OUT PATIENT DEPARTMENT CHEAT CODES

Disposition with Management (Most Common)

PULMONOLOGY

Community Etiology: LRTI acquired in the community within 24 hrs to less than 2 weeks
Acquired
Pneumonia (Adult) Clinical manifestations: fever, cough, and dyspnea
PE: rhonchi, crackles, wheezes, diminished breath sounds

Diagnosis: CXR: infiltrates, air bronchogram

Low-risk CAP
S. pneumoniae (most common), M. pneumoniae, H. influenzae, C. pneumoniae, M.
catarrhalis, enteric Gram (-) bacilli

Stable vital signs:

RR: <30 cpm
PR: <125 bpm
Temp: 36-40oC
BP ≥90/60 mmHg
No altered mental state of acute onset
No suspected aspiration
No or stable comorbids
CXR: Localized infiltrates, no pleural effusion, no abscess

Treatment (OUTPATIENT):
Do not require hospitalization, no major comorbid conditions, no antibiotic use within
the last three months

1. Previously healthy:
Amoxicillin: 1g/cap TID for 7 days
Azithromycin: 500 mg daily for 4 days or 500 mg daily for day 1 followed by 250 mg
daily for three days
Clarithromycin: 500 mg twice daily for five days
Doxycycline: 100 mg orally twice a daily for five days

2. Comorbids or recent antibiotic use

Amoxicillin-clavulanate: 625 mg/tab TID for 5-7 days
Cefuroxime 500 mg twice daily for 5-7 days
Cefpodoxime 200 mg twice daily for 5-7 days
Azithromycin 500 mg on day 1 followed by four days of 250 mg or clarithromycin 500 mg
twice daily or doxycycline (100mg twice daily) for 5-7 days
Levofloxacin 750 mg daily for 5-7 days
Moxifloxacin 400 mg daily for 5-7 days
Gemifloxacin 320 mg daily for 5-7 days
Moderate-risk CAP
S. pneumoniae, H. influenzae, C. pneumoniae, M. pneumoniae, M. catarrhalis, enteric Gram
(-) bacilli, Legionella, anaerobes

Unstable vital signs:

RR: ≥30
PR: ≥125 bpm
Temp: ≥40oC or ≤36oC
BP <90/60 mmHg
Altered mental state of acute onset
Suspected aspiration
Decompensated comorbids
CXR: Multilobar infiltrates, pleural effusion, abscess

Treatment (WARD):
Cetriaxone (1-2g daily) IV or Cefotaxime (1-2 g IV every 8 hours) or Ceftaroline (600 mg
IV every 12 hours ) or ertapenem (1 g IV daily) or ampicillin-sulbactam (1.5 to 3 g IV
every 6 hours) + macrolide (azithromycin 500 mg IV/orally daily or clarithromycin (500
mg twice daily orally or clarithromycin XL 500 mg twice daily) or doxycycline (100 mg
twice daily/IV

Levofloxacin 750 mg IV or orally daily

Moxifloxacin 400 mg IV or orally daily
Gemifloxacin 320 mg orally daily

*Combination therapy of beta-lactam +macrolide and monotherapy with respiratory

fluoroquinolones have same CAP efficacy yet combi therapy have better clinical outcome
due to immunomodulatory effects of macrolides

Treatment for 14 days

High-risk CAP
S. pneumoniae (most common), M. pneumoniae, H. influenzae, C. pneumoniae, M.
catarrhalis, enteric Gram (-) bacilli, Legionella, anaerobes, S. aureus, Pseudomonas

Unstable vital signs:

RR: ≥30
PR: ≥125 bpm
Temp: ≥40oC or ≤36oC
BP <90/60 mmHg
Altered mental state of acute onset
Suspected aspiration
Decompensated comorbids
CXR: Multilobar infiltrates, pleural effusion, abscess

