British National Formulary 36

1
(Composed & edited by Wasir Khan Zeerak)

email: - waserkhan@yahoo.com
waserkhan@gmail.com
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(British National Formulary-36)

Compiled by WASER KHAN ZERAK (September
1998)
________________________________________________________________________________
CHAPTER & PAGE # (Gastrointestinal System 1-1), (Cardiovascular System 2-8),
(Respiratory-Tract Infections 3-20), (Infections 4-26), (Skin 5-42), (Musculoskeletal &
Joints Diseases 6-52), (Endocrine System 7-57), (ENT 8-61), (CNS 9-65), (Obstetrics,
Gynaecology & Urinary-Tract Disorders 10-77), (Eye 11-81), (Opioid drugs #85), (Test-86),
(Nutrition & Blood 13-92)
_________________________________________________________________________________
Chapter 1 (Gastrointestinal system)
Dyspepsia
Aluminium hydroxide
Indications: dyspepsia
Medicine: Alu-cap®(3M), Aludrox®, Maalox®(Rhone-Poulenc-Rorer), & Mucogel,
Rialox®(Riyadh Pharma) suspension
_______________________________
Magnesium carbonate
Medicine: Aromatic magnesium carbonate oral suspension
_______________________________
Magnesium trisilicate
Medicine: Magnesium trisilicate mixture, BP, 5% suspension
_______________________________
Hydrotalcite
(Aluminium magnesium carbonate hydroxide hydrate)
Medicine: Hydrotalcite®(Hoechst Marion Roussel), Altacite® 500mg, Mucaine®(Wyeth)
contains (aluminium hydroxide, magnesium hydroxide & oxethazaine) tablets &
suspension
_______________________________
Sodium bicarbonate
Indications: rapid relief of dyspepsia; urinary tract, acidosis
Medicine: Sodium bicarbonate tablets, compound
_______________________________
Other drugs for dyspepsia & gastro-oesophageal reflux disease
Algicon® (aluminium hydroxide-magnesium carbonate co-gel, magnesium alginate, magnesium
carbonate) Altacite® (hydrotalcite=aluuminium, magnesium) Bisodol® heartburn tablets
(alginic acid, magaldrate, & sodium bicarbonate) Maalox® plus tablets (aluminium, magnesium,
activated dimethicone) Moorland® (aluminium, bismuth, calcium, magnesium, light kaolin)
2
_______________________________
Antispasmodic & other drugs altering gut motility
Antimuscarinics
Atropine sulphate 
Indications: mydriasis & cycloplegia
Medicine: Atropine® 600mg tablets, Actonorm powder®(atropine, aluminium, calcium,
magnesium, sodium bicarbonate, & peppermint oil)
_______________________________
Dicyclomine hydrochloride
Indications: adjunct in gastro intestinal disorders characterized by smooth muscle spasm
Medicine: Merbentyl®(Florizel) 10mg, kolanticon 200mg gel
_______________________________
Hyoscine butylbromide
Indications: symptomatic relief of irritable bowel syndrome; dysmenorrhoea
Medicine: Buscopan®(Boehringer Ingelheim Germany) 10mg tablets
_______________________________
Propantheline bromide
Medicine: Pro-Banthine®(Baker Norton) 15mg tablets
_______________________________
Alverine citrate
Medicine: Spasmonal®(Norgine) 60mg, alvercol graules
_______________________________
Mebeverine hydrochloride
& irritable bowel syndrome (IBS)
Medicine: Fybogel® Mebeverine (R&C) granules
_______________________________
Pepperment oil
Indications: relief of abdominal colic & distension, particularly irritable bowel syndrome
Medicine: Colpermin®(Upjohn), Mintec®(Monmouth) capsules
_______________________________
Cisapride
Indications: symptoms & mucosal lesions associated with gastro oesophageal reflux,
dyspepsia
Medicine: Prepulsid®(Janssen-Cilag) 10mg tablets
_______________________________
Ulcer healing drugs
Helicobater pylori infection
Triple therapy (1-week regimens)
Amoxycillin 500mg 3 times daily
Plus
Metronidazole 400mg tid
Plus
Omeprazole 20mg bid or 40mg OD for 7days
-----------------------------------
Clarithromycin 250mg bid
Plus
Metronidazole 400mg (or tinidazole 500mg) bid
Plus
Omeprazole 20mg bid or 40mg OD for 7dyas
3
_______________________________
Amoxycillin 1g bid
Plus
Claritromycin 500mg bid
Plus
Omeprazole 20mg bid for 7days
_______________________________
Triple therapy (2-week regimens)
Tetracycline 500mg Qid
Plus
Plus
Tripotassium dicitratobismuthate 120mg qid for 14days
_______________________________
Amoxycillin 500mg tid
Plus
Plus
Ranitidine 300mg at night, or 150mg bid for 14days
_______________________________
H2-receptor antagonists
Cemitidine
Indications: benign (harmless) gastric & duodenal ulceration, stomal ulcer, reflux
oesophagitis, Zollinger-Ellison syndrome, & other conditions where gastric acid
reduction is beneficial
Medicine: dyspamet®(SK&F) 200mg, Tagamet®(SK&F) 200mg, Cemit, Ultec®(Berk)
tablets & injection
_______________________________
Famotidine
Indications: Benign (harmless) gastric & duodenal ulceration, stomal ulcer, reflux
oesophagitis, Zollinger-Ellison syndrome, & other conditions where gastric acid
reduction is beneficial
Medicine: Pepcid®(MSD) 20mg tablets, Famodar® 20/40mg tablets
_______________________________
Nizatidine
Indications: benign gastric & duodenal ulceration, stomal ulcer, reflux oesophagitis,
Zollinger-Ellison syndrome, & other conditions where gastric acid reduction is beneficial
Medicine: Axid®(Lilly) 150mg capsules & injection
_______________________________
Ranitidine
Medicine: Zantac®(GlaxoWelcome) 150/300mg tablets
_______________________________
Ranitidine bismuth citrate
Medicine: Pylorid®(GlaxoWelcome) 400mg tablets
_______________________________
Selective antimuscarinics
Tripotassium dicitratobismuthate
4
Indications: benign gastric & duodenal ulceration, helicobacter pylori eradication
regimens
Medicine: De-nol®(Yamanouchi), De-noltab® 120mg tablets
_______________________________
Sucralfate
Indications: benign gastric & duodenal ulceration & chronic gastritis, prophylaxis of
stress ulceration
Medicine: Antepsin®(Chugai) 1g tablets
_______________________________
Misoprostol
Indications: benign gastric & duodenal ulceration & Nsaid-associated ulceration,
prophylaxis of Nsaid-induced gastric & duodenal ulcer
Medicine: Cytotec®(Searle) 200mcg injection, or with diclofenac or naproxen
_______________________________
Proton pump inhibitors
Omeprazole
Medicine: Losec®(Astra) 10/20mg tablets
_______________________________
Lansoprazole
Medicine: Zoton®(Lederle) 15mg Capsules
_______________________________
Pantoprazole
Medicine: protium®(Knoll) 40mg tablets
_______________________________
Other Ulcer-healing drugs
Carbenoxolone sodium 
Indications: oesophageal inflammation & ulceration
Medicine: Pyrogastrone® (Sanofi Winthrop) 20mg tablets
_______________________________
Anti-diarrhoeal drugs
Kaolin, light 
Indications: diarrhoea
Medicine: Kaolin mixture, BP 
_______________________________
Antimotility drugs
Codeine phosphate
Indications: diarrhoea
Medicine: Diarrest®(Galen) 5mg, Kaodene®(Knoll) 5mg suspension
_______________________________
Co-phenotrope
(Co-phnotrope is a miture of diphenoxylate & atropine sulphate. Dyphenoxylate is an opioid)
Indications: adjunct to rehydration in acute diarrhoea; chronic mild ulcerative colitis
Medicine: Lomotil®(Searle) Co-phnotrope 2.5mg/0.025mcg (diphenoxylate
hydrochloride, atropine sulphate) 2.5mg tablets. Note: Opioid drugs on page 85
_______________________________
5
Loperamide hydrochloride
Indications: adjunct to rehydration in acute diarrhoea; chronic mild ulcerative colitis in
adults & children over 4 years, chronic diarrhoea in adults only (loperamide is an opoid)
Medicine: Imodium®(Janssen-Cilag) 1/2mg capsules & tablets
_______________________________
Balsalazide disodium
Indications: treatment of mile to moderate in ulcerative colitis
Medicine: Colazide®(Astra) 750mg capsules
_______________________________
Mesalazine
Indications: treatment of mild to moderate ulcerative colitis & maintenance of remission
Medicine: Asacol®(SK&F) 400mg, Pentasa, Salofalk 250mg tablets
_______________________________
Olsalazine sodium
Indications: treatment of mild to moderate ulcerative colitis & maintenance of remission
Medicine: Dipentum®(Pharmacia & Upjohn) 250mg capsules
Note: denotes preparations that are considered to be less suitable for prescribing
Sulphasalazine
Indications: treatment of mild to moderate ulcerative colitis & maintenance of remission,
active crohn's disease
Medicine: Salazopyrin®(Pharmacia & Upjohn) 500mg tablets, suspension & suppository
_______________________________
Cholestyramine
Indications: diarrhoea associated with crohn's disease, ileal resection, vagotomy, diabetic
vagal neuropathy, & radiation; prutitis in liver disease, & hypercholesterolaemia
(increase level of cholesterol)
Medicine: preparations
_______________________________
Corticosteroids (in gastro-intestinal infection)
Budesonide
Indications: mild to moderate crohn's disease affecting the ileum or ascending colon
Medicine: Entocort®(Astra) 2mg/100ml cap & enema
_______________________________
Hydrocortisone
Indications: ulcerative colitis, proctitis, & proctosig-moiditis
Medicine: Colifoam®(Stafford-Miller) 10% foam in aerosol
_______________________________
Prednisolone
Indications: ulcerative colitis, & crohn's disease,
Medicine: Predenema®(Pharmax), Predfoam®, & Predsol® retenion enema
_______________________________
Sodium cromoglycate
Indications: food allergy (in conjunction with dietary restriction); asthma, allergic
conjuctivitis, allergic rhinitis
Medicine: Nalcrom®(Fisons) 100mg capsules
Laxatives
Bran
Indications: hypercholesterolaemia
Medicine: Trifyba®(Sanofi Winthrop) powder sachets
6
_______________________________
Ispaghula husk
Indications: hypercholesterolaemia, constipation
Medicine: Isogel®(Pfizer), Regulan®
_______________________________
Methycellulose
Indications: obesity, constipation
Medicine: Celevac®(Monmouth) 500mg tablets
_______________________________
Sterculia
Indications: constipation
Medicine: Normacol®(Norgine) granules
_______________________________
Stimulant laxatives
Bisacodyl
Medicine: Bisacodyl, Dolcolax®(Windsor) tablets, suspension, & suppository
_______________________________
Danthron
Indications: only for; constipation in geriatric practice; prophylaxis & treatment of
analgesic induced constipation in terminally ill patients of all ages; constipation in cardiac
failure & coronary thrombosis (condition in which bowel movement must be fee of
strain); acts within 6-12hours
Medicine: Co-danthramer® capsules & suspension
_______________________________
Docusate sodium
(Dioctyl sodium sulphosuccinate)
Medicine: Dioctyl®(Schwarz) 100mg Capsules, Docusol, & orgalax Micro-enema 120mg
_______________________________
Glycerol
(Glycerin)
Medicine: Glycerol® suppositories, BP
_______________________________
Oxyphenisatin
Indications: by rectum before diagnostic procedures or surgery
Medicine: Veripaque®(Sanofi) enema
_______________________________
Senna
Indications: constipation, senna acts in 8-12 hours
Medicine: Senna® 7.5mg tablets, Manevac® granules
_______________________________
Sodium picosulphate
(Sodium picosulfate)
Indications: constipation; bowel evacuation before abdominal radiological procedures
Medicine: the brand name Dulcolax® & Laxoberal®, Sodium picosulphate elixir
_______________________________
Faecal softners
Arachis oil
Medicine: Fletchers' Arachis Oil Retenion Enema®
7
_______________________________
Liquid paraffin 
Medicine: Agarol®, Liquid paraffin oral emulsion
_______________________________
Osmotic laxatives (means digestive laxative)
Lactitol
Indications: Constipation, may take up to 48hours to act, hepatic encephalopathy (portal
systemic encephalopathy)
Medicine: Lactitol powder
_______________________________
Lactulose
Indications: Constipation, it may take up to 48hours to act, hepatic encephalopathy (portal
systemic encephalopathy)
Medicine: Lactulose®, duphalc®(Solvay), Rialax®, Osmolax®, & suspension
_______________________________
Macrogols
(Polyethylene glycols)
Indications: chronic constipation, it may take up to 48hours to acts, hepatic
encephalopathy (portal systemic encephalopathy)
Side effects: abdominal distension and pain, and nausea
Medicine: Movicol®(Norgine) contains (polyethylene glycol 3350, sodium bicarbonate,
sodium chloride, potassium chloride) oral suspension
_______________________________
Magnesium slats
Indications: constipation, drug may take up to 48hours to acts, hepatic encephalopathy
(portal systemic encephalopathy)
Medicine: Cremaffin®, Malipar®, Magnesium Hydroxide Mixture, & Bp
_______________________________
Phosphates (rectal)
Indications: rectal use in constipation; bowel evacuation before abdominal radiological
procedures, endoscopy, & surgery
Medicine: Carbalax® suppositories, Fleet Ready-to-use enema
_______________________________
Sodium citrate (rectal)
Indications: rectal use in constipation
Medicine: fleet micro-enema (De Witt) 450mg, Micralax micro-enema
_______________________________
BOWEL CLEANSING SOLUTIONS
Citramag® (Bioglan) powder (magnesium citrate) effervescent in water
Picolax® oral powder (sodium picosulphate, magnesium citrate) for bowel evacuation
Klean-prep® oral powder ('macrogal', polyethylene glycol, anhydrous sodium sulphate, sodium
bicarbonate, sodium chloride, potassium chloride)
Fleet Phospho-soda® (De Witt)
Compound haemorrhoidal preparations with corticosteroids
Anugesic-HC cream contains (benzyl benzoate, bismuth oxide & hydrocortisone acetate
Betnovate rectal ointment contains (betamethasone valerate, lignocaine hydrochloride, &
phenylephrine hydrochloride, Proctosedyl ointment contains, (cinchocaine (dibucaine)
hydrochloride, hydrocortisone, Proctosedyl cream, ointment, suppositories, & foam in aerosol
pack, Xyloproct ointment, contains aluminium acetate, hydrocortisone, lignocaine, zinc oxide,
Procto-Glyvenol® Novartis (tribenoside & lidocaine hydrochloride) for external & internal
haemorrhoids cream & suppositories (for external & internal haemorrhoids)
_______________________________
8
Rectal sclerosants
Phenol
Indications: is used to inject haemorrhoids particularly when unprolapsed
Medicine: oily phenol injection, bp
Other preparations for Biliary disorders
Indications: raises biliary cholesterol solubility. It is not considered to be a useful adjunct
Medicine: Rowachol®(Rowa) capsule contains borneol 5mg, camphene 5mg, cineole
2mg, menthol 32mg, menthone 6mg, & pinene 17mg in olive oil
***************************************
Chapter 2 ( Cardiovascular system )
Cardiac glycosides
Digoxin
Indications: heart failure, supraventricular arrhythmias (particularly atrial fibrillation)
Medicine: Lanoxin®(GlaxoWelcome) 125mcg, Lanoxin-PG® 62.5mcg tablets &
injection
_______________________________
Digitoxin
Indications: heart failure, supraventricular arrhythmias (particularly atrial fibrillation)
Medicine: Digitoxin® 100mcg tablets
_______________________________
Enoximone
Indications: congestive heart failure where cardiac output reduced & filling pressures
increase
Medicine: Perfan®(Hoechst Marion Roussel) 5mg/ml injection
_______________________________
Milrinone
Indications: short term treatment of severe congestive heart failure unresponsive to
conventional maintenance therapy (not immediately after myocardial infarction); acute
heart failure, including low output states, following heart surgery
Medicine: Primacor®(Sanofi Winthrop) 1mg/ml injection
_______________________________
Diuretics
Thiazides & related diuretics
Note: (Thiazides are used to relieve oedema due heart failure & to reduce blood
presssure).
Note: There are some drugs which may cause impotency, that are Diuretics drugs
(Lasix®), beta-blocker drugs (Tenormin®, or Inderal®), anti-emitic (metocloperamide),
Adrenergic neurone blocking drugs (which reduce hypertension (e.g. guanethidine
monosulphate (Ismelin®) & bethanidine sulphate (Bendogen®), & Bang
_______________________________
Bendrofluazide
9
Indications: oedema, hypertension
Medicine: Bendorfluazide (Non-proprietary) 2.5mg, Neo-Bendromax®,
Asprinax®(Knoll), & Neo-NaClex® (Goldshield) tablets
_______________________________
Chlorothiazide
Medicine: Saluric®(MSD) 500mg tablets
_______________________________
Chorthalidone
Indications: oedema, hypertension, & diabetes insipidus
Medicine: Hygroton®(Alliance) 50mg tablets
_______________________________
Cyclopenthiazide
Medicine: Navidrex® 50mcg tablets
_______________________________
Hydrochlorothiazide
Medicine: Hydrosaluric®(MSD) 25mg tablets
_______________________________
Indapamide
Indications: essential hypertension
Medicine: Natrilix® 2.5mg tablets
_______________________________
Mefruside
Medicine: Baycaron®(Bayer) 25mg tablets
_______________________________
Metolazone
Medicine: Metenix®(Borg) 5mg tablets
_______________________________
Polythiazide
Medicine: Nephril®(Pfizer) 1mg tablets
_______________________________
Xipamide
Medicine: Diurexan® 20mg tablets
_______________________________
Loop diuretics
(Note: Loop diuretics are used in pulmonary oedema due to left ventricular failure & in
patients with longstanding heart failure who no longer respond to thiazides).
Frusemide
Indications: oedema, oliguria due to renal failure
Caution: frusemide may also cause impotency (Namerdy) in male
Medicine: Lasix®(Borg) 20mg tablets, paediatric liquid, injection
_______________________________
Bumetanide
Indications: oedema, oliguria due to renal failure
Medicine: Burinex®(Leo) 1mg tablets, & injection
10
Ethacrynic acid 
Indications: oedema where urgent diuresis essential
Medicine: Edecrin®(MSD) 50mg injection 
_______________________________
Torasemide
Medicine: Torem®(Boehringer Mannheim) 2.5mg tablets
_______________________________
Potassium-sparing diuretics
Amiloride hydrochloride
Indications: oedema, potassium conservation with thiazide & loop diuretics
Medicine: Amiloride® 5mg tablets, & oral solution Amilospare®, Amilamoni®, Froop®
_______________________________
Triamterene
Indications: oedema, potassium conservation with thiazide & loop diuretics
Medicine: Dytac®(Pharmark) 50mg capsules
_______________________________
Potassium canrenoate
Indications: oedema associated with secondary hyperaldosteronism, liver failure, &
chronic decompensated heart failure
Medicine: Spiroctan-M®(Boehringer Mannheim) 20mg injection
_______________________________
Spironolactone
Indications: oedema & ascites in cirrhosis of the liver, malignant ascites (means water in
abdomin), nephrotic syndrome, congestive heart failure; primary hyperaldosteronism
Medicine: Aldactone®(Searle), Spiroctan® 25mg tablets
_______________________________
Supraventricular & ventricular arrhythmias
Amiodarone hydrochloride
Indications: specialist use only
Medicine: Cordarone-X®(Sanofi) 10mg tablets
_______________________________
Disopyramide
Indications: ventricular arrhythmias, especially aftermyocardial infarction;
supraventricular arrhythmias (specialist use only)
Medicine: Rythmodan®(Borg) 100mg capsule,
_______________________________
Flecainide acetate / Procaine hydrochloride/ Propafenone hydrochloride /Quinidine
Indications: (specialist use only)
_______________________________
Ventricular arrhythmias
Bretylium tosylate
Indications: ventricular arrhythmias resistant to other treatment
Medicine: Bretylate®(GlaxoWelcome), Min-1-Jet® Bretyylium Tosylate 50mg injection
_______________________________
Lignocaine hydrochloride
Indications: ventricular arrhythmias, especially after myocardial infarction
Medicine: Lignocaine in glucose infusion, Xylocard®(Astra) 100mg injection
_______________________________
Mexiletine hydrochloride
11
Indications: ventricular arrhythmias, especially after myocardial infarction
Medicine: Mexitil®(Boehringer Ingelheim), Mexitil PL® 50mg capsules
_______________________________
Moracizine hydrochloride
Indications: ventricular arrhythmias in patients with underlying cardiac disease & history
of ventricular fibrillation or sustained venticular tachcardia, or of symptomatic non-
sustained due to premature vetricular contraction
Medicine: Ethmozine®(Monmouth) 200mg tablets
_______________________________
Beta-adrenoceptor blocking drugs
Propranolol hydrochloride
Indications: hypertension, angina, arrhythmias, and prophylaxis after myocardial
infarction, migraine prophylaxis
Caution: Inderal may cause some impotency to male
Medicine: Inderal®(Zeneca) 10/40/80mg tablets, injection
_______________________________
Acebutolol
Indications: hypertension, angina, & arrhythmias
Medicine: Sectral®(Rhone-Poulenc-Rorer), Secadrex® 200mg capsules
_______________________________
Atenolol
Indications: hypertension, angina, & arrhythmias
Medicine: Tenormin®(Stuart), Kalten®, Tenben®, Tenif® 50/100/150mg tablets &
capsules
_______________________________
Betaxolol hydrochloride
Indications: hypertension, glaucoma
Medicine: Kerlone®(Lorex) 20mg tablets
_______________________________
Bisoprolol fumarate
Indications: hypertension, angina
Medicine: Concor®(Merck) 2.5mg, Monocor®(Lederle), Monozide® 10/20mg tablets
_______________________________
Carvedilol
Indications: hypertension, angina, heart failure (specialist use only)
Medicine: Eucardic®(Beecham), Dilatrend® 12.5/25mg tablets
_______________________________
Celiprolol hydrochloride
Indications: mild to moderate hypertension
Medicine: Celectol®(Rhone-Poulenc-Rorer) 200mg tablets
_______________________________
Esmolol hydrochloride
Indications: short term treatment of supraventricular arrhythmias (including atrial
fibrillation, atrial flutter, & sinus tachycardia); tachycardia & hypertension in peri-
operative period
Medicine: Brevibloc®(Sanofi Winthrop) 10mg injection
_______________________________
Labetalol hydrochloride
Indications: hypertension including (hypertension in pregnancy, hypertension with
angina, & hypertension crisis
Medicine: Tr&ate®(Medeva) 50mg tablets
_______________________________
12
Metoprolol tartrate
Indications: hypertension, angina, arrhythmias, & migraine prophylaxis
Medicine: Betaloc®(Astra) 50mg, Lapresor®(Novartis) 50/100mg tablets
_______________________________
Nadolol
Indications: hypertension, angina, arrhythmias, & migraine prophylaxis
Medicine: Corgard®(Sanofi Winthrop) 40mg, Corgaretic® 40/80mg tablets
_______________________________
Oxprenolol hydrochloride
Indications: hypertension, angina, arrhythmias, & anxiety symptoms
Medicine: Trasicor®(Novartis), Trasidrex® 160mg tablets
_______________________________
Pindolol
Indications: hypertension, angina
Medicine: Visken®(Novartis) 5/10mg tablets
_______________________________
Sotalol hydrochloride
Indications: life-threatening arrhythmias including ventricular tachy arrhythmias,
symptomatic non-sustained ventricular tachyarrhythmias
Medicine: Sotalol®, Sotacor®(Squibb) 80mg tablets
_______________________________
Timolol maleate
Indications: hypertension, angina, & prophylaxis after infarction
Medicine: Betim®(Leo), Blocadren®(MSD) 10mg tablets
_______________________________
Vasodilator antihypertensive drugs
Diazoxide
Indications: severe hypertension associated with renal disease, hypoglycaemia
Medicine: Eudemine®(Goldshield) 15mg injection
_______________________________
Hydralazine hydrochloride
Indications: moderate to severe hypertension, with beta-blocker & thiazide; hypertension
crisis
Medicine: Apresoline®(Alliance) 25mg tablets
_______________________________
Minoxidil
Indications: severe hypertension, in addition to diuretic & a beta-blocker
Medicine: Loniten®(Pharmacia & Upjohn) 2.5mg tablets
_______________________________
Sodium nitroprousside
Indications: hypertension crisis, controlled hypotension in aneasthesia; acute chronic
heart failure
Medicine: intravenous solution10mglml
_______________________________
Centrally acting antihpertensive drugs
Clonidine hydrochloride
Indications: hypertension; migraine
Medicine: Catapres®(Boehringer Ingelheim), Dixarit®, Catapres® perlongets 250mcg
tablets & injection
_______________________________
Methyldopa
Indications: hypertension; in conjunction with diuretic; hypertensive crisis
13
Medicine: Aldomet®(MSD) 125/250mg tablets
_______________________________
Moxonidine
Indications: mild to moderate essential hypertension
Medicine: Physiotene®(Solvay) 200mcg tablets
_______________________________
Guanethidine monosulphate
Indications: hypertension crisis
Medicine: Ismelin®(Alliance) 10mg injection
_______________________________
Bethanidine sulphate 
Indications: hypertension
Medicine: bendogen®(Lagap) 10mg tablets 
_______________________________
Debrisoquine 
Medicine: Debrisoquine®(Cambridge) 10mg tablets
_______________________________
Alfa-adrenoceptor blocking drugs
Doxazosin
Indications: hypertension; benign prostatic hyperplasia
Medicine: Cardura®(Invicta) 1mg tablets
_______________________________
Indoramin
Indications: hypertension; benign prostatic hyperplasia
Medicine: Baratol®(Monmouth) 500mcg(0.05mg) Becasuse 1mg is equal to 1000mcg
_______________________________
Terazosin
Indications: mild to moderate hypertension; hyperplasia
Medicine: Hytrin®(Abbott) 2mg tablets
_______________________________
Phenoxybenzamine hydrochloride
Indications: hypertensive episodes in phaeochromocytoma
Medicine: Dibenyline 10mg capsules
_______________________________
Phentolamine mesylate
Indications: hypertensive episodes in phaeochromocytoma
Medicine: Rogitine®(Alliance) 10mg injection
_______________________________
Drugs affecting the renin-angiotensin system
Captopril
Indications: mild to moderate essential hypertension alone or with thiazide therapy &
severe hypertension resistant to other treatment; congestive heart failure (adjunct);
following myocardial infarction, diabetic nephropathy (micro albuminuria greater than
30mg/day) in insulin dependent diabetes
Medicine: Capoten®(Squibb), Capoxide 25mg tablets
_______________________________
Cilazapril
Indications: essential & renovascularht; congestive heart failure (adjunct)
Medicine: Vascace®(Roche) 250mcg
_______________________________
Enalapril maleate
14
Indications: essential & renovascularht; congestive heart failure (adjunct)
Medicine: Innovace (MSD) 2.5mg, Innozide 20mg(with diuretic) tablets
_______________________________
Fosinopril
Indications: hypertension; congestive heart failure (adjunct)
Medicine: Staril®(Squibb) 10mg tablets
_______________________________
Lisinopril
Indications: essential & renovascular hypertension, congestive heart failure (adjunct),
following mycordial infarction in haemodynamically stable patients; diabetic
nephropathy in normotensive insulin-dependent diabetes mellitis
Medicine: Carace®, Zestril®(Zeneca) 2.5/5mg tablets
_______________________________
Moesipril hydrochloride
Indications: essential hypertension
Medicine: Perdix®(Schwarz) 7.5/15mg tablets
_______________________________
Perindopril
Indications: essential & renovascular hypertension, congestive heart failure (adjunct)
Medicine: Coversyl®(Servier) 2/4mg tablets
_______________________________
Quinapril
Indications: essential hypertension; congestive heart failure (adjunct)
Medicine: Accupro (P-D) 5m tablets
_______________________________
Ramipril
Indications: mild to moderate hypertension; congestive heart failure (adjunct); following
myocardial infarction in patients with clinical evidence of heart failure
Medicine: Tritace®(Hoechst Marion Roussel) 1.25mg capsules
_______________________________
Trandolapril
Indications: mild to moderate hypertension; following myocardial infaction in-patient
with left ventricular dysfunction
Medicine: Gopten®(Hoechst Marion Roussel), Odrik®(Knoll) 500mcg capsules (with
calcium channel blocker, Tarka 2mg capsules
_______________________________
Angiotensin-II receptor antagonists
Candesartan cilesetil
Medicine: Amias®(Astra, Takeda) 2mg tablets
_______________________________
Irbesartan
Medicine: Aprovel®(Squibb, Sanofi Winthrop) 75mg tablets
_______________________________
Losartan potassium
Medicine: Cozaar®(MSD) 25mg tablets
_______________________________
Valsartan
Medicine: Diovan®(Novartis) 40mg tablets
15
_______________________________
Ganglion-blocking drugs (low down of blood pressure)
Trimetaphan camsylate
Indications: controlled hypotension in surgery
Medicine: Trimetaphan®(Cambridge) camsylate 50mg injection
_______________________________
Metirosine
Indications:
Medicine: Demser®(MSD) 250mg capsules
_______________________________
Angina
Nitrates
Glyceryl trinitrate
Indications: prophylaxis & treatment of angina; left ventricular failure
Medicine: Coro-nitro pump spray®(Boehringer Mannheim), Glyrin spray, Nitromin
aerosol spray®(Servier), Suscard®(Pharmax), Sustac, Nitrocine 1mg injection, tablets
_______________________________
Isosorbide dinitrate
Medicine: Isordil®(Monmouth), Sorbichew, Sorbitrate, Cedocard retart®(Pharmacia &
Upjohn), Sorbid, Isocard 20mg tablets
_______________________________
Isosorbide mononitrate
Medicine: Elantan®(Schwarz), Ismo, Monit, Imdur, & Modisal 20/25/40/50/70mg tablets
_______________________________
Pentaerythritol tetranitrate
Indications: prophylaxis of angina
Medicine: Mycardol®(Sanofi Winthrop) 30mg tablets
_______________________________
Calcium channel blockers
Amlodipine besylate
Indications: hypertension, prophylaxis of angina
Medicine: Istin®(Pfizer) 5mg tablets
_______________________________
Diltiazem hydrochloride
Indications: prophylaxis & treatment of angina, hypertension
Medicine: Adizem®(Napp) 60mg, Angitil, & Calcicard 90mg tablets
_______________________________
Felodipine
Indications: hypertension, prophylaxis of angina
Medicine: Plendil®(Astra) 2.5mg tablets
_______________________________
Isradipine
Medicine: Prescal®(Novartis) 2.5mg tablets
_______________________________
Lacidipine
Medicine: Motens®(Boehringer Ingelheim) 2mg tablets
_______________________________
16
Lercanidipine hydrochloride
Indications: mild to moderate hypertension
Medicine: Zanidip®(Napp) 10mg tablets
_______________________________
Nicardipine hydrochloride
Indications: prophylaxis of angina, mild to moderate hypertension
Medicine: Cardene®(Yamanouchi) 20mg tablets
_______________________________
Nifedipine
Indications: prophylaxis of angina, hypertension
Medicine: Adalat®(Bayer) 30mg, Adipine 10mg, Nifelese 20mg tablets
_______________________________
Nimodipine
Indications: prevention & treatment of ischaemic neurological deficits following
subarachnoid haemorrhage
Medicine: Nimotop®(Bayer) 30mg tablets
_______________________________
Verapamil hydrochloride
Indications: supraventricular arrhythmias, angina, & hypertension
Medicine: Cordilox®(Baker Norton) 40mg, Securon 240mg, Univer 120mg capsules &
tablets
_______________________________
Nicorandil
Indications: prophylaxis & treatment of angina
Medicine: Ikorel®(Rhone-Poulenc-Rorer) 10mg tablets
_______________________________
Peripheral & cerebral vasodilators
Cinnarizine 
Indications: peripheral vascular disease, raynaud's syndrome
Medicine: Stugeron®(Janssen-Cilag), Stugeron forte 75mg tablets
_______________________________
Naftidrofuryl oxalate 
Indications: peripheral vascular disease, raynaud's syndrome
Medicine: Praxilene®(Lipha) 100mg tablets
_______________________________
Nicotinic acid derivatives 
Indications: peripheral vascular disease, hyperlipidaemia
Medicine: Hexopal®(Sanofi Winthrop) 500mg, Ronicol 25mg tablets
_______________________________
Oxpentifylline 
Indications: peripheral vascular disease
Medicine: Trental®(Tillomed) 400mg tablets
_______________________________
Thymoxamine 
Indications: primary raynaud's syndrome, short term treatment, erectile dysfunction
Medicine: Opilon®(P-D) 40mg tablets
Co-dergocrine mesylate 
Indications: adjunct in elderly patients with mild to moderate dementia
Medicine: Hydergine®(Novartis) 1.5mg tablets 
_______________________________
17
Sympathomimetics
Dobutamine
Indications: inotropic support in infarction, cardiac surgery, cardiomyopathies, septic
shock, & cardiogenic shock
Medicine: Dobtrex®(Lilly), Posiject 12.5mg strong solution
_______________________________
Dopamine hydrochloride
Indications: cardiogenic shock in infarction or cardiac surgery
Medicine: Dopamine hydrochloride in dextrose (glucose) injection®(Abbott)
_______________________________
Dopexamine hydrochloride
Inotropic support & vasodilator in exacerbations of chronic heart failure & in heart failure
associated with cardiac surgery
Medicine: Dopacard®(Ipsen) strong sterile solution I/V
_______________________________
Isoprenaline hydrochloride
Indications: heart block, severe bradycardia, & bronchial asthma
Medicine: Savetrine IV®(Pharmax), Neo-Epinine® sublingual tablets
_______________________________
Xamoterol
Indications: see notes above
Medicine: Corwin®(Stuartt) 200mg tablets
_______________________________
Vasocontrictor sympathomimetics
Ephedrine hydrochloride
Indications: acute hypotension
Medicine: Ephedrine hydrochloride 3mg/ml injection
_______________________________
Metaraminol
Medicine: Aramine®(MSD) 10mg injection
_______________________________
Mehoxamine hydrochloride
Medicine: Vasoxine®(GlaxoWelcome) 20mg injection
_______________________________
Noradrenaline acid tartrate
Medicine: Loevophed®(Abbott) strong sterile solution
_______________________________
Phenylephrine hydrochloride
Medicine: Phenylephrine®(Knoll) 10mg injection
_______________________________
Cardiopulmonary resuscitation
Adrenaline
(Epinephrine)
Indications: for cardiac arrest,
Medicine: Adrenaline injection, 1 in 10000
_______________________________
Anticoagulants & protamine
Heparin
18
Indications: treatment of deep-vein thrombosis & pulmonary embolism, unstable angina,
acute peripheral arterial occlusion
Medicine: Heparin injection, Calciparine®(Sanofi Winthrop) 25000 units/ml, &
monoparin 1000units/ml, Multiparin 1000units/ml
_______________________________
Certoparin
Medicine: Alphaparin®(Grifols) 3000u/ml injection
_______________________________
Dalteparin sodium
Medicine: Fragmin®(Pharmacia & Upjohn) 12500units/ml injection
_______________________________
Enoxaparin
Medicine: Clexane®(Rhone-Poulenc-Rorer) injection
_______________________________
Tinzaparin
Medicine: Innohep®(Leo) 3500units/ml injection
_______________________________
Danaparoid sodium
Indications: prophylaxis of deep vein thrombosis in general & orthopaedic surgery
Medicine: Orgaran®(Durbin) 1250units/ml injection
_______________________________
Lepirudin
Indications: throboembolic disease requiring parenteral anticoagulation in-patients with
heparin-associated throbocytopenia type ii
Medicine: Refludan®(Hoechst Marion Roussel) 50mg injection
_______________________________
Epoprostenol
Indications: see note above
Medicine: Flolan®(GlaxoWelcome) infusion
_______________________________
Oral anticoagulants
Warfarin sodium
Indications: prophylaxis of embolization in rheumatic heart disease & atrial fibrillation;
prophylaxis after insertion of prosthetic heart valve; prophylaxis & treatment of vinous
thrombosis & pulmonary embolism; transient ischaemic attacks
Medicine: Warfarin 1mg tablets
_______________________________
Nicoumalone
Indications: prophylaxis of embolisation in rheumatic heart disease & atrial fibrillation;
Medicine: Sinthrome®(Alliance) 1mg tablets
_______________________________
Protamine sulphate
19
Indications: prophylaxis of embolisation in rheumatic heart disease & atrial fibrillation;
Medicine: Prosulf®(CP) 10mg injection
_______________________________
Antiplatelet drugs
Aspirin (antiplatelet)
Indications: prophylaxis of cerebrovascular disease or myocardial infarction
Medicine: Aspirin 75mg, Caprin®(Sinclair), & disprin 75mg tablets
_______________________________
Dipyridamole
Indications: prophylaxis of cerebrovascular disease or myocardial infarction
Medicine: Persantin®(Boehringer Ingelheim) 25mg, asasantin retard 25mg tablets
_______________________________
Clopidogrel *(new addition)
Indications: for reduction of atherosclerotic events In-patients with a history of
symptomatic atherosclerotic disease (ischaemic stroke, myocardial infarction or
established peripheral arterial disease)
Medicine: Plavix®(Sanofi Winthrop) 75mg tablets
_______________________________
Management of myocardiac infarction
Alteplase
Indications: acute myocardial infarction, pulmonary embolism
Medicine: Actilyse®(Boehringer Ingelheim) 10mg injection
_______________________________
Reteplase
Medicine: Repilysin®(Boehringer Mannheim) 10units/ml injection
_______________________________
Anistreplase
Medicine: Eminase®(Manmouth) injection
_______________________________
Streptokinase
Medicine: Streptase®(Hoechst Marion Roussel) 250'000units injection
_______________________________
Urokinase
Medicine: Urokinase injection
_______________________________
***************************************
20
Chapter 3 (Respiratory system)
Management of severe acute asthma

