Guide to private practice in medicine note 4


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Also known as GP note, "Pol" note, PP note
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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Guide to private practice in medicine note 4

  1. 1. Guide to private practice in medicine- note 4 Head Laceration Remove hair And particle with sprit + betadine Ciprofloxacin 250 mg bd Cloxacillin 500mg bd + pain killer PCM 1g + diclofenac sodium 50mg/ mefenamic acid 500mg Dress every other day Remove suture 8 day If nausea, vomiting - admit or take xray Do not give sedative, advice not to take alcohol Skin condition Dandruff 2% ketocanazole Micoral or nisoral or keto plus 2 times per week without touching eye In case of seborrhoeic dermatitis- 1% hydrocortisone cream LA 10% cetrimide shampoo Hair loss Multi vitamin Anemidox 1 tab nocte Zincoper syrup 1 tsp bd - adult 2 tsp bd Co vit - m 1 capsule nocte - 3 months Fungal infection
  2. 2. Malasessia furfur Generalized - itrakanozole 200mg capsule nocte 14 days Dnt give to pregnant, lactating women, male fertile expecting Local Micanazole Micral cream Cotrimazole - candid b 2 times perday until disappear + after 1 week Eczema + fungal infection Betamethasone + neomycine + micanazole.. - beclomine Beclazone - c - betamethasone + antifungal Beclazone - n - betamethasone + neomycine - for infected eczema Oinment good absorption for resistant cases Groin itch Candid b Above combination cream Treat family or contacts Eczema Dry eczema - steroid cream Hydrocortisone - mild Betamethasone - moderate Powercoat cream - plobstone propionate - potent Apply 2 times for a week Betamethasone cream + remove the cause + Dexamethasone or prednisilone 5mg bd - 1 bd Pritone 1/2 mane + 1 nocte
  3. 3. Non sedative Cetrizine / levo cetrizine / phenagen 1/2 bd 5mg Wet eczema - power coat cream + antibiotic Ciprofloxacine dnt give for children <12 years Ciprofloxacin - 500mg bd Or 250 mg bd Cefuroxime, Ciprofloxacin - bd Cloxacillin, cephalexine, erythromycin - 6 hrly Amoxicillin, clavulonic acid - tds Nail bed infection Antifungal solution - candid b - 2drop + antihistamin + pain killer + if infected - antibiotic Or 200mg itrakanazole 14 days nocte Ring block and remove the nail + tetanus toxoid Bacterial infection Abscess Pain killer + antibiotic Cut in cross with lignocaine No suture Put a betadine pack Dress everyother day Scabies Lindane solution - 3 consecutive days 3% sulfa nocte 3 consecutive days. avoid mucosa Antihistamine Antibiotic Treat other Children <2yr Warts - duofilm - 1 time nocte only above the wart but not near to eye If have to go for skin clinic - liquid nitogen
  4. 4. Callosities Salicilic acid patch - corn plast (40% w/w salicylic acid) Leave in place until it starts to detach. Cut - give lignocaine around Dress every other day Pain killer If infected, Toxoid /Antibiotic Pimples Antibiotic - 7 days - ciprofloxacillin/ doxycycline Wash face before sleep Isotrexin - 10mg - nocte Eudiana - only in night Burn Dry skin  Emoderm  Quadril Feet cleft  Emoderm Muscle cramp Vitamin E 200mg - nocte 1 month Polybion Saline wash Apply lignocaine gel over the burn Silverine - silver sulpha diazine apply Vaslin gauze Diazepam Pain killers Antibiotic Dressing every other day Toxoid ENT Wax Insect - put water 10cc syringe - butterfly Crocodile forcep Ear wash Waxsol - 3 days consequtly come 4th day
  5. 5. Eye Conjuctivitis Chloramphenicol eyedrop 1 drop 6hrly 5 days Gentamicin eye drop - metamycin Antihistamine - phenagan/ mefenamic acid Dexanel - neomycin + dexamethasone - inflammatory eye condition Nose Nasal bleeding RTI Upper RTI Adult Antibiotic Ciprofloxacin , cefalexine, cefuroxime Azithromycin, clarythromycin Mouth wash - betadine -( 10ml betadine + 60 ml water) 1 tsp + 1 cup water - 3 times per day Pain killer PCM 1g tds Mefenamic acid or diclofenac sodium Cough -dexamethasone / prednisilone + Deryphyllin - 150mg SR bd / salbutamol Piriton 1/2 mane + 1 nocte Children syrup Piriton syrup - 5mg in 5ml tsp Salbutamol - 4mg in 5ml Deryphyllin - 50mg in 5ml Phenagon - 5mg in 5ml