+SEVERE SEPSIS and SEPTIC SHOCK or

+MECHANICAL VENTILATION

Treatment (ICU):
 W/O P. aeruginosa
Ceftriaxone (1-2g daily) IV or Cefotaxime (1-2 g IV every 8 hours) or Ceftaroline (600
mg IV every 12 hours )or Ampicillin-sulbactam (1.5 to 3 g IV every 6 hours) + macrolide
(azithromycin 500 mg IV/orally daily) or Levofloxacin 750 mg IV or orally daily or
Moxifloxacin 400 mg IV or orally daily for 14-21 days

W/ P. aeruginosa
Piperacillin-tazobactam (4.5 g every 6 hours) or Imipenem (500 mg IV every six hours)
or Meropenem (1 g every six hours) or Cefepime (2g every 8 hours) or Ceftazidime (2g
every eight hours)
+
Ciprofloxacin (400 mg every 8 hours IV/daily) + Levofloxacin 750 mg daily IV or twice
orally)

Penicillin-allergic patients
Levofloxacin 750 mg IV or orally daily or Moxifloxacin 400 mg +aztreonam

W/ P. aeruginosa
Piperacillin-tazobactam (4.5 g every 6 hours) or Imipenem (500 mg IV every six hours)
or Meropenem (1 g every six hours) or Cefepime (2g every 8 hours) or Ceftazidime (2g
every eight hours)
+
Ciprofloxacin (400 mg every 8 hours IV/daily + Levofloxacin 750 mg daily IV or twice
orally)
+
Vancomycin (15 mg/kg IV every 12 hours) or Linezolid (600 mg IV every 12 hours

CURB 65 for prediction of mortality

Confusion of new onset
Urea ≥7 mmol/L (19 mg/dL)
Respiratory rate ≥30 breaths per minute
Blood pressure <90/60 mmHg
Age ≥65

Response to treatment:
Fever decreases within 72 hours
Temperature within 5 days
Respiratory signs return to normal

DISCHARGE: Once normal vital signs

Pediatric Clinical presentation: tachypnea

Community <2 months: >60 cpm
Acquired 2-12 months: >50 cpm
Pneumonia >12 months: >40 cpm

Other clinical manifestations:

Tachycardia
Flaring of ala nasi, intercostal/subcostal retractions, dullness, grunting, crackles,
wheezing, prominent abdomen

Indications for hospitalization:

Hypoxemia
Dehydration
Moderate to severe respiratory distress
Toxic appearance
Failure of outpatient therapy (72 hrs)
Complications
Suspicion that CAP is caused by S. aureus and Group A. Streptococcus
Underlying conditions that may predispose to a more serious course of pneumonia

TREATMENT
Neonates:
Early-onset pneumonia (<3 days old) = Ampicillin + Gentamicin
Late-onset pneumonia (>3 days old)= Vancomycin + Aminoglycoside

1 to 6 months
Toxic looking with hypoxemia: ADMIT
Not toxic looking: Erythromycin (50 mg/kg/day) OD in four divided doses for 14 days
(MC Bacteria: Chlamydia trachomatis (ref; uptodate)

6 months to 5 years

VIRAL PNEUMONIA
Gradual onset, lack of toxic appearance, low-grade fever, nonproductive cough, diffuse
auscultatory findings, wheezing
= No antibiotic needed, supportive

BACTERIAL PNEUMONIA
Abrupt onset, toxic-looking, high fever, productive cough, localized auscultatory
findings, localized chest pain, symptoms of sepsis

Typical
= Amoxicillin 90 mg/kg/day TID for 7-10 days (HC)
= Amoxicillin-clavulanate 90 mg/kg/day in 2-3 divided doses for 7-10 days

>5 years
Mycoplasma pneumoniae or C. pneumoniae:
= Erythromycin 40-50 mg/kg/day in 4 divided doses for 7-10 days (HC)
= Azithromycin 10 mg/kg on day 1 followed by 5 mg/kg/day on 4 more days
= Clarithromycin 15 mg/kg/day BID for 7 days

>18 years old

= Levofloxacin 8-10 mg/kg/day OD for 7 days I children 5-16 yrs old
= Levofloxacin 750 mg OD for children > 16 years old

