, 3. , , 4.

5. 6. 7. , increase intracranial pressure

Lobe segment

Upper Apical

Anterior Rt.Lt.Posterior Rt.

Lt.

600

300 300

Middle Lt. Lingual lobeRt. Middle lobe

150 150

Lower Superior Rt, LtAnterior basalLateral basal

Posterior

300 -

,,

, 2


120/209

110

1.

2.

1. ( Purse -lip breathing) (COPD)

2

2. (Diaphragmatic or abdominalbreathing )

1. 2.

3.

4.

5.

2

2 -3

2 -3


121/209

111

1.

2.

3.

4.

5.

6.

7.

1. 5

5 20-30

2. 10

10-20 3.

10 10-20 4.

5 20-30


122/209

112

5. 10

20-30 6. 5

20-30

1. 2. 3. 4. 5.

1.

2.

3.

1. 2.


123/209

113

1. 2. 2-3 15-30 2-3

3. , 4. 5.

1. - -

2.

3.

-

- -4.

- -5.

-

1.

1

2.


124/209

114

1.

,

2.

3.

4.

5.

1.

2. 3. /

24 10-15

24 15-20 4.

30 3-10 3

1.


125/209


126/209


127/209

117


128/209


129/209

120

5. (

)

1.

1. 2. 3. 4.

5. 6. 7. 8.

6. 6.1

1.

2.

1. 3

2.

3. Xyphoid process

4. lubricated

5. Syringe gastric content

6. gastric content 7. (0.9% NSS) 200-400 cc

8. Larvage

9.

Larvage 100 cc/kg


130/209

121

6.2 (NasogastricIntubation)

1. 1.1

() 12-18 120 . 5-12 45-75 .

1.2 50

1.3 2.

2.1 2.2

3.

3.1 3.2

3.3 6-8 Pharynx (Gagging) (Gasping) (Cyanosis)


131/209


132/209

123

6. urinary meatus7. 8.

7.2

1.

2.

1. 1-5 ( 7.1) plaster /

8. 1. 2. 3. 4.

1.

2.

1/3 3. 4.

5.

6. /

7.

8.

sterile

pressure dressing


133/209

124

9.

1. 2.

1. 2.

70% 3. (forceps)

4. 5.

10. cyst(Excission)

1. 2.

1.

2. 3.

4.

5. 6. stterile11.

1.

2.

3. discharge4.

1.

2. 3% undine

3. 4.

5. undine

1-2

6. 7.


134/209

125

12. papsmear

: 1. Contact bleeding2. Abnormal mass3. Abnormal vaginal

discharge

1.

2.

1. 2. 3.

labiamajora, mi-nora clitoris

4. 5. vaginal speculum

speculum

6. vaginal speculum spatula 95% alcohol

7. discharge

8. speculum

:

1. (IUD)2. (Nor plant)3. 4. Cyst5. VIA (Visual Inspection Using Acetic Acid)6. (Cryotherapy)


135/209

126

1. (Analgesics, Antipyretic and NSAIDS)

1.1 (Analgesics, Antipyretics)1. Acetaminophen (Paracetamal)2. Acetyl salicylic acid (aspirin)

1.2 (Nonsteroidal Antiinflammatory Drugs)1. Acetyl salicylic acid2. Ibuprofen

2. (Antihistamines) Chlorpheniramine maleate3. / (Drug used in Anaphylaxis / Shock Epinephrine (adrenaline)4. (Respiratory drugs)

4.1 /

1. Dextrometrophan2. Mixt. tussis3. Scill Ammon mixt

4.2 (refill )1. Aminophyllin2. Salbutamol

5. (Gastrointestinal Drugs)5.1

1. M. Carminative2. Sodium Bicarbonate

5.2 (Antacids)1. Antacid : aluminium hydroxide and magnesium hydroxide2. Cimetidine

5.3 (Antiemetics)1. Dimenhydrinate2. Metochopramide


136/209

127

5.4 (Antispasmodics)1. Atropine sulfate

2. Hyoscine-n-butylaromide (Buscopan)5.5 (Anticonstipations)1. Bisacodyl2. Magnesium hydroxide (milk of Magnesia)

5.6 5.6.1 (Replacement Solution)