  6. 6. + antibiotic syrup Cephalexin syrup - 125mg in 5ml give 6 hrly Erythromycin - 125 mg in 5ml give 6hrly Amoxycillin, cephalexin - 125mg Augmentin syrup LRTI PCM + diclofenac/ mefenamic acid Brufen syrup Syrup mefenamic acid - dollar Cough syrup Dry Visex, venox - contain salbutamol Ascodex Productive cough Hydrilline cough syrup Ascoril Ketotifen <2yrs - 1/2 tsp tds >2yrs - 1 tsp tds Adult - 2 tsp tds/ qds >3 weeks do FBC If eosinophil Hetrazan 6mg/kg day - tab 50mg course - 2tab tds - 2 weeks GIT Gastritis
  7. 7. Abdominal pain Abdominal pain + vomiting Domperidone 10mg tds / Phenagon 10 mg tds Domperidone Tab strength; 10mg ADULT 10mg tds ½ before meals 12-6 5mg <6…>15Kg 1 tea spoon <6…>15Kg ½ tea spoon Remarks; Galactorrhoea Syrup; Max dose; Phenagon Tab strength; 25mg,10mg ADULT 10-25mg daily 12-6 12.5mg daily <6…>15Kg 1 tea spoon <6…>15Kg ½ tea spoon Remarks Syrup; Max dose; Severe vomiting phenagon injection Any hollow structure spasm Propenthaline - 15mg tds Buscopane - 10mg (hyosine euton bromide) - tds or 6hry Propanthaline Tab strength; 15mg ADULT 15mg tds 12-6 <6…>15Kg <6…>15Kg Remarks Syrup; Max dose; Buscopan Tab strength; 10mg ADULT Stat 4 tabs, 10mg tds 12-6 5 mg tds <6…>15Kg No <6…>15Kg N0 Remarks Syrup; Max dose; If severe suppository or IM Diclofenac sodium 100mg suppository
  8. 8. + antibiotic - ciprofloxacin Celezib - 200mg bd Jeevani Lomotil in adults - if watery 1 tds one another day Children Antiotic syrup + jeewani + aanamalu + cream cracker Furosolidone 100mg Furazolidine Tab strength; 100mg ADULT 100mg 12-6 50mg <6…>15Kg 25mg 1tea spoon <6…>15Kg ½ tea spoon Remarks Syrup; Max dose; Gastritis Moderate Domperidone 10mg bd 5days Famotidine 20mg tds (good) 5days Cimetidine 200mg tds Digene syrup Omeprazole 20mg bd Esmoprazole If not responding triple therapy Amoxycilline / metranidazole + omeprazole + clarythromycin Constipation
  9. 9. Dulcolax 1 tab nocte 3 days. Or 10mg suppository Dulcolax Tab strength; 5 mg ADULT 5 mg nocte 12-6 <6…>15Kg <6…>15Kg Remarks Syrup; Max dose; Lactulose Tab strength; ADULT 2 tea spoon 12-6 1 tea spoon <6…>15Kg ½ tea spoon <6…>15Kg ¼ tea spoon Remarks Syrup; Max dose; Worm treatment <2yrs -pyrantel pamoate /combatrin - syrup/tablet Once in week 2 dose >2yrs - mebendazole 100mg bd -3days + vitamin B complex Iron deficiency in children Iron supplement syrups- roofer, mumfer Elemental iron 6mg/kg/day UTI - Increase water consumption Frusemide - 40mg mane NSAID + PCM CIPROFLOXACIN/NORFLOXACIN/CEPHALEXIN 500mg tds/COAMOXYCLAV Nitrofurantoin 50mg 6hrly (prophylaxis 100mg nocte) + Vit C 1 tab <1 yr - send to a pediatrician Candidiasis - Candid b cream - 1 week Female - candid V3/v6 pessary - pregnant
  10. 10. Urethritis Broad spectrum antibiotic UFR Female - PID Metranidazole + other antibiotic Loss appetite Multivitamin syrup Peritol syrup - clohexfidine Polybion injection CVS Hypertension Check BP 3 days >140/90mmHg Drug Usual dose Max dose daily Captopril 6.25mg bd 150mg Enalapril 5-20mg daily 40mg Atenolol 25-50mg daily Losartan 50mg daily 100mg Nifedipine SR 10mg bd 40mg bd Frusemide 40-80mg daily >50mg doses IV infusions only. Max 1.5g Spironolactone 25mg daily Atenolol – A/E- erectile dysfunction Aspirin 75mg nocte- to ↓ CV event risk Clopidogrel 75mg nocte Dyslipidemia Atovastatin 10-40 mg nocte (start if Total cholesterol is >200 & LDL >190) Fenofibrate 100-200mg nocte (If TG is high & LDL is normal) Still the diabetic pt with high TG → choice is Atovastatin Allergies Prednisilone 2 tds 1st day and 1 tds next day Hydrocortisone iv 100mg Nebulize 5mg salbutamol Vertigo- vestibular causes
  11. 11. Stemetil 5mg tds (max. 30mg daily) Betahistine 8-16mg tds Cinnarizine 30mg tds Motion sickness Hyoscine hydrobromide 150-300 μg before 30 minutes (max. 900μg daily) Cinnarizine 30mg 2h before journey→15mg 8hrly during journey SOS (Domperidone, metochlopramide/ maxalon- ineffective) Gyn and obs PV bleeding- Urine HCG Norethisterone 5mg tds 7days OCP - DMPA - once in 90 days Stop breast milk  Bromocriptine 2.5mg bd 14 days