PURPLE GLADIATOR KODIG & DRUGS

Highlighted = Pedia
Refer to TD Card/MIMS for Computations
Antibiotics Fever or Pain Relievers and Muscle Relaxants
● Cefixime ● HNBB 10mg/tab
○ 400 mg/tab: Take 1 tab once a day for 7 days ○ Take 1 tab every 8 hours as needed for
○ 200mg/tab: Take 1 tab every 12 hours for 7 abdominal pain
days ● Celecoxib 200mg/cap
○ UTI ○ Take 1 cap every 12 hours for 5 days
● Cefixime 100mg/5ml - 3rd gen ● Paracetamol 500 mg/tab
○ >6mo (or >3mo for PCAP): 8 mg/kg/24hr ÷ ○ Take 1 tab every 4 hours for Temp?37.8
Q12-24 (max dose: 400mg/24hr) ● Paracetamol + Orphenadrine Citrate (Norgesic)
○ Alternate dosing for acute UTI: 650mg/50mg/tab
■ 16 mg/kg/24hr ÷ Q12 on day 1, ○ Take 1 tab every 8 hours as needed for pain
followed by 8mg/kg/24hr ÷ Q24 x 13 ● Paracetamol 250mg/5ml
days ○ TD: 10-20 mg/kg/dose
● Cehftriaxone 2g TIV ○ (Kg x 10 x 45)/2 OR Kg x 0.2
○ Once a day ○ Give 4.5 ml every 4 hours for temp > 37.8 C
● Ceftriaxone 1g ● Paracetamol 100 mg/ml
○ Administer 500 mg single dose ○
○ STI - Gonorrhea ● Eperisone (Myonal) 50 mg
● Cefaclor 250 mg/5 ml ○ Take 1 tab 3x a day for 5 days
○ Give ____ml every 8 hours for 7 days ● Ibuprofen 200mg/tab or 400mg/tab
● Cefuroxime 500 mg/tab ○ Take 1 tab every 12 hours as needed for pain
○ Take 1 tab every 12 hours for 7 days ● Dexketoprofen Trometamol (Ketesse) 25 Mg
● Cefuroxime 250mg/5ml (50ml bottle) - 2nd gen ○ take 1 tab thrice a day for 5 days with full
○ For 3mo to 12 y.o stomach
○ Good for: UTI with Pneumonia pxts ○ Musculoskeletal pain
○ Pharyngitis and tonsillitis: ● Tramadol 50 mg/tab
■ 20mg/kg/24hr ÷ Q12 (max dose: ○ Take 1 tab as needed for SEVERE pain
500mg/24hr) ● Tramadol HCl + Paracetamol (Dolcet) 37.5/325
○ Otitis media, impetigo and maxillary sinusitis: mg/tab
■ 30mg/kg/24hr ÷ Q12 (max dose: ○ Take 1 tab every 8 hours as needed for pain
1g/24hr) ● Diclofenac 50mg/tab - for musculoskeletal/joint
○ Uncomplicated UTI (MIMS): ○ 1 tab TID as needed for pain
■ 3mo-2yr: 10mg/kg/24hr ÷ Q12 ● Ketorolac 10 mg
■ >2yr: 15mg/kg/24hr ÷ Q12 ○ 1 tab every 6 hours as needed for pain
● Ciprofloxacin 500 mg/tab ● Eperisone Hydrochloride (Myonal) 58 mg/tab
○ Take 1 tab every 12 hours for 7 days ○ 1 tab thrice a day for 5 days
● Co-Amoxiclav 625 mg/tab ○ muscle relaxant
○ IM/Surg: Take 1 tab every 12 hours for 7d ● Etoricoxib 120 mg/tab or 90mg/tab
○ ENT: Take 1 tab every 8 hours for 7 days ○ 1 tab now
○ Surg: 1 tab 2x a day for 7 days - ○ 1 tab once a day for 5 days
wound/Abrasion ● Parecoxib
● Co-amoxiclav (oral suspension) ○ In ER - 40mg IV now
○ Brand:Preparation ● Ketoprofen (Fastum) 25 mg/g - for pain at joint,
■ Amoclav: 156.25mg per 5ml (60ml ligaments and muscles
bottle) ←Use 125mg/5ml for ○ Apply 3-5 cm on the affected area once or
computation twice a day
■ Amoclav/Augmentin DS: 312.5mg per
5ml (60ml bottle) ←Use 250mg/5ml
for computation (commonly used)
■ Amoclav: 400mg/57mg per 5ml (70ml PEDIA
bottle) ● Ibuprofen (Dolan) 40 mg/ml Oral drops
○ TID Dosing: 20-40 mg/kg/24 hr ÷ Q8 ○ 0-2 mos : 0.5 -1 ml every 6 to 8 hours as
○ BID Dosing: 25-45 mg/kg/24 hr ÷ Q12 needed for pain or fever
(commonly used; TD:30) ○ 3-5 mos: 1 - 1.5 ml every 6 to 8 hours as
○ For highly resistant strain of S.pneumoniae in needed for pain or fever
acute otitis media and pneumonia: ○ 6 -12 mos: 1.5 - 2 ml as needed for pain or
 80-90mg/kg/24 hrs ÷ Q12 fever
○ watch out: abdominal pain and age for ○ 1-2 y: 2 - 2.5 ml as needed for pain or fever
children ● Ibuprofen (Dolan) 100 mg/5ml
● Clindamycin 300mg/cap ○ 1-2 y: 5 ml ---------
○ Take 1 cap every 6 hours for 7 days ○ 3-6 y: 5-10 ml --------
○ Take 1 cap every 8 hours for 7 days (infected ○ 7 - 12 y: 10 ml ------
sebaceous cyst) - full stomach ● Ibuprofen (Dolan) 200mg/5 ml
● Cloxacillin 500 mg ○ 1-2y : 2.5 ml --------
○ Take 1 tab every 6 hours for 7 days ○ 3-6y: 3 ml ------
● Sultamicillin 750 mg/tab ○ 7-12 y: 5 ml -------------
○ Take 1 tab every 12 hours for 7 days
○ ENT: Take 1 tab every 8 hours for 7 days
● Azithromycin 500mg/tab
○ Take 1 tab once a day for 5 days
○ Pneumonia/BIP
● Amoxicillin + Clauvanic acid 65mg/tab BID for 5 days
● Amoxicillin 250 mg/5ml
○ 30-50 mg/kg/day every 8 hours
○ Give ____ ml every 8 hours for 7 days
● Mupirocin Ointment 20mg/g
○ Apply to affected area 3x a day for 7 days
● Metronidazole 500mg/tab
○ 1 tab every 8 hours for 5 days
● Piperacillin-Tazobactam 4.5g IV
○ Now then every 8 hours
● Fosfomycin 3g/sachet
○ Dissolve 1 sachet in half glass water and take
as a single dose AFTER meals
○ Prophylaxis of UTI or for uncomplicated UTI
● Levofloxacin 500mg/tab
○ 1 tab once a day
○ UTI
● Cotrimoxazole 800mg/160 mg/tab
○ 1 tab every 12 hours for 7 days
○ UTI
● Sultamicillin 750 mg
○ Twice a day
○ For large wounds