Supportive care:
Patients with fever and pleuritic chest pain: antipyretics, no antitussives
 Respiratory distress patients: hydration
Supportive treatment

Acute CM: Nasal congestion, nasal discharges, sore throat, fever (in young children), anterior
Nasopharyngitis cervical adenopathy and erythema of nasal mucosa and oropharynx
(PEDIA)
Treatment (Nasal):
0.65 % NaCL Nasal Drops/Spray (1st line)
Instill 2-3 drops per nostril then suction/blow Q6 for 3-5 days

Phenylephrine HCL 5 mg + Chlorphenamine maleate 1 mg (Disudrin) 60 mL syrup Q6

1-3 months: 0.25 mL 1-2 years old: 1 mL >12 yrs old: 10 mL
4-6 months: 0.5 mL 2-6 years old: 2.5 mL
7- 12 monthsL 0.75 mL 7-12 years old: 5 mL

Acute CM: Nasal congestion, nasal discharges, sore throat, anterior cervical adenopathy and
Nasopharyngitis erythema of nasal mucosa and oropharynx
(ADULT)
Phenylpropanolamine HCL + Brompheniramine maleate 15/12mg/tab, (Nasatapp), 1
tab TID for 3 days
0.65 % NaCL Nasal Drops/Spray (1st line)
Instill 2-3 drops per nostril then suction/blow Q6 for 3-5 days
Oxymetazoline nasal spray, 2-3 sprays each nostril TID for 3 days
Phenylpropanolamine HCL + Chlorpheniramine maleate 25mg/2mg (Neozep),
one tab TID x 3 days
Paracetamol + Phenylpropanolamine 325 mg/25 mg /tab TID x 3-5 days

Treatment (Sore Throat):

Difflam lozenges QID
Hexetidine (Bactidol) gargle, gargle 15 mL x 30 seconds TID for consumption
Difflam gargle, gargle 15 mL x 30 seconds TID for consumption

Acute GS: Oral penicillin V: 500 mg TID for 10 days

Tonsillopharyngitis
(ADULT) If increased WBC with exudates: Ampicillin-Sulbactam 750 mg/tab, 1 tab BID-TID for 7
days
If normal WBC without exudates: Co-amoxiclav 625 mg/cap BID x 7 days
If normal WBC but with exudates: Clindamycin 300 mg/tab , 1 tab Q6 for 7 days
Cefuroxime 500mg/tab BID x 7 days

SUPPORTIVE

Acute Amoxicillin 50 mg/kg/day for OD-BID for 10 days

Tonsillopharyngitis
(PEDIA) Hypersensitivity to betalactam antibiotics
Azithromycin 12 mg/kg/day on Day 1 followed by 6 mg/kg/day on day 2 through 5
Co-amoxiclav 40 mg/kg/day BID for 10 days
 Clarithromycin 7.5 mg/kg/day BID for 10 days

Difflam lozenges TID x 5 days

Bactidol gargle 4x a day
Benzoxonium CL + Lidocaine HCl 0.5mg/0.5mg gargle qid

Allergic Rhinitis CM: Paroxysm of sneezing, rhinorrhea, nasal obstruction and nasal itching
(ADULT)
Treatment:

Cromolyn (sodium cromoglicate): Instill 1 spray in each nostril 3 to 4 times daily

Cetirizine 10 mg OD
Levocetirizine 5 mg OD in PM
Loratadine 10 mg OD x 7 days
Allergic Rhinitis CM: Paroxysm of sneezing, rhinorrhea, nasal obstruction and nasal itching
(PEDIA)
Treatment:

Cromolyn (sodium cromoglicate): Instill 1 spray in each nostril 3 to 4 times daily

Cetirizine:
10 mg OD for 6-12 yrs, 5 mg or 10 drops for 2-6 yrs old, 2.5 mg or 5 drops for <2 yrs old
(Oral drops: 10 mg/mL, Syrup: 5 mg/ 5mL)