Oral rehydralimsalts5.6.2 Absorbent : Kaolin

6. 6.1 (Multivitamin)6.2 (B. Complex)6.3 C (Vitamin C)

7. 7.1 Ferrous7.2 Ferrous sulfate

8. (Antihelmintic drugs)

8.1 Albendazole8.2 Mebendazole

9. (Antibacterial drugs)9.1 Amoxycillin9.2 Penicilin V.9.3 Erythromycin9.4 Co-trimoxazole9.5 Cloxacillin9.6 Tetracycline9.7 Norfloxacin

10. 10.1 Triamcinolone acetonide10.2 (Fungisides)

1. Gentian violet2. Clotrimazole

10.3 , , (Scabisides).Benzyl benzo.ate(Gposcabicide emul.)


137/209

128

10.4 (Antipruritics).Calamine lotion

10.5 Antiviral cream.Acyclovir cream10.6 Kerratolytic agent

Salicylic acid ointment10.7

.Chloramphenical eye ointment10.8

.Chloramphenical eye drop

10.9 (Other agents).methyl salicylate (GPO Analgesic Balm)11.

11.1 11.2 11.3

12. (Local anasthetics).lido caine HCl 2%

13. (Disinfectant and Antiseptics)13.1 alcohol13.2 chlorhexidire gluconatl

(Hibiscrub)13.3 Povidone cline13.4 Sodium hypochlorite13.5 Chlorhexidinet cetrimide (Savlon)

14. 14.1 Glucose 50%14.2 D5% NSS14.3 D5% N/214.4 Lactate Ringers Solution

15. 16.

.Pregnancy test specific for HCG

17. (refill)


138/209

129

18. Mycostatin Oral Suspension

19. Vaccine19.1 Immunoglobulin19.2 Rabies Vaccine

Paracetamal

1. 325 ., 500 .2. 120 . / 5 .3. 300 . / 2 .

:

- Hypothalamus Endogenous pyrogen

:1.

Aspirin Aspirin

2.

1. 650 - 1000 . 4 - 6 . 4 /

2. 10 - 15 ./. 4 - 6 . 5 dose


139/209

130

10 - 15 20 - 25 24

1. 10 2. 3.

Ibuprofen

200 .

Prostaglandins

Cyclooxygenase Arachidonic acid Prostaglandins

1. , Osteoarthritis, gouty arthritis, tendinitis

2. 3.

1. 400 - 800 . 3 - 4 2. 200 - 400 . 4 - 6 3. 400 . 4


140/209

131

Aspirin

-

- 3

Acetyl salicylic acid

(aspirin)

75 . (11/4 ) (Baby aspirin) 325 . (5 )

1. 2. , , , , ,

, ()3. 4. (TIA)

1.

- 1 - 5 1 1 ( 1 1 , 2 2 ) 1/4 (1 )

1 ( 1 )


141/209

132

- 5 - 10 1-11/2 - 10 2

4 - 6 2. 11/2 3 4

3. (TIA) 1 2

1.

2.

3. (Salicylate poisoning)

4.

5. (Platelets aggregation)

6. 1 12

(Reyes Syndrome) 7. 3

Chlorpheniramine maleate

1. 4 .2. 2 ./5 . 60 .3. 10 ./1 .

H1-receptor


142/209

133

- 1 1 . 2 1 - 5 1-2 . 3 6 - 12 2-4 . 3-4 4 . 3-4

(Anaphylactic shock)

10-20 . 40./ 0.2 ./.

- - - -

1.

2. 3.

Adrenaline (Epinephrine)

injection (aqueous Soln as HCI) 1 ./. (1:100)

1

2receptors

1receptor Myocardial Con-

tractility conductivity 2receptor bronchodilation vasodilation


143/209

134

1. 2. 3.

1. Anaphylaxis

0.01 ./. 0.5 . 0.2 - 0.5 . 1 .

15 2 4

2. 0.005-0.1 ./. 0.1 - 1 . 5

3. 1 : 200000 - 1 : 20000 0.1 - 0.2 .

hyperthyroid

1. 2. 3. 4. Epinephrine -adrenergic receptor

Dextromethorphan

15 .

medulla Threshold


144/209

135

10 - 20 . 4 30 . 6 - 8 120 . 2 - 6 2.5-5 . 4 30 .

