Safe drugs during pregnancy & Lactation A€clAUI 9 os! cliil Gio Ul Gygal Pee eek kt er een eet) I trimester oad! yo ygmuis 3 Ygl rd Lagad Soll ads yg sll doguiss © Risks yo y.4/ Benefits oils Is! 289 aga) oaainl © systemic drugs Jl zgalll Usd local preparations ossiwl * @iAgo dcp al ordiul systemic drugs elaaiul sic * bel Antibiotics 1. Penicillins 2. Cephalosporins gia sLAoll 3. Erythromycin Tetracycline - Quinolones - Aminoglycoside - Chloramphenicol Geldyll 9 Jou ad region Nitrofurantoin Uvamine retard caps oul gre GL la cWlguues 4289 Jord! gd diol oat! osu sosiall loco Analgesics Paracetamol Aclaslo oor s9 Viol isi eal Als oe Sua! liAuoll NSAIDS e.g. Brufen - cataflam 45042" trimester Lidl Joall 94 Lmolaail yAo)Gastro-enteritis AgxzoJlQjill Diagnosis _ Ai! Jail 99 alain gil [SLioll pmidl yo Aygsoll Ail > Presentation Diarrhea + vomiting & abdominal pain & fever Agee UH ga Jodi ybire (lass) 99 rir oil) Y gl @sigaw— aso &r2y5) 4 Lgao ygy a9 > Examination 8a eal g Abdominal examination Jas) History flow ss oi) Exclusion of Acute abdomen Ayala aA iio yl iss Guarding gi Rigidity i Tenderness 1529 uy! “Surgical abdomen” layle Bla, CUS) 9 ila yiso > Iry or 2ry? WYGE : and) poccl jlaall 98 AA siko Ins Ag 20! jill yl lio 21 GE : soa! jlaall ad [SLio ln Aljcl Yod Yo 9 Auli ALL 2ry causes are important § fatal GE ala gl 99 GLIAL Pupil Yard junit I + Botulism a.uiloows v Dilated fixed pupils Y Ptosis + generalized weakness andl aig g lolod payo dour> Y NO gag reflex gay, jule ardllia yo ylud ASA, GLall yurol lol % Organo-phosphorus Poisoninig ay! olsioll ows Pinpoint pupils + salivation , lacrimation , urination aylw asl JS % Zinc phosphide also) Hx of intake + severe irritability & shock> If Iry, what is the organism ? Viral GE Bacterial GE Parasitic GE Most common High grade fever |- Diarrhea + cramps Low grade fever Toxic look + blood or mucus Non-toxic patient Bloody diarrhea Peri-anal itching Profuse watery diart. | may occur aso 9 lawl gases Ugxoll UW aw yaad) | Aull Arigaw 9 pois! ayiga gl da 9 9A dig pd pd | TOXIC ayollg | btdo gles olso Lal Toxic ito UA Ayoll SII 99 oa Fverucccverw-eernes | Eouul JI gS way Eouul JU gS GAL laa alle alian, fo86 yaljclWealle lian, | goin aldo alin, yoo alelll alle + A&giall olalagll osains D abell alle + > Complicated or not ? *Gldall 9.0 Agsoll willl 98 jlo alle liad gl aalall cull 94 JoAsn alll Blas Yiisdo 9) Diagnosis of dehydration 1. Delayed Skin turgor suai plan €ay1m Youll als ais Lod 2. Dry mucous memb. Dry asdllin glu gle pasion 3. Sunken eye dgaJ Alagastio Yrs pilin 4, Oliguria lap Juld allio Youll gle clus gl Oliguria is the surest sign of dehydration management (ello Gui Qn Ringer JA) dloall Ale! yaa gia lao! gasi (ololeil+ isalolalao ail aiclallc esol grim ls laclowad Visceralgine .)g.0] + Primperan Jgiol IV infusion plasig prix gi alo Jglro pau 