Note:
1st generation cephalosporin = Gram +
2-3 = mix
4th generation cephalosporin = Gram -
Acid Peptic Disease/GERD Cough
● Pantoprazole 40mg/tab 1. Productive: Mucolytic
○ FOR ER: 40mg IV now ○ N-acetylcysteine (Fluimucil) 600mg
○ FOR HOME MEDS: Take 1 tab 30 mins before i. Dissolve in half glass water and drink
breakfast at night
■ 2-4 weeks: Peptic Ulcer ○ N-acetylcysteine (Fluimucil) 100mg/sachet
■ 4 weeks: GERD i. Dissolve 1 sachet in small amount of
○ Prevents stress ulcers water and give 3 times a day for 5
○ UGIB - prevention of rebleeding, and for the days
prophylaxis of acute bleeding stress ulcers ○ Ambroxol 30 mg/5ml - Micokinetics
● Omeprazole 40mg/tab (mucolytic and expectorant)
○ Take 1 tab 30 mins before breakfast for 7 or i. Give ____ml twice a day for 7 days
14 days ○ Ambroxol 15 mg/5ml - Micokinetics
○ Take 1 tab 30 min before breakfast for 30 days (mucolytic and expectorant)
● Omeprazole 20 mg/cap i. Give ____ml twice a day for 5 days
○ Take 1 cap once a day before breakfast for 2 ○ Other: Carbocysteine
weeks ○ Carbocisteine (Solmux) 500mg/cap
● Esomeprazole 40mg/tab i. 1 capsule 3x a day or every 6 hours
○ Take 1 tab 30 mins before breakfast for 7 days for 5 days
 ● Metoclopramide 10mg/tab 2. Dry: Antitussive
○ Take 1 tab every 8 hours for nausea/vomiting ○ Butamirate citrate (Sinecod forte) 50mg/tab
○ In ER - 10mg IV i. 1 tab TID (every 8 hours) for 5 days
● Algina sachet ○ Butamirate citrate 7.5 mg/5 ml
○ 1 sachet as 3x a day after meals i. 3-6y: Give 5 ml three times a day for
● Gaviscon 7 days
○ Take 1 sachet 3x a day 1 hour after meal ii. 6-12y: Give 10 ml three times a day
● Ranitidine 150 mg/tab for 7 days
○ Take 1 tab OD for 5 days iii. > 12 y: Give 15 ml three times a day
● Domperidone 10mg/tab or for 7 days
○ take 1 tab 3x a day before meals for 5 days ○ Guaifenesin
● Famotidine ○ Dextromethorphan
○ IV → Dilute 2 ml (20 mg) with 0.9% NaCl inj ○ Robitussin
○ Vitex negundo L. Lagundi 600mg/tab
i. 1 tab 3x/day for 5 days

Vertigo/Motion Sickness/Nausea and Vomiting Colds

● Metoclopramide (Plasil) 10 mg/tab ● Sinupret forte
○ Take 1 tab every 8 hours as needed for ○ 1 tab TID for 5 days
vomiting ● Mometasone Furoate - runny nose
● Meclizine (Bonamine) 25mg/tab ○ 2 sprays on nostril once a day at bedtime for
○ Take 1 tab every 8 hoq urs 2 weeks
● Betahistine 24mg/tab ● Sodium Chloride (NaCl) nasal spray - stuffy nose
○ Take 1 tab every 12 hours for 2 weeks (salinase nasal spray)
○ Vertigo/BPPH ○ 2 sprays on nostril 3x a day for 7 days
● Cinnarizine 25 mg/tab ● Phenylephrine HCl + Chlorpheniramine Maleate +
○ 1 tab 3x a day for nausea or vomiting Paracetamol (Nafarin - A) Clogged
○ Take 1 tab every 8 hours for 5 days
○ If allergic rhinitis, acute rhinitis (pale boggy
and congested turbinates)
● Phenylpropanolamine HCL + Brompheniramine
Maleate (Nasatapp) 15 mg/12 mg tablet
○ Take 1 tablet twice a day