1. Uncontrolled asthma in adults (treatment)
Nebulised salbutamol 5mg, or nebulised terbutaline 10mg, oral prednisolone 30-60mg
2. Acute severe asthma in adults
Treatment: oxygen 40-60% if avialable, nebulised salbutamol 5mg or nebulised
terbutaline 10mg, oral prednisolone 30-60mg or i/v hydrocortisone 200mg
3. Life-threatening asthma in adult
Treatment: oral prednisolone 30-60mg, or i/v hydrocortisone 200mg (immediately)
Nebulised beta2 stimulant with nebulised ipratropium or subcutaneous terbutaline or
salbutamol
_______________________________
Acute severe asthma
Salbutamol
Indications: asthma & other conditions associated with reversible airways obstruction;
premature labour
Medicine: Ventolin®(A&H) 2/4mg, Volmax®(DF) 4mg tablets, syrup & nebulised
inhalar
_______________________________
21
Turbutaline sulphate
Indications: asthma & other conditions associated with reversible airways obstruction;
premature labour
Medicine: Bricanyl®(Astra), Bricanyl SA 5/7.5mg tablets
_______________________________
Bambuterol hydrochloride
Indications: asthma & other conditions associated with reversible airways obstruction
Medicine: Bambec®(Astra) 10mg tablets
_______________________________
Eformoterol fumarate
(Formoterol fummarate)
Indications: reversible airways obstructions (including nocturnal asthma & prevention of
exercised-induced bronchospasm)
Medicine: Foradil®(Novartis), Oxis turbohaler (dry powder inhaler)
_______________________________
Fenoterol hydrochloride
Indications: reversible airways obstruction
Medicine: Berotec®(Boehringer Ingelheim), Bronchodil aerosol inhaler
_______________________________
Salmeterol
Indications: reversible airways obstructions (including nocturnal asthma & prevention of
exercised-induced bronchospasm)
Medicine: Serevent®(A&H) dry powder for inhaler
_______________________________
Tulobuterol hydrochloride
Medicine: Respacal®(UCB Pharma) 2mg tablets
_______________________________
Indications: reversible airways obstruction,
Medicine: Ephedrine hydrochloride 15mg tablets/injection
_______________________________
Orciprenaline sulphate 
Medicine: Alupent®(Boehringer Ingelheim) 20mg tablets
_______________________________
Antimuscuranic bronchodilatores
Oxitropium bromide
Indications: reversible airways obstruction particularly in chronic bronchitis
Medicine: Oxivent®(Boehringer) aerosol inhalation
_______________________________
Theophyllin
Indications: reversible airways obstruction, acute severe asthma
Medicine: Nuelin®(3M), Lasma, Theo-dur, & Uniphylline continus 125/200/300mg tab
_______________________________
Aminophylline
(Note: aminophylline is a stable mixture or combination of theophylline & ethylenediamine; the
ethylenediamine confers greater solubility in water)
Medicine: Pecram®(Novartis), Phyllocontin continus 225mg tablets
_______________________________
Corticosteroids
22
Beclomethasone Dipropionate
Indications: prophylaxis of asthma especially if not fully controlled by bronchodilators or
cromoglycate
Medicine: Rino Clenil®(Chiesi Italy), AeroBec®(3M), Becodisks®(A&H), Aerobec
forte, becloforte aerosol inalation
_______________________________
Budesonide
Medicine: Pulmicort®(Astra) aerosol inhalation
_______________________________
Fluticasone propionate
Medicine: Flixotide®(A&H) dry powder for inhalation
_______________________________
Sodium cromoglycate
Indications: prophylaxis of asthma; food allergy,
Medicine: Intal®(Fisons) aerocrom aerosol inhalation, capsules & injection
_______________________________
Nedocromil sodium
Indications: prophylaxis of asthma
Medicine: Tilade®(Fisons) 2mg aeroso inhalation
_______________________________
Related therapy
Ketotifen
Indications: it is an antihistamine & has no well value in the action of brochial asthma. It
is resemble to cromoglycate sodium, but to some extent well
Medicine: Zaditen®(Novartis) 1mg capsules
_______________________________
Montelukast
Indications: adjunctive therapy in prophylaxis of mild to moderate & exercise-induced
asthma inadequately controlled by inhaled corticosteroid & short-acting beta2-stimulant
used as needed
Medicine: Singulair®(MSD) 5mh tablets
_______________________________
Zafirlukast *(added latest formula)
Indications: for the prophylaxis of asthma
Medicine: Accolate®(Zeneca) 20mg tablets
_______________________________
Hexoprenaline sulphate
Indications: treatment & prevention of dyspnoea due to bronchial asthma, spasmodic
bronchitis, chronic bronchitis, & emphysema
Medicine: Ipradol®(Nycomed Astria) tab three times daily for 5 days
_______________________________
Antihistamine
Non-sedating antihistamine
Acrevastine
Indications: symptomatic relief of allergy such as hay fever, urticaia
Medicine: Semprex®(GlaxoWelcome) 8mg capsules
_______________________________
Astemizole
Medicine: Hismanal®(Janssen-Cilag) 10mg tablets
23
_______________________________
Cetirizine hydrochloride
Medicine: Zirtek® or Zyrtec®(UCB Pharma) 10mg tablets
_______________________________
Fexofenadine hydrochloride
Medicine: Telfast®(Hoechst Marion Roussel) 120/180mg tablets
_______________________________
Loratadine
Medicine: Clarityn®(Schering-Plough), Lorine® 10mg tablets
_______________________________
Mizolastine
Medicine: Mizollen®(Lorex) 10mg tablets
_______________________________
Terfenadine
Medicine: Triludan®(Hoechst Marion Roussel) 60mg tablets
_______________________________
Sedating antihistamine
Azatadine maleate
Medicine: Optimine®(Schering-Plough) 1mg tablets
_______________________________
Brompheniramine maleate
Medicine: Dimotane®(Wyeth) 4mg tablets
_______________________________
Chlorpheniramine maleate
Medicine: Piriton®(Stafford-Miller) 2/4mg tablets & syrup
_______________________________
Clemastine
Indications: symptomatic relief of allergy such as hay fever, urticia, & aslo can inject as
2cc emergency injection, possess less drowziness
Medicine: Tavegil®(novaritis) 1mg tablets
_______________________________
Cyproheptadine hydrochloride
Indications: symptomatic relief of allergy such as hay fever, urticaia, & migraine
Medicine: Periactin®(MSD) 4mg tablets
_______________________________
Diphenhydramine hydrochloride
Indications: it is recommended for, to aid relief of temporary sleep disturbance & night
times pain
Medicine: Benadryl® expt, Medinex®, & Panadol night® 25/50mg tablets & syrup
_______________________________
Diphenylpyraline hydrochloride
Indications: a component of cough & decongestant preparations
_______________________________
24
Hydroxyzine hydrochloride
Indications: pruritis, anxiety (short-term)
Medicine: Atarax®(Pfizer) 10mg, Ucerax 25mg tablets & syrup
_______________________________
Doxylamine
Indications: ingredient of cough & decongestant preparations
_______________________________
Mebhydroline
Indications: symptomatic relief of allergy such as hay fever, urticaria & eczema
Medicine: Incidal®() tablets
_______________________________
Mequitazine
Medicine: Primalan®(Rhone-Poulenc-Rorer) 5mg tablets
_______________________________
Phenindamine tartrate
Medicine: Thephorin®(Sinclair) 25mg tablets
_______________________________
Pheniramine maleate
Indications: ingredeint of cough & decongestant preparations
_______________________________
Promethazine hydrochloride
Indications: symptomatic relief of allergy such as hay fever, urticaia, emergency
treatment of anaphylaxtic reactions, sedation, motion sickness
Medicine: Phenergan®(Rhone-Poulenc Rorer) 10mg syrup, tablets & injection
_______________________________
Trimeprazine tartrate
Indications: urticaria & pruritus
Medicine: Vallergan®(Rhone-Poulenc-Rorer) 10mg tablets
_______________________________
Triprolidine hydrochloride
Indications: cough & decongestant ingredient
_______________________________
Allergic emergencies
Adrealine
(Epinephrine)
Indications: emergency treatment of acute anaphylaxis; angioedema; cardiopulmonary
resuscitation
Medicine: Adrenaline® injection, Bp, 1 in 1000, min-i-jet adrenaline1mg/ml injection
_______________________________
Pulmonary surfactants
Beractant
Indications: treatment of respiratory distress syndrome in preterm infants who are
intubated & receiving mechanical ventilation, whose heart rate & arterial oxygenation are
continuously monitored
Medicine: Survanta®(Abbott) 25mg/ml suspension
_______________________________
Colfosceril palmitate
25
Medicine: Exosurf neonatal®(GlaxoWelcome) 108mg suspension
_______________________________
Poractant alfa
Indications: treatment of respiratory distress syndrome or hyalline membrane disease in
neonates over 700g
Medicine: Curosurf®(Serono) 80mg/ml suspension
_______________________________
Pumactant
Medicine: Alec®(Brittania) 100mg suspension
_______________________________
Mucolytics
Carbocisteine
Indications: reduction of sputum viscosity
Medicine: Mucopront®(Heinrich Mack Germany), (capsule 375mg) & (syrup 250mg),
Mucodyne®(Rhone-Poulenc-Rorer) 125mg/5ml syrup, tablets & capsules
_______________________________
Methyl cysteine hydrochloride
(Mecysteine hydrochloride)
Indications: reduction of sputum viscosity
Medicine: Visclair®(Sinclair) 100mg tablets
_______________________________
Dornase alfa
Medicine: Pulmozyme®(Roche) 100units(1mg/ml) nebulised solution
_______________________________
Opioid Cough suppressants
Codeine phosphate
Indications: dry or painful cough
Medicine: Codeine linctus, BP, Galcodine® (Norton) syrup
_______________________________
Dextromethorphan
Indications: for dry or painful cough
Medicine: Dextromethorphan®(Julphar) syrup
_______________________________
Methadone hydrochloride
Indications: cough in terminal disease
Medicine: Methadone linctus
_______________________________
Morphine hydrochloride
Indications: cough in terminal disease
_______________________________
Expectorant & demulcent cough preparations
Actifed tablets contain (pseudoephedrine, triprolidine). Actifed syrup contains (guaiphenesin,
pseudoephedrine, & triprolidine). Bronalin expectorant contains (ammonium chloride, &
diphenhydramine). Davenol contains (carbenoxamine, ephedrine, & pholcodine). Tixylix catarrh
contains (diphenhydramine, menthol). Hill's balsam adult expectoran® (ipecacuanha,
pholcodine). Vicks medinite® (dextromethorphan, doxylamine, ephedrine, paracetamol)
Polaramine® expectorant (Schering-Plough) expectorant (dexchlorpheniramine maleate, &
26
pseudoephedrine sulfate & guaifenesin) Resyl® (Roche) expectorant, (guaifenesin)
Silomat®(Boehringer Ingelheim Germany) antitussive syrup (clobutinol hydrochloride)
Romilar® (Roche) expectorant Cantac 400® (phenylpropanolamine, chlorpheniramine)
Saridon®(Roche) contains propyphenazone (that is Phenazone in real), amidopyrine.
_______________________________
Corticosteroids
Hydrocartisone sodium succinate
Indications: adrenocortical insufficiency, shock, hypersensitivity, reactions (such as
anaphylactic shock & angioedema), inflammatory bowel disease, haemorrhoids,
rheumatic disease, skin
Medicine: Efcortesol®(GlaxoWelcome) injection, Hydrocortone®(MSD) tablets, &
Solo-Cortef® (Pharmacia & Upjohn) injection
_______________________________
Opoid Analgesics
Morphine remains the most valuable opioid analgesic for severe pain although it
frequently causes nausea & vomiting.
***********************************
Chapter 4 ( Infections )
Antiboitics drugs
Penicillins
Benzylpenicillin
(Penicillin G)
Indications: throat infections, otitis media, streptococcal endocarditis (bacterial infections
of heart valve), meningococcal meningitis, pneumonia; prophylaxis in limb amputation
Medicine: Crystapen®(Britannia) 600mg powder for reconstitution
_______________________________
SUMMARY OF ANTIBACTERIAL THERAPY
Gastro-Intestinal System
Gastro-enteritis
27
Antibiotic not usually indicated
Frequently self-limiting & may not be bacterial
Campylobacter Enteritis
Ciprofloxacin or erythromycin
Invasive salmonellosis (typhoid)
Ciprofloxacin or trimethoprim
Shigellosis (bacillary dysentry)
Ciprofloxacin or trimethoprim
Antibiotic not indicated for mild cases, ciprofloxacin should be used for trimethoprim-resistant strains
Typhoid fever
Ciprofloxacin or chloramphenicol
Infections from Indian subcontinent, Middle East, & SouthEast Asia may be chloramphenicol-
resistant & ciprofloxacin may be more appropriate
Antibiotic-associated colitis (pseudomembranous colitis)
Oral metronidazole or oral vacomycin
Metronidazole is an antimicrobial drug with high activity against anaerobic bacteria &
protozoa. For indications see below metronidazole page#35
Biliary-tract infection
A cephalosporin or gentamicin
Peritonitis
A cephalosporin (or gentamicin) + metronidazole (or clindamycin)
_______________________________
Respiratory System
Haemophilus influenzae epiglottitis
Cefotaxime (Claforan®) or chloramphenicol (gives intravenously)
Exacerbation of chronic bronchitis
Amoxycillin or trimethoprim or tetracycline
Uncompicated community-acquired pneumonia
Amoxycillin (or benzylpenicillin if previously healthy chest or erythromycin if penicillin-
allergic) add flucloxacillin if staphylococcus suspected
Suspected atypical pneumonia
Erythromycin
Hospital-aquired pneumonia
A broad spectrum cephalosporin (e.g cefotaxime or ceftazidime) or an antipseudomonal
penicillin + an aminoglycoside (gentamicin or kanamycin or neomycin)
_______________________________
Central Nervous System
Meningitis caused by meningococci
Benzylpenicillin or cefotaxime [give rifampicin for 2 days before hospital discharge]
Meningitis caused by pneumococci
Cefotaxime (Claforan® 500mg vial)
Meningitis caused by haemophilus influenzae
Cefotaxime or chloramphenicol
Meningitis caused by Listeria
Amoxycillin + gentamicin
_______________________________
Urinary Tract
Acute pyelonephritis or prostatitis
Trimethoprim or gentamicin or cephalosporin or a quinolone (like ciprofloxacin), [treat
prostatis with trimethoprim or a quinolone for 4 weeks]
'Lower' urinary-tract infections
Trimethoprim or amoxycillin or nitrofurantoin or oral cephalosporin
28
_______________________________
Genital System
Syphilis
Procaine penicillin (or tetracycline or doxycyline or erythromycin if penicillin-allergic)
Gonorrhoea
Amoxycillin with probenecid (or spectinomycin or a quinolone if penicillin-allergic)
Uncomplicated genital chlamydial infections, non-gonococcal urethritis & non-
specific genital infection
Doxycycline or erythromycin [treats for 7-21 days]
Pelvic inflammatory disease
Metronidazole + doxycycline (or erythromycin)
_______________________________
Ear, Nose, & oropharynx
Dental infections
Phenoxymethylpenicillin (or amoxycillin) or erythromycin or metronidazole
Tetracycline for chronic destructive forms of periodontal disease
Sinusitis
Amoxycillin or doxycycline or erythromycin [treats for 2 weeks]
Otitis externa
Flucloxacillin
Otitis media
Amoxycillin (or erythromycin if penicillin-allergic)
Throat infections
Phenoxymethylpenicillin (or erythromycin if penicillin-allergic) or oral cephalosporin
_______________________________
Skin
Impetigo
Topical fusidac acid or mupirocin; oral flucloxacillin or erythromycin if widespread
Topical treatment for 7 days usually adequate; maximum duration for topical treatment 10 days
Erysipelas
Phenoxymethylpenicillin
Cellulitis
Phenoxymethylpenicillin + flucloxacillin (or erythromycin alone if penicillin-allergic) or
Co-amoxiclav alone
Animal bites
Co-amoxiclav
_______________________________
Eye
Purulent conjunctivitis
Chloramphenicol or gentamicin eye-drops
_______________________________
Category A Diseases that may be caused by Biological Attack*
Disease Initial Epidemiology (Attack) Treatment
Anthrax Influenza-like syndrome Ciprofloxacin, Doxycycline (2 or more
antibiotics with severe disease)
Plague Severe pneumonia Streptomycin, Gentamicin, &
Fluoroquinolones (ciprofloxacin)
Tularemia Influenza-like syndrome Streptomycin, Gentamicin, & Fluoro-
quinolones (cipro, norfloxcin,levoflox)
Smallpox (viral Chickenpox outbreak in all ages Supportive; possibly antiviral agents (e.g.
disease) groups Viralzole, )
Viral Meningococcemia outbreak in all age Supportive; Ribavirin
hemorrhagic groups
29
fever
Botulism Cranial nerve palsies, (Palsy) flaccid Polyvalent equine antitoxin
muscle weakness, respiratory
compromise
Phenoxymethylpenicillin
(Penicillin V)
Indications: tonsilitis, otitis media, erysipelas; rheumatic fever & pneumonococcal
infection prophylaxis
Medicine: Apsin, tenkicin 125/250/500mg
_______________________________
Procaine penicillin
(Procaine benzylpenicillin)
Indications: penicillin-sensitive infections, tonsilitis, otitis media, erysipelas; rheumatic
fever & pneumonococcal infection prophylaxis
Medicine: Bicillin®(Yamanouchi) 360mg injection, NOT for intravenous administration
_______________________________
A table of different kinds of group of antibiotics
GROUP DRUGS' NAME
Penicillins benzylpenicillin, phenoxymethlpenicillin, procaine penicillin
Penicillinase- flocloxacillin
Resistant Penicillin
Broad-Spectrum amoxycillin, ampicillin, co-amoxyclav, co-fluampicil, pivampicillin
Penicillins
Antipseudomonal azlocillin, piperacillin, ticarcillin
Penicillins
Cephalosporins & cefaclor, cefadroxil, cefixime, cefodizime, cefotaxime, cefoxitin, cefpirome,
Cephamycins cefpodoxime, ceftazidime, ceftibuten, ceftriaxone, cefuroxime, cephalexin,
cephamandole, cephazolin, cephradine,
Other Beta-Lactam aztreonam, imipenem with cilastatin, meropenem
Antibiotics
Tetracyclines tetracycline, demeclocycline, doxycycline, lymecycline, minocycline,
oxytetracycline
Aminoglycosides gentamicin, amikacin, kanamycin, neomycin sulphate, netilmicin, tobramycin
Macrolides erythromycin, azithromycin, clarithromycin
Clindamycin clindamycin
Some Other chloramphenicol, sodium fusidate, spectinomcin, vancomycin, teicoplanin, &
Antibiotic colistin (polymyxins)
Sulphonamides co-trimoxazole(trimethoprim+sulphamethoxazole), sulfametopyrazine,
(Sulfa sulphadiazine, sulphadimidine
Anti- capreomycin, ethambutol, isoniazid, pyrazinamide, rifabutin, rifampicin,
Tuberculous(TB) streptomycin
Antileprotic dapsone, clofazimine,
Quinolones ciprofloxacin, cinoxacin, grepafloxacin, levofloxacin, nalidixic acid, norfloxacin,
ofloxacin
Urinary-Tract nitrofurantoin, hexamine hippurate
Infections Drugs
Antifungal amphotericin, fluconazole, flucytosine, griseofulvin, itraconazole, ketoconazole,
miconazole, nystatin, terbinafine
Antiviral aciclovir, amantadine, famciclovir, inosine pranobex, valaciclovir
Antimalarials chloroquine,halofantrine, mefloquine, primaquine, proguanil, proguanil with
atovaquone, pyrimethamine, pyrimethamine with sulfadoxine, pyrimethamine with
dapsone, quinine, doxycyline
Ameobicides diloxanide furoate, metronidazole, tinidazole
Anthelmintics mebendazole, piperazine, niclosamide, albendazole, thiabendazole
_______________________________
Flucloxacillin
30
Indications: infections due to beta-lactamase-producing staphylococci incldung otitis
externa; adjunct in pneumonia, impetigo, cellulitis & in staphylococcal endocarditis
Medicine: Floxapen®(Beecham) 250/500mg capsules
_______________________________
Broad-spectrum penicillins
Amoxycillin
Note: A modern & usefull penicillin, but allergic reaction should be monitored
Indications: urinary-tract infections, otitis media, sinusitis, chronic bronchitis, invasive
salmonellosis, & gonorrhoea
Medicine: Amoxil®(Bencard), Prencimox®(Squibb) injection, cap susp 125/250/500mg
_______________________________
Ampicillin
salmonellosis, & gonorrhoea
Medicine: Penbritin®(Beecham) 250mg capsules, with (cloxacillin) Ampiclox®
(Beecham) 250mg capsules
_______________________________
Co-amoxiclav
(A mixture of amoxycillin + clavulante)
Indications: infections due to beta-lactamase-producing strains (where amoxycillin alone
not appropriate) including respiratory-tract infection, cellulitis, animal bites, severe dental
infection with spreading cellulitis
Medicine: Amoclan, Julmentin, Augmentin, & Augmentin-Duo 156/375/625/1000mg
Note: Augmentin®(Beecham) suspension (amoxycillin 125mg + clavulanic acid 31mg,
total 156mg)
_______________________________
Co-fluampicil
(A mixture of equal parts by mass of flucloxacillin & ampicillin)
Indications: mixed infections involving beta-lactamase-producing staphylococci
Medicine: Magnapen®(Beecham) 250/250 capsules, syrup & injection
_______________________________
Pivampicillin
salmonellosis (typhid), & gonorrhoea
Medicine: Pondocillin®(Leo) 500mg tablets
_______________________________
Antipseudomonal penicillins
Azlocillin
Indications: infections due to pseudomonas aeruginosa
Medicine: Securopen®(Bayer) 1g vial
_______________________________
Piperacillin
Medicine: Pipril®(Lederle), Tazocin 1g vial
_______________________________
Ticarcillin
Medicine: Timentin®(Beecham) 1.6g injection
_______________________________
Cephalosporins, cephamycins, & other beta-lactam antibiotics
(Cephalosporins group)
31
Cefaclor
Indications: the Cephalosporins are broad spectrum antbiotics which are used for the
treatment of septicaemia, pnemonia, meningitis, biliary-tract infections, similar
antibacterial spectrum although indivisual agents have differing activity agaisnt certain
organisms
Medicine: Keftid, Distaclor®(Dista), distaclor MR, Ceclor 125/250/500/1000mg
_______________________________
Cefadroxil
Indications: infections due to sensitive gram-positive & gram-negative bacteria such as
respiratory-tract infections, skin & soft tissue infections, bones infections & joints
infections (osteomyelitis & septic arthritis), gentourinary tract infections: (pyelonephritis,
cystitis, urethritis), gynaecological infections, bacterial endocarditis
Medicine: Droxil®(United Pharma Jordon), Baxan®(Bristol-Myers) 500mg capsule &
suspension
_______________________________
Cefixime
Indications: infections due to sensitive gram-positive & gram-negative bacteria (see
above cefaclor & cefadroxil)
Medicine: Suprax®(Rhone-Poulenc-Rorer) 200mg tablets & paediatric oral suspension
_______________________________
Cefodizime
Medicine: Timecef®(Hoechst Marion Roussel) 1g injection
_______________________________
Cefotaxime
Indications: infections due to sensitive gram-positive & gram-negative bacteria, surgical
prophylaxis; haemophilus epiglottitis & meningitis (see above cefaclor & cefadroxil)
Medicine: Claforan®(Hoechst Marion Roussel) 1g injection
_______________________________
Cefoxitin
Medicine: Mefoxin®(MSD) 1g injection
_______________________________
Cefpirome
Indications: (see above cefaclor & cefadroxil) infections due to sensitive gram-positive &
gram-negative bacteria
Medicine: Cefrom®(Hoechst Marion Roussel) 1g injection
_______________________________
Cefpodoxime
Indications: (see above cefaclor & cefadroxil) respiratory-tract infection but in
pharyngitis & tonsillitis reseversed for infections which are recurrent, chronic, or resistant
to other antibiotics
Medicine: Orelox®(Hoechst Marion Roussel) 100mg tablets
_______________________________
Cefprozil *(added latest formula)
Indications: for upper respiratory-tract infections; otitis media; acute exacerbation of
chronic bronchitis; skin & soft tissue infections
Medicine: Cefzil®(Bristol-Myers) 250mg/5ml suspension, (reconstituted with water)
_______________________________
Ceftazidime
32
Medicine: Fortum®(GlaxoWelcome), kefadim 1g vial (injection)
_______________________________
Ceftibuten
Medicine: Cedax®(Schering-Plough) 40mg capsules
_______________________________
Ceftriazone
Medicine: Rocephin®(Roche) 1g injection
_______________________________
Cefuroxime
Medicine: Zinacef®(GlaxoWelcome), Zinnat® 125/250/500/1000mg sus, tab & injection
_______________________________
Cephalexin
Indications: infections due to sensitive gram-positive & gram-negative bacteria,
pneumonia, boils, carbuncle & respiratory-tract infections, gynecological & obstetrical
infections, pyelonephritis, prostatitis, gonorrhoea, bone & joint infections, & skin & soft
tissue infections
Medicine: Ceporex®(GlaxoWelcome), keflex, 250/500mg syrup, capsules & injection
_______________________________
Cepham&ole
Indications: infections due to sensitive gram-positive & gram-negative bacteria
Medicine: Kefadol®(Dista) 1g injection
_______________________________
Cephazolin
Medicine: Kefzol®(Lilly) 1g injection
_______________________________
Cephradine
Medicine: Velosef®(Squibb) 250/500/1000mg capsules & injection
_______________________________
Other beta-lactam antibiotics
Aztreonam
Indications: gram-negative infections including pseudomonas aeruginosa, haemophilus
influenzae, & neisseria meningitidis
Medicine: Azactam®(Squibb) 1g injection
_______________________________
Imipenem with cilastatin
Indications: aerobic & anaerobic gram-positive & gram-negative infections; surgical
prophylaxis; gonoccocal urethritis or cervicitis, not indicated for CNS (central nervous
system) disorders
Medicine: Primaxim®(MSD) 500mg, I/m injection
_______________________________
Meropenem
Indications: aerobic & anaerobic gram-positive & gram-negative infections
33
Medicine: Meronem®(Zeneca) 250mg injection
_______________________________
Tetracycline
Tetracycline
Indications: exacerbation of chronic bronchitis; brucelosis, chlamydia, mycoplasma, &
rickettsia; acne vulgaris, rosacea
Caution: tetracycline should not be given to patient with kidney disease, children under
12 years & pregnant or breast-feeding women.
Medicine: Achromycin®(Lederle), Tetrachel, & Deteclo 125/250/500/1000mg
Note: Methacycline is also a brother-like agent of tetracycline & this is chemically made
from tetracycline, Medicine: is Rondomycine® capsule
_______________________________
Demeclocycline hydrochloride (Ledermycin)
Indications: exacerbation of chronic bronchitis; brucelosis, chlamydia (trachoma,
psittacosis, salpingitis, urethritis, & lymphogranuloma venerum), mycoplasma, &
Medicine: Ledermcin®(Lederle) 150/300mg capsules
_______________________________
Doxycycline
Indications: brucellosis, prophylaxis of Traveler's diarrhoea, cholera, Eye infections
(trachoma & paratrachoma), legionnaires' disease, acne, lyme disease, Mouth infections
(periodontal disease), gynaecological infections as pelvic inflammatory disease, sexually
transmitted diseases (gonorrhoea, syphillis, yaws where penicillin is contraindicated, &
chancroid), respiratory-tract infections (bonchitis, tonslitis, pneumonia (Eaton agents),
sinusitis, pharyngitis, & otitis media), agents of psittacosis & ornithosis, inguinale, & the
spirochetal agent of relapsing fever, Q fever, Eperythrozoonosis & others, surgical
prophylaxis & wound infections, respiratory-tract infections (acute urethral syndrome,
cystitis, uncomplicated gonococcal infections, acute epididymoorchitis, nongonococcal
urethritis, cystitis, purulent urethritis & prostatitis), diffuse peritonitis, chronic ascites &
vaginal discharge & acute intestinal amebiasis
Medicine: Vibramycin®, Vibramycin-D® (Invicta) 50/100/250mg capsules & injection
_______________________________
Lymecycline
Medicine: Tetralysal®(Galderma) 300mg capsules
_______________________________
Minocycline
rickettsia; acne vulgaris, rosacea, & chicken pox
Medicine: Minocin®(Lederle) 50/100/250mg capsules & injection
_______________________________
Oxytetracycline (Terramycin® (Pfizer)
rickettsia; acne vulgaris, rosacea, dysentry, ameobic dysentry, & pneumonia
Medicine: Terramycin®(Pfizer) 250mg drops, capsules vaginal tab, & injection
_______________________________
Aminoglycosides
Gentamicin
Indications: septicaemia & neonatal sepsis; meningitis & other cns infections; biliary-
tract-infections, acute pyelonephritis or prostatitis, endocarditis caused by viridans
34
streptococci or enterococcus faecalis (with a penicillin); pneumonia in hospital patients,
adjunct in listerial meningitis
Medicine: Gentamicin (Non-proprietary), Cidomycin®(Hoechst Marion Roussel), &
Genticin 40mg injection
_______________________________
Amikacin
(Amikacin is a derivative of kanamycin)
Indications: serious gram-negative infections resistant to gentamicin
Medicine: Amikin®(Bristol-Myers) 250mg injection
_______________________________
Kanamycin 
Indications: a modern antiboitic which is effictive like streptomycin (but is not
streptomycin) this cannot be absorbed by orally therefore can be given by I/M, &
effective in dysentry, superseded by other aminoglycosides
Medicine: Kannasyn®(Sanofi Winthrop) 1g injection only, Kanamycin® injection only
_______________________________
Neomycin sulphate
(Neomycin is too toxic for parenteral (e.g. for i/v or i/m) administeration & can only be used for
infections of the skin of mucous membranes. Oral administeration may lead to malabsorbtion.
Small amount of neomycin may be absorbed from the gutt in-patients with hepatic failure &, as
these patients may also be uraemic, cumulation may occur with resultant ototoxicity.)
Indications: bowel sterilisation prior to surgery
Medicine: Nivemycin®(Knoll) 500mg tablets,
_______________________________
Netilmicin
Indications: serious gram-negative infections resistant to gentamicin
Medicine: Netillin®(Schering-Plough) 10mg injection
_______________________________
Tobramycin
Indications: septicaemia & neonatal sepsis; meningitis & other CNS infections; biliary-
tract-infections, acute pyelonephritis or prostatitis, endocarditis caused by viridans
streptococci or enterococcus faecalis (with a penicillin); pneumonia in hospital patients,
adjunct in listerial meningitis, (especially those infections where other antiboitics failed)
like infections encephalopathy, pneumonia, carbuncle & urithritis, close to kanamycin
Medicine: Tobramycin®(Lilly) 40mg, Nebcin®(Lily) 10mg injection
_______________________________
Macrolides
Erythromycin
Indications: alternative to penicillin in hypersensitive patients; campylobacter enteritis,
pneumonia, legionnaires' disease, syphilis, non-gonococcal urethritis, chronic prostatitis,
acne vulgaris & rosacea; diphtheria & whooping cough prophylaxis
Medicine: Erythromycin, Erymax®(Elan), Erymin, Ilosone, & Tiloryth 125/250/500mg
_______________________________
Azithromycin
Indications: respiratory-tract infection; otitis media, skin & soft tissue infections;
uncomplicated genital chlamydial infections
Medicine: Azithromax®(Pfizer) 250/500mg capsules & suspension
_______________________________
Clarithromycin (klacid®)
Indications: respiratory-tract infection, mild to moderate skin & soft tissue infections;
adjunct in the treatment of duodenal ulcers by eradication of Helicobacter. Pylori
Medicine: Klaricid®(Abbott), klacid 125/250/500mg tablet, suspension & injection
35
_______________________________
Clindamycin
Indications: staphylococcal bone & joint infections, peritonitis; endocarditis prophylaxis
Medicine: Dalacin-C®(Pharmacia & Upjohn) 75/150mg capsule suspension & injection
_______________________________
Some other antibiotics
Chloramphenicol
Indications: avoid repeated courses & prolonged treatment; reduce doses in hepatic or
rental impairment; blood counts required before & periodically during treatment; monitor
plasmachloramphenicol concentration in neonates
Medicine: Chloramphenicol (Non-proprietary) 250mg capsules, kemicetine®(Pharmacia
& Upjohn) 1g injection, Paraxin® syrup, cap, ointment & injection
_______________________________
Sodium fusidate (Fucidin®)
Indications: infections caused by penicillin-resistant staphylococci, especially
osteomyelitis, staphylococcal endocarditis
Medicine: Fucidin®(Leo) 250mg suspension, intravenous infusion
_______________________________
Spectinomycin
Indications: active against gram-negative including N.Gonorrhoeae
Medicine: Trobicin®(Pharmacia & Upjohn) 2g injection
_______________________________
Vancomycin
Indications: prophylaxis & treatment of endocarditis & gram-positive cocci including
staphylococci
Medicine: Vancocin®(Lilly) 125mg capsules
_______________________________
Teicoplanin
Indications: potentially seiou gram-positive infections including endocarditis, dialysis-
associated peritonitis
Medicine: Targocid®(Hoechst Marion Roussel) 200mg injection
_______________________________
Colistin
Indications: active against gram-positive organism, including pseudomonas aeruginosa
Medicine: Colomycin®(Pharmax) 1.5million units, tablets & injection
_______________________________
Sulphonamides & trimethoprim
Note: Sulphonamide is the Sulpha or (Sulfa) group, which are more effective & less
toxic.
_______________________________
Co-trimoxazole (septrin®)
(A mixture of trimethoprim & sulphamethoxazole (belongs to Sulfa group) in proportions of 1
part to 5 parts (5:1) & there are also properties of antibacterial & antiviral )
Indications: chronic bronchitis, urinary-tract infections (pyelitis, pyelonephritis, cystitis,
urethritis, prostatitis), & otitis media, gastrointertinal infections: (typhoid & paratyphoid
fevers, bacillary dysentery, gastroenteritis, cholera), acute & chronic osteromyelitis, acute
brucellosis, dental & periodontal infections, skin & soft tissue infections (pyoderma,
furuncles, abscesses, wound infections, acne, & measles)
Note: septrin is useless in (T.B. syphilus & pseudomona pyeosinea) disease & usefull for
the rest of disease.