Loratadine 10 mg OD for > 12 yrs old

2 tsp OD for >30 kgs 2-12 yrs old
1 tsp OD for <30 kgs 2-12 yrs old
Acute AVR CM: <10 days of symptoms yet improving (purulent anterior nasal discharge)
Rhinosinusitis Treatment: Supportive
(Adult)
ABR CM: >10 days persistence of symptoms with facial pain, high grade fever without
clinical improvement

Treatment: Supportive

Co-amoxiclav 625 mg/tab TID for 5-7 days

Co-amoxiclav 2000 mg/125 mg BID for 5-7 days for high resistance risk

Doxycycline 100 mg twice daily/ 200 mg once daily for 5- 7 days

Clindamycin 150 mg or 300 mg every 6 hrs + cefixime (400 mg OD) or Cefpodoxime
(200 mg twice daily)
Acute AVR CM: <10 days of symptoms yet improving (purulent anterior nasal discharge)
Rhinosinusitis Treatment: Supportive
(PEDIA)
ABR CM: > 10 days persistence of symptoms with facial pain, high grade fever without
clinical improvement
Treatment: Supportive

Co-amoxiclav 45 mg/kg/day BID for 10 days

Co-amoxiclav 90 mg/kg/day BID for 10 days (HD for resistance)
 Levofloxacin 10-20 mg/kg/day BID for 10 days (anaphylaxis)
Cefpodoxime 10 mg/kg/day BID (non-anaphylaxis)
Ceftriaxone 50 mg/kg/day OD IV/IM followed by the appropriate oral therapy in cases
of vomiting
Upper Respiratory Symptomatic Treatment for COUGH:
Tract Infection Ambroxol 75 mg OD x 5 days
(ADULT) NAC 600 mg/sachet, dissolve one sachet in ½ water TID for 5 days
Fluimucil 600 mg/tab, one tab OD for 7 days

Symptomatic Treatment for Cough and Cold:

Dynatussin Capsule, QID for 5 days

Upper Respiratory Symptomatic Treatment for COUGH:

Tract Infection
(PEDIA) Carbocisteine Drops (40 mg/mL), Syrup (200 mg/ 5 mL), Susp (500 mg/5 mL), Cap
(500mg)

1-3 mos: 0.5 mL TID

3-6 mos: 0.75 mL TID
6- 12 mos: 1 mL TID
2-3 yrs: ½ tsp TID; 4-7 yrs: 1 tsp TID
8- 12 yrs: 1 ½ tsp
> 12 yrs: 1 cap/1-2 tsp
NAC 100 mg/sachet, dissolve one sachet in ½ water TID for 5 days

Symptomatic Treatment for Cough and Cold:

Dynatussin syrup, 1 tsp QID for 5 days

Epistaxis Tranexamic acid 500 mg/tab q8 PRN for bleeding

(Nosebleed)
Pulmonary DAT, CXR PA Lat, CBC, Sputum AFB x 2, Sputum GSCS, TB gene Xpert (automatic for
Tuberculosis >65 yrs old), For SGPT if baseline liver fxn is needed, Refer to TB DOTS
 Vitamin B complex, 1 tab OD
Clarithromycin 500 mg BID
NAC 600 mg/sachet, dissolve one sachet in ½ water TID for 5 days

Bronchial Asthma Duavent 1 neb q8 PRN for difficulty of breathing every 15 minutes for 3 doses
in Acute Salbutamol inhaler MDI 2 puffs PRN as needed for shortness of breath
Exacerbation Fluimucil 600 mg/tab, one tab OD for 7 days
Sinupret #14 2 bragees TID for 7 days
Salmeterol xinafoate, fluticasone propionate (Seretide) MDI 25/250 mcg, 2 puffs BID
Salbutamol inhaler MDI 2 puffs PRN as needed for shortness of breath
Tiotropium bromide 18 mcg/cap, 1 cap OD

(See GINA guidelines)

GASTROENTEROLOGY
Abdominal pain at the ER:HNBB IV
Vomiting at the ER: Metoclopramide (plasil) 10 mg/IV
Hyperacidity at the ER: Esomeprazole (Clessol) 40 mg/IV, Lansoprazole (Prevacid) 30 mg/tab OD or IV
 HNBB 10 mg/tab #10, one tab q6 PRN
Plasil 10 mg/tab q8 for vomiting

