This is an article with medical content to be used only by registered medical practitioners or interns. The author of this compilation shall not be in any way held responsible for any untoward events caused by the irrational use of the information given below by non-qualified people.
This data has been compiled from various sources by Dr. Anoop Prathapan. Opinions provided in brackets are that of the author, based on his clinical practice experience. This page contains only dosages for adults.
PART I
General Information
Parenteral Antibiotics (ATD stands for After Test Dose)
Inj. Amoxicillin + Clavulanic acid 1.2g IV BD ATD
Inj. Cefaperazone + Sulbactam 1..5g/3g IV BD ATD
Inj. Ceftriaxone 1g IV BD ATD
Inj. Ceftriaxone + Sulbactam 1.5g/3g IV BD ATD
Inj. Ciprofloxacin 200mg IV BD ATD
Inj. Levoflox 750mg IV BD ATD
Inj. Piperacillin + Tazobactam 4.5g IV Q6H/Q8H ATD
Inj. Cefotaxim 1g IV BD ATD
Inj. Crystalline Penicillin (CP) 10/15/20L Units IV Q6H ATD
Inj. Amikacin 250mg IV OD or rarely BD ATD (this medicine is very highly ototoxic)
Inj. Gentamicin 80mg IV OD ATD (rarely used now, ototoxic)
Inj. Metrogyl 500mg IV Q8H
Inj. Ampicillin 500mg IV Q6H ATD
Oral Antibiotics
Tab. Moxclav 625mg 1-1-1 x 5 days OR 1g (875 + 125) 1-0-1 x 5 days
Cap. Mox 500mg 1-1-1 x 5 days
Tab. Ciplox 500mg 1-0-1 x 5 days
Tab. Azithromycin 500mg 1-0-0 x 3 days (highly advisable that this is not used for initiating treatment for an Upper Respiratory Tract Infection as efficacy is pathetic. Better to start with Mox or Moxclav)
Tab. Norflox 400mg 1-0-1 x 5 days
Tab. Ciplox-TZ 1-0-1 x 5 days
Tab. Norflox-TZ 1-0-1 x 5 days
Cap. Doxycycline 100mg 1-0-1 x 7 days (for skin/scrub/lepto)
Tab. Levoflox 500mg or 750mg 1-0-0 x 5 days (ideally for an LRTI)
Tab. Cefixime 200mg 1-0-1 x 5 days
Tab. Cefixime+ Clavulanic acid 325mg 1-0-1 x 5 days
Other Medications
Tab. Pantocid 40mg 1-0-0 x 5 days (can be given BD as well)
Tab. Rantac 150mg 1-0-0 x 5 days (can be given BD as well)
Syp. Mucaine gel 10ml three times a day before each meal or twice a day as is required. (Mucaine Gel is Oxetacine + Aluminium Hydroxide + Milk of Magnesia)
Tab. Paracetamol 500mg 1-1-1 (only if and as long as fever, myalgia or headache persist)
Tab, Cetrizine 10mg 1-0-1 OR 0-0-1 x 5 days
Tab. Levocetrizine 5mg 1-0-1 OR 0-0-1 x 5 days
Tab. Albendazole 400mg 1 HS on the night you prescribe it.
Tab. DEC 100mg 1-1-1 x 14 days (for eosnophilia)
Inj. Emeset 4mg IV BD and Tab. Emeset 4mg 1-0-1
Tab. Betahistine 8/16/32 BD or TDS depending on the severity of the symptoms
Tab. Stemetil MD 1-0-1 x 5 days
Tab. Avil 25mg 1-0-1 x 5 or 7 days
Tab. Atarax 25mg 1-0-1 x 5 or 7 days (for pruritis)
Inj. Deriphylline 100mg IV Q8H or BD
Tab. Fexofenadine 120/180mg 0-0-1 for a week or ten days or even months - depending on the symptoms.