Medicine: Septrin®(GlaxoWelcome) 125/250/500mg tablets, syrup & intravenous
infusion
36
_______________________________
Sulfametopyrazine 
(Sulfalene)
Indications: urinary-tract infection, chronic bronchitis
Medicine: Kelfizine W®(Pharmacia & Upjohn) 2g tablets
_______________________________
Sulphadiazine
Indications: prevention of rheumatic fever recurrence, toxoplasmosis
Medicine: Sulphadiazine (Non-proprietary) 500mg tablets
_______________________________
Sulphadimidine
Indications: respiratory-tract infection
Medicine: Sulphadimidine (Non-proprietary) 500mg tablets
_______________________________
Trimethoprim
Indications: urinary-tract infection, acute & chronic bronchitis
Medicine: Monotrim, Trimopan®(Berk) 50/100mg tablets, suspension & injection
_______________________________
Antituberculous drugs (TB)
Capreomycin
Indications: in combination with other drugs, tuberculosis resistant to first-line drugs
Medicine: Capastst®(Dista) 250mg capsules
_______________________________
Ethambutol hydrochloride
Indications: tuberculosis, in combination with other drugs
Medicine: Ethambutol (Non-proprietary) 100/400mg tablets
_______________________________
Isoniazid
Dose: this consists of (INH +Vit.B6), should be adjunt along with streptomycin & P.A.S
Medicine: Isonex Forte®, Isoniazid (Non-proprietary) 50mg tablets, & injection
_______________________________
Pyrazinamide
Medicine: Zinamide®(MSD) 500mg tablets
_______________________________
Rifabutin
Indications: prophylaxis of mycobacterium avium complex infections, treatment of non-
tuberculous mycobacterial disease
Medicine: Mycobutin®(Pharmacia & Upjohn) 150mg capsules
_______________________________
Rifampicin
Indications: brucellosis, legionnaires' disease, seious staphylococcal infections,
tuberculosis, leprosy, & prophylaxis of meningococcal meningitis
Medicine: Rifadin®(Hoechst Marion Roussel), Rimactane®(Novartis), Rifater, Fifinah,
Rimactazid 150/300mg capsules, tablets & injection
_______________________________
Streptomycin
Indications: tuberculosis, in combination with other drugs, very usefull in tuberculosis
(T.B), as a side-effect this can cause deafness, therefore vitamin-B6 should be prescribed
along with strptomycin
Medicine: Streptomycin sulphate®(Medeva) 1g injection
37
_______________________________
Antileprotic drugs (Drugs for Leprosy)
Dapsone
Indications: leprosy, dermatitis, & herpetiformis, for mycobacterum leprae
Medicine: Dapsone (Non-proprietary) 50mg tablets
_______________________________
Clofazimine
Indications: leprosy
Medicine: Lamprene®(Alliance) 100mg capsules
_______________________________
Metronidazole
Indications: anaerobic infections leg ulcers & pressure sores, bacterial vaginosis, acute
gengivitis, acute dental infections, protozoal infections & skin
Medicine: Flagyl®(Rhone-Poulenc-Rorer), Metrolyl®(Lagap) 200/400mg tablets,
suppositories, suspension & I/V
_______________________________
Tinidazole
Indications: anaerobic infections including dental, protozoal infections, & skin
Medicine: Fasigyn®(Pfizer) 500mg tablets
_______________________________
Quinolones
Ciprofloxacin
Indications: respiratory-tract infection, urinary-tract infection, gonorrhoea, &
Pseudomonal lower respiratory-tract infection in cystic fibrosis, prophylaxis of
meningococcal meningitis
Medicine: Ciproxin®(Baypharm), Ciprobay®(Bayer) 250/500mg tablets
_______________________________
Cinoxacin
Indications: urinary-tract infection
Medicine: Cinocac®(Lilly) 500mg capsules
_______________________________
Grepafloxacin
Indications: community-acquired pneumonia, chronic bronchitis, uncomplicated
gonorrhoea, non-gonococcal urethritis & cervicitis
Medicine: Raxar®(A&H) 400mg tablets
_______________________________
Levofloxacin
Indications: acute sinusitis, chronic bronchitis, pneumonia, complicate urinary-tract
infection, & skin & soft tissue infections
Medicine: Tavanic®(Hoechst Marion Roussel) 250/500mg tablets
_______________________________
Nalidixic acid
Indications: urinary-tract infections
Medicine: Mictral®(Sanofi Winthrop) granules, Negram 500mg
_______________________________
Norfloxacin
Indications: urinary-tract infection, chronic relapsing respiratory-tract infection,
Medicine: Utinor®(MSD), Noroxin 200/400mg tablets
_______________________________
Ofloxacin (Tarivid®)
Indications: urinary-tract infection, lower respiratory-tract infection, uncomplicated
gonorrhoea, & severe or complicated infections
38
Cautions: hepatic & renal impairment; history of psychiatric illness; avoid in children &
growing adolescents
Medicine: Tarivid®(Hoechst Marion Roussel) 200mg tablets
_______________________________
Urinary-Tract Infections
Nitrofurantoin
Indications: urinary-tract infections
Medicine: Furadantin®(Procter & Gamble Pharm.), Macrobid 50/100mg tablets &
capsules
_______________________________
Hexamine hippurate 
(Methenamine hippurate)
Indications: prophylaxis & long-term treatment of recurrent urinary-tract infections
Medicine: Hiprex®(3M) 1g tablets
_______________________________
Antifungal drugs
Amphotericin
(Amphotericin B)
Indications: interstinal c&idiasis, oral & perioral infections
Medicine: AmBisome®(NeXstar) intravenous infusion, Fugilin®(Squibb) 100mg,
Fungizone®(Squibb) 50mg, Abelcet 5mg/ml intravenous infusion
_______________________________
Fluconazole
Indications: vaginal candidiasis & candidal balanitis, mucosal candidiasis, tinea pedis,
corporis, cruris, pityriasis versicolor, & dermal candidiasis, invasive candidal infections,
prevention of relapse of cryptococcal meningitis aids patients, prevention of fungal
infections
Medicine: Diflucan®(Pfizer) 50mg capsules
_______________________________
Flucytosine
Indications: systemic yeast & fungal infections; adjunct to amphotericin (or fluconazole)
in cryptococcal meningitis, adjunct to amphotericin in severe systemic candidiasis & in
other severe or long-standing infections
Medicine: Alcobon®(ICN) 10mg intravenous infusion
_______________________________
Griseofulvin
Indications: dermatophyte infections of the skin, scalp, hair & nails, where topical
therapy has failed or is inappropriate, antifungal
Medicine: Fulcin®(Zeneca), Grisovin®(GlaxoWelcome) 125mg tablets
_______________________________
Itraconazole
Indications: (oropharyngeal & vulvovaginal candidiasis, Pityriasis versicolor & other
dermatophyte infections, onychomycosis, histoplasmosis; alternative where other
antifungal drugs inappropriate or ineffective in systemic infections (aspergillosis,
candidiasis & cryptococcosis including cryptococcal meningitis), & in maintenance
treatment of AIDS patients to prevent relapse underlying fungal infection, prevention of
fungal infection in neutropenia when standard therapy inappropriate)
Medicine: Sporanox® 100mg capsules
_______________________________
Ketoconazole (Nizoral®)
Indications: systemic mycoses, serious chronic resistant mucocutaneous candidiasis,
serious resistant gastro-intestinal mycoses, chronic resistant vaginal candidiasis, resistant
39
dermatophyte infections of skin or finger nails (not toe nails); prophylaxis of mycoses in
immunosuppressed patients
Medicine: Nizoral®(Janssen-Cilag) 100/200mg tablets, suspension & shampoo
_______________________________
Miconazole
Indications: prevention & treatment of oral & intestinal fungal infections, localised
lesions, smear
Medicine: Daktarin®(Janssen-Cilag) 24mg/ml oral gel
_______________________________
Nystatin
Indications: candidiasis, nystatin is not absorbed when given by mouth & is too toxic for
parenteral use. Also can be used for yeasts & fungi but is for candida albicans
Medicine: Nystan®(Squibb) 500000units tablets pastilles & suspension
_______________________________
Terbinafine
Indications: dermatophyte (fungal) infections of the nails, ringworm infections (including
tinea pedis, crusis, & corporis) where oral therapy appropriate (due to site, severity or
extent), terbinafine is more active than nystatin (also see page 49 for skin fungal
infections)
Medicine: Lamisil®(Novartis) 250mg tablets & cream only
_______________________________
Antiviral drugs
Aciclovir
(Acyclovir)
Indications: herpes simplex & varicella-zoster
Medicine: Aciclovir (Non-proprietary), Virovir, Zovirax®(GlaxoWelcome) 200mg
tablet, suspension & cream
_______________________________
Amantadine hydrochloride
Indications: herpes zoster
_______________________________
Famciclovir
Note: famciclovir is a pro-drug of penciclovir
Indications: treatment of herpes zoster, acute genital herpes simplex & suppression of
recurrent genital herpes
Dose: for herpes zoster infections 250mg three times daily for 7 days, & for genital heres
infections 250mg three times daily for 5 days
Medicine: Famvir®(Beecham) 125/250mg tablets & cream
_______________________________
Inosine pranobex 
Indications: mucocutaneous herpes simplex, adjunctive treatment of genital warts
Medicine: Imunovir®(Ardern) 500mg tablets
_______________________________
Valaciclovir
Note: valaciclovir is a pro-drug of aciclovir
Indications: treatment of herpes zoster & herpes simplex infections of skin & mucous
membranes including initial & recurrent genital herpes
Medicine: Valtrex®(GlaxoWelcome) 500mg tablets
_______________________________
Human Immunodeficiency Virus (HIV)
40
Didanosine (Videx®(Bristol-Myers), Lamivudine (Epivir®(GlaxoWelcome), Stavudine
(Zerit®(Bristol-Myers), Zalcitabine (Hivid®(Roche), Zidovudin (Retrovir® (GlaxoWelcome),
Indinavir (Crixivan® (MSD), Nelfinavir (Viracept®(Roche), Ritonavir (Norvir®(Abbott),
Sazuinavir (Invirase®(Roche), Nevirapine (Viramune®(Boehringer Ingelheim), Cidofovir
(Vistide®(Pharmacia & Upjohn), Ganciclovir (Cymevene® (Roche), Foscarnet
Sodium(Foscavir®(Astra), Tribavirin(Virazide®(ICN), (above are all formulas)
Indications: Antiviral drugs, (above formulas of antiviral drugs)
_______________________________
Antiprotozoal drugs
Treatment of malaria
Chloroquine
Indications: chemoprophylaxis & treatment of malaria, rheumatic arthritis, & lupus
erythematosus
Medicine: Avloclor®(Zeneca), Nivaquine®(Rhone-Poulenc-Rorer) 200mg tablet, syrup
& injection
_______________________________
Halofantrine hydrochloride
Indications: treatment of uncomplicated chloroquine-resistant falciparum malaria or
chloroquine-resistant vivax malaria
Medicine: Halfan®(SK&F) 250mg tablets
_______________________________
Mefloquine
Indications: chemoprophylaxis of malaria, treatment of uncomplicated falciparum malaria
& chloroquine-resistant vivax malaria
Medicine: Lariam®(Roche) 250mg tablets
_______________________________
Primaquine
Indications: adjunct in the treatment of plasmodium vivas & P.Ovale malaria (eradication
of liver stages)
Medicine: Primaquine (Non-proprietary) 7.5mg tablets
_______________________________
Proguanil hydrochloride
Indications: chemoprophylaxis of malaria
Medicine: Paludrine®(Zeneca) 100mg tablets
_______________________________
Proguanil hydrochloride with atovaquone
Indications: treatment of acute uncomplicated falciparum malaria, particularly where
resistance to other antimalarial drugs is suspected
Medicine: Malarone®(GlaxoWelcome) 250mg tablets
_______________________________
Pyrimethamine
Indications: malaria (but used only in combined preparations incorporating dapsone or
sulfadoxine); toxoplasmosis
Medicine: Daraprim®(GlaxoWelcome) 25mg tablets
_______________________________
Pyrimethamine with sulfadoxine
Indications: adjunct to quinine in treatment of plasmodium falciparum malaria
Medicine: Fansidar®(Roche) tablets (pyrimethamine 25mg, sulfadoxine 500mg)
_______________________________
Pyrimethamine with dapsone
Indications: prophylaxis of plasmodium falciparum malaria (limited use)
Medicine: Maloprim®(GlaxoWelcome) 12.5mg/100mg tablets
41
_______________________________
Quinine
Indications: falciparum malaria; nocturnal leg cramps
Medicine: Quinine sulphate (Non-proprietary) 200/300mg tablets
_______________________________
Amboebicides
Diloxanide
Indications: chronic amoebiasis
Medicine: Furamide®(Knoll) 500mg tablets, Entamizole® Dose: tablets three times
_______________________________
Diloxanide with Metronidazole
Indications: acute amoebic dysentery, chronic intestinal aboebiasis & other system
diseases due to Entamoeba histolytica, giardiasis
Medicine: Furazol®(Egyptian Pharm.) 250/200mg tablets, & paediatric suspension
_______________________________
Metronidazole
Indications: intestinal amoebiasis, extra-intestinal amoebiasis (including liver abscess) &
symptomless amoebic cyst passers, urogenital trichomoniasis, giardiasis
_______________________________
Tinidazole
Indications: see metronidazole
_______________________________
Trichomonacides
Metronidazole is the treatment of choice for Trichmonas vaginalis infection. If
metronidazole is ineffective, Tinidazole may be tried; it is usually given as a single 2-g
dose, with food. A further 2-g dose may be given if there is no clinical improvement.
_______________________________
Antigiardial drugs
Mepacrine hydrochloride
Indications: giardiasis; discoid lupus erythematosus
Medicine: Mepacrine hydrochloride 100mg tablets
_______________________________
Leishmaniacides
Sodium stibogluconate
Indications: leishmaniasis
Medicine: Pentostam®(GlaxoWelcome) 100mg/ml injection
_______________________________
Drugs for pneumocystis pneumonia
Atovaquone
Indications: treatment of mild to moderate pneumocystis carinii pneumonia in patients
intolerants of co-trimoxazole
Medicine: Wellvone®(GlaxoWelcome) 750mg/ml suspension
_______________________________
Pentamidine isethionate
Medicine: Pentacarinat®(JHC) 300mg injection
_______________________________
Trimetrexate
Indications: see notes above, (specialist use only)
Medicine: Neutrexin®(Ipsen) 25mg injection
42
_______________________________
Anthelmintics
(Drugs for threadworms)
Mebendazole
Indications: threadworm, roungworm, whipworm, & hookworm infections
Medicine: Vermox®(Janssen-Cilag) 100mg tablets & suspension 100mg/5ml
_______________________________
Piperazine
Indications: threadworm & roundworm infections
Medicine: Pripsen®(Seton) 4g oral powder, Antepar® suspension
_______________________________
Niclosamide
Indications: tapeworm infections
Medicine: Yomesan®(Bayer) 500mg tablets
_______________________________
Albendazole
Indications: adjunct to surgery in hydatid cysts caused by echinococcus granulosus or
E.Multilocularid, or primary treatment if surgery not possible, strongyloidiasis
Medicine: Zentel® 200mg as single dose 2 tablets, Eskazole®(Beecham) 400mg tablets
_______________________________
Thiabendazole
Indications: see note above
Medicine: Mintezol®(MSD) 500mg cheweble tablets
_______________________________
Diethylcarbamazine
Indications: is effective against microfilariae & adults of Loa loa, wucheria bancrofti, &
Brugia malayi
Medicine: Hetrazan®(Lederle) tablets
***************************************
43
Chapter 5 ( skin )
Topical local anaesthetics & antipruritics
Calamine
Indications: pruritus
Medicine: Calamine cream & lotion contains (zinc oxide 3%, liquid paraffin, sodium
citrate, liquefied phenol, & water)
_______________________________
Crotamiton
Indications: pruritus (including pruritus after scabies)
Medicine: Eurax®(Novartis) cream & lotion
_______________________________
Doxepin hydrochloride *(new addition)
Indications: for relief of pruritis associated with eczema
Medicine: Xepin®(Bioglan) 5% cream, as side effect can cause drowsiness
_______________________________
Topcial local anaesthetics
Indications: relief of local pain, for use in anaesthesia
Medicine: Anethaine®(amethocaine), Dermidex®(lignocaine, alcloxa, cetrimde,
chlorbutol), Solarcaine®(benzocaine, triclosan)
_______________________________
Topical antihistamine
Indications:
Medicine: Aller-eze® cream (dipenhydramine), Anthisan®(mepyramine), Caladryl®
(diphenhydramine, calamine, camphor), R.B.C® (antazoline, calamine, camphor,
cetrimide, menthol), Systral®(chlorphenoxamine (for anti-pruritis, antiallergic), Wasp-
eze® spray (mepyramine, benzocaine)
_______________________________
Topical corticosteroids
Hydrocortisone
Indications: mild inflammatory skin disorders such as eczemas,
Medicine: Cobadex®(Cox), Dioderm®(Dermal), Efcortelan®(GlaxoWelcome),
Hydrocortisyl®(Hoechst Marion Roussel), Mildison, Enonacort, Fucidin-H (here H
stands for hydrocortisone as its ingrients, & fusidic acid) cream & ointment
_______________________________
Hydrocortisone butyrate
Indications: severe inflammatory skin disorders such as ecemas unresponsive to less
potent corticosteroids, psoriasis
Medicine: Locoid®(Yamanouchi) cream
_______________________________
Alclometasone dipropionate
Indications: inflammation skin disorders such as eczemas
Medicine: Modrasone®(Dominion) cream & ointment
_______________________________
44
Beclomethasone dipropionate
Medicine: Propaderm®(GlaxoWelcome) cream & ointment
_______________________________
Betamethsone esters
Medicine: Betacap®(Dermal), Betnovate®(GlaxoWelcome), Betnovate-N®(N stands for
neomycin), Betamousse, Diprosone, Diprosalic, Betnovate-C (betamethasone & C stands
for Clioquinol as antimicrobials), Lotriderm cream & ointment
_______________________________
Clobetasol propionate
Indications: (short-term treatment only of severe resistant in skin disorders such as
recalcitrant eczemas unresponsive to less potent corticosteroid; psoriasis, impetigo
Medicine: Dermovate®(GlaxoWelcome), Dermovate-NN (contains clobetasol, & NN
stands for neomycin & nystatin also its ingrients as antimicrobials) cream & ointment
_______________________________
Clobetasone butyrate
Indications: eczemas & dermatitis of all types; maintenance between courses of more
potent corticosteroids
Medicine: Trimovate®(GlaxoWelcome) cream
_______________________________
Desoxymethasone
Indications: severe acute inflammatory, allergic & chronic skin disorders; psoriasis
Medicine: Stiedex®(Stiefel) cream & lotion
_______________________________
Diflucortolon valerate
Indications: severe inflammatory skin disorders such as eczemas unresponsive to less
Medicine: Nerisone®(Schering Health) cream & ointment
_______________________________
Fluocinolone acetonide
Indications: inflammatory skin disorders such as eczemas; psoriasis
Medicine: Synalr®(Zeneca) cream & ointment
_______________________________
Fluocinonide
Medicine: Metosyn®(Zeneca) cream & ointment
_______________________________
Fluocortolone
Medicine: Ultralanum®(Schering-Plough) plain contains fluocortolone hexanoate,
fluocortolone pivalate cream & ointment
_______________________________
Flurandrenolone
Indications: inflammatory skin disorders such as eczemas
Medicine: Haelan®(Norex) cream
_______________________________
45
Medicine: Cutivate®(GlaxoWelcome) cream & ointment
_______________________________
Halcinonide
Medicine: Halciderm®(Squibb) topical cream
_______________________________
Mometasone furoate
Medicine: Elocon®(Schering-Plough) cream & ointment
_______________________________
Triamcinolone acetonide
Medicine: Adcortyl with graneodin®(Squibb), Aureocort®(Lederle), Nystadermal,
Pevaryl TC®(TC stands for econazole nitrate (Janssen-Cilag), Ledercort® cream & oint
_______________________________
Preparations for Eczemas & Psoriasis
Ichthammol
Indications: chronic lichenified (fungus) eczema
Medicine: Ichthammol ointment, Ichthab&®, Ichthopaste®, Zinc & Ichthammol cream
_______________________________
Gamolenic acid
Indications: symptomatic relief of atopic eczema, mastalia
Medicine: Epogam®(Searle) 40mg capsules
_______________________________
Seborrhoeic dermatitis
Lithium succinate
Indications: seborrhoeic dermatitis
Medicine: Efalith®(Searle) ointment
_______________________________
Topical preparations for psoriasis
Calcipotriol
Indications: plaque psoriasis
Medicine: Dovonex®(Leo) cream
_______________________________
Tacalcitol
Indications: plaque psoriasis
Medicine: Curatoderm®(Merck) ointment
_______________________________
Tazarotene
Indications: mild to moderate plaque psoriasis affecting up to 10% of skin area
Medicine: Zorac®(Allergan) gel
_______________________________
Coal tar
Indications: psoriasis & occasionally chronic atopic eczema
Medicine: Calamine & Coal Tar Ointment, Alphosy®(Stafford-Miller), Carbo-Dome®
(Lagap), Clinitar, Exorex, Pregmatar, Psorigel®(Galderma) cream & ointment
_______________________________
46
Dithranol
Indications: subacute & chronic psoriasis
Medicine: Dithrocream®(Dermal), Micanol®(Medeva), Psorin® cream & ointment
_______________________________
Salicylic acid
Indications: hyperkeratotic skin disorders
Medicine: Salicylic acid ointment, & zinc & salicylic acid paste
_______________________________
Acitretin
Note: acitretin is a metabolite of etretinate
Indications: severe extensive psoriasis resistant to other forms of therapy; palmoplantar
pustular psoriasis
Medicine: Neotigason®(Roche) 10/25mg capsules
_______________________________
Oral immunosuppressants for Posriasis
Cyclosporin
Indications: (short-term) treatment of severe atopic dermatitis, severe psoriasis
_______________________________
Methotrexate
Indications: severe uncontrolled psoriasis unresponsive to conventional therapy,
(specialist use only), malignant disease
_______________________________
Topical preparations for acne
Benzoyl peroxide
Indications: acne vulgaris
Medicine: Acnicide®(Galderma), Nericur, PanOxyl®(Stiefel), Benzamycin®(Bioglan),
Quinoderm, Clindacin T®(United Pharm. Co. Jordon) cream & lotion, gel
_______________________________
Azelaic acid
Medicine: Skinoren®(Schering-Health) cream
_______________________________
Antibiotics
Medicine: Benzamycin® Gel (erythromycin + benzoyl peroxide), Clindacin® C
(clindamycin phosphate), Dalacin T®(clindamycin), Eryacne®(erythromycin),
Topicycline® (tetracycline), Zineryt®(erythromycin + zinc acetate) lotion & gel
_______________________________
Topical retinoids & related preparations for acne
Adapalene
Indications: mild to moderate acne
Medicine: Differin®(Galderma) Gel
_______________________________
Tretinoin
Dose: apply once daily in normal cases
Medicine: Retin-A®(Janssen-Cilag) cream
_______________________________
Isotretinoin
47
Medicine: Isotrexin®(Stiefel) gel
_______________________________
Note: Topical corticosteriods should not be used in acne
_______________________________
Abrasive agents 
Medicine: Brasivol®(Stiefel), Ionax scrub®(Galderma) gel
_______________________________
Brand & gesic for acne vulgaris
Nicotinamide (papulex gel®(Bioglan)
Salicylic acid (acnisal solution®(DermaPham)
_______________________________
Oral preparation for acne
Cyproterone acetate
Medicine: Dianette®(Schering Health) 2mg tablets
_______________________________
Isotretinoin
Medicine: Roaccutane®(Roche) 5mg capsules
_______________________________
Preparations for warts & calluses
Salicylic acid
Indications: for warts
Medicine: Cuplex gel, Salactol paint®(Stiefel), Salatac®(Dermal) gel, & Posalfilin
ointment
_______________________________
Formaldehyde
Medicine: Veracur®(Typham) gel
_______________________________
Glutaraldhyde
Medicine: Glutarol®(Dermal) solution
_______________________________
Genital warts
Podophyllum
Indications: for genital warts
Medicine: Podophyllin®(Ardern) paints, Condyline, Warticon®(Perstorp) cream
_______________________________
Shampoos & some other scalp preparations
Alphosyl 2 in 1®(Stafford-Miller) shampoo contains coal tar extract, for dandruff;
psoriasis, seborrhoeic dermatitis, scaling & itching, use once or twice in a week
Betadine shampoo contains povidone-iodine, for seborrhoeic scalp, dandruff, pruritus,
scaling, exudation & erythema
Lenium®(Janssen-Cilag) cream contains, selenium sulphide, for seborrhoeic dermatitis,
& dandruff, Caution: avoid using 48 hours befre or after applying hair colouring or
waving preparations
Meted®(DermaPharm) shampoo contains, salicylic acid, for scaly scalp disorders
including psoriasis, seborrhoeic dermatitis, & dandruff
Nizoral®(Janssen-Cilag) shampoo contains, ketoconazole, for seborrhoeic dermatitis &
dandruff
48
Polytar AF®(Stiefel) shampoo contains, coal tar, arachis (peanut) oil extract, for
seborrhoeic dermatitis, & dandruff
Selsun blue®(Abbott) shampoo contains selinium sulphide, for seborrhoeic dermatitis &
dandruff, & pityriasis versicolor. Caution: avoid using 48 hours befre or after applying
hair colouring or waving preparations
_______________________________
Minoxidil
Indications: male-pattern baldness (men & women)
Medicine: Regaine®(Pharmacia & Upjohn) topical solution
_______________________________
Antibacterial preparations
Bacitracin zinc
Indications: bacterial skin infections, baciitracin is active against gram-positive
organisms, e.g. hemolytic streptococci, staphylococci, Clostridia, Corynebaterium
diphtheriae as well as Treponema pallidum, & some gram-negative pathogens like
Neisseria & Haemophilus influenzae
Medicine: Baneocin®(Biochemie (Astria) powder & ointment
_______________________________
Framycetin sulphate
Indications: bacterial skin infections
Medicine: Suframycin®(Hoechst Marion Roussel) ointment, Sofra-tulle dressing gauze
_______________________________
Gramicidin
Indications: bacterial skin infections, properties antibacterial, antifungal & antiallergic
Medicine: ingredients of Kenacomb are (triamcinolone acetonide (antiallergic),
neomycin (antibaterial), gramicidin (antibacterial), & nystatin(antifungal)
_______________________________
Mupirocin
Medicine: Bactroban®(Beecham) ointment
_______________________________
Neomycin sulphate
Indications: bacterial skin infections, neomycin acts both against gram-positive & gram-
negative pathogens, e.g. staphylococci, Proteus, Enterobacteraerogenes, Klebsiella
pneumoniae, salmonellae, shigallae, Haemophilus influenzae, Pasteurella, Neisseia
meningitidis, Vibrio cholerae, Bordetella pertussis, Bacillus anthracis, Corynebacterium
diphtheriae, Streptococcus faecalis, Listeria monocytogenes, Escherichia coli &
Mycobacterium hemorrhagicae
Medicine: Cicatrin®(GlaxoWelcome) cream, Graneodin ointment
_______________________________
Polymyxins
Medicine: Polyfax®(Dominion), Colomycin®(Pharmax) ointment & powder
_______________________________
Silver sulphadiazine (Flamazine)
Indications: prophylaxis & treatment of infection in burn wounds; as an adjunct to (short-
term) treatment of infection in leg ulcers & pressure sores; as an adjunct to prophylaxis of
infection in skin graft donor sites & extensive abrasions; for conservative management of
finger-tip injuries
Medicine: Flamazine®(S&N Health) cream
_______________________________
Chlortetracycline hydrochloride
49
Medicine: Aureomycin®(Lederle) ointment
_______________________________
Fusidic acid
Indications: staphylococcal skin infections
Medicine: Fucidin®(Leo) cream, gel, ointment & intertulle
_______________________________
Gentamicin
Medicine: Cidomycin®(Hoechst Marion Roussel) topical cream
_______________________________
Metronidazole
Indications: acute inflammatory exacerbations of acne rosacea, inflammatory papules,
pustules, & erythema
Medicine: Metrogel®(Novartis) gel, Noritate®(kestrel) cream, Rozex®(Stafford-Miller)
cream & gel, Anabact gel
_______________________________
Antifungal preparations
Amorolfine
Indications: fungal nail infections (also see page 61 for ear fungal disease)
Medicine: Loceryl®(Roche) cream & nail lacquer
_______________________________
Benzoic acid
Indications: ringworm (tinea)
Medicine: Benzoic acid ointment, Compound, BP (Whitfield's ointment) apply twice daily
_______________________________
Benzoyl peroxide
Indications: fungal skin infections, particularly tinea pedis
Medicine: Quinoped®(Quinoderm Ltd) cream
_______________________________
Clotrimazole
Indications: fungal skin infections (also see page 61 for ear fungal infections)
Medicine: Canesten®(Baypharm), Masnoderm®(Dominion) cream, solution, spray &
dusting powder
_______________________________
Econazole nitrate
Indications: fungal skin infections
Medicine: Pevaryl®(Janssen-Cilag) cream & lotion
_______________________________
Ketoconazole
Medicine: Nizoral®(Janssen-Cilag) cream & shampoo
_______________________________
Miconazole nitrate
Medicine: Daktarin®(Janssen-Cilag) cream & dusting powder & spray
_______________________________
Nystatin
Indications: skin infections due to candida spp.
Medicine: Nystan®(Squibb), Nystaform®(Schering-Plough), Tinaderm-M cream gel &
ointment
50
_______________________________
Salicylic acid
Caution: flammable; avoid in pregnancy & children under 5 years
Medicine: Phytex®(Pharmex) paint
_______________________________
Salicylic acid with Sulfur
Indications: for anti-fungal & keratolytic
Medicine: Salicylic acid & Sulfur Soap®(Hayat KSA) salicylic acid 3% & sulfur 10%
_______________________________
Sulconazole nitrate
Medicine: Exelderm®(Zeneca) cream
_______________________________
Terbinafine
Indications: fungal skin infections, fungal infections of skin caused by dermatophytes
such as Trichophyton (e.g. T. rubrum, T. T. violaceum), Microsporum canis and
Epidermophyton floccosum. Pityriasis (tinea) versicolor due to pityrosporum orbiculare
(also known as Malassezia furfur). Lamisil cream only: Yeast infections of the skin,
principally those caused by genus Candida (e.g. Candida albicans), (for oral uses also see
page 38)
Medicine: Lamisil®(Novartis) cream & tablets
_______________________________
Tioconazole
Medicine: Trosyl®(pfizer) nail solution
_______________________________
Undecenoates
Indications: fungal skin infections, particularly tinea pedis
Medicine: Mycota®(Seton) cream, dusting powder & spray
_______________________________
Anti-viral preparations
Aciclovir (Zovirax®) GlaxoWelcome
Indications: for the treatment of initial & recurrent labial & genital herpes simplex
infections
Medicine: Zovirax cream, Zovirax® Cold Sore cream, & Eye ointment
_______________________________
Penciclovir
infections
Medicine: Vectavir®(Beecham) cream
_______________________________
Idoxuridine in dimethyl sulphoxide 
infections
Medicine: Herpid®(Yamanouchi) application
_______________________________
Scabies
Benzyl benzoate
Indications: scabies
Medicine: Ascabiol®, Benzyl benzoate (Non-proprietary) application
_______________________________
51
Carbaryl
Indications: scabies
Medicine: Carylderm®(Seton), Derbac C, Suleo-C lotion
_______________________________
Malathion
Indications: heade lice
Medicine: Derbac-M®(Seton), Quellada M cream & lotion
_______________________________
Permethrin
Indications: head lice
Medicine: Lyclear®(Warner Lambert) cream
_______________________________
Phenothrin
Indications: crab lice & head lice
Medicine: Full Marks®(Seton) lotion
_______________________________
Disinfectants & cleansers
Alcohol
Indications: skin preparations before injection
Medicine: industrial methylated spirits
_______________________________
Sodium chloride
Indications: skin preparations before injection
Medicine: Normasol®(Seton), Sterac solution
_______________________________
Cetrimide
Indications: skin disinfection
Medicine: ingrdient of "Steripod", Tisept & Travasept
_______________________________
Hexachlorophane
Indications: preventio of neonatal staphylococcal sepsis,
Medicine: Ster-Zac®(Seton) powder
_______________________________
Triclosan
Indications: skin disinfection
Medicine: Aquasept®(Seton), Manusept®(Seton)
_______________________________
Aluminium acetate
Indications: exudative eczematous reactions & wounds
Medicine: Aluminium acetate lotion
_______________________________
*Crystal violet/ *Hydrogen peroxide/ *Potassium permanganate
Indications: skin disinfection, particularly cleansing & deodorising wounds & ulcers
_______________________________
Aluminium chloride
Indications: heperhidrosis affecting axillae, hands or feet
Medicine: Driclor®(Stiefel) application
_______________________________
Potassium permanganate
Indications: cleansing & deodorising suppurating eczematous reactions & wounds
Medicine: Permitabs®(Bioglan) solution tablests
_______________________________
52
Emollients
Zinc & castor oil ointment (for napkin & urinary rash), Alcoderm®(liquid paraffin, cetyl
alcohol, stearyl alcohol, sodium lauryl sulphate, carbomer, triethanolamine, sorbitan
monostearate, sorbitol, spermaceti, silicone fluid) for dry skin conditions
Kamillosan®(chamomile extracts 10.5%) for napkin rash, sore nipples & chapped hands
_______________________________
Sarnol lotion®(steifel UK) contains menthol, camphor and benzyl alcohol) for soothing,
smothing, and irritating skin
_______________________________
Important Prescription
 Boric acid glycerine is the best therapy for dissection lips in the world than other.
 Gentien voilet is the best prescription for stomatitis or thrush than the world.
 Caster oil is the best prescription for purgative (Julab).
 Quinine is the best for malaria in the world.
 Anti-septic vasline like zinc & boric ointment is the best for healing injuries.
 Tanic acid or chromic acid lotion is the best for gum disease.
************************************
53
Chapter 6 ( Musculoskeletal & joint diseases)
Drugs used in rheumatic diseases & gout