Tx: Combination of
1. Antihistamine + Decongestant (Clogged)
2. Antihistamine + NaCl Spray
Hypertensive Drugs Cardio Drugs
● Amlodipine 5mg/tab ● Aspirin 80 mg/tab
○ 1 tab once a day ○ Take 1 tab once a day
● Perindopril + Amlodipine 3.5/2.5 mg/tab ○ Remove aspirin (5-7 days) before any surgical
● Carvedilol 12.5 mg/tab or 6.5mg/tab procedure
○ 1 tab BID ● Cilostazol 100 mg / tab no
● Propranolol 10mg/tab ○ 1 tab every 12 hours
○ 1 tab TID ○ prevent vasospasm hence delaying cerebral
○ A sa ischemia after a subarachnoid hemorrhage
○ Take 1 tab as needed for palpitations every secondary to aneurysm
12 hours ● Clopidogrel 75 mg/tab
● Nebivolol 5mg/tab ○ Take 1 tab once a day
○ 1 tab 3x a day ● Trimetazidine TMZ 35mg/tab
● 50 mg/tab - 100mg/tab ○ 1 tab once a day
○ Take 1 tab once a day ● Nifedipine 60 mg/tab
● Irbesartan 300mg/tab - w/DM ○ 1 tab twice a day
○ Take 1 tab once a day ● Calcium Gluconate
● Clonidine 75 mcg/tab ○ Cardioprotective
○ Dissolve 1 tab sublingual as needed for BP ● Atropine IV - Bradycardia
>160/90 ○ First dose 0.5-1mg bolus
● Spironolactone 25 mg/tab ○ Repeat every 3-5 min
○ 1 tab once a day ○ Max 3 mg
● Enalapril 5mg/tab ● SD Dopamine 5mcg/kg/hr
 ○ 1 tab once a day ○ AF in SVR
● Telmisartan 80mg/tab or 40mg/tab ● Adenosine - for SVT
○ 1 tab once a day ● Propranolol 10mg
● Indapamide (thiazide diuretic) 1.5mg/tab ○ 1 tab TID PRN
○ 1 tab twice a day ● ISDN
● Nicardipine drip - Emergency ○ 5mg sublingual
○ 2mg IV
○ Maintain MAP 110-130
● Furosemide 40mg/tab
● 1 tab twice a day
● Nimodipine 30 mg/tab
○ 2 tabs every 4 hours
*Combination drugs refer to CFM notes section below
Crisis: Hypertensive urgency or emergency
Urgency: Acute rise in blood pressure without acute
end-organ damage; diastolic blood pressure usually >120
mmgHG
Emergency: Acute rise in blood pressure with acute
end-organ damage; diastolic blood pressure usually >120
mmHg no
Safe BP - 160/90
Diabetes/Hyperglycemia/Hypogylcemia Hyperlipidemia/ Dyslipidismia
● Metformin 500 mg/tab or 1000mg ● Atorvastatin 40 mg/tab or 80 mg/tab
○ Take 1 tab once a day ○ Take 1 tab once a day at bedtime
○ First line ○ Inh. Plaque Adhesion and Min. Plaque
○ DM: Take 1 tab three times a day Regression
■ Max is 3000 mg but di siya optimize ● Rosuvastatin 10mg/tab or 20mg/tab
so might as well 2000 mg lang ibigay ○ Take 2 tab once a day
then add nalang another drug :) ○ Inh. Plaque Adhesion and Plaque regression
● Gliclazide 60 mg ● Simvastatin 20mg or 40 mg or 80 mg
○ 1 tab once a day ○ 1 tab once a day
● Glimepiride ○ Inh. Plaque adhesion
● D50 50mL slow push for hypoglycemia
● Empagliflozin + Metformin 12.5/ Best given at night: statin clearance optimal 11 pm to 2 am
● 1000mg/tab
○ Take 1 tab once a day
● Janumet
● Dipogliptozine
Conversion = mmol/dL x 18 (18.3)
Constant = 18
*Combination drugs refer to CFM notes below
Lessen dose if GFR <50 → 500 mg ONLY
- If GFR <30 → discontinue to prevent lactic acidosis
It
Ear Infection Sore Throat/Tonsillitis
● Ofloxacin otic drops ● Benzydamine + Chlorhexidine (Difflam) oral
○ Instill 5 drop on R/L ear 2x a day for 7 days ○ Gargle 15 ml undiluted for 30 sec, 3x a day for
● Neomycin sulfate + Triamcinolone Acetonide + 7 days
gramicidin + nystatin otic drops (Vendicom) ● Difflam throat spray
○ Instill 3 drops on R/L ear 3x a day for 7 days ○ Instill 2-3 sprays TID for throat pain
● Polymyxin B + Neomycin + Fluocinolone otic drops ○ ENT: Instill 2-3 sprays on throat 3x a day for 7
○ Instill 3 drops on R/L ear 3x a days for 7 days days
● (PND) Polymyxin B + Neomycin + Dexamethasone otic ● Difflam lozenge
drops (Neotic) ○ Dissolve 1 lozenge every 6 hours for throat
○ Sig. Instill 3 drops on R/L ear 3 times a day for clearance
7 days ● Hexetidine 0.1% Soluti- (Bactidol)
○ Gargle three times a day
○ Not used for everyday hygiene use listerine
 instead
● Kamillosan Spray
○ Spray onto throat three times a day
● Povidone iodine oral solution (Betadine)
○ Sig. Gargle 15ml undiluted for 30 seconds 3
times for 7 days
UTI Kidney Stones/Nephrolithiasis
● Fosfomycin 3g/sachet ● Potassium Citrate 1080 mg/tab
○ Dissolve 1 sachet in half glass water and take ○ Take 1 tab 2x a day for 7 days
as a single dose at least 1 hour before or at ● Rowatinex
least 2 hours after meal ○ Take 1 tab 3x a day for 5 days
○ UNCOMPLICATED UTI ○ Sambong forte 500mg - 1 tab 3x a day
● Ciprofloxacin 500 mg/tab
○ Take 1 tab every 12 hours for 7 days Order: (Nephrolithiasis)
○ COMPLICATED UTI - CBC, UA, Crea
● HNBB (Buscopan) 10 mg.tab - CT Stonogram
○ 1 tab TID as needed for pain
Notes:
- Female, Reproductive Age, Hypogastric and Flank Pain Kidney - CKD
- No need for Urinalysis expect UTI ● Ketoanalogue 600mg/tab
- Recurrent if: 3 in 1 year or 2 in 6 months ● 1 tab 3x a day

Asthma /Obstructive Respi Antihistamine/Runny Nose/Itchy Nose/Clogged/

● Salbutamol + Ipratropium Nebulization Hypersensitivity Reaction
○ Nebulize 1 nebule every 6 hours for 3 days ● Levocetirizine + Montelukast (Zykast)
then as needed ○ Take 1 tab OD for 7 days
● Salmeterol + Fluticasone Propionate (seretide) 25 ○ ENT: Take 1 tab once a day at bedtime for 2
mcg/125mcg weeks
○ 2 puff every 12 hours for 2 weeks ● Methylprednisolone 16mg/tab
● Salbutamol + Ipratropium MDI ○ Take 1 tab BID a day for 5 days
○ 2 puff every 6 hours ● Mometasone Furoate - runny nose
● Budesonide + Formoterol ○ 2 sprays on nostril once a day at bedtime for
○ 1 puff twice a day 2 weeks
● Hydrocort (Corticosteroid) ● Sodium Chloride nasal spray - stuffy nose
○ 2 sprays on nostril 3x a day for 7 days
PEDIA: ● Sinu Forte - clogged
● NSS Nebulization ○ Take 1 tab every 8 hours for 5 days
○ Nebulize 2 ml every 8 hours for 5 days ● Sinupret Forte Dragee
● Pulmodual 3 doses 15 minutes apart, and ○ take 1 dragee 3x a day for 7 days
budesonide nebulization 1 dose n ● Phenylephrine HCl + Chlorpheniramine Maleate +
● Paracetamol (Nafarin - A) Clogged
○ Take 1 tab every 8 hours for 5 days
● Loratadine + Betamethasone (Claricort) 5mg/250mcg
● 1 tablet twice a day for 7 days

PEDIATRICS
● Diphenhydramine 12.5 mg/5ml
○ Give 10 ml twice a day as needed
● Cetirizine 5mg/5ml syrup
○ 5ml once a day at bedtime or as needed for
itchiness
● Cetirizine 2.5mg/ml drops
○ 1 ml once a day at bedtime or as needed for
itchiness for 3 days
● Cetirizine + Phenylephrine HCl
○ 2-5y: Give 2.5 ml every 12 hours
○ 6-12y: Give 5 ml every 12 hours
● Phenylephrine HCl + Chlorphenamine maleate
(Disudrin) 5 mg/ml
○ 2-6y: 2.5 ml every 6 hours for 3 days
○ 7-12y: 5 ml every 6 hours for 3 days
 ○ >12y: 10 ml every 6 hours for 3 days
● Loratidine + Phenylephrine HCl syrup 5mg/5ml
○

Hyperthyroidism BPH
● Methimazole 10mg/tab ● Tamsulosin 400mcg/tab po
○ 1 tab BID ● 1 tab once a day at bedtime for ___

Gout Bleeding
● Colchicine 500 mcg/tab ● Tranexamic Acid 500 mg/tab
○ Take 1 tab 3x a day for 5 days ○ Take 1 tab every 8 hours for 3-5 days
○ HOLD if with loose stools
● Febuxostat 40 mg, 80mg, 120 mg Notes: PMH: ask for NSAID use, risk for H. pylori, chronic
○ Take 1 tab once a day obstructive lung disease, chronic renal insufficiency,
○ Used to lower uric acid level l
● Allopurinol
○ Take 1 tab once a day
● Probenecid 500 mg/tab
○ Take 1 tab one a day for 7 days
Acute Attack:
● NSAID (first line), Colchicine, Glucocorticoids
For transfusion: Chronic Venous Insufficiency
4 units PRMC properly typed & crossmatched ● Cilostazol 50mg/tab
○ 1 tab twice a day
○ Sulodexide 250LSU/cap
○ 1 cap twice a day