250 ple Las gl uae (Auto + Gala) sLAo) gle gins cilgiol aag5Buscopan, Viscerlagine \40 Ja) Imoxdiwi yAoo Spasmofen ampoule (hyoscine + ketoprofen) Acute abdomen sisiiul a3 Il azol yAuo gi gai Egioo 4,86 Anti-spasmodics 4 e@gouo Home treatment 1. Antibiotics 4,86 Bacterial GE 99 gil lalAgll oxAi UILS 99 ggis aLAo ygas Ysa Aysi4 II Aig voll Ajill yl a4Ly galjoll azo g gl Shigella Lule lniis yg) gill Bloody diarrhea cilla 45 Il olsI10 —7 Quinolones olsAiu! U.Aa) 9Salmonella gd days Ags aalgin 9 Ags0 Uji ga gi gd Yosall Glalaoll og ais Nad Go 1a5lio ois I3l gall aldol Geog orc Jabll gle Hide) YA! Ls dogliio 722) Ayo Gloils3 cllacl g Aiudgp/I 99 aiUiS gl Viral or Parasitic GE 1939 OUI JUS 99 yuuas gl aay ol [51 Vlaols ius! Gastro-enteritis is usually cause by Gram -ve bacteria 92 016 Wes ggs3ll sla gil Uilegoro Wis g Quinolones (Ciprofloxacin) Ciprofar 500 tab 10 tab.. 20 LE Cipro SOO tab 10 tab. SLE Ciprobay 500 tab lell 10 tab. 46 LE oll5 dro) yaicluy Jal as, gl delay JAI [ud aclu 12 JS Yayd (olstall yc Lays) dgls Jad) 1 ogslAIL gill Jbl g glUDL aalaiol iti) Salmonella (Typhoid) 6 Shigella ila .p9 Ladi ggsail alaallHeadache Elaual Diagnosis > History = Onset, course, duration Say gl Uda $ gaol Lay Site, character Saylacgi alll usd aldo What 1 & J Saul Udy 9 Gb ain Associated symptoms § (@mg3 Glaus —ArigAu 193) ol2o Peerrrer ern rr enri cen tie erie itr iter) RED Flags for headache (SNOOP) (Urgent CT & referral to a specialist) 1. Systemic symptoms High fever - Persistent vomiting - Neck rigidity 2. Neurological symtoms Disturbed consciousness - Seizures - Focal neurological signs 3. Onset : Sudden , Severe 4. Onset : Above 40 years 5. Previous headache with different characters Ga) JURA QUI DEI 5S NEVER MISS Meningitis & Encephalitis 1. Meningitis Fever - disturbed consciousness - meningism LoS gas lol dpan0 asd) + acai ad ls8d + Gigs 2. Encephalitis Fever - disturbed conscious. - seizures — focal neuro. lesion oad gl Ehii99 Quoc Al ouio gl lait + cgi! ed yla5d + Arig’> Ask about 8 common causes of chronic headache tulgb alas Alaol 60 Joleil ac alo iido ¢ laa 6ygmuioll Lund slesiuul ais 9 dalie Alas Ulalll Go Jolsill aia Vol Yojoll load! Glu! pau] yo clas 8 yc Jluin 1. Eye : Error of refraction $DUg Wail 9d ALAsio yd Jluim LU siti balas ulaia BLAU Yuldo gl aus rill 99 25 99 VJ 114 YLal pd ylite Uy élrol 40 MUL slg Yio YU YA) Elo 99 Gay ust) alino 2. Nose : Sinusitis SD 0g Assi] Ugis Jaic Jlurio syn 9 ii guile gle glansall ad gauaily doin dail igiall elie EoSpll a9 98 old) plagy YLsil lod jy) alll+ ysloll orm gle neatly 3. Ear: Otitis Media or Externa § lmin Glad caljlyal 94 F cLilag 94 Gag yd YLsil Jluim 4, Mouth : Tooth pain § yluuhll ga ll gl Aiko Saic ylsil Jluia 92H Ayollg Yluwhl 9d Udo 95 LLal Yui UA sro ius ail Bile Ylaylo 9 Elaay 5. Fever & any source of infection e.g. common cold § syull