Non-steroidal inflammatory drugs
Ibuprofen
Indications: pain & inflammation in rheumatic disease (including juvenile arthritis) &
other musculoskeletal disorders; mild to moderate pain including dysmenorrhoea; post-
operative analgesia; fever & pain in children
Medicine: Brufen®(Knoll), Fenbid®(Goldshield) 200/400/600mg tablets
_______________________________
Aceclofenac
Indications: pain & inflammation in rheumatoid arthritis, osteoarthritis, & ankylosing
spondylitis
Medicine: Preservex®(UCB Pharma) 100mg tablets
_______________________________
Acemetacin
Indications: pain & inflammation in rheumatic disease & other musculoskeletal disorders;
post-operative analgesia
Medicine: Emflex®(Merck) 60mg capsules
_______________________________
Azapropazone
Indications: cms has restricted azapropazone to use in rheumatoid arthritis, ankylosing
spondylitis & acute gout only when other Nsaids (Non-steroids & inflammatory diseases)
have been tried & failed
Medicine: Rheumox®(Wyeth) 300mg capsules & tablets
_______________________________
Diclofenac sodium
other musculoskeletal disorders; acute gout; post-operative pain
Medicine: Voltarol®(Novartis), diclomax®(P-D) sr, motifene, voltaren tablets capsules
& injection
_______________________________
Chlorzoxazone (Parafon®)
Indications: pain & spasm, myalgia, tension headache, lumbago, spondylarthroses, &
cervical root syndrome
54
Medicine: Parafon®(Cilag) tablets (paracetamol 300mg, chlorzoxazone 250mg)
_______________________________
Diflunisal
mild to moderate pain including dysmenorrhoea
Medicine: Dolobid®(Morson) tablets
_______________________________
Etodolac
Indications: pain & inflammation in rheumatoid arthritis & osteoarthritis
Medicine: Lodine®(Monmouth) 200mg capsules & tablets
_______________________________
Fenbufen
Indications: pain & inflammation in rheumatic disease & other musculoskeletal disorders
Medicine: Lederfen®(Lederle) 300mg capsules
Fenoprofen
Medicine: Fenopron®(Norex) 300mg tablets
_______________________________
Flurbiprofen
Indications: pain & inflammation in rheumatic disease & other musculoskeletal disorders,
mild to moderate pain including dysmenorrhoea; post-operative analgesia
Medicine: Froben®(Knoll) 50mg tablets capsules & suppositories
_______________________________
Indomethacin
Indications: pain & moderate to severe infection in rheumatic disease & other acute
musculoskeletal disorders; acute gout; dysmenorrhoea; closure of ductus arteriosus
Medicine: Indomethacin (Non-proprietary), Indomax®(Ashbourne), Indocid®(Morson)
50/75mg capsules, suspension & suppositories
_______________________________
Ketoprofen
Indications: pain & inflammation in rheumatic disease & other musculoskeletal disorders,
& after orthopaedic surgery; acute gout; dysmenorrhoea
Medicine: Oruvial®(Rhone-Poulenc-Rorer), Orudis®(Rhone-Poulenc-Rorer) 50mg
capsules & injection
_______________________________
Mefenamic acid
Indications: mild to moderate pain in rheumatoid arthritis (including juvenile arthritis),
osteoarthritis, & related conditions; dysmenorrhoea & menorrhagia
Medicine: Ponstan forte®(Elan) 250/500mg tablets suspension & capsules
_______________________________
Meloxicam
Indications: pain & inflammation in rheumatoid disease; exacerbation of osteoarthritis
(short-term), ankylosing spondylitis
Medicine: Mobic®(Boehringer Ingelheim) 7.5/15mg tablets & suppositories
_______________________________
Nabumetone
Indications: pain & inflammation in osteoarthritis & rheumatoid arthritis
Medicine: Relifex®(Bencard) 500mg tablets & suspension
_______________________________
Naproxen
55
other musculoskeletal disorders; dysmenorrhoea; acute gout
Medicine: Naprosyn®(Roche), Nycopren®(Ardern), Synflex®(Roche) 250/500mg
tablets suspension & suppositories
_______________________________
Phenylbutazone 
Indications: ankylosing spondylitis when other therapy unsuitable
Medicine: Butacote®(Novartis) 100mg tablets
Piroxicam
other musculoskeletal disorders; acute gout
Medicine: Feldene®(Pfizer), Unicam 10/20mg gel tablets & injection
_______________________________
Propyphenazone
Indications: pain & reduces fever, headache, toothache & fever associated with cold &
"flu"
Medicine: Saridone®(Roche) tablet contains paracetamol, propyphenazone & caffeine
_______________________________
Sulindac
acute gout
Medicine: Clinoril®(MSD) 100/200mg tablets
_______________________________
Tenoxicam
acute gout
Medicine: Mobiflex®(Roche) 20mg tablets & injection
_______________________________
Tiaprofenic acid
acute gout
Medicine: Surgam®(Florizel) 200mg tablets & capsules
_______________________________
Aspirin
(Acetylsalicylic acid)
(including juvenile arthritis); antiplatelet
Medicine: Dispirin®() 75mg tablets
_______________________________
Benorylate
mild to moderate pyrexia (fever)
Medicine: Benoral®(Sanofi Winthrop) tablets granules & suspension
_______________________________
Corticosteriods
Local corticosteriods injection
Indications: local inflammation of joints & soft tissues
Medicine: Decadron®(MSD), Hydrocortistab, Deltastab, & Lederspan
_______________________________
Drugs which suppress the rheumatic disease process
56
Sodium aurothiomalate
Indications: active progressive rheumatoid arthritis, juvenile arthritis
Medicine: Myocrisin®(JHC) 20mg injection
_______________________________
Auranofin
Indications: active progressive rheumatoid arthritis when Nsaids inadequate alone
Medicine: Ridaura®(Yamanouchi) 3mg tablets
_______________________________
Penicillamine
Indications: severe active rheumatoid arthritis, & Wilson's disease
Medicine: Distamine®(Dista), Pendramine®(ASTA Medica) 125mg tablets
_______________________________
Antimalarials
Chloroquine
Indications: active rheumatoid arthritis (including juvenile arthritis), systemic & discoid
lupus erythematosus; malaria
_______________________________
Hydroxychloroquine sulphate
Indications: active rheumatoid arthritis (including juvenile arthritis), systemic & discoid
lupus erythematosus
Medicine: Plaquenil®(Sanofi Winthrop) 200mg tablets
_______________________________
Immunosupressants
Azathioprine
Indications: detail not avialable
_______________________________
*Cyclosporin / *Methotrexate/ *Sulphasalazine
Indications: active rheumatoid arthritis; ulcerative colitis
_______________________________
Drugs for treatment of gout
Colchicine
Indications: acute gout, (short-term) prophylaxis during initial therapy with allopurinol &
uricosuric drugs; prophylaxis of familial Mediterranean fever (recurrent polyserositis)
Medicine: Colchicine (Non-proprietary) 50mcg tablets
_______________________________
Allopurinol
Indications: prophylaxis of gout & uric acid & for calcium oxalate renal stones
Medicine: Zyloric®(GlaxoWelcome) 100mg tablets
_______________________________
Probenecid
Indications: gout prophylaxis (to correct hyperuricaemia); reduction of tubular excretion
of penicillins & certain cephalosporins
Medicine: Benemid®(MSD) 500mg tablets
_______________________________
Sulphinpyrazone
Indications: gout prophylaxis, hyperuricaemia
Medicine: Anturan®(Novartis) 100mg tablets
_______________________________
Drugs which enhance neuromuscular tranmission
Neostigmine
57
Indications: myasthenia gravis (weakness of muscles)
Medicine: Neostigmine (Non-proprietary) 15mg tablets & injection
_______________________________
Distigmine bromide
Indications: myasthenia gravis; urinary retention
_______________________________
Edrophonium chloride
Indications: myasthenia gravis
Medicine: Edrophonium (Non-proprietary) 10mg/ml injection
_______________________________
Pyridostigmine bromide
Indications: myasthenia gravis
Medicine: Mestinon®(ICN) 60mg tablets
_______________________________
Skeletal muscle relaxants
Baclofen
Indications: chronic severe spasticity resulting from disorders such as multiple sclerosis
or traumatic partial section of spinal cord
Medicine: Lioresal®(Novartis) 5/10mg tablets & injection
_______________________________
Dantrolene sodium
Indications: chronic severe spasticity of voluntary muscle
Medicine: Dantrium®(Procter & Gamble Pharm.) 25mg capsules
_______________________________
Diazepam
Indications: muscle spasm of varied aetiology, including tetanus
_______________________________
Tizanidine
Indications: spasticity associated with multiple sclerosis or spinal cord injury or disease
Medicine: Zanaflex®(Athena) 2mg tablets
_______________________________
Carisoprodol 
Indications: (short-term) symptomatic relief of muscle spasm
Medicine: Carisoma®(Pharmax) 125mg tablets
_______________________________
Methocarbamol 
Indications: (short-term) symptomatic relief of muscle spasm
Medicine: Robaxin®(Shire) 750mg tablets & 100mg injection
_______________________________
Quinine
Indications: for nocturnal leg cramps
_______________________________
Hyaluronidase
Indications: enhance permeation of subcutaneous or intramuscular injections, local
anaesthetics & subcutaneous infusions; promote resorption of excess fluids & blood
Medicine: Hylase®(CP) 1500units injection
_______________________________
Rubefacients & other topical antirheumatics
Topical NSAIDs & counter-irritants
58
Algesal®cream (diethylamine salicylate) Ibugel Gel (ibuprofen) Oruvial gel
(ketoprofen). Radian®-B Muscle lotion (ammonium salicylate, camphor, menthol,
salicylic acid) Salonpas®(Hismitsu Japan) gel, spray & patches (methyl salicylate,
menthol, & camphor)
**********************************
Chapter 7 ( Endocrine system )