Peptic Ulcer Gastric ulcer: distal to the junction between the antrum and acid secretory mucosa
Disease Duodenal Ulcer: first portion of the duodenum (3 cm of pylorus)

CM:
Character of abdominal pain:
GU: burning or gnawing discomfort, precipitated by food
DU: burning or gnawing discomfort, keeps awake between midnight and 3am, occurs 90
minutes to 3 hrs after a meal, relieved by antacid or food

Complications: Bleeding

Diagnostics: CBC, Amylase, Na, K, Calcium

Upper GI series or Endoscopy with rapid urease assay
ECG (anemia-related ischemic changes

TREATMENT:
Amoxicillin 500 mg/tab, 2 tabs BID for 10-14 days
Clarithromycin 500 mg/tab, 1 tab BID for 10-14 days
Pantoprazole or Omeprazole 40 mg/tab OD 30 mins before breakfast for 10-14 days
Rebamipide (Mucosta) 100 mg/tab, 1 tab TID for 5 days

Gastroesophageal Disposition: Avoid carbonated drinks and caffeinated drinks, avoid salty foods, advised
Reflux Disease small frequent meals

PPI
ER: Esomeprazole (Clessol) 40 mg IV, Omeprazole 40 mg IV, Lansoprazole 30 mg IV
Pantoprazole (Pantopraz or Pantoloc) or omeprazole (omepron) 40 mg/tab, one tab
OD 30 minutes before breakfast
Rabeprazole Na 20 mg/tab, one tab OD 30 minutes before breakfast for 7 days
Lansoprazole (Prevacid) 30 mg/tab, OD 30 minutes before breakfast
Gaviscon chewable tablet, two tabs twice a day after meals for 5 days
Magnesium hydroxide + Aluminum hydroxide (Maalox) suspension, 2-3 tsp QID as
needed for pain
Domperidone 10 mg/tab, 15-30 mins before meals TID for 5 days
Oral Ulcers Miconazole oral gel (Daktarin) 2% x 3.5 mg. Apply generously to affected area qid
Bactidol TID gargle
Difflam gel (Benzydamine) apply q3
Hemorrhoids Fibrosine 1 sachet in 1 glass of water OD before breakfast for 15 days
Constipation: Senokot 2 tabs ODHS for 15 days
Faktu ointment: Apply 2-3 times daily to affected area TID
Amoebiasis OR: Hydrite
Metronidazole 500mg/tab q8 x 7 days
Ciprofloxacin 500 mg/tab, one tab twice a day for 7 days
 Functional Fleet enema
Constipation Polyethylene glycol (Surelax) 1 sachet in 1 glass of water ODHS. Discontinue if with
LBM
Acute Check for signs of dehydration
Gastroenteritis
(ADULT) BRAT: Banana, Rice, Apple Tea
Increase oral fluid intake:
ORS Hydrite 1 sachet in 200 mL water and drink volume per volume per bout of vomit
or loose stools
Stool former: Racecadotril (hidrasec) 100 mg/cap BID-TID x 3 days or until stools are
formed
Bacillus clausii (Erceflora) 1 vial TID for 5 days
HNBB 10 mg/tab OD for 2 days

AGE Bacterial:
Cefuroxime 500 mg/tab BID for 7 days
Cefalexin 500 mg/tab q6 for 7 days

WHO Management of Diarrhea Guidelines

Acute BRAT: Banana, Rice, Apple Tea
Gastroenteritis Increase oral fluid intake:
(PEDIA) ORS Hydrite 1 sachet in 200 mL water and drink volume (50 mL-200 mL) per volume
per bout of vomit or loose stools
Stool former: Racecadotril (hidrasec) 100 mg/cap BID-TID x 3 days or until stools are
formed
Bacillus clausii (Erceflora) 1 vial TID for 5 days
HNBB 10 mg/tab OD for 2 days
Zinc sulfate, OD x 2 weeks