Walel gle Jluin (oS 99 puS5— ofl 9 oll audy— Aad - dyigdw) Lac! Iu gale a) 192 Lmaie Jao puis willl 6. Chronic constipation (Uojo Elna uu) Yoo gl ULuulll yo Gojoll ULuolllER management $ glilolzo Gratin olauii, JLaiull gla ayoll g STierMiievere aerate Mla SeliCaiime meron atone) lait Gla Ala gl gilguine uy Jula5 Jos ofl Any patient with convulsions + fever, exclude : ningitis & Encephaliti Febrile convulsions ay)allolaiii!: Jl gS + (Gai 5 — gmat 5) yyy le Lariy During seizure Gliuit cil 1. Oxygen by mask casa Sgl ale alaad 2. Recovery position SdlaUl Aog.ad oui 3. Suction of secretion (elo g) lis! | kaosiss 4. Anticonvulsant * Diazepam Neuril ampoule (10 mg in 2 ml) Amp ..O5LE PRS Gos) Ute gliglan ayo glass 9 alo aw 10 94 Jai oso! AES REET (Peck env Cv eLearn) Boe) Jvc gl (pau 399 21043 y921 (025 10 / oun I) ans JAJA Rectal acyall yudi g23 YAoo: Vgsil4 14)5 Ble Yito g) 100 quill Aaj ple alaag 10 = Galo) dail gle ous O.1= aly © edi yUguiil Aajpuy Acpoll aus ude Wael gl © JUSII to 08,845 iy 9 Jgsol= ow 2 = 4cja/!: 0420 yo psiJoiallgl ©ocal anathesia jy. i Lalessimin Mepacaine (1.8 mi) all oust! (sally aso gad) asa gl pS ansaid ji 03 Mepacaine -L (adrenalized) scab loudI! (Penis 9 Toes g Fingers 9 égioo) sola Ojiny gl ara glo Xylocaine 2% vial (50 ml! pdiiiuroll 99 gu puAdl Jal Lido / Lignocaine spray falrul agall pd ansainy Laulradurawioa aline Ayoll 919 Gadd sal ye ybryslo yAI yall AgBxo a1o4 gl jrA0 paw 2 JAI alo Jolao pau | ay Jets Lo Jd jsAoII G45 yoo p14 alas lS padt lasts 9 Glee Jaan dayasiil! Lal gd Maximum dose :5 mg/Kg sow 20 gulga jr4oU wall sall= aad 70 aijg osu : Hin Suspect toxicity if: headache, drowsiness, circumoral numbness Subcutaneous jiso Intradermal 2)! Wil 94 yaais $ alall as yo alll ga caida gul aSbl gli! ule * Swelling of edges Li asa alibi.5l = Resistance on injection taal clijl aoglog wai * Pain on injection doll cli] ollise all Saulrdi fei paral!Anti-Cough medications G54I)I Ggal Goull p8 ba93901 Ugall gn Gall au US law ugh Eggo Aad egal Eggo loli 9 lady) 9 Abin g lar 955 goal! pd 224! galgl cus Avo Qsloll Ulall g aosriuio bil clgall é5/ 9 Guu gAa4Jl Egi us gle Jamul) Eggo! yal 9 440 Laing) Ase ism i lags ama E9Adgell [sil Most common practical causes of eveae eter reer) 1. Current Flu or 5 joi pS ylaial § dzigaw F jum476 élaoS jiglalU Aub Abel yd © S yuj93 U0 Gllodu © N gl dasaub cul anil gJ.. Post-Viral coughs noun lod Acute Bronchitis 99 Jaa Wle pau Yacquul yc gb 2. ACE inhibitors e.g. Capotril § Capoten $ SAU Iga sdly Jul AdsLLU! ASI Ailal LayUl pail yo ACEI ALL Yo beall Aygal 3. GERD $ ol Gas lol agus eac Ble go> gl daszoll ad ric Ylja yd aaj Luni eal 0 bazall elas)! oaszyius) oj!) JW g aspiration & irritation of acid ww) Drugs for “Dry cough” contains : eg. dextromethorphan Aa4II yo UUs 9 Aoll pd A245 j40 ple YossDrugs for “Productive cough” contains : ole gga 29 