Inj. Hydrocortisone 1-2 mg/kg IV q6hr initially for 24 hours; maintenance: 0.5-1 mg/kg q6hr (for status asthamticus)
Prescribe all supplements like B-Complex tablets, multivitamins, Calcium, Iron or Zinc only once a day, unless specifically indicated for a higher daily dose.
Dengue Fever - Warning Signs
Abdominal pain or tenderness.
Persistent vomiting.
Clinical fluid accumulation.
Mucosal bleed.
Lethargy or restlessness.
Liver enlargement > 2 cm.
Laboratory findings of increasing HCT concurrent with a rapid decrease in platelet count. (get it done in a reliable lab, please)
For Dengue, no antibiotics are required to be prescribed unless there is a secondary infection. For all dengue positive patients with thrombocytopenia, please repeatedly check TC, PCV, platelet count on alternate days until the platelet count stays above 1 Lakh. As per State protocols, platelet transfusion is given only for recorded counts less than 20,000.
Calculation of Iron deficit
COPD - 2022 GOLD guideline for Assessment and Management
Bronchial Asthma - 2021 GINA guideline for assessment and management
Diagnosis of Diabetes (figures)
from Harrison's Textbook of Internal Medicine 20th edition
Maximum doses of approved non-insulin anti-diabetic agents (ADA guideline, 2021)
I could have easily typed out the above information in a much less complicated format, but off-late there has been some unnecessary, puny confusion regarding the maximum daily doses of Metformin, in a particular sector. So, I posted this table here, which is from a page of the 2021 ADA guideline for the treatment of Diabetes.
Oral Anti-Hypertensive Drugs page 957 – Braunwald’s Heart Disease 10th Edition read in the order of Drug Class/Drug Name/Dose Range mg/day (no. of doses per day)
Diuretics
Thiazide and Thiazide Type Diuretics
Chlorthalidone 6.25-50 (1)
Hydrochlorthiazide 6.25-50 (1)
Indapamide 1.25-5 (1)
Metolazone 2.5-5 (1)
Loop Diuretics
Furosemide 20-160 (2)
Torsemide 2.5-10 (1-2)
Bumetanide 0.5-2 (2)
Ethacrynic Acid 25-100 (2)
Potassium Sparing Diuretics
Amiloride5-20 (1)
Triamterine25-100 (1)
Spironolactone12.5-400 (1-2)
Eplerenone25-100 (1-2)
Beta Blockers
Standard Beta Blockers
Acebutolol 200-800 (2)
Atenolol 25-100 (1)
Betaxolol 5-20 (1)
Bisoprolol 2.5-20 (1)
Carteolol 2.5-10 (1)
Metoprolol 50-450 (2)
Metoprolol XL 50-200 (1-2)
Penbutolol 10-80 (1)
Pindolol 10-60 (2)
Propranolol 40-180 (2)
Propranolol LA 60-180 (2)
Timolol 20-60 (2)
Vasodilating Beta Blockers
Carvedilol 6.25-50 (2)
Carvedilol CR 10-40 (1)
Nebivolol 5-40 (1)
Labetolol 200-2400 (2)
Calcium Channel Blockers (Dihydropyridines)
Amlodipine 2.5-10 (1)
Felodipine 2.5-20 (1-2)
Isradipine CR 2.5-20 (2)
Nicardipine SR 30-120 (2)
Nifedipine XL 30-120 (1)
Nisoldipine 10-40 (1-2)
Calcium Channel Blockers (Non-Dihydropyridines)
Diltiazem CD 120-540 (1)
Verapamil HS 120-480 (1)
Angiotensin Converting Enzyme Inhibitors
Benazepril 10-80 (1-2)
Captopril 25-150 (2)
Enalapril 2.5-40 (2)
Fosinopril 10-80 (1-2)
Lisinopril 5-80 (1-2)
Moexipril 7.5-30 (1)
Perindopril 4-16 (1)
Quinapril 5-80 (1-2)
Ramipril 2.5-20 (1)
Trandolapril 1-8 (1)
Angiotensin Receptor Blockers
Cendesartan 8-32 (1)
Eprosartan 400-800 (1-2)
Irbesartan 150-300 (1)
Losartan 25-100 (2)
Olmesartan 5-40 (1)
Telmisartan 20-80 (1)
Valsartan 80-320 (1-2)
Direct Renin Inhibitor
Aliskiren 75-300 (1)
Alpha Blockers
Doxazosin 1-16 (1)
Prazosin 1-40 (2-3)
Terazosin 1-20 (1)
Phenoxybenzamine 20-120 (2) for pheochromocytoma
Central Sympatholytic Drugs
Clonidine 0.2-1.2 (2-3)
Clonidine Patch 0.1-0.6 (weekly)