6 - 12 5 -10 . 4 60 . 2

-

-

- 7

Mixt. tussis

Mixt. Tussis Camphorated opium tincture Glycyrrhiza fluidextract


145/209

136

1 - 2 3 - 4

6

Glycyrrhiza

- - 7

Mist. Scill. Ammon(Squill and Ammonia Mixt.)

Mixture 100 . Camphorated opium tincture 13.00 .Ammonium carbonate 2 Squill tincture 3.2 .Serega tincture 12 .

1 3 6 1 3


146/209

137

6

- 6

-

Phenothaizine, Barbiturates, Benzodiazepines

Salbutamol

Salbutamol

Syrup 2 ./5 .

direct acting sympathomimetic agents Beta-2-receptor

Beta-1-receptor ()


147/209

138

2 - 4 . 6 - 8

0.1 - 0.2 ./ 6 - 8

1. Hyperthyroidism 2.

3. 12

Sodium Bicarbonate mixture

Sodamint

300 . 50 ./5 .

: 1 3 : 1 3


148/209

139

-

- milk alkaline syndrome

pH

- -

Mixture Carminative

180 . 15 . - compound cardamom Tr. 1.80 .

- Weah ginger Tr. 0.12 .- Capsicum Tr. 0.12 .

: 1 3 - 4

:

8.5%


149/209

140

Antacid

1. pH

2. pepsin pH 2

pH 5 pepsinogen 3. pH

40 - 80 mEq. (15-

30 .) 1 3 6-8

1. Aluminium Phosphate

Phosphate 2. Aluminium

3. Magnesium

Magnesium 4. pH pepsin

2 pH acid rebound

1.

(systemic alkalosis) 2.

3. antacid 1 - 2 antacid


150/209


151/209

142

1.

2. 3. B12

B12 1 B12

Dimenhydrinate

50 .

H

1 receptor

6 : 25-50 . 3

15-30 15-30

1 - 5 : 12.5-25 . 3

-

-

- narrow angle- -


152/209

143

-

-

Metoclopramide

5 ./. in 2 .

:10 . 6

: 1 ./

-

- Prolactin

-

- 6-8 2-3

-


153/209

144

Hyoscine-n-butyl bromide

20 ./1 . 10 .

anticholinergic

Muscarinic

20-

30 . 100 . 1-2 3-4

6-12 1 3-4 5 . 15 ./

anaphylactic reaction anaphylactic shock

1. 6 2.


154/209

145

Atropine Sulfate

Injection 0.6 . in 1 .

Acetylcholine Muscarinic agonists Muscarinic

receptor .

1. Cholinesterase 2.

0.4 - 0.6 .

4 Acetylcholine (0.3-0.6 .) 1

0.01 ./.

Physostiine

40

Ulcerative Colitis, ileus, chronic lung disease, hyperthyroidism, neuropathy, hepatic renal disease


155/209

146

Milk Of Magnesia (MOM)

250 .

Magnesium

15 - 30 .

Hypermagnesemia,

CNS depression, Hypertension Dehydration

- 1 - - Magnesium

-

- - 1 -


156/209

147

Bisacodyl

5 . 10 . : Dulcolax

:

1 - 3 1 12

1 1 30

ORS

1 () 1 ( 150 )


157/209

148

6 2-3

6 - 2 3 - 4 2 - 5 5 - 10 5

1. 2.

3. 4. 24 .

(Absorbent)Kaolin ()

1. 2. 3.

1 - 2 1/2 - 1 4 - 6

(Kaolin) 2


158/209

149

Vitamin B6

10 .

Vit B6 Pyridoxal phosphate (PLP) ()

co-enzyme enzymes amino acid metabolism

Nutritional Supplement 2.5 - 10 . 3 2 - 5 . 10 - 20 . 3 2 - 5 .

B6 (2-6 2-40 ) , ,

1. Levodopa

Levodopa 2. B6 (2-6 /)

1. Isoniazid B6 10 - 50 .2. oral contraceptive B6 Co-enzyme

B6


159/209


160/209

151

1. 2.

pernicious anemia

Ferrous Fumarate

1 325 . ( iron 106 .)