Chest pain Muscle Sprain/Musculoskeletal Strain

● Rule out: MI, Costochondritis, APD, GERD ● Eperisone 50 mg/tab
● Order: Pantoprazole/ Gaviscon or Pain meds + ECG, ○ 1 tab TID - for frozen shoulder, muscle strain
Trop I, CBC, CXR, Na, K, Cl ● Diclofenac 50mg/tab - for musculoskeletal/joint
○ 1 tab TID as needed for pain
● Ketoprofen gel (Fastum)
○ Apply to affected area 3x a day for pain
● Ice compress every 4 hours for 20-30 mins
● Elevate foot at same level
Constipation/Fecal Stasis Diarrhea/ AGE/ Acute GI Upset/Vomiting
● Lactulose - Osmotic ● Racecadotril 100 mg/tab
○ Take 30cc once a day at bedtime. Hold if BM ○ Take 1 tab 3x a day until formed stool
>2 ● Rifaximin 200mg/tab - for travelers diarrhea
● Bisacodyl - Stimulant ● Take 1 tab 3x a day for 3 days
○ 5mg OD before bedtime ● KCL tablet 750 mg/tab
○ If you don't feel pooping ○ Take 1 tab 3x a day for 6 doses
● Dulcolax suppository ● Vitamin B-complex, iron, buclizine hydrochloride
○ Insert 2 suppository per anal canal ○ Take 1 cap once a day
● Lactulose ○ For increase appetite
○ Give 5 ml a day for 5 days or until 2-3 ● Dibencozide (Heraclene forte) 3mg/tab
episodes of stool ○ take 1 tab once day
● Dulcolax suppository 5 mg #2 ● Bifilac
○ Insert 1 suppository per anal canal ○ take 1 tab twice a day for 3 days
○ if cannot defecate insert one more ● Erceflora
● Diet: Increase fluids and Fiber Intake ○ take 1 vial once a day for 3 days
● Otilonium bromide 40mg/tab
○ take 1 tab every 6-8 hours as needed for
crampy abdominal pain
 Vomiting = Metabolic Alkalosis
Diarrhea = Metabolic Acidosis
PEDIATRICS
● ORS (Pedialyte or Vivalyte)
○ Dissolve in 1 glass of water then drink for
every episode of loose stool (IM)
○ PEDIA
■ Give as much as wanted in small sips
for every episode of fever, vomiting
or loose stool (PEDIA >10)
■ Give 100-200ml in small sips for every
bout of fever, vomiting or loose stool
(PEDIA 2-10y/o)
■ Give 50-100ml in small sips for every
bout of fever, vomiting or loose stool
(PEDIA <2y/o)
● Pedialyte 30 or 45
○ Give 100-200 mL via sips of water as needed
● Bacillus Clausii (Erceflora)
○ 1 vial once a day for 5 days
● Zinc Sulfate 55.5mg/5mL
○ Under 6mos: Give 2.5mL once a day for 14
days
○ 6mo and older: Give 5mL once a day for 14
days
● Zinc Sulfate 27.5mg/ml (oral drops)
○ Under 6mos: Give 1mL once a day for 14 days
○ 6mo and older: Give 2mL once a day for 14
days
● Zinc Gluconate tablet
○ Give 1 tab once a day for 14 days
● Lactobacillus reuteri (Flotera) chewable tablet/drops
○ (4y/o and up) Give 1 chewable tablet
once/twice a day for 5 days
○ (1-3y/o) Give 5 drops once a day for 7 days
○ Probiotic food supplement (PEDIA)
● Racecadotril 30 mg
○ Give 1 sachet and mix in small amount of
water given once a day for 5 day
● Domperidone 5 mg/5ml
○ Give 5 ml three times a day before meals
● Domperidone 10mg/tab
○ Give 1 tab 3x a day before meals for 5 days
Misc/ Vitamins / Others Supplements/Correction
● Pregabalin 50 mg/tab ● Vitamin C + Zinc
○ 1 tab BID ○ Take 1 tab once a day
○ Anti-neuropathic pain/Anticonvulsant ● Ferrous Sulfate + Folic Acid
○ Nerve pain ○ Take 1 tab once a day
● Pregabalin 75 mg ● NaCl tab 1g
○ Take 1 tab once daily as needed for pain ○ 3x a day for 6 doses (For Sodium correction)
● Gabapentin 300 mg/tab ○ 3x a day for 5 days #15
○ 1 tab BID ● NaHCO3 100 meqs IV (for sodium correction)
● Neomycin sulfate + Triamcinolone Acetonide + ● KCl Tablet 600mg/tab (Kalium Durule)
gramicidin + nystatin otic drops (Vendicom) ○ 1 tab TID (for Potassium correction) for 6
○ Instill 3 drops on R/L ear 3x a day for 7 days doses
● Mineral oil ● KCl tablet > KCl IV
○ Instill to earfill on R/L ear for 10-15 mins 3x a ○ Tablet is more tolerable
day for 7 days ● Potassium Citrate 15meqs/tab
● Vitamin B Complex ○ 1 tab twice a day
○ In PNSS 1L x 100cc/hr ● Calcium polystyrene (kalimate)
○ If intoxicated (alcohol)- ○ 1 sachet thrice a day for 3 doses
● Protexin Restore sachet
 ○ Mix in small amount of water, milk or juice
and give once a day for 7 days
○ Probiotics (PEDIA)
● Multivitamin syrup
○ Give 5 ml once a day
● Vitamin C + Zinc Syrup
○ Give 2.5 ml once a day
Difficulty Sleeping Seizures/Anticonvulsants
● Diphenhydramine (Benadryl) 50mg/tab ● Diazepam 5 mg TIV
○ Take 1 tab once a day at bedtime for difficulty ● Clonazepam 2 mg/tab
of sleeping ○ Take ½ tab once a day at night
● Melatonin 2 mg ○ Take ¼ tab once a day at night
○ Take 1 tab once a day, 1-2 hours before ● Levetiracetam 500 mg IV
bedtime ○ every 12 hours
○ To treat epilepsy
● Levetiracetam 1g IV
○ Every 12 hours
○ To prevent Seizures
● Lacosamide 100 mg/tab
○ 1 tab every 12 hours
○ Partial onset Seizures
●
Notes:
- Scarring usually in the temporo-parietal area
Pedia: Benign Febrile Seizure, Seizure (Epilepsy), Seizure due
to skin infection (staph)
Hypersensitivity Reaction (Whole Body)
● Diphenhydramine 50 mg IV now
● Hydrocortisone 200 mg IV now
● Epinephrine 0.3 IM
● Famotidine 20 mg IV now
○ Scombroid reaction
Take home medication:
● Diphenhydramine 50mg/tab - 1 tab once a day
● Prednisone 10mg/tab - 1 tab twice a day
PEDIA:
● Diphenhydramine 12.5 mg/5ml
○ Give 10 ml twice a day as needed
Substance Ingestion Bruise