Guanabenz 2-32 (2)
Guanfacine 1-3 (1)
MethylDopa 250-1000 (2)
Reserpine 0.05-0.25 (1)
Direct Vasodilators
Hydralazine 10-200 (2)
Minoxidil 2.5-100 (1)
Drugs for Hypertensive Urgencies and Emergencies
from Braunwald’s Heart Disease 10th Edition
Cockcroft and Gault formula to calculate creatinine clearance
(140-age)x weight in Kg divided by (plasma creatinine x 72) for males
[(140-age)x weight in Kg divided by (plasma creatinine x 72)] x 0.85 for females
Classification of CKD based on GFR and ACR categories
Almost all the drugs need to be dose-adjusted in accordance with a failing kidney. There has been yet another unnecessary puny argument in certain sectors in connection with the eGFR value at which Metformin should be stopped.
The dose of metformin should be reduced to once a day when the GFR touches 45 and should be completely stopped when the GFR touches 30. This means Metformin can be prescribed safely only up to and until CKD stage 3a and not below that. (NICE guidelines UK)
The UK NICE guidelines original link to the above information is this
Vitamin D3 deficiency - how to supplement
Vitamin D3 60,000 IU once a week x 6 weeks followed by once a month x 6 months
It can be in any form - Soft gel capsules, granules for reconstitution, or as syrup
The ONLY three brands that I prescribe are:-
D-Rise granules (60,000 IU per sachet) one sachet in one glass of milk (or water) once a week x 6 weeks followed by followed by once a month x 6 months (D-Rise is a product of USV pharma - a good one)
Syrup Depura (60,000 IU/5ml) 5ml once a week x 6 weeks followed by once a month x 6 months (Depura is a product of Sanofi - it is also agood one)
Syrup Arachitol Nano (60,000 IU/5ml) 5ml once a week x 6 weeks followed by once a month x 6 months (Arachitol Nano is a product of Abbot, the ones who make the all famous Thyronorm - it is also a good, and internationally well accepted one)
Uprise D3 softgel capsules by Alkem Pharma or D-Rise Capsules by USV are reasonable ones to prescribe if anyone is strictly in favour of only capsules. I seldom prescribe it, anyways. After all, it is the doctor's choice on which brand to prescribe. The above information is only for use by those young doctors who do not know any brand to prescribe.
Alternatively, some people who have had gastric resection surgeries for any reason or in those who have malabsorption states, Injections of Vitamin D3 need to be given, the dose of which is,
Inj. Arachitol Nano 1.5lakhs IU IM Stat.
The Vitamin D3 levels need to be assessed after three months and the injection repeated if required.
please note that unless there are specific indications for injection, please do not prescribe an injection.....weekly oral doses will be enough.....
Tab. Fluconazole - how to prescribe
Tab. Fluconazole 150mg once a week x 4 weeks.
Any maternal exposure to fluconazole during pregnancy — whether in low or high doses — may increase the risk for spontaneous abortion, and high-dose fluconazole during the first trimester may increase the risk for cardiac septal closure anomalies. So it is best that fluconazole is not prescribed during pregnancy.
Rabies Prophylaxis (India)
Attached is the National Guideline for Rabies Control and Prophylaxis in India (2019)
This document contains all authentic details on how to classify the wounds how to clean the wounds ad how to administer serum and vaccine. This is a Government of India guideline applicable all over the country and cannot be challenged by anyone in any hospital.