- -

1-2

- - Antacid (), tetracycline, Norfloxacin, Ciprobay

2 .-


161/209

152

Ferrous sulfate

Ferrous sulfate 300 . equivalent to 60 .iron

co-factor enzymes

haemoglobin myoglobin

1.

2.

4-6 ./ 3

50-100 . 3 30-60 .

/

1. 2. Hemolytic

3. 6

4. Tetracycline

- -


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153

Albendazole

1 Albendazole 200 . Albendazole 100 ./5 .

Albendazole Benzimidazoles

neurocysticercosis

2

- 400 . 3-4 - Neurocysticercosis 15 .//

8-30

1. 2 2. 3. 4.

1. 2. 3. 4.


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154

Mebendazole

1 Mebendazole 100 . 500 . 100 ./5 . (1 )

, , ,

12 - 1 (100 .) 2 - 3 (

) 500 / 1 1 ()

2 - 12 - 1 2 - 3

- , - 1-2 - 3

,


164/209


165/209

156

Penicillin V(Phenoxymethyl Penicillin)

250 . (4 ) 125 ./5 . (2 )

250

. (4 ) 1 4 3 7 - 10 50,000 . 3 - 4

(Anaphylactic shock)

-

- -

1. 2.

3.


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157

4.

- - 7

Erythromycin

250 . 125 ./5 .

1.

2.

: 250-500 . (1-2 ) 6

4

7.5-25 . 1 6 15-50 . 1 12

10-14

1. 2.


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158

1.

2. Theophyline Digoxin Carbamazepine Methylprednisolone Erythomycin

Co-trimoxazole

- 1 - Sulfamethoxazole 400 .

- Trimethoprim 80 .- 1 - Sulfamethoxazole 200 .- Trimethoprim 40 .

Streptococci, Sta-

phylococci, Pneumococci, Haemophilus influenzae, Neisseria, E. coli, Salmonella,Shigella, Vibrio

cholerae

- :-

- :-

- Gonococci- Typhoid paratyphoid Typhoid

Bacillary-

- 12 2 2

- - 6 - 12 1 2 -


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159

- 6 - 5 2 -

- 6 - 5 2 - - 6 - 5 1 2 - - 6 - 12 2 2 -

- Sulfa, Trimethoprim- ,

- - - G6PD

-

- () () - Pseudomembranous

- Erythema multiform, Stevens-Johnson Syndrome

- Neutrophil Agranulocytosis, Megaloblastic anemia, Purpura

- -

-


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160

Doxycycline

100 .

Oxytetracycline

anaerobes Protozoa

- Mycoplasma

,

-

-

- 100 . 12 100-200 . 50 - 100 . 12

- 2.2 ./. 12 2.2 - 4.4 ./. 1.1 - 2.2 ./. 12 ( 745 . )

-

Photosensitive

- 8

-


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161

-

Doxycycline Anticoagulants, Penicillins, Antacid,

Alcohol CNS depressant

Cloxacillin Sodium

- 250 . (Dry syrup) 125 ./5 .

- Staphylococci, Streptoccocci Pneumococci

- 250 - 500 . 4 1

2 1 (62.5 -125 .)2 - 10 1 - 2 (125 - 250 .) 10 2 - 4 (250 - 500 .)

20 50 ./. 4

1. Penicillins

2. eosinophillia SGOT

3.


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162

1.

2. Penicillins Cephalosporins3. 4.

1

Norfloxacin

:- 100, 200 400 .

:- DNA gyrase DNA

Mycoplasma, legionella Mycobacterium Pseudomonas-

:- -

-

:-

200 - 400 . 2 7-10 -

400 . 2 10-21 1 2

- 800 .


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163

- 400 . 2 3 - 5

:

:

1. Norfloxacin

2. probenecid Norfloxacin Norfloxacin 3. Theophylloine, Phenytoin Norfloxacin

Theophyline, Phenytoin

Benzyl Benzoate (25%, 12.5%)

Lotion Benzyl Benzoate 25% () 12.5%

(Lotion 25 - 28%)1.