● Within 6 hours of ingestion: Activated Charcoal, then ● Cold Compress for 15 minutes, 4-5x daily for first 3
after 30 mins - 1 hour give Na Sulfate days, then warm compress thereafter until swelling
subsides
Eyes/Ophtha Eyes/Ophtha
● Sodium Hyaluronate eye drops ● Erythromycin eye ointment
○ For dry eyes ○ Apply 1 strip on affected area ____eye/s
○ Instill 1 drop to both eyes 4-6x a day (can be every 4 hours
more than 6x, but not less than 4x) ○ Used along with tobradex on more severe
○ 1 drop on ___ eye/s 4 times a day cases
■ 8 am -- 12 pm -- 4pm -- 8 pm ● Mupirocin ointment
● Tobramycin + Dexamethasone eyedrops (Tobradex) ○ 1 strip to the affected area 3 times a day for 7
○ For conjunctivitis, prophylaxis in trauma days
○ Instill 1 drop to affected eye (sometimes both ● Ibuprofen 200 mg/tab
eyes for prophylaxis or bacterial ○ 1 tab every 6 hours as needed for pain
conjunctivitis) every 4 hours ● Celecoxib 200 mg/cap
(8am-12pm-4pm-8pm) ○ 1 cap every 12 hours as needed for pain
○ If bacterial conjunctivitis, suggest change of ● Co-amoxiclav 625mg/tab
bedsheets, don’t wear makeup. If wore ○ 1 tab every 8 hours for 7 days
 makeup when symptomatic, throw makeup ● Warm compress - 10-15 minutes 4x a day for dry eyes
away. ● Cold compress - 10-15 minutes 4x a day for allergies
● Tobramycin + Dexamethasone eye ointment ● Vitamin C - 500mg/tab 2x a day to improve healing
○ 1 strip on __ eye/s 3 times a day as lid
hygiene
● Levofloxacin (Oftaquix 0.5%) eyedrops
○ For conjunctivitis also
○ 1 drop every 4x a day
● Moxifloxacin eye drops
○ For bacterial conjunctivitis
○ 1 drop on ___eye/s 4 times a day for 7 days
● Prednisolone Acetate eye
○ Reduce irritation, redness, burning,
swelling/inflammation
○ 1 drop on ___ eye/s 4 times a day
● Carboxymethyl Cellulose Sodiu
○ instill 1 drop to both eyes 4x a day
(8am-12nn-4pm-8pm)
Eyes/Ophtha ENT (Common Medication)
● Anesthetics ● Betahistine 24mg/tab
○ Proparacaine hydrochloride 0.5% ○ Sig. Take 1 tab every 12 hours for 2 weeks
■ Alcaine with dye ● Benzydamine + Chlorhexidine (Difflam C)
■ Alcaine without dye ○ Sig. Gargle 15ml undiluted for 30 seconds 3
○ Dye Strips times a day for 7 days
■ Swipe on affected eye ● Celecoxib 200mg/cap (Coxidia)
○ Tropicamide Phenylephrine Hydrochloride ○ Sig. Take 1 cap every 12 hours as needed for
(Sanmyd) pain
■ 1 drop every 15 minutes for 3 doses ● Ibuprofen 400mg/tab (Faspic)
■ Dilation ○ Sig. Take 1 tab every 6 hours as needed for
○ Tropicamide (Mydriacyl) 0.5% pain
■ 1 drop every 15 minutes for 3 doses ● Co-amoxiclav 625mg/tab (Bactiv)
■ Dilation used >140/80 BP ○ Sig. Take 1 tab every 8 hours for 7 days
■ Hypertensive ● (PNF) Polymyxin B + Neomycin + Fluocinolone otic
○ Pilocarpine drops (Aceflo)
■ 1 drop every 15 minutes for 3 doses ○ Sig. Instill 3 drops on R/L ear 3 times a day for
■ For Trabeculectomy - surgery for 7 days
glaucoma (Filtration Surgery)
ENT (Other Medications) ENT (Other Medications)
● Docusate sodium 5mg/ml (Irwax) ● Mineral oil
○ Sig. Instill to earfill on R/L ear for 5 mins 3 ○ Sig. Instill to earfill on R/L ear for 10-15 mins
times a day for 3-5 days 3 times a day for 7 days
● Ebastine 20mg/tab ● Mometasone Fuorate
○ Sig. Take 1 tab once a day before bedtime for ○ Sig. 2 sprays on each nostril once a day at bed
2 weeks time for 2 weeks
● Eperisone 50mg/tab (Myelax) ● Neomycin sulfate + Triamcinolone acetonide +
○ Sig. Take 1 tab every 8 hours for 5 days gramicidin + nystatin otic drops (Combiz)
● Fluticasone propionate (Nasoflo) ○ Sig. Instill 3 drops on R/L ear 3 times a day for
○ Sig. 2 sprays on each nostril once a day before 7 days
bedtime for 2 weeks ● Ofloxacin otic drops (Oflobiz)
○ Sig. Instill 5 drops on R/L ear 2 times a day for
7 days
Chicken Pox/Varicella Hand, Foot and Mouth Disease
● Acyclovir 500mg/tab (Rash/Mouth Ulcer)
○ take 1 tab 5 daily for 10 days ● Kamillosan spray
● Acyclovir 400mg/5ml ○ Spray onto mouth lesion 3 times a day
● Acyclovir cream ● Rowagel 2%
○ Apply 1 strip to lesions 5x daily ○ Apply to mouth ulcers 4 times a day after
meals and before bedtime
● Diet: Cold foods
● Others: Cetirizine, Paracetamol,
Tuberculosis
● Isoniazid, Rifampicin, Pyrazinamide, Ethambutol,
Streptomycin
● Rifampicin, Isoniazid, Pyrazinamide, Ethambutol 150
mg/75 mg/ 400 mg/ 275 mg
○ Initial phase: Take 1 tab once a day for 2
months
● Rifampicin, Isoniazid, Ethambutol
○ Continuation phase: Take 1 tab once a day for
4-6 months
● Rifampicin, Isoniazid
○ 3-5 tabs a day for 4 months
NOTEL Tablets should be taken once hour before or two hours
after meals
● Alternative
○ Amikacin
○ Ciprofloxacin, Ofloxacin
○ Ethionamide
○ P Aminosalicylic Acid
○ Capreomycin
○ Cycloserine
Category 3 Animal Bite Notes:
Chart Order: ● ERIg dose formule
● Tetanus Toxoid 0.5 mL TIM ○ ERIG: Patient’s Weight in KG x 40
● Tetanus Ig 250 IU TIM ■ ERIg 3,200 IU TIM ()ANST
● Anti-Rabies 0.5 mL TIM ● HRIG KG X 20
● ERIg dose IU TIM () ANST ● EACH VIAL HAS 300 UNITS
● Anti-Rabies Vaccination Card (Brand Names)
○ Verorab - 4 doses (Day 0, 3,7,14)
○ Speeda - 5 doses (Day 0,3,7, 14,21)
Take Home Meds:
● Co-amoxiclav 625mg/tab
○ Take 1 tab BID for 7 days
● Paracetamol 500mg/tab
○ Take 1 tab every 6 hours as needed for pain
● Mupirocin ointment
○ Apply on affected are 3 times a day for 5 dyas