Drugs used in diabetes
Insulins
(Short-acting insulins)
Soluble insulin
A sterile solution of insulin (e.i Bovine or procrine) or of human insulin
Indications: diabetes mellitus; diabetic ketoacidosis
Medicine: Hypurin Bovine Neutral®(CP) 100units/ml, Pork Velosulin®(Novo
Nordisk, GlaxoWelcome), Hyman Actrapid, Hyman Velosulin injection
_______________________________
Insulin lispro
Indications: diabetes mellitus
Medicine: Humalog®(Lilly) 100units injection
_______________________________
Intermediate-& long-acting insulins
Insulin zinc suspension

Indications: diabetes mellitus, long-acting
Medicine: (highly purified animal) Hypurin bovine lente®(CP), Lentard MC®(Novo
Nordisk), Human monotard®(Novo Nordisk) injection, Subcutaneous injection according
to patient's requirements
_______________________________
Insulin zinc suspension
(Crystalline insulin)
Indications: diabetes mellitus (long acting)
Medicine: Human ultratard®(Novo Nordisk), Hulin ZN®(Lilly) injection
_______________________________
Isophane insulin
59
Medicine: Hypurin bovine isophane®(CP), Pork insulatard®(Novo Nordisk,
GlaxoWelcome), Humulin I injection
_______________________________
Protamine zinc insulin
Indications: diabetes mellitus (long acting)
Medicine: Hypurin bovine protamine zinc®(CP)
_______________________________
Biphasic isophane insulin
Indications: diabetes mellitus, (intermediate acting)
Medicine: Pork mixtard 30®(Novo Nordisk, GlaxoWelcome), Humulin MI®(Lilly),
Humulin M2®(Lilly) injection
_______________________________
Oral antidiabetic drugs
Chlorpropamide
Indications: diabetes mellitus, (for use in diabetes insipidus)
Medicine: Diabenese®, Chlorpropamide (Non-proprietary) 100mg tablets
_______________________________
Glibenclamide
Medicine: Daonil®(Hoechst Marion Roussel), Euglucon®(Hoechst Marion Roussel)
2.5/5mg tablets
_______________________________
Gliclazide
Medicine: Diamicron®(Servier) 80mg tablets
_______________________________
Glimepiride
Medicine: Amaryl®(Hoechst Marion Roussel) 1/2/3/4/5/6mg tablets according to
diabetic range
_______________________________
Glipizide
Medicine: Glibenses®(Pfizer), minodiab®(Pharmacia & Upjohn) 2.5/5mg tablets
_______________________________
Gliquidone
Medicine: Glurenorm®(Sanofi Winthrop) 30mg tablets
_______________________________
Tolazamide
Medicine: Tolanase®(Pharmacia & Upjohn) 100mg tablets
_______________________________
Tolbutamide
Medicine: Rastinon®(Hoechst Marion Roussel) 500mg tablets
_______________________________
Biguanides
Metformin hydrochloride
Indications: diabetes mellitus, dose according to sugar level
60
Medicine: Glucophage®(Lipha) tab 500mg according to sugar level range or TID
_______________________________
Other antidiabetics
Acarbose
Indications: diabetes mellitus inadequately controlled by diet or by diet with oral
hypoglycaemic agents
Medicine: Glucobay®(Bayer) 50mg granules
_______________________________
Guar gum
Indications:
Medicine: Guarem®(Bybar) granules
_______________________________
Treatment of HYPOGLYCAEMIA (very low range of glucose in blood)
Glucagon
Indications: see dose below
Dose: by subcutaneous, or i/m, for decreasing range of glucose in blood, or for
emergency give granulated sugur
Medicine: GlucaGen®(Novo Nordisk) 1mg injection
_______________________________
Diazoxide
Indications: chronic intractable hypoglycaemia (for use in hypertensive crisis)
Medicine: Eudemine®(Medeva) 50mg tablets
_______________________________
Thyroid & antithyroid drugs
Thyroxine sodium
Indications: hypothyroidism (reduction of thyroid hormones)
Medicine: Thyroxine (Non-proprietary) 25mcg tablets
_______________________________
Liothyronine sodium
Indications: hypothyroidism (reduction of thyroid hormones)
Medicine: Tertroxin®(Goldshield) 20mcg tablets
_______________________________
Antithyroid drugs
Carbimazol
Indications: hyperthyroidism, (increase of thyroid hormones)
Medicine: Neo-mercazole®(Roche) 5mg tablets
_______________________________
Iodine & iodide
Indications: thyrotoxicosis (pre-operative)
Medicine: Aqueous iodine oral solution
_______________________________
Male sex hormones & antagonists
Testosterone & Easters
Indications: androgen deficiency in men associated with primary or secondary
hypogonadism (weakness of sex)
Medicine: Restandol®(Organon) 40mg cap, Primoteston Depot®(Cambridge) 250mg
injection, Sustanon®(Organon) 50/100/250mg injection, &ropatch® patches
_______________________________
61
Mesterolone
Indications: androgen deficiency & male infertility associated with hypogonadism (25mg
3-4 times daily for several month, child not recommended)
Medicine: Proviron®(Schering Health) 25mg tablets
_______________________________
Anti-&rogens (hypersexuality & sexual deviation)
Note: this drug is used for those males who have high sex
Cyproterone acetate
Indications: male hypersexuality, prostate cancer 50mg daily after food
Medicine: androcur®(Schering Health) 50mg tab
_______________________________
Finasteride
Indications: benign prostatic hyperplasia
Medicine: Proscar®(MSD) 5mg tab
_______________________________
Anabolic steroids
Note: All the anabolic steroids have some &regenic activity but they cause less
virilisation than androgens in women. Their protein-building property led to the hope that
they might be widely useful in medicine but this hope has not been realised. Their use as
body builders or tonics is quite unjustified; the are abused by some athletes. Anabolics
steroids have also been given for osteoporosis in women but are no longer advocated for
this purpose. Anablic steroids are used in the treatment of some aplastic anaemias & to
reduce the itching of chronic biliary obstruction. (Anabolics drugs use some body-
builders for their body).
_______________________________
Nandrolone
Indications: osteoporosis in postmenopausal women; aplastic anaemia, weakness,
enlarged protate gland, muscular weakness & kidney disease
Medicine: Deca-Durabolin®(Organon) 25mg injection
_______________________________
Stanozolol
Indications: vascular manifestations of Behcet's disease, hereditary angioedema
Medicine: Stromba®(Sanofi Winthrop) 5mg tablets
_______________________________
Hypothalamic & pituitary hormones & anti-oestrogens
Anti-oestrogens
Clomiphene citrate
Indications: are used in the treatment of female infertility due to oligomenorrhoea or
secondary amenorrhoea (e.g. associated with polycystic ovarian disease).
Medicine: Clomid®(Hoechst Marion Roussel) 50mg tab, Serophene®(Serono) 50mg tab
_______________________________
Raloxifene
Indications: for the prevention of psotmenopausal osteoporosis
Medicine: Evista®(Lilly) 60mg tablets
************************************
62
Chapter 8 ( Ear, nose & oropharynx )
Drugs acting on the ear