PART II
Some model prescriptions
These are how I prescribe. It is not necessary that these prescriptions be by-hearted and copy-pasted by the reader.
Prescription for an uncomplicated Upper Respiratory Tract Infection (URTI)
Cap. Mox 500mg 1-1-1 x 5 days OR Tab. Moxclav 625mg 1-1-1 x 5 days
Tab. Cetrizine 10mg 1-0-1 x 5 days OR Tab. Levocetrizine 5mg 1-0-1 x 5 days
Tab. Pantocid 40mg 1-0-0 x 5 days in empty stomach (not mandatory, unless the patient demands it, for probable drug-induced gastritis)
Syp. Ambrodil 10ml three times a day until the cough subsides
Tab. Paracetamol 500mg 1-1-1 or SOS only if and as long as fever, myalgia or headache persist.
Saline gargle and Steam inhalation
Advise the patient to not stop antibiotics before the full course, irrespective of his/her symptoms.
I never start with Azithromycin for a URTI, as never even once have I had a patient who has recovered completely with a three-day course of Azithromycin. Those who approached me with poor recovery were all prescribed earlier with azithromycin, invariably. So it is best that Azithromycin is never used to start treatment for URTI.
I usually start with either Mox or Moxclav, then Cefixime, then Cefixime + Clavulanic acid, and thereafter, if still symptomatic, admit and give parenteral antibiotics.
If the symptoms do not subside with any of these, ask the patient to return to the doctor with CBC, URE, Peripheral Smear, AEC, and a throat swab culture (if possible)
Prescription for an uncomplicated Urinary Tract Infection
Tab. Norflox 400mg 1-0-1 x 5 days or Tab. Nitrofuratoin 100mg 1-0-1 x 7 days or Tab. Cefixime 200mg 1-0-1 x 5 days (in pregnancy and lactation)
Tab. Meftal Spas 1 SOS OR Tab. Flavoxate 200mg 1 SOS (to reduce the pain)
Syp. Citralka 10ml three times a day
plenty of oral fluids
When a patient comes with symptoms suggestive of UTI, (first visit) start him on this prescription straightaway. There is absolutely no need to get a URE sent at that stage. If the symptoms do not subside with these medicines, ask them to return with CBC, URE, Urine Culture, and Ultrasound Scan Abdomen.
Prescription for Acute Gastroenteritis
Tab. Ciplox TZ 1-0-1 x 5 days or Tab. Cefixime 200mg 1-0-1 x 5 days (when specially indicated)
Tab. Pantocid 40mg 1-0-1 x 5 days
Tab. Cyclopam 1 SOS (to reduce the pain, if any)
plenty of oral fluids with ORS
Cap. Racecadotril 100mg 1-1-1 (until the loose stools subside)
avoid hard-to-digest foods and oily/fried foods.
When a patient comes with symptoms suggestive of Acute Gastroenteritis, (first visit) start him on this prescription straightaway. There is absolutely no need to get a CBC, URE sent at that stage. If the symptoms do not subside with these medicines, ask them to return with CBC, URE, Ultrasound Scan Abdomen, Stool Routine and Stool Culture.
Treatment of Paracetamol Poisoning
Stomach Wash
Insert Ryles Tube and Foley’s Catheter
Give activated Charcoal
Antidote is N-Acetyl Cysteine (NAC)
Oral Administration of NAC
Loading Dose 140mg/Kg bodyweight
Regular Doses 70mg/Kg bodyweight x 17 doses four hours apart
Intravenous Administration of NAC
Loading Dose 150mg/Kg body weight in 200ml of 5% dextrose and infused I/V over one hour
Regular Doses 50mg/Kg body weight in 500ml of 5% dextrose and infused I/V over four hours followed by 100mg/Kg body weight in 1,000ml of 5% dextrose and infused I/V over 16 hours
This page will be updated on a regular basis. So, please keep checking this page for updated information. If anyone feels any other heading needs to be included, kindly drop me a mail at anoop.prathapan@gmail.com and we will work on it, for sure.
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