2. Lotion 3. 1-2


173/209


174/209


175/209

166

lotion

Methyl salicylate

ointment

Methyl salicylate

40% Salicylic acid ointment


176/209

167

() -

5

-

- - - ()

Triamcinolone acetonide

0.1% in oral paste

Phagocytosis

Lysosome Prostaglandin- thromdoxane

3 - 4

Herpeslabialis, Herpangina


177/209

168

Chloramphenical eye drop/ointment

eye drop solution 0.5% eye ointment 1%

1-2 3 -6

48 5-10 5-10

Chloramphenical eye drop 2-8 C 1

Hista - oph

Eye drop 5, 10 Antazolin HCI 0.05% + Tetrahydrozolin HCI

0.04%

- Antazolin HCI 0.05%

- Tetrahydrozoline HCI 0.04% Alpha-adrenergic receptor (conjunctival decongestant)


178/209

169

Ocular allergic Ophthalmic decongestion Conjunctivitis ()

1-2 4-6

5-10 5-10

1. Anticholinergic Atropine

2. 2 - 4 -

3. 1

Acyclovir cream

(Acyclovir 5 /100 )

(Herpes Simplex virus infection)

(herpes labialis)

5 4 5

5

acyclovir propylene glycol


179/209

170

250 .

2 - 4 4

Capsule / / 250 , 500

- - (pharyngo tonsillitis)

0.5-2 4

14%


180/209

171

2-3

1. 2. 3.

Lidocaine HCI

injection Lidocain HCI 2%

200 .

(3./.) 500 .

Lidocaine

-

-


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172

1. 6 .. 4 ..-

2. Laryngocope,, , ,

3.

1. Amide (Lidocaine, Prilocaine, Bupivacaine)2.

3. 4. 5. -

Ethyl alcohol

Ethyl alcohol 60-90% (v/v)

70%

: 10

: 90% 2 : 15 : 20 : 10

HIV : 5 : 20% Formalin

30

1. 70% Skin antiseptic 2. 70% Disinfectant 3.


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173

1.

2. 0.2-0.4 Sodium nitrite

3. 4. 5.

Povidone iodine 10%

Povidone iodine 10% iodine 1% (10,000 ppm) Povidone iodine 10%

: 85%

Clostridium Pseudomonas cepacia Staphylococcus aureus : : : 80 ppm 10 HIV : 80 ppm 10 :

7.5 %, 10% Povidone-iodine solution Pack

1. 2. 3. 4. 1

5.


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174

Cresol (Lysol)

Phenol Phenol 3-10 Phenol Cresol 0.3-0.6% 10

: : : :

HIV: 0.5% 10 :

1. 2% 2. 5% 3.

1. (Hy-

perbilirubinemia)2. 3. 4.

Lysol 50% Cresol Soap solution 1 : 40

1 : 100


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175

Glutaraldehyde 2%

: 12 : 1 : 10 : 10 HIV : 10 : 10

1. Sterilization 3 -

10 2. Disinfection

3 - 10 3. Decontamination Secondary use HIV , HBV

30

1. 2.

3 3. 4. Glutaraldehyde Acid form

Activate

5. Glutaraldehyde 28 Activator

6. Disinfection Glutaraldehyde 10 Sterile


185/209

176

Sodium trizaine-3-one (virkon)

0.5% Chlorine 5,000 ppm (Sodium Hypochlorite 5%)

: 100 ppm 10 : 125 ppm 3-10 : 100 ppm 1 : 500 ppm 10 HIV: 50 ppm 10

:

1. 2. 7 3. 4. 5. 6. .

Glucose 50%

: 50% Glucose in 50 .

: Hypoglycemia

: Hypoglycemic coma 50% Glucose solution 50 .

1. Diabetic coma GlucoseGalactose malabsorption syndrome


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177

2. Insulin Insulin

3. Anuria4. Whole blood Haemolysis Clumping5. Hypertonic solution Glucose

Hyperosmola syndrome ()6. Local pain, Vein irritation Thrombophle-

bitis ()7. edema, Hypocalcemia, Hy-

pomagnesemia Hypophosphataemia.

D 5% NSS (5% dextrose+0.9% NacI)

:Injectable solution

: -

1. 2. 3.

: -

1.

2.


187/209

178

D 5% N/2 (5% dextrose+0.45% Nacl)

:Injectable solution

: 1. 2. 3.

:

1. Dextrose Blood sugar

Blood sugar Insulin

2. 3.

4.

Lactate ringers solution

:Injectable solution Electrolyte Extra cellular fluid

1. 2. Systemic alkalinizer

:


188/209

179

1.