Otitis externa
Aluminium acetate
Indications: inflammation in otitis externa
Medicine: Aluminium acetate ear drops
_______________________________
Betamethasone sodium
Indications: eczematous inflammation in otitis externa
Medicine: Betnesol®(Medeva), Vista-methasone-N®(Martindale), (with antibacterial)
Betnesol-N® (here N for neomycin sulphate) drops for ear, eye or nose
_______________________________
Dexamethasone
Medicine: Otomize®(Stafford-Miller), Sofradex®(Florizel) drops & ear spray
_______________________________
Flumethasone pivalate
Medicine: *(with antibacterial) Locorten-Vioform®(Novartis Health Consumer) eardrops
_______________________________
Hydrocortisone
63
Medicine: Neo-Cortef®(Dominion), (with antibacterial--) Gentisone HC®(Roche)
drops & ointment
_______________________________
Prednisolone sodium phosphate
Medicine: Predsol-N®(Medeva) drops (for ear, nose & eye)
_______________________________
Triamcinolone acetonide
Medicine: Audicort®(Wyeth), Tri-Adcortyl Otic®(Squibb), (contains triamcinolone
acetonide, gramicidin, neomycin, and nystain) eardrops & ointment
_______________________________
Anti-infective preparations
Chloramphenicol
Indications: bacterial infection in otitis externa
Medicine: Chloramphenicol (Non-proprietary) eardrops
_______________________________
Clioquinol
Indications: mild bacterial or fungal infections in otitis externa (see also page 49, fungal)
Medicine: Locorten-vioform drops
_______________________________
Clotrimazole
Indications: fungal infections in otitis externa (also see page 49 for fungal disease)
Medicine: Canesten®(Baypharm) solution
_______________________________
Framycetin sulphate
Medicine: Sofradex®(see under dexamethasone)
_______________________________
Gentamicin
Medicine: Cidomycin®(Hoechst Marion Roussel), Garamycin®(Schering-Plough),
Genticin drops (for ear & eye)
_______________________________
Neomycin sulphate
Medicine: Audicort, Betasol, Otosporin® (neomycin + polymyxin sulphate +
hydrocortisone) ear drops
_______________________________
Otitis media, (Removal of ear wax)
Medicine: Almond oil, Olvie oil, Cerumol, Exterol, Otex, Waxsol®(docusate sodium),
(Norgine) ear drops
_______________________________
Drugs acting on the nose
Antihistamine
Azelastine hydrochloride
Indications: allergic rhinitis
Medicine: Rhinolast®(ASTA Medica) aqueous nasal spray
_______________________________
Levocabastine
Indications: treatment of allergic rhinitis
64
Medicine: Livostin®(Ciba Vision) nasal spray
_______________________________
Corticosteriods
Beclomethasone dipropionate
Indications: prophylaxis & treatment of allergic & vasomotor rhinitis
Medicine: Beconase®(A&H) nasal spray
_______________________________
Betamethasone sodium phosphate
Indications: non-infected inflammatory conditions of nose
Medicine: Vista-Methasone®(Martinadale), Betnesol
_______________________________
Budesonide
Indications: prophylaxis & treatment of allergic & vasomotor rhinitis, nasal polyps
(mucus membran)
Medicine: Rhinocort Aqua®(Astra) nasal spray
_______________________________
Dexamethasone isonicotinate
Indications: treatment of allergic rhinitis
Medicine: Dexa-Rhinaspray Duo®(Boehringer Ingelheim) nasal spray
_______________________________
Flunisolide
Indications: prophylaxis & treatment of allergic rhinitis
Medicine: Syntaris®(Roche) nasal spray
_______________________________
Medicine: Flixonase®(A&H) nasal spray
_______________________________
Mometasone furoate
Medicine: Nasonex®(Schering-Plough) nasal spray
_______________________________
Nedocromil sodium
Indications: prophylaxis & treatment of seasonal allergic rhinitis
Medicine: Tilarin®(Fisons) aqueous nasal spray
_______________________________
Sodium cromoglycate
Indications: prophylaxis of allergic rhinitis
Medicine: Rynacrom®(Fisons), Vividrin®(Pharma-Global) nasal spray
_______________________________
Topical nasal decongestants
Indications: nasal decongestion
Medicine: Ephedrine nasal drops
_______________________________
Xylometazoline hydrochloride
Indications: nasal congestion
Medicine: Fenox®(phenylephedrine, xylometazoline), Dristan®, & Otrivine® nasal spray
_______________________________
Ipratropium bromide
Indications: rhinorrhoea associated with allergic & non-allergic rhinitis
Medicine: Rinatec®(Boehringer Ingelheim) nasal spray
65
_______________________________
Epistaxis(bleeding from nose)
(Epistaxis has several reasons: high blood pressure, acute rhinitis, haemophilia, leukemia)
Bismuth subnitrate & iodoform
Indications: packing cavities after ear, nose or oropharyngeal
Medicine: Oxbipp®, Oxbipp-G® paste
_______________________________
Drugs for oral ulceration & inflammation
Benzydamine hydrochloride
Indications: painful inflammatory conditions of oropharynx
Medicine: Difflam®(3M) oral rinse
_______________________________
Carbenoxolone sodium
Indications: mild oral & perioral (out side of mouth like lips) lesions (injury or sore)
Medicine: Bioral®(Merck Consumer Health) gel, Bioplex®(Cortecs) mouthwash
_______________________________
Carmellose sodium
Indications: mechanical protection of oral & perioral lesions
Medicine: Orabase®(ConvaTec) oral paste, Orahesive®(ConvaTec) powder
_______________________________
Corticosteriods
Indications: oral & perioral lesions
Medicine: Adcortyl in orabase®(Squibb), Corlan®(Medeva) oral paste
_______________________________
Salicylates
Indications: mild oral & perioral lesions
Medicine: Choline Salicylate dental gel, (with salicylic Acid "Pyralvex®(Norgine)" oral
paste
_______________________________
Tetracycline
Indications: severe recurrent aphthous ulceration; oral herpes
Medicine: Anbesol® (cetrimide), Bioral gel® (carbenoxolone), Bonjela gel® (choline
salicylate), Bonjela pastilles® (aminacrine, lignocaine), Oragard® (cetylpyridinium,
lignocaine)
_______________________________
Oropharyngeal anti-infective drugs: Fungal infections
Amphotericin
Indications: oral perioral fungal infections
Medicine: Fungilin®(Squibb) lozenges, oral suspension
_______________________________
Miconazole
Indications: oral perioral fungal infections, intestinal fungal infections
Medicine: Daktarin®(Janssen-Cilag) oral gel, Dumicoate®(Dumex) denture lacquer
_______________________________
Nystatin
Indications: oral & perioral fungal infections
Medicine: Nystan®(Squibb) pastilles, oral suspension (100000units/ml)
_______________________________
Viral infections: (Mouthwashes, gargles, & dentifrices)
Cetylpyridinium chloride
Indications: oral hygiene
Medicine: MerocetSeton mouthwash
66
_______________________________
Chlorhexidine glucoanate
Indications: oral hygiene; plaque inhibition
Medicine: Chlorohex®(Colgate-Palmolive), Corsodyl®(Beecham) dental gel, & Eludril®
mouthwash
_______________________________
Hexetidine
Medicine: Oraldene®(Warner Lambert) mouthwash
_______________________________
Oxidising agents
Medicine: Hydrogen Peroxide mouthwash, Peroxyl®(Colgate-Palmolive),
Bocasan®(Oral B Labs) mouthwash
_______________________________
Povidone-iodine
Medicine: Betadine®(Seton) mouthwash
_______________________________
Sodium chloride
Medicine: Sodium chloride (salt) mouthwash
_______________________________
Thymol
Medicine: Compound Thymol glycerin
_______________________________
Pilocarpine hydrochloride
Indications: treatment of dry mouth, salivary gland hypofunction
Medicine: Salagen®(Chiron) 5mg tablets
*******************************
Chapter 9 ( Central nervous system )
Hypnotics
Benzodiazepines
Nitrazepam
Indications: insomnia (short-term use)
Medicine: Nitrazepam (Non-proprietary) 5mg, Mogadon®(Roche) tablets & oral susp
_______________________________
Flunitrazepam
Medicine: Rohypnol®(Roche) 1mg tablets
_______________________________
Flurazepam
Medicine: Dalmane®(Roche) 15mg capsules
_______________________________
Loprazolam
67
Medicine: Dormonoct®(Hoechst Marion Roussel) 1mg tablets
_______________________________
Lormetazepam
Medicine: Lormetazepam (Non-proprietary) 500mcg tablets
_______________________________
Temazepam
Medicine: Temazepam (Non-proprietary) gel filled cap, tab & oral solution
_______________________________
Zolpidem tartrate
Medicine: Stilnoct®(Lorex) 5mg tablets
_______________________________
Zopiclone
Medicine: Zimovane®(Rhone-Poulenc-Rorer) 3.75/7.5mg tablets
_______________________________
Chloral hydrate 
Medicine: Chloral mixture, Welldorm®(S&N Health) tablets
_______________________________
Triclofos sodium
Indications: insomnia (short-term use) can be used in children in sleeplessness cautiously
Medicine: Triclofos (Non-proprietary) 500mcg/5ml oral suspension, Tricloryl® syrup,
_______________________________
Chlormethiazole
Indications: insomnia (short-term use), restlessness & agitation, alcohol withdrawal
Medicine: Heminevrin®(Astra) 192mg capsules & syrup
_______________________________
Drugs used in nausea & vertigo
Voming of pregnancy: nausea in the first trimester of pregnancy does not require drug therapy. On rare
occasions if vomiting is severe, an antihistamine or a phenothiazine (e.g. promethazine (Phenorgan®) may
be required. If symptomes have not settled in 24 to 48 hours then a specialist opinion should be sought.
(Sees page 71)
Anti-histamine
Indications: night sedation & insomnia (short-term), (for more detail sees page 71)
Medicine: Phenergon®(Rhone-Poulenc-Rorer) syrup
_______________________________
Anxiolytics
Diazepam
Indications: (short-term) use in anxiety or insomnia, adjunct in acute alcohol withdrawal;
status epilepticus; febrile convulsions; muscle spasm; peri-operative use
Medicine: Diazepam (Non-proprietary), Rimapam, Valium®(Roche) 2mg tablets oral
suspension, injection, & suppositories
_______________________________
Alprazolam
Indications: anxiety (short-term use)
Medicine: Xanax®(Pharmacia & Upjohn) 250mcg tablets
_______________________________
Bromazepam
68
Medicine: Lexoten®(Roche), Lexotenal®(Roche) 3/6mg tablets
_______________________________
Chlordiazepoxide
Indications: anxiety, insomnia (short-term use)
Medicine: Librium®() 5/10/25mg tablets, Chlordiazepoxide hydrochloride (Non-
proprietary) 5mg tablets
_______________________________
Clorazepate dipotassium
Medicine: Tranxene®(Boehringer Ingelheim) 7.5/15mg capsules
_______________________________
Lorazepam
Indications: (short-term) use in anxiety or insomnia status epilepticus; peri-operative
Medicine: Lorazepam (Non-proprietary), Ativan®(Wyeth) 1/2.5mg tablets & injection
_______________________________
Oxazepam
Medicine: Oxazepam (Non-proprietary) 10mg tablets
_______________________________
Buspirone hydrochloride
Medicine: Buspar®(Bristol-Myers) 5mg tablets
_______________________________
Beta-blockers
Meprobamate 
Medicine: Meprobamate (Non-proprietary), Equagesic 400mg tablets
_______________________________
Barbiturates
Indications: severe intractable insomnia only in patients already taking barbiturates, very
effective hypnotics, therefore carelessness is dangerous
Medicine: Amytal®(Flynn), Soneryl®(Concord) 200mg tablets, & injection
_______________________________
Antipsychotic drugs
Chlorpromazine hydrochloride (Largactil®)
Indications: schizophrenia, & other psychoses, mania (short-term), antiemetic in
palliative care
Medicine: Largactil®(Rhone-Poulenc-Rorer) 10/20mg tablets suspension & injection
_______________________________
Droperidol
Indications: tranquillization & emergency control in mania
Medicine: Droleptan®(Janssen-Cilag) 10g tablets & injection
_______________________________
Benperidol
Indications: control of deviant antisocial sexual behavior
Medicine: Anquil®(Janssen-Cilag) 250mcg tablets
_______________________________
Flupenthixol
Indications: schizophrenia & other psychoses, particularly with apathy & withdrawal but
not mania or psychomotor hyperactivity; depression
Medicine: Depixol®(Lundbeck) 3mg tablets & injection
69
_______________________________
Fluphenazine hydrochloride
Indications: schizophrenia, & other psychoses, & mania (short-term)
Medicine: Moditen®(Sanofi Winthrop) 1mg tablets
_______________________________
Haloperidol
Indications: schizophrenia & other psychoses, mania, (short-term) adjunct management
of psychomotor agitation, excitement, & violent or dangerously impulsive behavior
Medicine: Dozic®(Rosmount), Haldol®(Janssen-Cilag), Serenace®(Baker Norton)
1.5/3/5mg tablets, suspension, & injection
_______________________________
Loxapine
Indications: acute & chronic psychoses
Medicine: Loxapac®(Lederle) 10mg capsules
_______________________________
Methotrimeprazine
Indications: schizophrenia
Medicine: Nozinan®(Link) 25mg tablets & injection
_______________________________
Oxypertine
Medicine: Oxypertine®(Sanofi Winthrop) 10mg capsules
_______________________________
Pericyazine
Medicine: Neulactil®(JHC) 2.5mg tablets & injection
_______________________________
Perphenazine
Medicine: Fentazin®(Goldshield) 2mg tablets
_______________________________
Pimozide
Medicine: Orap®(Janssen-Cilag) 2mg tablets
_______________________________
Promazine hydrochloride
Indications: night sedation, for insomnia, (short-term) adjunct management of
psychomotor agitation, restlessness
Medicine: Promazine (Non-proprietary) 25mg tablets oral solution
_______________________________
Prochlorperazine
Indications: schizophrenia & other psychoses, anti-emitic & for giddyness
Medicine: preparations, (Stemetil®)
_______________________________
Sulpiride
Medicine: Suparex®(Bristol-Myers), Sulpitil®(Pharmacia & Upjohn) 200mg tablets
_______________________________
Thioridazine (Melleril®)
70
Medicine: Melleril®(Novartis) 10mg tablets, suspension & injection
_______________________________
Trifluoperazine
Medicine: Stelazine®(Goldshield) 1mg tablets spansules & syrup
_______________________________
Zuclopenthixol acetate
Indications: (short-term) management of acute psychoses, mania, or exacerbations of
chronic psychosis
Medicine: Clopixol Acuphase®(Lundbeck) 50mg/ml oily injection
_______________________________
Zuclopenthixol dihydrochloride
Indications: schizophrenia & other psychoses, particularly when associated with agitated,
aggressive, or hostile behavior
Medicine: Clopixol®(Lundbeck) 2mg tablets & injection
_______________________________
Atypical antipsychotics
Amisulpride
Medicine: Solian®(Lorex) 50mg tablets
_______________________________
Clozapine
Indications: schizophrenia in patients unresponsive to, or intolerant of, conventional
antipsychotic drugs
Medicine: Clozaril®(Novartis) tab
_______________________________
Olanzapine
Medicine: Zyprexa®(Lilly) 2.5/5/7.5mg tablets
_______________________________
Quetiapine
Medicine: Seroquel®(Zeneca) 25mg tablets
_______________________________
Risperidone
Indications: acute & chronic psychoses
Medicine: Risperdal®(Janssen-Cilag, Organon) 1mg tablets
_______________________________
Sertindole
Medicine: Serdolect®(Lundbeck) 4mg tablets
_______________________________
Anti-psychotic depot injectios
Fluphenazine decanoate
Indications: maintenance in schizophrenia & other psychoses
Medicine: Modecate concentrate®(Sanofi Winthrop) 100mg/ml injection
_______________________________
Flupenthixol decanoate
Indications: mainenance in schizophrenia & other psychoses
71
Medicine: Depixol®(Lundbeck) 20mg injection
_______________________________
Haloperidol decanoate
Indications: maintenance in schizophrenia & other psychoses
Medicine: Haldol Decanoate®(Janssen-Cilag) 50mg injection
_______________________________
Pipothiazine palmitate
Indications: maintenence in schizophrenia & other psychoses
Medicine: Clopixol®(Lundbeck) 200mg injection
_______________________________
Anti-manic drugs
Lithium carbonate
Indications: treatment & prophylaxis of mania, manic-depressive illness, & recurrent
depression; aggressive or self-multilating behavior
Medicine: Liskonum®(SK&F), Priadel®(Del&ale) 200/400mg tablets
_______________________________
Lithium citrate
Indications: treatment & prophylaxis of mania, manic-depressive illness, & recurrent
depression; aggressive or self-multilating behavior
Medicine: Li-Liquid®(Rosemount) 509mg/5ml oral solution
_______________________________
Anti-depressants drugs
Amitriptyline hydrochloride
Indications: depressive illness, particularly where sedation is required; nocturnal enuresis
in children (for more detail also see page 78 for adult & children enuresis)
Medicine: Lentizol®(P-D), Tryptizol®(Morson), Triptafen®(Goldshield) 25mg tablets,
capsules & injection
_______________________________
Clomipramine hydrochloride (Anafranil®)
Indications: depressive illness, phobic (anxious) & obsessional (fascination, passion)
states; adjunctive treatment of cataplexy (trance) associated with narcolepsy(trance, sleep
Medicine: Anafranil®(Novartis) 10/25/75/150mg tablets syrup & injection
_______________________________
Dothiepin hydrochloride
in children, (for more detail also sees page 78 for adult & children enuresis)
Side effects: dry mouth, blurred vision, tremur, sweating, chills, headache, giddiness
Medicine: Prothiaden®(Knoll) 25/75mg tablets & capsules
_______________________________
Doxepin
(to do urine on bed at night) in children
Medicine: Sinequan®(Pfizer) 10mg capsules
_______________________________
Imipramine hydrochloride
Indications: depressive illness; nocturnal enuresis in children
Medicine: Tofranil®(Novartis) 10/25mg tablets & syrup
_______________________________
Lofepramine
Indications: depressive illness
Medicine: Gamanil®(Merck) 70mg tablets
_______________________________
72
Nortriptyline (Motival®)
Indications: depressive illness; nocturnal enuresis in children
Medicine: Allegron®(Dista), Motipress®(Sanofi Winthrop) 10mg tablets & motival
10mg tablets
_______________________________
Protriptyline hydrochloride
Indications: depressive illness, particularly with apathy & withdrawal
Medicine: Concordin®(MSD) 5mg tablets
_______________________________
Trimipramine
Medicine: Surmontil®(Futuna) 50mg capsules & tablets
_______________________________
Related antidepressants
Maprotiline hydrochloride
in children
Medicine: Ludiomil®(Novartis) 10mg tablets
_______________________________
Mianserin hydrochloride
Indications: depressive illness, particularly where sedation is required
Medicine: Mianserin (Non-proprietary) 10mg tablets
_______________________________
Mirtazapine
Medicine: Zispin®(Organon) 30mg tablets
_______________________________
Trazodone hydrochloride
Medicine: Molipaxin®(Hoechst Marion Roussel) 50mg capsules & tablets
_______________________________
Viloxazine hydrochloride
Medicine: Vivalan®(Zeneca) 50mg tablets
_______________________________
Monoamine-oxidase inhibitors(maois)
Phenelzine
Medicine: Nardil®(P-D) 15mg tablets
_______________________________
Isocarboxazid
Medicine: Isocarboxazid®(Cambridge) 10mg tablets
_______________________________
Tranylcypromine
Medicine: Parnate®(SK&F), Parstelin 10mg tablets
_______________________________
Moclobemide
Indications: major depression; social phobia (fear)
73
Medicine: Manerix®(Roche) 150mg tablets
_______________________________
SSRIs & related anti-depressants
Citalopram
Indications: depressive illness, panic (terror) disorder
Medicine: Cipramil®(Lundbeck, Du Pont) 10mg tablets
_______________________________
Fluoxetine
Indications: depressive illness, bulimia nervosa, obsessive-compulsive disorder, child not
recommended
Medicine: Prozac®(Dista) 20mg capsules
_______________________________
Fluvoxamine maleate
Indications: depressive illness, obsessive-compulsive disorder
Medicine: Faverin®(Solvay) 50/100mg tablets
_______________________________
Paroxetine
Indications: depressive illness, obsessive-compulsive disorder
Medicine: Seroxat®(Beecham) 20mg tablets
_______________________________
Sertraline
Medicine: Lustral®(Invicta) 50mg tablets
_______________________________
Nefazodone hydrochloride
Medicine: Dutonin®(Bristol-Myers) 100mg tablets
_______________________________
Venlafaxine
Indications: depressive ilness
Medicine: Efexor®(Wyeth), Efexor XL®(Wyeth) 37.5/75mg capsules & tablets
_______________________________
Flupenthixol
Indications: depressive illness, (short-term), for use in psychoses,
Medicine: Fluanxol®(Lundbeck) 1mg, 500mcg=0.5mg tablets
_______________________________
Reboxetine
Medicine: Edronax®(Pharmacia & Upjohn) 4mg tablets
_______________________________
Tryptophan
Indications: depressive illness, (specialist use only)
Medicine: Optimax®(Merck) 500mg tablets
_______________________________
Central nervous system stimulants
Dexamphetamine
Indications: narcolepsy, adjunct in the management of refractory hyperkinetic states in
children (under specialist supervision)
Medicine: Dexedrine®(Medeva) 5mg tablets
_______________________________
Methylphenidate hydrochloride
74
Indications: part of a comprehensive treatment programme for attention-deficit
hyperactivity disorder when measures alone prove insufficient (under specialist
supervision)
Medicine: Ritalin®(Novartis) 10mg tablets
_______________________________
Modafinil
Indications: narcolepsy
Medicine: Provigil®(Cephalon) 100mg tablets
_______________________________
Appetitie suppressants
Methylcellulose
Indications: adjunct in obesity (fatness)
Medicine: Celevac®(Monmouth) 500mg tablets
_______________________________
Phentermine 
Indications: not recommended
Medicine: Duromine®(3M), Ionamin®(Torbet) 15mg capsules
_______________________________
Drugs used in nausea & vetigo
Notes: the most effective drug for the prevention of motion sickness is Hyoscine.
Antihistamines are slightly less effective, but are generally better tolerated.
Antihistamine
Cinnarizine
Indications: vestibular disorders, such as vertio, tinnitus, nausea, vomityin meniere's
disease; motion sickness; vascular disease
Medicine: Stugeron®(Janssen-Cilag), Stugeron forte 15mg tablets
_______________________________
Cyclizine
Indications: nausea, vomiting, vertigo, motion sickness, & labyrinthine disorders
Medicine: Valoid®(GlaxoWelcome) 50mg tablets & injection
_______________________________
Dimenhydrinate
Medicine: Dramamine®(Searle) 50mg tablets
_______________________________
Meclozine hydrochloride
Indications: motion sickness
Medicine: preparations, a brand of sea-legs®
_______________________________
Medicine: Preparations, Phenergan®(Rhone-Poulenc-Rorer) 10mg syrup & tablets
_______________________________
Promethaine theoclate
Indications: nausea, vomiting, vertigo, & motion sickness, labyrinthine disorders (acts
longer then the hydrochloride)
Medicine: Avomine®(Manx) 25mg tablets
_______________________________
Chlorpromazine hydrochloride
Indications: nausea & vomiting of terminal illness (where other drugs have failed or are
not avialable)
75
_______________________________
Perphenazine
Indications: severe nausea, vomiting
_______________________________
Prochlorperazine
Indications: severe nausea, vomiting
Medicine: Stemetil®(Rhone-Poulenc-Rorer) 5mg, Buccastem®(R&C) 3mg tablets,
syrup, suppositories, & injection
_______________________________
Trifluoperazine
Indications: severe nausea & vomiting
_______________________________
Domperidone
Indications: acute nausea & vomiting, functional dyspepsia
Medicine: Motilium®(Sanofi Winthrop) 10mg tablets, suspension & suppository
_______________________________
Metoclopramide hydrochloride
Indications: adults, nausea & vomiting, particularly in gastro-intestinal disorders &
treatment with cytotoxics or radiotherapy; migraine
Caution: metoclopramide may casue some impotency (Namerdy) to male
Medicine: Primperan®(Synthelabo France), Maxolon®(Monmouth) 5mg, Gastromax
30mg, Maxolon SR 15mg tablets capsules syrup & injection
_______________________________
Granisetron
Indications: nausea & vomiting, post-operative
Medicine: Kytril®(Beecham) 1mg tablets paediatric liquid & sterile solution
_______________________________
Ondansetron
Indications: treatment of post-operative nausea & vomiting
Medicine: Zofran®(GlaxoWelcome) 8mg tablets syrup, injection & suppositories
_______________________________
Tropisetron
Indications: prevention & post-operative nausea & vomiting
Medicine: Navoban®(Novartis) 5mg capsules & injection
_______________________________
Nabilone
Medicine: Nabilone®(Cambridge) 1mg capsules
_______________________________
Hyoscine hydrobromide
(Scopolanine hydrobromide)
Indications: motion sickness
Medicine: Bascopan®(Novartis), Scopoderm tts 1mg patch
_______________________________
Bestahistine dihydrochloride
Indications: vertigo, tinnitus & hearing loss associated with meriere's disease
Medicine: Serc®(Solvay) 8mg tablets
_______________________________
Non-opioid analgesics
76
Aspirin (actylsalicylic acid), Paracetamol (acetaminophen), Ibuprofen, Nefopam
hydrochloride
_______________________________
Opioid analgesics (see detail of Opioid drugs on page#85)
Morphine salts
Indications: acute pulmonary oedema; peri-operative analgesia
Medicine: Oramorph®(Boehringer Ingelheim), Sevredol®(Napp), Morcap SR®(Sanofi
Winthrop), Mxl®(Napp), Zomorph, Morphine 10mg tablets, suspension & injection
_______________________________
Buprenorphine
Indications: moderate to severe pain; peri-operative analgesia, but as a side effect brings
vomiting, but may not make habit, more times efective than morphine
Medicine: Temgesic®(R&C) 200mcg tablets & injection
_______________________________
Codeine phosphat
Indications: mild to moderate pain
Medicine: Codafene Continus® 15mg tablets syrup & injection
_______________________________
Dextromoramide
Indications: severe pain
Medicine: Palfium®(Boehringer Mannheim) 5mg tablets & suppositories
_______________________________
Dextropropoxyphene hydrochloride
Indications: mild to moderate pain
Medicine: ingredient, of Doloxene®(Lilly) 65mg capsules
_______________________________
Diamorphine hydrochloride
(Heroin hydrochloride)
Indications: acute pulmonary oedema
Medicine: Diamorphine (Non-proprietary), Diagesil®(Berk) 10mg tablets & injection
_______________________________
Dihydrocodeine tartrate
Indications: moderate to severe pain
Medicine: DF 118 forte®(Napp), DHC continus®(Napp) 40mg tablets
_______________________________
Dipianone hydrochloride
Medicine: Diconal®(GlaxoWelcome) 10mg tablets
_______________________________
Fentanyl
Indications: chronic intractable pain due to cancer
Medicine: Durogesic®(Janssen-Cilag) 25mcg patches
_______________________________
Hydromorphone hydrochloride
Indications: severe pain in cancer
Medicine: Palladone®(Napp) 1.3mg tablets
_______________________________
Meptazinol
Indications: moderate to severe pain, including post-operative & obstetric pain & renal
colic; peri-operative analgesia
Medicine: Meptid®(Monmouth) 200mg tablets & injection
_______________________________
77
Methadone hydrochloride
Indications: severe pain, adjunct in treatment of opioid dependence
Medicine: Mathadone (Non-proprietary), Physeptone®(GlaxoWelcome) 5mg tablets
_______________________________
Nalbuphine hydrochloride
_______________________________
Pentazocine 
Medicine: Pentazocine (Non-proprietary) 50mg, Fortral®(Sanofi Winthrop), Sosegon®,
Fortagesic®(Sanofi Winthrop) 15mg tablets, injection, capsules & suppositories
_______________________________
Pethidine hydrochloride
Indications: moderate to severe pain, obstetric analgesia
Medicine: Pethidine (Non-proprietary), Pamergan P 100®(Martindale) 50mg tablets &
injection
_______________________________
Phenazocine hydrobromide
Indications: severe pain
Medicine: Narphen®(Napp) 5mg tablets
_______________________________
Tramadol hydrochloride
Medicine: Tramake Insts®(Galen), Zamadol®(ASTA Medica), Zydol®(Searle) 50mg
capsules, tablets & injection
_______________________________
Treatment of the acute Migraine attack
Ergotamine tartrate 
Indications: acute attacks of migraine & migraine variants unresposive to analgesia
Medicine: Cafergot®(Alliance), Lingraine®(Sanofi Winthrop), and Migril® (Glaxo
Welcome) 1/2/3mg tablets & aerosol inhhalation (oral)
_______________________________
Flunarizine
Indications: prophylaxis of classic (with aura) or common (without aura) migraine.
Symptomatic treatment of vestibular vertigo, due to a diagonesed functional disorder of
the vestibular system
Dosage: initial dose 10mg (atnight), younger than 65 years, & above 5mg only
Medicine: Sibelium®(Janssen-Cilag) 5mg capsules
_______________________________
Isometheptene mucate 
Indications: migraine attack
Medicine: Midrid®(Shire) 65mg capsules
_______________________________
Rizatriptan *(new addition)
Indications: for the acute treatment of migraine attacks
Medicine: Maxalt®(MSD) 5/10mg, Note: Maxalt® Melt wafers should be placed on the
tongue & allowed to dissolve; contain aspartame equivalent to phenylalnine 2.1mg
_______________________________
Naratriptan (Naramig®(GlaxoWelcome) 2.5mg tab
Sumatriptan (Imigran®(GlaxoWelcome) 50mg tablets
78
Tolfenabic acid (Clotam®(Cortecs) 200mg rapid tab
Zolmitriptan (Zomig®(Zeneca) 2.5mg tab
Indications: acute attack of migraine
_______________________________
Prophylaxis of migraine
Pizotifen
Indications: prevention of vascular headache including classical migraine, common
migraine, & cluster headache
Medicine: Sanomigran®(Novartis), Mosegar® (Novartis)
_______________________________
Clonidine hydrochloride
Indications: prevention of recurrent of migraine, vascular hadache, menopausal flushing,
& hypertension
Medicine: Dixarit®(Boehringer Ingelheim), Catapres
_______________________________
Methysergide 
Indications: prevention of severe recurrent of migraine & cluster headache in patients
who are refractory to other treatment & whose lives are seriously disrupted (important:
hospital supervision only)
Medicine: Deseril®(Alliance) 1mg tab
_______________________________
Antimuscarinic drugs used in Parkinsonism
Orphenadrine hydrochloride
Indications: Parkinsonism; drug-induced extra-pyramidal symptoms (but not tardive
dyskinesia)
Medicine: Biorphen®(Bioglan) 25mg, Disipal®(Yamanouchi) 50mg tablets
_______________________________
************************************
Chapter 10 (Obstetrics, Gynaecology, & Urinary-tract