Category 2 Wound Care/ Skin Care

● Tetanus Toxoid 0.5 mL TIM ● Mupirocin ointment
● Tetanus Ig (Immunoglobulin) 250 IU TIM ○ Apply on affected area 3 times a day for 5
● Anti-Rabies 0.5 mL TIM days
● Zinc Oxide + Calamine (Calmoseptine)
○ Apply on affected area 2-4 times a day
Tetanus Vaccine
● Minor/Clean
○ Not immunized then: Complete vaccination
■ Tetanus toxoid 0.5 mL TIM
○ Complete Immunization then:
■ <10 years: dont give
■ >10 years: Tetanus toxoid 0.5mL TIM
● Major/Clean or tetanus prone
○ Not immunized OR completely immunizied
but >10 years
■ Tetanus Ig 250 IU TIM
■ Tetanus toxoid 0.5 mL TIM
○ 5-10 years
■ Tetanus toxoid 0.5 mL TIM
● Tetanus prone: delayed or incomplete debridement
○ Not immunized OR completely immunizied
 but >10 years
■ Tetanus Ig 500 IU TIM
■ Tetanus toxoid 0.5 mL TIM
■ Antibiotic therapy
○ 5-10 years
■ Tetanus toxoid 0.5 mL TIM
■ Antibiotic therapy
IM Cases Management
UGIB LGIB
● S&S: Hematemesis, Melena (14-5days), Hyperactive ● S&S: Hematochezia
Bowel sounds, Elevated BUN ● DDX: Bleeding Diverticulosis; Internal Hemorrhoids;
● DDX: Bleeding Peptic Ulcer Disease, Esophageal Malignancy; Inflammatory Bowel disease, Vascular
Varices, Dieulafoy lesion, Mallory Weiss Tear, Erosive Ectasias, Colitis, Postpolypectomy Bleeding
Disease; Neoplasms, Vascular Extasias, Prolapse ○ Rare: Solitary rectal ulcer syndrome, Trauma,
Gastropathy Varices, Fistula, AVM, Radiation or Ischemic
● Management: Colitis
○ NPO ● Management:
○ D5 NSS x 80 cc/hr ○ NPO
○ CBC, Na, K, BUN, Crea, CBG, PT/PTT, 12LECG, ○ D5 NSS x 80 cc/hr
CXR, UA, WA CT w/ contrast ○ CBC, Na, K, BUN, Crea, CBG, PT/PTT, 12LECG,
○ Ceftriaxone 2g IV OD, Metronidazole 500 mg CXR, UA, WA CT w/ contrast
IV TID, Pantoprazole 40 mg IV BID, Tranexamic ○ Ceftriaxone 2g IV OD, Metronidazole 500 mg
Acid 500 mg, IV TID IV TID, Pantoprazole 40 mg IV BID, Tranexamic
● Give Pantropazole 80mg bolis TIV since it can reduce Acid 500 mg, IV TID
blood clots then drip 8 mg for 8 hours
DKA HHS
- Hyperglycemia - Severe Hyperglycemia (elevated osmolality)
- Metabolic acidosis - pH >7.3
- Ketonemia (elevated betahydrocybutyrate) - Minimal or negative ketonemia
- Volume depletion - Profound volume depletion
- Young> Elderly; T1DM > T2DM - Elderly > Young; T2DM, 20% w/o hx of T2DM
- Acute Presentation - Longer, protracted course of illness
- Tx
- Fluids
Stroke Management
Stroke Stroke Management: CVD Bleed --summary
Ictus: Time last seen normal IVF: 0.9 NSS 1L x 16 hrs (NPO) or 0.9 NSS 1L x 30 cc/ hr (once
<4.5h + no bleed → tpa oral feeding)
<4h → CT scan to rule out Bleed; wala pang makikitang infarct - PNSS fluid
>4-5hs or days → MRI Diagnostics
- Cranial MRI - DWI - PT/PTT
MRI if you are suspecting infarct - If you plan to start warfarin/heparin
Bleed at posterior → MRI since may bone na nakaharang Medication
Treat Territorial Infarct and Hemorrhage as one ● Mannitol 150 mg TSIV push every 8 hours
○ For decompression
INFARCT: NIHSS ● Atorvastatin 20 mg/tab
HEMORRHAGE: ICH ○ 1 tab once a day
SUBARACHNOID HEMORRHAGE: HUNT and HESS ● Citicoline 1g TIV every 12 hours - wala lang
● Pantoprazole 40 mg TIV once a day
Loss of balance/Dizziness CC → Occipital area → MRI ● Metoclopramide 10 mg TIV every 8 hours for nausea
or vomiting
NEUROPROTECTION ● For infarct: loading dose of Aspirin 80mg 2 tabs,
Watch Out for 5 Hs for Stroke Atorvastatin 80mg, and Citicoline 1g TIV
- Hypotension
- Treat only if MAP >130 mmHg Disposition:
- Hyperglycemia ● Monitor CBG 3x a day premeal
- Do CBG Monitoring to preserve penumbra ● Monitor MAP 110-130 for permissive hypertension
- Hypoxemia ○ Permissive HTN for the first 7 days to
- Hook pxt to mechanical ventilator; prevent maintain MAP at 110-130 mmHg
 desaturation ● Monitor vital signs and record
- Hyponatremia ● Measure input and output and record
- Prevent seizures (<118) Normal is 135-145
- Hyperthermia
- Destruction of cellular enzymes and
membranes
IM MUST KNOWS
Basic ECG ACS ORDERS
Rate:
Irregular: counts 30 big box → count number of R waves 12L ECG
14 R waves x 10 sec = 140 bpm Troponin I
Regular: 1500/small boxes ng R-R interval CBC, Na, K, Bun, Creatinine, SGPT, SGOT, PT, PTT, CBG, CXR
Rhythm: consistent/inconsistent number of boxes between R
intervals Load the following medication:
Axis: Lead I (+ or -) and AVF (+ or -) ● Aspirin 50mg 4 tabs
Interval: ● Clopidogrel 75mg 4 tabs
Hypertrophy: V1 (Amplitude/Small boxes of S waves) + V5 or ● Atorvastatin 80mg 1 tab
V6 (Amplitude of R waves) = Total ● Enoxaparin 0.6cc SC OD
- If > than 35 → LVH is present ● Enalapril 50mg?? 1 tab
- “Sokolow Lyon” ● Carvidolol 6.25mg 1 tab
OR R in aVL ≥ 11 mm ● Pantoprazole 40mg 1 tab
- RVH: Apex upward, retrosternal space obliterated
- LVH: Apex downward, retrocardiac space obliterated Where to place ECG?
“Cornell Criteria” - if mahaba S and R Right: Snow over Grass (white green)
- Add the R wave in aVL and the S wave in V3. If the Left: Smoke over Fire (black red)
sum is greater than 28 millimeters in males or greater
than 20 mm in females
Ischemia: St segment elevation/depression, T wave inversion, MAP
pathologic Q waves 2/3 of Diastolic + 1/3 of Systolic
- Location: HISAL (See below)
Miscellaneous For Permissive Hypertension to save penumbra
● V1 and V6
○ MaRRoW - Right Bundle Branch Block
○ WiLLiaM - Left Bundle Branch Block
■ Sgarbossa criteria
HISALS (if not complete pairing: nonspecific ST/T wave
changes)
High Lateral: I, AVL
Inferior: II, III, AVF
Septal: V1 and V2
Anterior: V3 and V4
Lateral: V5 and V6
How to tell if significant elevation/depression?
Chest leads: ≥2mm
Limb leads: ≥1mm