2. Lactic acidosis3. Lactate Bicarbonate Lactate ion Lactic acidosis

4. shock Lactic acid

- 0.9% NSS Lactate Ringers solution 20 ././- 1 NSS/2 Loctate Ringers solution 0.9% NSS 1,000

- 2,000 ./1/2 - 1 Hypovolemia

(Keep vein open) 0.9% NSS

Methylergometrine

injection 0.2 ./. in 1 .

- 0.2 .

2 - 4 5 - 0.2 .

1 ( 5 . 0.9% N.S.S)


189/209

180

-

- - -

1. ergot

2. cerebrovascular accident 60

3. obliterative vascular disease

4.

8 c

Cinnarizine

25 .

cinnarizine (calcium channel blockers)

diphenylpiperazine (Ca2+)

(dizziness), (vertigo),

(cerebral or - peripheral circulatory disorder), (ves-tibular disorder),


190/209

181

25-50 . 3

(peripheral -Circulatory disorder) : 50-75 . 3 (cerebral circulatory disorder) :25 . 3 : 25 . 6

(CNS depressants)

Diazepam

(10 . / 2 .)

- - - GABA

-

(Status epilepticus)


191/209

182

- - Status

epilepticus 0.1 - 0.5 ././

-

- -

- - -

Diazepam 5 .

apnea

Thiazide

50 . : Hydrochlorothiazide (HCTZ)

1.

2. 3. (Pulmonary edema)

1 - 2 1/2 - 1


192/209

183

1.

()2.

Mycostatin Oral Suspension

12 .

-

(Candrda or Monilia)

- -

1 . 4 1 . 4

1. 2.

3. 1%

2


193/209

184

21 22 28

1. 2. 3.

1. FSH Follicle

2. 3.

:

- 21 , 22

7 21 6 22

- 28

-

1. 2. 3.

4. 5.


194/209


195/209

186

1, 6

:

1. 1 5

2. 4 - 6 3. 2

1. 2.

1 3 3. 4. 7

5. 24 6. 7 7. 6 - 1 8. 5

1. 5

5

2. 7 3. 7 4.

7


196/209

187

5.

1.

3 - 6 2.

3.

(over stock)(expired)

3

1. .........2. .......... (.301 stock card)3.

-

1. ()

(.301 stock card)

1 x 1000 1 12 x 1000


197/209

188

.301 stock card z 6

3 -

()

.301 stock card 1 - ()

1 = () ( - )(+) ()(-)

2. ()

2 1 ( 1 )

3.

() stock -

3.1 .301 stock

card -- - 1 1

stock card

stock card


198/209

189

stock card 2 - 2 stock card1

stock card stock card

(.) stock card

3.2

3.2.1 3.2.2 3.2.3 3.2.4 3.2.5

3.3 .

(dosage form)


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190

(thera-peutic action)

() A Z

,

.

5 (manufac-turing date)

- Ampicilin 25 , Penicillin 30, Tetracyclinc

- 2 - 8

-

4. 2

4.1 4.2 ..2535

(Drug Interaction)

2 1-2 .

Antacid Cimetidine Tetracycline, Doxycycline Ferrous Sulfate, Folic Acid Tetracyclin, Doxycy-


200/209

191

cline Sodium bicarbonate pH Tetracycline Cimetidine, Erythromycin Theophylline

Theophyne (Aminophylline Ethylenediamine Theophylline) Hyoscine dyspeptic Domperidone Antacid, Milk of magnesia enteric coatcd Bisacodyl, Erythromycin Penicillin Tetracycline Penicillin Tetracycline

(Drug interactions)Alcohol :

- Antihistamines, Antipsychotics, Methyldopa, RopectAmpicillin :

- AllopurinolAspirin :

- , Steroids

Chlorpropamide, Glibenclamide :- Alcohol, HCTZ, Propranolol, Rifampicin, Thyroxin

Digoxin :- , HCTZ, Furosemide, Steroids

Gentamicin, Kanamicin :- Furosemide, Muscle relaxants, Penicillins

HCTZ : - IndomethacinPhenytoin

- INHPropranolol :

- IndomethacinTetracycline :

- , , :