GENITOURINARY
Acute Cystitis for Check for Urinalysis, CBC with PC
WOMEN
Acute uncomplicated cystitis:

Nitrofurantoin 100 mg.tab, BID for 5 days

Trimethoprim-sulfamethoxazole 160/800 mg, one tab BID for 3 days
Fosfomycin, 3 grams single dose, dissolved in one glass of water
Cefuroxime, 500 mg/tab, BID for 7 days

Acute complicated cystitis

Ciprofloxacin 500mg/tab BID for 7 days

Levofloxacin 750 mg/tab BID for 7 days
Co-Amoxiclav 625 mg/tab, TID for 10-14 days

Acute Check for Urinalysis, CBC with PC, Urine GSCS

pyelonephritis for D5NM 1 Liter for 8 hours
WOMEN
Acute uncomplicated pyelonephritis
 Ciprofloxacin 500mg/tab BID for 7 days
Levofloxacin 750 mg/tab BID for 7 days
Co-Amoxiclav 625 mg/tab, TID for 10-14 days

Acute complicated pyelonephritis

Mild to Moderate pyelonephritis

Ceftriaxone 1 g every 24 hrs
Ampicillin + gentamicin 1-2 g every 6 hours

Severe:
Piperacillin-tazobactam 3.375 g every 6 hours
Meropenem 1 g every 8 hours
Acute cystitis for CM: CBC with PC, Urinalysis
PREGNANT
Nitrofurantoin 100 mg.tab, BID for 5 days
Fosfomycin, 3 grams single dose, dissolved in one glass of water *
Cefuroxime, 500 mg/tab, BID for 5 days
Co-Amoxiclav 625 mg/tab, TID for 7 days
Acute CM: CBC with PC, Urinalysis
pyelonephritis for
PREGNANT Mild to Moderate pyelonephritis
Ceftriaxone 1 g every 24 hrs
Ampicillin + gentamicin 1-2 g every 6 hours

Severe:
Piperacillin-tazobactam 3.375 g every 6 hours
Meropenem 1 g every 8 hours
Acute cystitis in ADMIT
children <2 yrs (Ampicillin-gentamicin)
Acute cystitis in Amoxicillin 13.3 mg/kg/day TID
children >2 yrs Co-amoxiclav 22.5 mg/kg/day BID
Cefdinir 14 mg/kg/day OD
Cefixime 4 mg/kg/day BID
Cefuroxime 15 mg/kg/day BID
Nitrofurantoin 1.25-1.75 mg/kg QID

Duration: 5 days
Ureterolithiasis Tamsulosin 0.4 mg/tab OD
Hyoscine 10 mg/tab q8 for pain
Tramadol/Paracetamol (Algesia) 37.5 mcg/ 325mg/tab q8 for breakthrough pain
Benign Prostatic CM; men >50 yrs old, storage symptoms, voiding symptoms, irritative symptoms
Hyperplasia
For WAUTZ to include prostate, PSA, urinalysis

Tamsulosin 400 mg/tab, 1 tab OD

Tamsulosin + Finasteride, 1 tab OD for 3 weeks
CARDIOLOGY
Hypertension LSLF Diet
Hypertensive work up, CBC, Na, K, Creatinine, SGPT, FBS, Lipid profile, Urinalysis, 12-L
ECG, Chest xray PA-L, Advised regular blood pressure monitoring
Losartan 50 mg BID or 100 mg OD in AM
 Amlodipine 5 mg BID, 1 tab in AM, 1 tab in the evening or 10mg/ tab, 1 tab OD
Losartan + Hydrochlorothiazide 50/12.5 mg, 1 tab OD
Telmisartan 40 mg/tab OD
Nebivolol 5 mg/tab, 1 tab OD
Telmisartan 40 mg/tab, 1 tab in the AM
Irbesartan 150 mg/tab, 1 tab OD
Clopidogrel 75 mg/tab at lunch
Propranolol 10 mg/tab BID
Captopril 25 mg/tab TID
Furosemide 40 mg/tab OD
Spironolactone 25 mg/tab OD
Clonidine 75 mcg/tab, 1 tab PRN if BP > 160/90
Atorvastatin 20 or 40 mg/tab OD
Rosuvastatin 5 mg/tab ODHS
Simvastatin 40 mg/tab, 1 tab ODHS