Disorders)
Prostaglandins & oxytocics
Carboprost
79
Indications: postpartum haemorrhage due to uterine atony in-patients unresponsive to
ergometrine & oxytocin
Medicine: Hemabate® (Pharmacia & Upjohn)
_______________________________
Dinoprostone
Indications: Induction of labour
Medicine: Prepidil®(Pharmacia & Upjohn) cervical gel, Propess®-RS (Ferring)
passeries, Prostin E2® (Pharmacia & Upjohn) tablets (each have different method to use)
_______________________________
Dinoprost 
Indications: for induction of abortion, given by the extra-amniotic route, are the preferred
prostaglandins for the medical induction of late therapeutic abortion
Medicine: Prostin F2 alpha®(Pharmacia & Upjohn) 5mg intra-amniotic injection
(hospital only; rarely used, consult product literature)
_______________________________
Ergometrine maleate
Indications: prevention & treatment of haemorrhage, (bleeding due to incomplete
abortion can be controlled with ergometrine & oxytocin, given by intra-muscular)
Medicine: Ergometrine®(Alliance) tab & injection, (with oxytocin= Syntometrine®) by
I/M
_______________________________
Gemeprost
Indications: induction of abortion, (administered vaginally)
Medicine: Gemeprost®(Farillon) pessaries 1mg
_______________________________
Oxytocin
Indications: induction of labour for medical reasons or stimulation of labour in hypotonic
uterine inertia, (prevention of postpartum haemorrhage, after delivery of placenta),
incomplete, inevitable or missed abortion
Medicine: Syntocinon®(Alliance) 5units/ml injection
_______________________________
Preparations for vaginal atrophy
Oestrogens, topical
Indications: application of cream containing an oestrogen may be used on a (short-term)
basis to improve the quality of the vaginal epithelium in menopausal atrophic vaginitis
Medicine: Ortho Dienoestrol®(Janssen-Cilag), Ovestin®(Organon), Premarin®(Wyeth),
Tampovagan®(Co-Pharma), Vagifem®(Novo Nordisk), Estring Vaginal cream, pessaries
& tablets
_______________________________
Fungal infections
Indications: vaginal & vulval c&idiasis
Medicine: Clotrimazole®(clotrimazole), Canesten®(clotrimazole), Ecostatin®
(econazole), Femeron® (miconazole nitrate), Lomexin® (fenticonazole nitrate), Nizoral®
(ketoconazle), Pevaryl® (econazole nitrate), Travogyn® (isoconazole nitrate vaginal
tablets) creams & pessaries
_______________________________
Contraceptives
Combined oral contraceptives
Combined oral contraceptives
Indications: contraception; menstrual symptoms
Dose: each tablets should be taken at approximately same time each day; if delayed by
longer than 12 hours contraceptive protection may be lost
80
Low strength
Loestrin 20 contains norethisterone acetate 1mg, ethinyloestradiol 20mcg
Mercilon®(Organon) contains desogestrel 150mcg, ethinyloestradiol 20mcg tablets
Standard strength
*(Ethinyloestradiol with levonorgestrel)
Eugynon 30®(Schering Health), Logynon®(Schering Health), Microgynon® 30,
(Schering Health) Ovran 30®( Schering Health), BiNovum®(Janssen-Cilag),
Brevinor®(Searle), Loestrin 30®(P-D), Norimin®(Searle), Synphase, Cilest®(Janssen-
Cilag), Femodene®( Schering Health), Minulet, Triadene
High strength
Ovran®(Searle), Norinyl-I, (ethinyloestradiol with levonorgestrel)
_______________________________
Oral progestogen-only contraceptives
(Progestogen-only pill, "POP")
Indications: contraception
Dose: 1 tablets daily at same time each day, starting on day 1 of cycle then continuously;
if administration delayed for 3 hours or more it should be regarded as a 'missed pill'
Medicine: Femulen® contains ethynodiol diacetate 500mcg tablets
Micronor® contains norethisterone 350mcg tablets
Microval® contains levonorgestrel 30mcg tablets
Norgeston® contains levonorgestrel 30mcg tablets
Noriday® contains norethisterone 350mcg tablets
Nesgest levonorgestrel 37 5mcg tablets tablets
_______________________________
Parenteral porgestogen-only contraceptives,(Injections)
Indications: contraception
Medicine: Depo-provera® contains medroxyprogesterone acetate 150mg, I/M injection
Noristerat contains norethisterone enanthate 200mg I/M, injection
Norplant Implant capsules contains levonorgestrel 38mg in each polydimethylsiloxane
(silicone) capsule
_______________________________
Drugs for Urinary Retention
Alfa-blockers
Alfuzosin hydrochloride
Indications: urinary retention, relax smooth muscle in benign prostatic hyperplasia
producing an increase in urinary flow-rate & an improvement in obstructive symptoms
Medicine: Xatral®(Lorex) & Xatral SR 2.5/5mg tablets
_______________________________
Doxazosin
Medicine: Cardura®(Invicta) 1mg tablets
_______________________________
Indoramin
Medicine: Doralese®(Bencard) 20mg tablets
_______________________________
Prazosin
81
Medicine: Hypovase®(Invicta) 500mcg tablets
_______________________________
Tamsulosin hydrochloride (Omnic®)
Indications: urinary retension, relax smooth muscle in benign prostatic hyperplasia
producing an increase in urinary flow-rate & an improvement in obstructive symptoms,
Medicine: Flomax MR®(Yamanouchi) 400mcg capsule, Omnic®(Yamanouchi)
0.4gm=400mcg tab
_______________________________
Terazosin
Indications: chronic urinary retention, relax smooth muscle n benign prostatic hyperplasia
producing an increase in urinary flow-rate& an improvement in obstructive symptoms
Medicine: Hytrin®(Abbott) BPH 2mg tablets
_______________________________
Parasympathomimetics
Bethanechol chloride 
Indications: urinary retention
Medicine: Myotonine®(Glenwood) 10mg tablets 
_______________________________
Carbachol 
Indications: urinary retention
Medicine: Carbachol (Non-proprietary) 2mg tablets
_______________________________
Distigmine bromide
Indications: urinary retention, myasthenia gravis
Medicine: Ubretid®(Rhone-Poulenc-Rorer) 5mg tablets
_______________________________
Urinary frequency & incontinence
(Those adult & children who has habite of urining on bed, & have no control at sleeping)
Flavoxate hydrochloride
Indications: urinary frequency & incontinence, dysuria, urgency (seriousness); bladder
spasms due to catheterisation
Medicine: Urispas 200®(Shire) 200mg tablets
_______________________________
Oxybutynin hydrochloride
Indications: urinary frequency, urgency & incontinence, neurogenic bladder instability &
nocturnal enuresis
Medicine: Cystrin®(Lorex) 3mg, Ditropan®(Lorex) 2.5mg tablets & elexir
_______________________________
Propantheline bromide
Indications: adult enuresis
_______________________________
Tolterodine tartrate
Indications: urinary frequency, urgency & incontinence
Medicine: Detrusitol®(Pharmacia & Upjohn) 1mg tablets
_______________________________
Drugs used in urological pain
Alkalinisation of urine
Potassium citrate
Indications: relief of discomfort in mild urinary-tract infections; alkalinisation of urine
Medicine: Potassium citrate mixture (BP),
_______________________________
82
Sodium bicarbonate
Indications: relief of discomfort in mild urinary-tract infections; alkalinisation of urine
_______________________________
Sodium citrate
Indications: relief of discomfort in mild urinary-tract infections
Medicine: Cymalon®(Seton), Cystemune®(Abbott), Cystoleve sachet & tablets
_______________________________
Other preparations for urinary disorders
Medicine: Rowatinex capsules
Indications: is claimed to of benefit in urolithiasis for the expulsion of calculi (stone)
**************************************
83
Chapter 11 ( Eye )
Antibacterials
Chloramphenicol
Indications: is a broad spectrum antiboitic, & is the drug of choice for superficial eye
infections
Medicine: Chloromycetin®(Goldshield) ophthalmic ointment, Sno Phenicol®(Chauvin)
eye drops
_______________________________
Chlortetracycline
Indications: local treatment of infections, including trachoma
Medicine: Aureomycin®(Lederle) ophthalmic ointment
_______________________________
Ciprofloxacin
Indications: superficial bacterial infections
Medicine: Ciloxan®(Alcon) ophthalmic solution
_______________________________
Framycetin sulphate
Medicine: Soframycin®(Florizel) eye drops & ointment
_______________________________
Fusidic acid
Medicine: Fucithalmic®(Leo) eye drops & oint
_______________________________
Gentamicin
Medicine: Garamycin®(Schering-Plough), Cidomycin®(Hoechst Marion Roussel), &
Genticin®(Roche) drops (for ear & eye)
_______________________________
Neomycin sulphate
Medicine: Neosporin®(Dominion) eye drops
_______________________________
Ofloxacin
Medicine: Exocin®(Allergan) ophthalmic solution (eye drops)
_______________________________
Polymyxin B sulphate
Medicine: Polyfax®(Dominion), Polytrim eye drops & ointment
_______________________________
Propamidine isethionate
Indications: local treatment for infections
Medicine: Brolene®(Rhone-Poulenc-Rorer), eye drops & oint
_______________________________
Antifungals(antivirals)
Aciclovir
(Acyclovir)
Indications: local treatment of herpes simplex infections
84
Medicine: Zovirax®(GlaxoWelcome) eye ointment, tablets & injection
_______________________________
Corticosteroids
Betamethasone
Indications: local treatment of inflammation (short-term)
Medicine: Betnesol®(Medeva), Betnesol-N®(Medeva) drops (for ear, eye or nose)
_______________________________
Clobetasone butyrate
Medicine: Cloburate®(Dominion) eye drops
_______________________________
Dexamethasone
Medicine: Maxidex®(Alcon), Maxitrol, Sofradex®(Florizel) drops & ointment for (ear or
eye)
_______________________________
Fluorometholone
Medicine: FML®(Allergon) ophthalmic suspension (=eye drops), FML-Neo eye drops
_______________________________
Hydrocortisone acetate
Medicine: Neo-Cortef®(Dominion) drops & ointment (for ear or eye)
_______________________________
Prednisolone
Medicine: Pred forte®(Allergan), Predsol®(Medeva), Predsol-N drops (for ear & eye)
_______________________________
Other anti-inflammatory preparations
Antazoline
Indications: alldergic conjuncitivitis
Medicine: Otrivine-antistin®(CIBA Vision) eye drops
_______________________________
Azelastine hydrochloride
Indications: seasonal allergic conjunctivitis
Medicine: Optilast®(ASTA Medica) eye drops
_______________________________
Levocabastine
Indications: seasonal allergic conjuntivitis
Medicine: Livostin®(CIBA Vision) eye drops
_______________________________
Lodoxamid
Indications: allergic conjunctivitis
Medicine: Alomide®(Alcon) ophthalmic solution (=eye drops)
_______________________________
Nedocromil sodium
Medicine: Rapitil®(Fisons) eye drops
_______________________________
Sodium cromoglycate
85
Medicine: Hay-Crom®(Norton) Aqueous, Vizon®(Global-Pharma), & Vivdrin eye drops
& eye ointment
_______________________________
Mydriatics & cycloplegics
Antimuscarinics
Atropine sulphate
Indications: refraction procedures in young children
Medicine: Isopto Atropine®(Alcon) eyes drops
_______________________________
Cyclopentolate hydrochloride (Mydrilate®(boehringer ingelheim) eye drops
Homatropine hydrobromide (minims® Homatropine hydrobromide) eye drops
Tropicamide (Mydriacyl®(Alcon) eye drops
Indications: refraction procedures in young children
_______________________________
Sympathomimetics
Phenylephrine hydrochloride
Indications: mydriasis
Medicine: Minims®(Chauvin) phenylephrine hydrochloride eye drops
_______________________________
Treatment of glaucoma
Carbachol (Isopto carbachol®) eye drops, Pilocarpine (Isopto carine®, ocusert®,
pilogel) eye drops, Adrenaline (Eppy, simplene®) eye drops, Brimonidine tartrate
(Alphagan®) eye drops, Dipivefrine hydrochloride (Propine®) eye drops,
Guanethidinemonosulphate (Ganda®) eye drops
_______________________________
Beta-blockers
Betaxolol Hydrochloride (Betoptic® Eye Drops), Carteolol Hydrochloride (Teoptic®)
eye drops, Levobunolol Hydrochloride (Betagan®) eye drops, Metipranolol (Minims
Metipranolol®) eye drops, Timolol Maleate (Timoptol®) tablets & capsules
Acetazolamide (Diamox®) eye drops, Dorzolamide (Trusopt®) eye drops, Latanoprost
(Xalatan®) eye drops
_______________________________
Local Anaesthetics
Amethocaine Hydrochloride (Minims®Amethocaine Hydrochloride) eye drops
Lignocaine Hydrochloride (Minims® Lignocaine Hydrochloride) eye drops
Oxybuprocaine Hydrochloride (Minims® Benoxinate (Oxybuprocaine) Hydrochloride)
Proxymetacaine Hydrochloride (Ophthaine®) eye drops
_______________________________
Tear deficiency, ocular lubricants & astringents
Acetylcysteine
Indications: tear deficiency, impaired or abnormal mucus production
Medicine: Illube®(Alcon) eye drops
_______________________________
Carbomers
(Polyacrylic acid)
Indications: dry eyes including keratoconjunctivitis sicca, unstable tear film
Medicine: GelTear®(Ciba Vision), viscotears eye drops
_______________________________
Hydroxyethylcellulose (Minims® Artificial Tears) eye drops, Hypromellose (Isopto
Alkaline, Isopto Plain, & Isopto Frin) eye drops, Liquid Paraffin (Lubri-Tears, Lacri-
Lube) eye ointment, Paraffin, Yellow, Soft (Simple Eye Ointment)
86
Polyvinyl Alcohol (Hypotears, Liquifilm Tears) eye drops, Sodium Chloride (Minims®
Sodium Chloride eye drops)
Indications: irrigation, including first-aid removal of harmful substance; intravenous
infusion-ocular or topical irrigation during surgical procedures
Zinc Sulphate (Zinc Sulphate) eye drops
Indications: tear deficiency
_______________________________
Ocular diagnostic & peri-operative preparations
Fluorescein Sodium (Minims®Fluorescien Sodium)
Indications: Detection & Foreign Bodies
Rose Bengal (Minims®Rose Bengal)
Indications: Detection & Foreign Bodies
Acetylcholine Chloride (Miochol) Apraclonidine (Iopidine®) Diclofenac Sodium
(Votarol® Ophtha) Flurbiprofen Sodium (Ocufen®) Ketorolac Trometamol (Acular®)
_______________________________
Treatment of guidelines, (Examples of permitted & prohibited substances)
Disease Allowed Banned
Asthma Sodium cromoglycate, Products containing
theophylline, salbutamol, sympathomimetics eg
terbutaline, salmeterol, Ephedrine, isoprenaline,
beclomethasone, fluticasone, fenoterol, rimiterol,
(by inhalation only & written orciprenaline
notification of administration
should be given to relevant
medical authority)
Cold/Cough All antibiotics, steam & Products containing
menthol inhalations, permitted sympathomimetics eg
antihistamines, terfenadine, Ephedrine, pseudoepheedrine,
astemizole, pholcodine, phenylpropanolamine
guaiphenesin,
dextromethorphan,
paracetamol
Diarrhoea Diphenoxylate, loperamide, Products containing opioids eg
products containing electrolytes Morphine
(eg Dioralyte, Rehidrat)
Hay fever Antihistamines, nasal sprays Products containing ephedrine,
containinga corticosteriod or pseudoephedrine
xylometazoline, eyedrops
containing sodium
cromoglycate
Pain Aspirin, codeine, Products containing opioids,
dihydrocodeine, ibuprofen, caffeine
paracetamol, all non-steroidal
anti-inflammatories,
dextropropoxyphene
Vomiting Doperidone, metoclopramide
_______________________________
_______________________________
LATIN ABBREVIATIONS
a.c =ante cibum (before food)
87
b.d =bis die (twice daily)
o.d =omni die (daily)
o.m =omni mane (in the morning)
o.n =omni nocte(at night)
p.c =post cibum(after food)
p.r.n =pro re nata(when required)
q.d.s =quarter die sumendus(four times daily)
q.q.h =quarta quaque hora(every four hours)
stat =immediately
t.d.s =ter die sumendus(three times daily)
_______________________________
BACTERIOLOGY
Bacteria are of various shapes: Cocci, Bacilli, Vibrios, Spirilla, Actinomycosis & Virus,
which are mentioned below in detail.
BACTERIOLOGY
Germ's Name Typ Illness Antibiotics
Staphylococcus Aureus G+ Boils(skin disease) Penicillin more usefull than
sulha drugs
Strptococcus G+ Stomatitis, scorlet fever, (Sulphonamide)Sulfa drugs &
rheumatism, Erysipelas(skin) penicillin both useful
Pneumococcus G+ Pneumonia, meningitis Penicillin streptomycin, sulfa
(sarsam), & continuous puss drugs (sulphonamid), sigmamycin,
of ear kanacilin, erythromycin,
lincomycin, chloramphenicol
Neisseria Gonorrhoea G- Gonorrhoea(sozak) Penicillin(augmentin), sulpha
Meningococcus G- Meningitis(sersam) Penicillin, sulfa drugs
(sulfadiazine, sulphadimidine)
Salmonella Typhi G- Typhoid fever, Chloramphenicol the best drug
Shigella (4 types) shigella G- Bacillury dysentry (khuni (Sulfaguanidin+Terramycin) or
shigee, s.flaxis, s.soniae paichus) (Neomycin+ Streptopenicillin)
Friedlander's Bacillus G- Respiratory-tract infections, (Streptomycin the best), but
pneumonia penicillin & sulfa uneffetive
Proteus Vulgaris G- Cystitis(warrame masaana) Streptomycin the best, septran
also well(uneffective penicillin
Pastearella Pestis G- Plague(Taa'oon) Sulpha drugs, & streptomycin
Brucella Abortus G- Malta fever(andriolent fever) (Streptomycin+sulfa)or septren
Heamophelus Influenza G- Infuenza, pneumonia, Rather less effective penicillin
bronchititis &sulfa(treatment with
streptomycin) or septren or all
Heamophelus.Pertussis G- Whooping cough (kali kansi) Chloramphenicol,streptomycin
& terramycin usefull, but
penicillin is useless
Corynebacterium G+ Diphtheria(khunnaq) Streptopenicillin (streptomycin
Diphtheria + procaine penicillin) best vial
Mycobacterium T B G+ T.B (tuberculosis), leprosy Streptomycin, either use 3 or 4
antiboitics at onetime
Leprosy G+ Skin T.B, Streptomycin, or INH tablets
Vibrio Cholera G- Cholera Furaxone can kill these gerns,
chlorostrep, (but Selin is useful
Glander's Bacillus G- Neck glands enlargment, Septrin (trimethoprim +
(fatal disease) sulphamethaxazole)
Actinomyces Bovis G+ (Actinomyces) mouth skin Sulpha + streptopenicillin, or
funga boils(yellow color puss) jaws septren
Bacillus Anthrax G+ Skin disease(boils) Penicillin,sulfa,(septren is best
Clostridium G+ Tetanus, gas gangrien, food Penicillin, sulfa drugs, & other
poisoning antibiotics or serum
Pseudomonas Pyocyanea G- Boils,diarrhoea,ear puss, Penicillin+septrin more useless
, (only streptomycin &
88
kanamycin usefull)
Lactobacillus G+ Usefull germs for digestion Usefull germ & perment milk
(no cause disease) to curd, kill germs in intestine
Spirochaeta Pallida Proto Syphisil(Atashk) leuchorhea, Penicillin, Flagyl also useful,
zon Relapsing fever, vincent's but oxytetracycline is the best
angina (stomatitis)
Richettsia G- Typhus, trench & Q fever Treat with Chloramphenicol,
(v+b) tetracycline,(penicillin useless)
Virus (Protozon) Proto Jaundice, small fox(chichak), Try different kinds of
zon chicken fox, messle, mumps, antibiotics, & antiviral drugs
Yellow fever, Sand Fly fever (Viralzole or sulpha (septrin)
E.Histolytica (Protozon Proto Ameobic dysentry & Flagyl (metronidazole)
Germ) Not Bacteria zon ameobic absess (liver)
Trypanosoma (Protozon) Prot Sleeping sickness Amphotericin B
Leishmania (Protozon) Proto Oriental sore (kalazaar), Amphotericin B
zon Leishmaniasis
Plasmodium (Virus) Proto Malaria (4 kinds) Quinine, fansidar, chloroquine,
zon basoquine
Filaria Bancrafti Nema Filariasis (Lymph glands Diethylcarbemazine
(Nematoda group) toda enlargment) (Hetrazan® or Banocide®)
Bilharziasis (Trematoda) Trem Diarrhea, Cystitis, & RBC in Stibophen or Stibatin injection
atoda urine & stool
Tularaenas Proto Tularaemia (Fever, neck Streptomycin + Sulphadiazine
zon glands' enlargment) + Terramycin(oxytetracycline)
Toxoplasma Proto Abortion of pregnance, or Terramycin + Septran
zon died in pregnancy,
Coccidiosis Protoz Boils, Bacillary dysentry, Amphotericin-B, Nystatin
on & fever
Fungal
Skeletal system
*Skull bones (8 big bones of skull)
Frontal bone : bone of eyebrow (forearm)
Parietal bone : bone adjunct to skull, & also attached to frontal bone
Temporal bone : bone connected with both side of ears, & cannot move
Occipital bone : bone back of skull
Sphenoid bone : bone beneath of skull
Ethmoid bone : bone back of nose
_______________________________
*Bones of Face (14 bones)
Zygomatic consist on eye bones, projected area of check beside eyes & ears near face
Maxillac consist on two bones make upper jaws, hard surface of upper jaws (palate)
Nasal Bones consist of two thin bones make the arch (bridge) of nose
Lachrymal consist of two small bones make the inside orbit walls of eyes, & inside
this a cave goes to nose, the water of eyes go to nose on this way, when
blocks then water fall on checks
Vomer this ventricle bone goes through palate into nose, & divides the nasal
cavity in two portions, & attaches with ethmoid bone
Palatine Details are not mentioned
Inferior Conchae(Turbinate): these bones make the projected side of nose
Mandible this makes the lower jaw, which can move
Sinus there are some sinus in the bones of head & face, which all opens in
nose, & due to this pressure of bones reduce, & make in voice
resonance
_______________________________
*Shoulder girdle & upper limb
Clavicle 1 bone of shoulder
Scapula 1 bone of shoulder also
Humerus 1 bone of arm beside shoulder
Ulna 1 consists of two parallel bones, one is Ulna & other is Radius
Radius 1 (see notes of Ulna above
Carple 8 bones of wrist (8 bones)
89
Meta carpel 5 bones of hand
Palanges 14 bones of finger (one finger divided in three portions)
_______________________________
*Pelvic girdle & legs
Pelvic bones of buttocks (pelvic consist of 4 big bones)
Ischium 2 bones
Ilium 2 bones
Pubis 2 bones
Sacrum 1 bone
_______________________________
*Leg bones
Femur 1 bone of thigh
Tibia 1 thigh consist of two parallel bones, one is Tibia & other is fibula
Fibula 1 (see note of Tibia)
Patella 1 bone of knee (joint bone like ball)
Tarsal 8 bone of upper side of foot near attached to leg
Meta tarsals 5 bones of lower foot attached to finger of foot
Phalanges 14 bones of fingers of the foot
_______________________________
Opioid analgesics
Morphine is the opoiod of choice for the treatment of severe pain in pallative care, although it
frequently causes nausea & vomiting. Buprenorphine has both opioid agonist & antagonits
properties. It has a longer duration of action than morphine & sublingually is an effective
analgesic for 6 to 8 hours. Codieine is effectivce for the relief of mild to moderate pain but is too
constipating for long-term use. Dextromoramide is less sedating than morpnine & has a short
duration of action. Diphoxylate (in combination with atropine, as co-phenotrope) is used in acute
diarrhoea. Dipipanone used aline is less sedating than morphine but the only preparation
available contains an anti-emetic & is therefore not suitable for regular regimens in palliative
care. Dextropropoxyphene given alone is a very mild analgesic somewhat less potent than
codeine. Combinations of dextropropoxyphene with paracetamol (co-proxamol) or aspirin have
little more analgesic effect than paracetamol or aspirin alone. Diamorphine (heroine) is a
powerful opioid analgesic. It may cause less nasea & hypotension than morphine.
Dyhydrocodeine has an analgesic efficacy similar to that of codeine. The dose by mouth is
usually 30mg Qid. Alfentanil, fentanyl & remifentanil are used by injection for intra-operative
analgesia. Meptazinol is claimed to have a low incidence of respiratory depression. Methadone
is less sedating than morphine & acts for longer periods. In prolonged use, methadone should not
be administered more often than twice daily to avoid the risk of accumulation & opioid
overdosage.
Nalbuphine has a similar efficacy to that of morphine for pain relief, but may have fewer side
effects & less abuse potential. Oxycodone is used as the pectinate in suppositories for the control
of pain in palliative care. Papaveretum is (a mixture of 253 parts of morphine sulphate, 25 parts
of papaverine & 20 parts of codeine hydrochloride). It is used peri-operative. Pentazocine has
both agonist & antagonist properties & precipitates withdrawal symptomes, including pain in-
patients dependent on other opioids. By injection it is more potent than dihydrocodeine or
codeine. It is not recommended, & in particular, should be avoided after myocardial infarction as
it may increase pulmonoary & aortic blood pressure as well as cardiac work. Pethidine produces
prompt but short-lasting analgesia; it is less constipationg than morphine. It is not suitable for
severe continuing pain. It is used for analgesia in labour. Phenazocine is effective in severe pain
& can be administered sublingually if nausea & vomiting are a problem. Tramadol has been
recently introduced & is claimed to produce analgesia by two mechanisms; an opioid effect & an
enhancement of serotoninergic & adrenergic pathways.
There are also some other opioid drugs. Codeine (for cough), Dextromethorphan (for cough),
Noscophine (for cough), Ipumorphine (for anti-emetic), & Nelorphine (as anti-dote for opium)
_______________________________
90
Chapter 12 ( Laboratery Tests )
Various kinds of test