- Ampicillin, Rifampicin, Tetracycline


201/209

192

:Aspirin Spontaneous onset

Aspirin

Paracetamol

: Ibuprofen Indomethacin Mefenamic Naproxen

ductus ateriosus pulmonary circulation persistant pulmonary hypertension

(Morning sickness) 80 vitamin B6 (Pyridoxine) 50-200 ./

Dimenhydrinate

(Heart burn)

(Constipation)

Saline laxative Ex. .. Salt, Na. Salt. Electrolyte imbalance, fetal dehydrationEmollients eg. Mineral oil. Castor oil Fatty soluble vitamin absorption

disturbanceStimulants eg. Bisacodyl, Senna extract uterine stimulant

bulk laxative Psyllium seed (Metamucil ) Lactulose (Duphalac ) Lactitol(Importal )

(Vaginal irritation) Candida albicans Trichomonasvaginalis Candidiasis Clotrimazole


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193

Trichomonas Metronidazole 200 . 3 7

Penici llins Spiramycin

Erythromycin ( Erythhromycin estorate Hepatotoxic

Alcohol

Aminoglycosides (:- Gentamicin, Kanamycin)

Antineoplastic & Cytotoxic agents ,

(:- Cyclophosphamide,Methotrexate, Fluorouracil)

Antithyroid drugs (:- PTU)

Benzodiazepines (:- Diazepam) ,

Chloramphenical Grey syndrome

Corticosteroids

NSAIDs Premature closure of Ductus arteriosus(:- Indomethacin, Ibuprofen)

Oral hypoglycemic drugs

(:- Chlorpropramide, Metformin,Glibenclamide)


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194

Sex hormone

(:- Estrogen, Progestogen)

Sulfonamide Kernicterus

Tetracyclines , (:- Tetracycline, Doxycycline)

Furosemide

Hydrochlorothiazide Aspirin (high dose)

, ,

Carbamazepine

Phenobarbitone

Phenytoin

Propranolol

Quinine


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195

1.

2.

3. active metabolite

4. corticosteroid, Decongestant Topical steroid Inhalation nasal spray decongestant

5. peak drug concentration half life sustained release peak drug concentration 1-3

peak concentration Tricyclic anti-depressant

6. sedatives anesthetics


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196

half life 4-5 half life

( 95%) 1-2 half life ( 50-75%)7.

Alcohol Diazepam* Phenobarbital*Aspirin Diuretics PhenytoinAmpicllin Ergotamine Prednisolone*Amitryptyline* Haloperidol* PropranololBisacodyl Hexoprenaline (Ipradol) ReserpineChloramphenical* Indomethacin StreptomycinConjugated estrogen* Lorazepam* Sulfa drugs(Premarin )

Cotrimoxazole* Mefenamic acid TetracyclineCyproheptadine Metronidazole*Note : * =

(Adverse drug reations)

:- :-- Penicillins ( , , )- Tetracycline - Hormones- Sulfa drugs - Sulfa drugs- TB drugs - Tetracycline- Antimalarial drugs - Thyroid- - - -

- : -- Steroids (, )


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197

:- - Aspirin- - Gentamicin

- - Kanamycin- - Sulfa drugs : - - Streptomycin( ) :-

- Chloramphenical - Chloroquin- Chloroquin - Ethambutol- Chlorpromazine - INH- Phenytoin - Steroids

- PTU - Quinine- Primaquine : -- Phenylbutazone - Furosemide

:- - Gentamycin(, ) - Kanamycin

- Aspirin - Quinine- NSAIDs - Streptomycin- Steroids

:-- Aspirin- Indomethacin


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198

1. 2. 3. 4. 5. .. 6. .. 7. .. 8. .

9. . 10. . 11. 12. 13. .14. .15. 16. 17. 18. 19. 20. 21. 22. 23.

24. 25. 26. 27. .28.


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199

.. 2543

1. . . 2. . 3. . . 4. . . 5. . 6. . 7. . 8. 9. . 10. . 11. . 12. . 13. 14.

15. 16. 17. 18. 19. 20. 21. 22.

23. 24. 25. 26. 27. 28. 29. 30.

31.


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200

32. 33.

34. 35. 36. 37. 38. 39. . 40. . 41. . .

Documents

PCU Manual Treatment 1