SEE JNC 8 for details

CVA infarct LSLF, dec uric acid test
For Plain Cranial CT Scan

Aspirin 80 mg/tab OD
Citicoline 1 g OD
Trimetazidine 35 mg/tab, 1 tab BID
Lactulose 30 cc ODHS hold if BM > 2

ENDROCRINOLOGY
Diabetes mellitus DM Diet
FBS, HbA1c, lipid profile (TCB after 3 months)

Metformin 500 mg/tab OD

Metformin + Sitagliptin 500/50 tab OD
Glimepiride 2 mg OD
Gliclazide 60 mg/tab OD after lunch
Linagliptin 5 mg/tab 1 tab OD
Apidra 6 units SQ TID pre-meals
Lantus 34 units OD at PM
MUSCULOSKELETAL
Musculoskeletal Gout: Low purine diet
Strain MSK: Lumbosacral X-ray

Paracetamol + Phenadrin (Norgesic Forte) 650 mg/50mg/ tab, TID for 5 days
Paracetamol + Tramadol (Cetadol) 500 mg/tab q6 for pain
Ibuprofen 400 mg/tab 1 tab TID
Mefenamic acid 500 mg/tab
ASA 80 mg/tab OD
Etoricoxib (Arcoxia) 120 mg, 1 tab OD for 3-5days
Diclofenac gel, apply to both knees BID (Osteoarthritis)
Baclofen 5 mg TID x 3 days (Muscle relaxant)
Gouty Arthritis Celecoxib 200 mg/tab, 1 tab BID or PRN for 3-5 days for pain
Colchicine 500 mg/tab, 1 tab BID
Febuxostat 40 mg/tab, 1 tab Od
Pregabalin 75 mg/tab, 1 tab OD in PM
INFECTIOUS
Gonorrhea Treatment: Ceftriaxone 250 mg IM in a single dose for treatment of gonococcal infection
+Azithromycin 1 gram in a single oral dose
Bacterial Vaginosis Criteria: Amsel’s clinical criteria
– Homogenous vaginal discharge
– pH ≥ 4.5
– Amine-like odor when mixed with KOH (whiff test)
 – Wet smear demonstrates clue cells greater in number than 20% of the of
vaginal epithelial cells
*** 3 out of 4 criteria is sufficient for diagnosis
Treatment
– Metronidazole 500 mg twice daily for 7 days
– Metronidazole gel 0.75%, 5 g intravaginally once daily for 5 days
– Clindamycin cream 5%, 5 g intravaginally qhs for 7 days

Animal Bite ER: Anti-rabies vaccine (Verorab) + anti-tetanus (Tetagram) + tetanus toxoid (Imatet or
Serotet)
Co-amoxiclav 625 mg/tab BID for 7 days
Cloxacillin 500 mg/cap Q6 for 7 days
Mupirocin ointment BID
Infected/Puncture Ciprofloxacin 500 mg/tab BID
Wound Cloxacillin 300 mg/cap q6 for 7 days
Ampicillin-Sulbactam 750 mg/tab BID for 7 days
Co-amoxiclav 625 mg/tab BID for 7 days
Sultamicillin 750mg/tab, 1 tab TID
Mupirocin ointment BID
Ingrown Nail Clindamycin 300mg/tab q6 x 7 days
Cellulitis CBC, Blood culture, Bone X-ray, UA

Clindamycin 300 mg/cap q6 x 7 days

Celecoxib 200 mg/tab BID x 7 days
Sultamicillin 750 mg/tab BID for 7 days
Hydroxyzine 25 mg/tab OD at bedtime as needed for itchiness
Soft Tissue Indomethacin cream apply BID
Swelling
Measles Supportive Treatment:

Vitamin A:
Infants < 6 months of age: 50,000 IU
Infants 6- 11 months of age: 100, 000 IU
Children > 12 months of age: 200,000 IU
Mumps Supportive:
Paracetamol (10-20 mg/kg/day) every 4 hrs for fever > 37.8
OPHTHALMOLOGY
Bacterial Vigamox (Moxifloxacin) apply 1 drop TID for 4 days
Conjunctivitis Tobramycin eye drops 1-2 drops TID for 4 days
Stye Erythromycin ointment apply BID for 7 days
Warm Compress
HEENT
Benign Positional CM: Episodes of vertigo lasting for a minute with no hearing symptoms
Paroxysmal Vertigo
Betahistine hydrochloride 24 mg/tab ODHS x 5 days or 10 mg/tab TID as needed for
dizziness
Metoclopramide 10 mg/tab TID PRN Nausea
Cinnarizine 25 mg/tab TID PRN for rotatory dizziness
 Stugeron forte 75 mg/tab for 5 days
Flunarizine hydrochloride 5 mg/tab ODHS for 14 days
Migraine Flunarizine 10 mg ODHS or 5 mg/tab, 2 tabs ODHS for 5 days
Acute Otitis Media Amoxicillin 500 mg/tab BID-mild for 7 days
(Adult) Amoxicillin 875 mg/tab BID-severe for 7 days
Co-amoxiclav 625 mg BID for 7 days
Cefuroxime 500 mg BID for 7 days
Acute Otitis Media Amoxicillin 90 mg/kg/day BID for 10 days
(Children) Co-amoxiclav 90 mg/kg/day and 6.4 mg/kg/day BID for 10 days
Cefuroxime 30 mg/kg/day BID for 10 days
DERMATOLOGY
Atopic Dermatitis Hypoallergenic diet, INC OFI,

Cetirizine 10 mg/tab, 1 tab OD in AM for 7 days

Diphenhydramine 25 mg/tab, 1 tab ODHS for severe itchiness
Betamethasone (Dermovate cream), apply thinly to affected area TID for 3 days
Jergens Ultrahealing lotion, apply to affected area TID
Burn Mupirocin ointment, apply to affected area BID
Varicella/ Aciclovir 800 mg/tab, take 1 tab every 4 hours to 5x daily for 5-7 days
Chickenpox Paracetamol
Cetirizine
Fungal Infection Hypoallergenic diet, KOH smear, Avoid scratching

Loratadine 10 mg/tab, 1 tab OD in AM x 7days

Ketoconazole 2% cream, apply to affected area thinly in OD x 2 weeks
OTHERS
HNBB 10 mg/tab TID for 5 days
Hepatitis work up HbsAg, HBeAg, Anti-HBV, Anti-HCV, SGPT, Total Bilirubin, B1, B2, AST/ALT, ALP
Obstructive CBC, Na, K, Crea, SGPT, SGOT, Total Bilirubin, B1, B2, TPAG, PT/PTT, WAUTZ
jaundice workup
PRENATAL CHECK 10 Danger Signs of Pregnancy
UP 1. Vaginal Bleeding
2. Fever and Chills
3. Passage of Fluid from Vagina
4. Abdominal Pain
5. Headaches
6. Vomiting
7. Blurring of Vision
8. Dysuria
9. Edema
10. Absence of Fetal Movement

QCGH OB OPD Notes

Laboratories: (Usually >12 weeks)

CBC with PC
BT RH
UA
 HbsAg, VDRL, HIV, 75 OGTT
Pap smear (1st prenatal check up, 31 weeks, no sexual contact within 4-7 days)

UTZ: < 12 weeks: TVS (not necessary)

➢ 13-27 weeks: Pelvic Ultrasound
➢ 28-36 weeks: BPS
➢ > 37 weeks: BPS with NST
Follow up:
4-28 weeks: Once a month
29-36 weeks: Every 2 weeks
37 weeks onwards: Every week

Medications:

< 12 weeks > 12 weeks

Multivitamins OD Multivitamins OD
Folic Acid OD Calcium BID
Ferrous Sulfate OD Ferrous Sulfate OD

IMMUNIZATION

PGI NMDS