STROKE Focal Neurologic Deficit

● Numbness or weakness of one side of the body
WRITING THE DIAGNOSIS: ● Visual field problem
● Trouble speaking or understanding
CVD Infarct ● Walking, balance and coordination problems
[Hyperacute/Acute/Subacute/Chronic] CVD Infarct, [right/left] Increase Intracranial Pressure
[ MCA/ACA/PCA territory], [cortical/subcortical], probably ● Triad: Headache, papilledema, vomiting
[cardioembolic/non-embolic], NIHSS, MRS, * ● Other signs: Deterioration, Cushing’s triad, anisorca
Meningeal Irritation
* If cardioembolic: + CHADVASc, HASBLED score ● Nuchal Rigidity
● Brudzinski Sign
Intracerebral Hemorrhage ● Kernig’s sign
[Hyperacute/Acute/Subacute/Chronic] ICH, [ # cc by Kothari], Seizures
[right/left] [ __/casuloganglionic area], [subcortical], probably ● Focal seizures
[hypertensive], NIHSS, MRS ● Generalized seizures
● Acute symptomatic seizures
Subarachnoid Hemorrhage ● PNES
[Hyperacute/Acute/Subacute/Chronic] SAH, probably location ● Old strokes leads to seizures (scar tissues)
of ruptured aneurysm (ACOM/PCOM/MCA), NIHSS, Hunt and ○ Usual location of seizures
Hess Grade, Fisher Scoring ■ parieto -temporal area
DO NOT TREAT IF FIRST SEIZURE
- If after stroke -- “Post stroke seizure and not a seizure
History and PE disorder”
- Complete Neuro PE Exam - If recurs - TREAT AND REQUEST FOR EEG
- Reflexes
- Handedness Differential Diagnosis
- To know the prominence of the weakness, if it 1. Stroke or TIA ---- ROSIER SCORE
is on the right--it will be more prominent 2. Stroke Mimicker
a. Metabolic
i. Hypoglycemia
ii. Hyperosmolar, hyperglycemic,
nonketotic state
iii. Acid-base imbalance
iv. Infection -- UA
3. “Stroke Adam Attack”
a. Secondary to low blood flow in the brain stem
i. Low blood flow to the reticular
system
ii. Look at the vital signs - hypotensive,
bradycardic episodes
iii.
IV infusion rTPA indications RADIOLOGY - IM
- Age greater than >18 and less than <80 Radiology Reading: PRIM
- Prone to hemorrhagic conversion if >80 years Penetration
old Rotation
- NIHSS Score of 6 to 21 (basically <22) Inspiratory Effort:
- MRS > or = 2 Motion
- BP < 185/110
- Not on warfarin or heparin, platelets and coagulation PA view: to know cardiomegaly
normal
- ASPECTS score of 6 or greater Early Signs of Infarction -- Plain Cranial CT Scan
- Within 6 hours of symptom onset of stroke Gray white matter differentiation loss
- Some guidelines kasi up to 6 hours pwede ka Insular ribbon sign
mag rTPA aRtery: dense MCA sign
- Others: treatment given withing 3 hrs Lentiform nucleus obscuration
- Acute ischemic stroke receiving intravenous rTPA
within 4.5 h of onset Cranial MRI
- Early major infarction excluded (parenchyma - Better imaging for posterior circulation ischemic
hypo-attenuation or brain swelling >1/3 rd MCA strokes because CT poorly visualized posterior fossa
territory lesions
> IV Alteplase Eligibility
ABC pO2 levels
A: pCO2/0.8
B: [713 x FiO2] - A 80 normal
C: [(80 ÷ (p02 ÷ B)) + A] ÷ 713 x 100 60-80 mild
45-59 moderate
Ung sagot sa C. Ayun ung basis king i increase or decrease ung <40 severe
o2 supplement
ARDS severity (PFratio)
Fio2 300 normal
21% - room 200-300 mild
24% - 1lpm 100-200 moderate
28% - 2lpm <100 severe
32% - 3lpm
36% - 4lpm Mask: 6 to 10 L/minute
40% - 5lpm Nasal Cannula: only good for 5L
44% - 6lpm Anything above 10L per minute, increased risk for potential
48% - 7lpm bleeding for prolonged use
52% - 8lpm
56% - 9lpm
60% - 10lpm
ABG Normal Range
pH 7.35-7.45
PaCO2 35-45 mmHg
HCO3 22-26 mEq/L
Anion 8-12

Electrolyte Hyponatremia: NaCl tablet

Hypernatremia: Normal Saline → 5% dextrose
Hypokalemia: IV repletion
- <10 mEq/h (unmonitored setting)
- 40 mEq/h (continuous ECG monitoring - “flat T + u
wave or prominent u wave”
- KCl Tablet
Hyperkalemia:
- K+ removal: Kayexalate/Nebulized albuterol/Dialysis
- Shift K+: Glucose/ Insulin/NaHCO3 1 ampule IV
- Counteract cardiac effects: Calcium gluconate 5-10
mL of 10% solution
Hypocalcemia:
- Asymp: Oral or IV Calcium
- Acute Symp: IV 10% calcium gluconate
- Note: Associated deficit in magnesium, potassium,
and pH must also be corrected; hypocalcemia will be
refractory to treatment if coexisting hypomagnesemia
Hypercalcemia: PNSS

Pseudohyponatremia from hyperglycemia

Corrected Na: measured Na 6 [(1.6 (glucose -100))/100]
● 131 + (1.6(350 - 100))/100]
○ 131 + 4 = 135
Osmolarity
2Na + (BUN/2.80 + (Glucose/18)
262 + 5 + 19 = 286