edly a4! gal 4 Mucolytics 021 Wyio eg, bromohexine, ambroxol + Expectorant ali sya e.g. guainfenesin * Bronchodilator s2.iU) gwoo eg. aminophylline, terbutaline Guloio deh eyall gl boos us logas ASU wigs Antihistaminic 45)! Ig!) ualaoll yulasil 9 ay) eg. chloropheniramine, oxomemazine romsall dy) ecbul splay Yolo ou ejsildso gm lll arsil gioia lail Sayruil ashy Aa4 II Mls go AOL ASU Ulpt Bagis br89 4516 aI As) (jogiJl J4d 6519 Ads) faeLW dyysoll 9 jl! aygall Bag LAoi dyi14 aI AS) 09)! cli] 2a4J) agin Lal ieluro Yu) 9 89 Lac g bla Gallgun Jlrs ej) Aa4 clga gi dag Jud Saal | 1 F posli Vo dass aas 2Parasitic infection in adults JUSSI 8 Ulayal Presentation lo gost gull gglAsiull yabl 1. Diarrhea, constipation, tenesmus (ab itloxylo 9 Giay 9 1415 loa! 5.24) A4isi gl SLucol gf flaw! 2. Bloody or mucoid stool po gl bls0 a49 jul 3. Abdominal cramps ase 4, Peri-anal itching Qui! 409 aie 185 yiymsy 5. Anemia boil sluul pauil yo yaya ellsil awlul gle prio pl Inegi G35 9 Ylass 99 Go 251 ylite Jb Jalas Joss oj! lablaio pl ylayall élgil pail Entamoeba - Giardiasis - Oxyuris - ascaris - Anklystoma Treatment _ PEEL aL LVegetative form Metronidazole yo &sloJlAcjall ating gayle cLadll mw Liolll yo os Egill > Metronidazole Flagyl SOO tab 20 tab..6LE Amrizol 500 tab 20 tab..SLE Eat dro) Log cho 3 pays Secnidazole Fladazole 500 tab 4tab. OLE 53 Ug a8 6 alg 60 JAill a2) Lal,dl gyTinea Versicolor GigloIl Linu Presentation = Most common type of tinea pinay WWle Lill yo éo/ paul usually occur in summer Gy 9 uaylljLall gal icesil Commonly pale & less 9 ALi Adolé Lal 9 Aaild ga) Wle commonly dark lesions soit layleintiys Le p44] ety ods usually scaly 6 tend to jail g jatall gle ioks srl 4 merge forming larger patch . dal ASI g Spl g IAI usually occur in trunk, neck, eS proximal extremities Lipo at cla ay pall Lidl elgil US Gude gle pal paaud yo Ai Ig avo pre digloll Lint! Treatment éplul L.A5 Yoo S6ul yl ULSI ons5 of) yy ellsll go uur) Ula Bio JS 455 Soo g Ul ui YSoo 9 Lal egy lo wale soma ol 1. Instructions Agog auibeS ule clei! oisis Aloo) Abin ouini 0 laiuib olasiwl 2. Topical anti-fungal Tain Bis 9 GLagll Adlaigl! und gioliul! gl as! &Ag Ud = In small lesions ay4Jl olsriwl Lads Dermatin cream (Clotrimazole 1%) ISLE Miconaz cream (Miconazole 2%) 3LE Batrafen cream (Ciclopirex 1%) SLE Lamisil cream (Terbinafene 1%) IBLE Guegtul dso Tele 9 at.e ylas= In large lesions or hairy area e.g. scalp Nizapex shampoo (ketoconazole 2%) Nizoral shampoo (ketoconazole 2%) Gregiul dro! Log daly dso dlodly Glau (03 Gyl03 10 dao) Gla * Resistant cases ells) apolooIl UlaIlad Selsun blue shampoo wJlé yur dala Ad 32LE acguul dro) Logs dang 6.0 eld) Bhasin 05 G193 10 620) GLa Lid yo Lig arall gd Lcgiul daalg 5.0 giolitL oloriwlll Lads © 8q)0) pildg alla; Lignano 94) yl Jad) lal gle Adbrio gl pILiutlalle ala! jh55 9 Gull yo youth log dus) 5.45 38 AyLal gl alls) grolitl gull 3. Systemic anti-fungal (Fluconazole is the best) Flucoral caps 2 capsules .14.5 LE Fungican caps I capsule .. 