(HEMATOLOGY REPORT or CBC)#1
CBC Normal Range Reference
WBC or TLC 4000-11000 cmm (or) 4-11  appendix,
x103cmm. pneumonina,tonslitis, bonchitis,
fever
RBC M4.5-6.5/F3.8-5.8 mil/cmm  Enaemia
Hemoglobin M13-18/F12-16g/dl  Enaemia
Hematocrit M40-55/F37-47 %  heart failure & anoxemia(low
range)
MCV (Mean corpuscular 78-93 ft
valume)
MCH (Mean corpuscular A27-32/C24-30 pg
hemoglobin)
MCHC (Mean corpuscular 31-36g/dl
hemoglobin concentration)
Platelets 150-400 x103/cmm Usually helps in coagulating
blood/  low rang haemorhage
WBC-DIFFERENTIAL
Segments or Neutrophils or 40-75% Acute infections, tonslitis,
Polymorph appendix pneumonia, &80%
Bands 0-1%
Lymphocytes 20-45%  in T.B lymphocyte reaches to
40, & polymorph
Monocytes 2-10%
Eosinocytes 1-6%  reaches 6% if worms,
Rheumatic fever, asthma,urtica
Basophils 0-1%
E.S.R 1st hour M0-5/F0-7mm.  in TB, & rheumtism reaches
2nd hour M0-20/F0-20mm. above 100
Reticulocyte count 0.2-2
Prothrombine time 10-14 minutes When  Haemorrhage
Part Thrombine time
Bleeding time 2-10 minutes
Clotting time 5-11 minutes
Film of malaria
Abbrevation: =increase of normale range, =decrease of normal range

_______________________________
91
COMPLETE URINE ANALYSIS#2

Test of a normal person
Physical Examination Normal Range  &  can cause disease
Colour Yellow
Odour Light yellow
Reaction Ph5- 7 (Acidic)
Specific gravity 1.10 - 1.30
Chemical Examination
Glucose Nagetive  Diabetes coma/brain damage
Albumin Trace  Nephritis if positive
Portien Negligable trace
Blood Negativedd Renal colculus, nephritis
Ketone Negative  If increase cause Sugar
Nitrite Negative
Bilirubin Negative  Jaundice
Bilirubin Negative  Jaundice
Urates Chronic Nephritis
Urobilinogen Normal trace  Jaundice
Microscopical Examination
Pus Cells (A part of WBC) (0 - 3)/HPF  renal colculus or Cystitis
Red Cells (R.B.C) (0 - 3)/HPF  renal colculus or Cystitis
Epithelial Cells Few /HPF
Crystals Nil /HPF  may cause renal colculus
Casts Nil /HPF Nephritis
Ova (worm eggs) Nil
Protozoa (like trypanosoma, Nil Fungal germs if seen
Leishman, toxoplasma)
Yeast (fungal) like, candida Nil Fungal germs
albicans,
Trichomonas Nil
Bacteria Nil may diagnose bacterial infections in body
Note: Two kinds of urine, Acidic & Kari. The crystals of salty urine are below.
-The Kari urine has many salts & crystals, which is calcium carbonate, ammonium biurate, triple
phosphate, calcium phosphate & feathery triple phosphate.
-The main things which makes the urine salty & crystals are uric acid, calcium oxalate, Sistine,
amarfer urits, calcium hydrogen phosphate.
_______________________________
(SEMEN ANALYSIS)#3
Physical examination Normal Range Descriptions with N. range
Amount Normal 2.5-5ml(or)3cc-7cc Clotting Yes/now
Colour Normal opaque grayish or Reaction Alkaline or
yellowish white other
Semigelatinous & viscous Yes / No Odour Masty: Y/N
Liquefication with in 30min Yes/No
CYTOLOGIC
Crystals Presence / No R.B.C. Prese/Absen
Epitheial cells Presence / Absent Leucocytes (0-3)
SPERMATOZOA (below normal range of motility & sluggish are given of a patient)
Sperm count Normal: 60-200 million/ml Detail: Normal: 60 million or
MOTALITY in percent Initial 1hour 2hour 3hour more /ml or 150 or 200 million
Highly motile(movable) 65 65 65 per total entire ejaculation.
Minimal normal: 20-million/ ml
Sluggish (slow or dull) 5 5 5
or 125 million per total entire
Dead 30 30 30
92
ejaculation & sperm motilty
should be 75%.
_______________________________
(STOOL ANALYSIS)#4
Physical Examination Normal Description
Colour Brown
Consistency Hard
Odour Faecel
PROTOZOA (parasites)
E. Histoveg E. Hisoeyst E. Coliveg E. Colicyst G. G.
Lameliaveg Lameliacyst
T. Hominis C. Mesnili These are all fungal germs
HELMINTH
Acaris Enterobius Tri.tri Hook-Worm Strongyloids S.Mansoni
T.Saginata H.Nana
OTHERS
Pus cells (0 - 3) Bacillary dysentry, or dysentry exodate seen
Erythrocytes (0 - 3)
Blood Nil Bacillary dysentry if along pus cell seen
Undigested foods Nil If seen may cause Dyspepsia
Worms Nil
Mucus Nil
Ova (worm eggs) Nil If worms or its cysts may be seen, dyspepsia
_______________________________
(SPUTUM TEST)#5
Physical exam. Normal range Description
Colour White off
Odour Nil
Blood Nil Reveals TB or heart disease
Pus Nil  bronchitis
Microscopic exam.
Epithelial cells Trace
Pus cells Trace Reveals bronchitis
Bacteria Not seen
Ziell Neelsen Stain Nil (TB germs not seen) Reveals TB disease
Gram's Stain
_______________________________
(BLOOD CHEMISTRY)#6
Test Required Normal Range Informations

Blood Sugar Fasting 65-110 mg/dl Brain demage/ or diabetic coma if
increase 700mg/dl 
B. Sugar Post Pradium 80-140 mg/dl
Blood Sugar Random
KIDNEY FUCNTION TESTS
Urea 15-45 mg/100ml  cause kidney failure, Uraemia
Sodium 137-145 U/L  Nephritis
Chloride 96-5.0 m mol/L  Nephritis
Creatinine M0.5-1.2/F0.8-1.5 mg/dl  Nephritis,
LIVER FUNCTION TESTS
Alanine Amino M upto 42 U/L
93
Transferase (ALT) (F) upto 32 U/L
Alanine Amino M upto 37 U/L
Transerase (AST) (F) upto 32 U/L
Alkaline Phosphatase 100-290 U/L Jaundice & hyperparathyroidism
Gamma Glutamyl M 10-50 U/L
Transferase ( GT) (F)7-32 U/L
Total Bilirubin Upto 1mg/100ml
Direct Bilirubin Upto 0.25mg /100mg
Total Protein 6.2-8 g/dl
Albumin 3.8-5.4 g/dl
LIPID PROFILE
Cholesterol 140-270 mg/100ml
Triglycerides 70-170 mg/100ml
High-density Lipoprotein M  55mg/100ml
(HDL) (F) 65mg/100ml
Low-density Lipoprotein Upto 150 mg/100ml
(LDL)
Total Lipids 400-1000 mg/100ml
CARDIAC ENZYMES
Creatine Kinase (CK) Upto 195 U/L
Lactic Dehydrogernase Upto 195 U/L
(LDH)
Aspartate Amino (M) upto 37 U/L
Transferase (AST) (F) upto 31 U/L
OTHER ENSYMES
Acid phophatase Upto 220 U/L
Amylase
OTHER TESTS
Uric Acid (M) 3.0-7.0mg/100ml
(F) 2.5-6.0mg/100ml
Other Tests
S.G.P.T 5-40 U/L When both range  then disturb liver
S.G.O.T. 5-35 U/L funtion, & cause Jaundice
_______________________________
Some critical values of blood & plasma, which is considered dangerous when goes up () or
down () of its normal range. #7
Critical values Convensional low Convensional high
Carbon dixide (B.P.S) 10 Comlex interwuven 40 Comlex interwuven pattern
(mmol/L, or mEq/dl) pattern of acidosis, alkaosis, & of acidosis, alkaosis, & anoxemia
anoxemia
Phosphate(serum) 1mg/dl Seizure & Coma None/none
Potassium (s), mEq/L or   2.5 muscle weakness, 6.5mmol/L Cordiotoxicity
mmol/L paralysis, cardiac arrhythmi with arrhythmias
Prothrombin time None   40s Haemorrhage
Salicylate(s) None 700 or 5.07mmol/L
continuing untreated toxicity
B=blood, P=plasma, S=serum, aB=arterial blood
_______________________________
Some other necessery tests #9
Test Name Normal Range Description
Widal's test (blood test) Negative If positive(+) helps to diagnose Typhoid
W.R. Test (Wassermann) (N) Blood test If (+), helps to diagnose in Syphilis
Kahn Test (blood test) Negative For diagnoses of Syphilis
94
_______________________________
Chapter 13 (Nutrition and Blood)

Iron-defeciency anaemias
Oral iron
Ferrous sulphate
Indications: iron-defeciency anaemia
Medicine: Ferrus Sulphate oral solution (Non-proprietary), Feospan®(Medeva) capsules 150mg, Slow-
Fe®(novartis) 160mg tablets
_______________________________
Ferrous fumarate
Dose: prophylactic, 1 tablet daily; therapeutic, 1 tablet twice daily
Medicine: Fersamal®, Fersaday®(Goldsheild)
_______________________________
Ferrus gluconate
Medicine: Ferrous gluconate (Non-proprietary)
_______________________________
Polysaccharide-Iron Complex
Medicine: Niferex®, Niferex-150®(Tillomed)
_______________________________
Sodium Ironedetate
Medicine: Sytron®(Link) elixir 190mg 5ml
_______________________________
Iron & Folic acid
Indications: defeciency of iron and folic acid in pregnancy
Medicine: Fefol®, Ferrograd Folic®, Galfer FA®, Pregaday®, and Lexpec with Iron®
_______________________________
Parenteral iron
Iron Sorbitol
Medicine: Jectofer®(Astra) 50mg injection
_______________________________
Drugs used in megaloblastic anaemias
Hydroxocobalamin
Indications: pernicious anaemia and other mactocytic anaemia without neurlogical involvement, initially
0.25-1mg on alternate days for 1-2 weeks, tobacco amblyopia and Leger's optic atrophy
Medicine: Hydroxocobalamin (Non-proprietary) 1mg injection
_______________________________
Cyanocobalamin
95
Indications: vitamin-B12 deficiency of dietary origin
Medicine: Cyanocobalamin (Non-proprietary), Cytacon, and Cytamen® (Goldshield) 35mcg injection
_______________________________
Drugs used in hypoplastic, haemolytic, and renal anaemias
Nandrolone
Indications: aplastic anaemia, postmenopausal osteoporosis (see also Anabolic Steroids)
Medicine: Deca-Durabolin 100®(Organon) oily injection
_______________________________
Epoetin Alfa and Beta
(Recombinant human erythropoietins)
Indications: severe symptomatic anaemia of renal origin in adults with renal insufficiency not yet dialysis
(under specialist supervision)
Medicine: (Epoetin ALPA (Eprex®(Janssen-Cilag) 2000units, (Epoetin beta (Neo-Recormon ®(Roche)
500units vial (injection)
_______________________________
Desferrioxamine mesylate
(Deferoxamine Mesilate)
Indications: iron poisoning, emergency treatment of poisoning
_______________________________
Oral Sodium & Water
Sodium chloride
Indications: sodium depletion (reduction)
Medicine: Slow Sodium®(HK Pharma) 600mg tablet
_______________________________
Oral Rehydration Salts (ORS)
Indications: fluid and electrolyte loss in diarrhoea
Medicine: Diocalm Junior®(Seton) 350mg oral powder, Dioralyte®(Rhone-Poulenc-Rorer) effervescent
tablets, and Rehidrat® (Searle) oral poder
_______________________________
(Oral Bicarbonate) for chronic acidotic states such as uraemic acidosis or renal tubular acidosis. It may
also be used for to make the pH of urine alkaline, for use in dyspepsia
_______________________________
Intravenous Administration
Sodium chloride
Indications: electrolyte imbalance
Medicine: Sodium Chloride intravenous infusion, Sodium chloride & Glucose intravenous infusion,
Ringer's solution for injection
_______________________________
Glucose
(Dextrose Monohydrate)
Indications: fluid replacement, provision of energy
Medicine: Glucose intravenous infusion
_______________________________
Dextran 40
Indications: conditions associated with peripheral local slowing of the blood flow; prophylaxis of post-
surgical thromboembolic disease
Medicine: Gentran 40®(Baxter), Rheomacrodex®(Cambridge)
_______________________________
Vitamins (A, B, C, D, E, K & Multivitamin preparations)
Vitamin A
(Retinol)
Indications: the prophylaxis and treatment of vitamin A deficiency states manifested by night blindness
(nyctalpia), thickening of the conjuctiva (xerophthalmia), necrosis (decayed) of the cornea (keratomalacia),
keratinization and drying of the skin, sprue, colitis, hepatic cirrhosis, acne vulgaris, psoriasis, ichthyosis
and hyperkeratosis
Dose: prophylaxis or treatment of vitamin A deficiency 25'000 - 50'000 IU daily or in severe cases 100'000
IU to 200'000 IU daily (care should be prefered)
Medicine: vitamins A & D= Halycitrol®(LAB), Minadex®(Seven Seas) vit. A, D & C for children,
Vitamin A Palmitate®(Cambridge) 50'000unite for injection, Univit-A tab
96
_______________________________
Riboflavine (Riboflavin, vitamin B2), Thiamine (Vitamin B1), Pyridoxine hydrochloride (vitamin B6),
Nicotinamide (for acne vulgaris), Vitmin C (Ascorbic acid) for prevention & treatment of scurvy
_______________________________
Vitamin D
Ergocalciferol (Calciferol, vit. D2), Alfacalcidol (1a-Hydroxychoescalciferol), Calcitriol (1,25-

Dihydroxycholecalciferol), Cholecalciferol (Colecalciferol, vitamin D3), Dihydrotachysterol
Indications: for vitamin D deficiency, malabsorbtion of intestine, liver disease
Medicine: Vitamin D is not available in plain, but is available with A & D in market.
_______________________________
Vitamin E
Indications: malabsorbtion in cystic fibrosis, & malabsorbtion in cholestasis
Medicine: Vitamin E®(Cambridge) 500mg suspension
_______________________________


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(Composed & edited by Wasir Khan Zeerak)

(British National Formulary-36)

Chapter 1 (Gastrointestinal system)

Chapter 2 ( Cardiovascular system )

Chapter 3 (Respiratory system)

Management of severe acute asthma

Chapter 6 ( Musculoskeletal & joint diseases)

Drugs used in rheumatic diseases & gout

Chapter 7 ( Endocrine system )

Insulin zinc suspension

Chapter 8 ( Ear, nose & oropharynx )

Drugs acting on the ear

Chapter 9 ( Central nervous system )

Chapter 10 (Obstetrics, Gynaecology, & Urinary-tract

Chapter 12 ( Laboratery Tests )

Various kinds of test

Abbrevation: =increase of normale range, =decrease of normal range

COMPLETE URINE ANALYSIS#2

Test Required Normal Range Informations

Chapter 13 (Nutrition and Blood)

Ergocalciferol (Calciferol, vit. D2), Alfacalcidol (1a-Hydroxychoescalciferol), Calcitriol (1,25-

(Composed & edited by Wasir Khan Zeerak)

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