10 LE Equal a3) Gail 03 yl yatlgues G2) ULAy sgmar0 Jin 909) Jol Us Ubrdb lo Ayoll yo ulbin ual Jiu 524) 9 Gril ofl ais lgall yl St Recs ae een yy Rx/ Nizapex shampoo Uacgul dao) Adu! gle Logs daal9 640 grolis (eloJL ta ais (05 GI193 10 Spy 9 quoliul Aq) 9 Bais fo &G4I Jans) Rx/ Flucoral caps Egsuul asy Gags 05 Yb Gatlgurs Ado ob gle Gloulsill Us goTonsillitis joUI Ula Age: 2-12 years (usually >4 years) = Toxic-look * High-grade fever + Enlarged tender cervical LN * Red spots over pharynx Treatment 1. Analgesic & Antipyretic Sjhall PABA og al ga bajLul lato olsAinsl (yb an sall— gala aa3— 4434) gle OlaloSIl &AQ UY lati! 94 Guwlio!! yAuoll gl dy),a)! WAdls Lisl 40.4 a9 Paracetamol - gas 6 0.13) © Ibuprofen gl Paracetamol :4iw—jamis6s0 © Declophenac gj Ibuprofen oi Paracetamol -dimcso us) © Ibuprofen Brufen 100 mg/Smi syrup 6LE 10 - 15 mg/Kg/day - Jlabbll 94 acyl anus = per dose (divided every 4 - 6 hours) byall Yjilo aa cileLu 6 ~ 4 JS deja! plasi g (2/yjgI gglusd 6aaigll dey + Paracetamol Cetal suppositories 5 supp 15 LE Pyral suppositories 5 supp . 15 LE ayball Ujis lo aa olelw 6 Us awe)Treatment of Type 2 DM GIL! Egil Go pAuuII Apo alle 1, Patient education / Diet / Exercise Gubroll daly duuyloo 9 Jl g uu ayo) Aalall ailaill yusi ug! pala eusall gd Ayia! WLI! dab ito: Cua wisi! Vala! gle Wa yoll Grau Gwguill oldi0 Aulus yas @usss Lull sal 2. Oral anti-diabetic drugs 1. Biquanides (Metformine) lala aaysb (05 2. Sulphonylureas @cgor0 yauiil g aml 3. Repaalinide 4, Combinations yas; 0 yricgoro gle ggini dygal shia yuol © 489 Repaglinide g/ 449 Sulphony! gi 49 Metformin load Golo orail gldcsoil agi urd ido g) © Metformin + Sulphonylurea Sulphonylurea General Contraindications of sulphonylurea 1. Renal failure 2. Hepatic failure 3. G6PD deficiency|. Gliclazide > Trade names Diamicron tab (80 mg) 20 tab. 9LE Diamicron 30 MR tab 30 tab. ALE Diamicron 60 MR tab 30 tab. 26LE > Dose Starting dose = 40-80 mg & Maximum dose = 320 mg Diamicron > Log, cLirsil Lud 9 jUaall Jud Yay ya Diamicron MR > Log, jodi Jud yay gala! Diamicron oasimin g) lami ae . short acting ail (cLissil 43 9 sll! 48) Gud.0 ple asd deal oj) 9 U99 9 V9}8 Yai pty 624 as) 2945 jgle gy Logs 41530 L948 Yai Lal bogs Grey 9 U4ay8 pad say yay Ko Diami IR (Modified Ri eat 1388 alg 60 alii Acyail g al4 ogull placa) os Lalpalll sac 95 ol gulel j44)5 osdtuul 29/5 jgle gl 9 Liog) slg yayS— Lal . Glibenclamide > Trade names Daonil tab (5 mg) 20 tab..6LE Glibenase tab (5 mg) 20 tab .. ISLE > Dose ‘Starting dose = 5 mg (2.5 in old age) & Maximum dose = 15 mg (oul LS 98 248 a) aogs jllaall ad yoy long acting ail) 6aalg 840 s5Uy) © ahd 3 gol sa) YolsSbl sac 39) 29/3 jgle gig yLAII laclo hogy yajy9s hal ©