Conversion of labs Insulin Sliding Scale

● FBS 4 units - Give 180-220
○ mmol/L x 18 = mg/dL 6 units - 221-260
● Total Cholesterol, HDL, LDL, 8 units - 261-300
○ mmol/l÷0.0259 = mg/dL 10 units - >300 ko
○ TC: <200
○ HDL: M >/= 40 ; F >/= 50
○ HDL: >50 for both
○ LDL:
■ 0 RF </= 130
■ 1-2 RF 100
■ >2 <70
 ● Triglycerides
○ mmol/l÷0.011 = ng/dL
●
Notes:
Lipid Goal: Less than 55 ng/dL
>200 TC, regardless of components is at risk for ASD
A value of >150 mg/dL TAG is abnormal
A value of 300-400 mg/dL TAG can present a lipemic blood
sample
A value of >400 mg/dL TAG is a risk for pancreatitis
Radiology
RADIOLOGY T2W: old infarcts
Radiology Reading: PRIM Swan: Hemorrhage
Penetration DWI: Useful in Acute phases of stroke
Rotation GRE: preferred when you compare it to CT, hemorrhage
Inspiratory Effort: Flair: Infarcts
Motion
PA view: to know cardiomegaly; winged scapula
AP view: infants
_________________________________________________
VIEWS:
AP: Shoulder, Pelvic , T-cage
AP-O-L: Fingers (fanning lateral), Foot, Hand
AP-L: Arm, forearm, wrist, elbow, thigh, leg, knee, ankle ( with
mortis view), skull, cervical spine, thoracolumbar, lumbosacra
Surgery Cases at ER
Hemorrhoids Cholecystitis/Choledocholesistitis
● Diosmin + Hesperidin (Daflon) ● Murphy sign - inspiratory arrest
○ 2 tablets twice a day for 7 days ● Clolicky pain - on and off pain
○ May also be given to varicose veins ○ Pulsation is caused by forcing of passage
● Policresulen + Cinchocaine HCl (Faktu) ● Charcot's Triad: RUQ pain, Fever, Jaundice
○ Apply every after bowel movement for 7 days ● Reynolds Pentad: RUQ pain, Fever, Jaundice,
● Psyllium fiber sachet Confusion, Shock
○ 1 sachet in a ½ glass of water per orem ● BSAFE structures
● Senna glycoside (Senokot) ● Aspirin should be stopped 5-7 days (life of platelets)
○ 2 tablets at bedtime per orem ● Most Gallstones of Filipinos are Mixed
○ Not all of gallstone can be dissolved by
DRE: normal but with painless bleed medications
● Tc-99m pertechnetate scan ○ Making it smaller will complicate since it may
● No survival benefit DRE for prostate cancer immediately pass through ducts and obstruct
LABS: WBS, SGPT, SGOT, B1 and B2
Procedures:
● Open
● ERCP - diagnostic and therapeutic (hooking or
catching to grab stone)
● Laparoscopy
DDX: Gallbladder hydrops, Mirizzi Syndrome
S/P Laparoscopic Cholecystectomy
● Paracetamol 900 mg TIV every 8 hours for 3 doses
--PAIN
● Diclofenac drip 150 g in 500 cc/PNSS to run for 24
hours --NSAID
● Ketesse 50 mg TIV q8 - NSAID
● Tramadol 50 g IV every 8 hours for 3 doses - Opioid
● Cefuroxime 500 mg per tab 1 tab every 12 hours after
 negative skin test- second generation cephalosporin;
against enterobacteriaceae

Appendicitis Acute Pancreatitis

● MANTRELS/ALVARADO SCORING ● ATLANTA score
● CT scan is the golden standard ● PNSS OR PLR 1L bolus
● Ultrasound for Pedia/Pregnant ○ Protective ang PLR
● Suspect ruptured if pxt has RLQ pain for 3 days ○ Dont give D5W → autophagocytosis na yung
● Surgery definitive treatment pancreas
● Pantoprazole 40 mg IV
Migrating of pain 1 ● Metoclopramide 10 mg IV
Anorexia 1 ● Diag:
Nausea/Vomiting 1 ○ Urinalysis, 12L ECG, PT,
Tenderness on RLQ 2 ○ CBC, Na, K, BUN, Crea, Ionized Calcium
Rebound Tenderness 1 ○ SGPT, Amylase, Lipase
Elevated Temperature 1 ○ WACT with Contrast
Leukocytosis 2 ○ Hydrate PNSS x 100cc/hr
Shift of WBC count to the left 1 ○ Ketorolac 30 mg IV now
BISAP
ALVARADO SCORING B: Bun > or = 25 mg/dl
1-4 points = Discharge I: Impaired mental status
5-6 points = Observation/Admission SIRS
7-10 points = Surgery Age >60
Pleural Effusion
IMAGING:
● Initial: UTZ
Ruptured Appendicitis Thyroid Disorders
● Piperacillin-Tazobactam 4.5 g TIV every 8 hours S/P Total Thyroidectomy
○ Gram-positive and Gram-negative bacteria Post-op medication:
including Pseudomonas aeruginosa. ● Paracetamol 900 mg TIV every 8 hours for 3 doses --PAIN
● Metronidazole 500 mg TIV every 5 hours ● Diclofenac drip 150 g in 500 cc/PNSS to run for 24 hours
○ antibiotic and antiprotozoal medication. --NSAID
● Paracetamol 900 mg TIV every 6 hours for 4 doses after ● Tramadol 50 g IV every 8 hours for 3 doses - Opioid
negative skin test ● Cefuroxime 500 mg per tab 1 tab 2x a day to complete for 7
● Nalbuphine 5 milligrams in 1 cc PNSS through slow days
intravenous push every 6 hours for 4 doses ● Etoricoxib 60 mg per tab 1 tab 2x a day for 5 days

Pressure Ulcers 5 W’s of Post-Op Fever

● Stage 1 ● Wind
○ Erythema ○ Atelectasis/pneumonia; 1-2d post op
○ Cool running water ○ Prevent: deep breathing, incentive spirometry
● Stage 2 ● Water
○ Bullae ○ UTI/CAUTI; 3-5d post op
○ Tx: Hydrocolloid dressing needed for autolytic ○ Prevent: change catheter every 72h, perineal care, push
debridement; should be left on for several days fluids
● Stage 3 ● Wound
○ Yellow = adipose ○ Surgical site infection; >4 day Post-op
○ Wet to dry dressing; Debridement ○ Prevent: Dress change, sterile technique, cleaning
● Stage 4 agents
○ Bone and Muscle ● Walking
○ Wet to dry dressing; debridement ○ DVT/PE
○ Prevent:early ambulation, compression, stocking,
Note: Turn patient every 2 hours to off load any pressure areas heparin or enoxaparin
● Wonder Drugs

Medications Commonly Given Carpal Tunnel Syndrome

● Meclizine HCL 25 mcg per tab - nausea, vomiting, dizziness Undescended Testis
caused by motion sickness; antihistamine
● Albumin + Furosemide 40 mg TIV + KCL tablet
● Omeprazole 40 mg/cap 1 cap OD for 2 days
● Nalbuphine 5 g in 10 ml PNSS thru slow IV push every 8
hours for 3 doses -Opioid
● Potassium Chloride 1 tab 3x a day per orem for 9 doses
● Better if oral since di siya masakit and usually tolerated ng
patient
● Insulin + Potassium
 ● Ciprofloxacin 400 mg TIV
● Esomeprazole 40 mg/tab every 8 hours

OBGYNE
Pregnancy Medication STI
1. Ferrous Sulfate + Folic Acid 1. Gonorrhea
a. Take 1 tablet once a day 1 hr before lunch a. Ceftriaxone 1g
2. Calcium + Vitamin D i. Give 500 ml thru IM as single dose
a. Take 1 tablet 2x a day with breakfast and after negative skin test
dinner 2. Chlamydia
3. Multivitamins a. Doxycycline 100mg/tab
a. Take 1 tablet once a day i. Take 1 tablet twice a day for 7 days
Laboratory: HAT, STD, Hepa B Ag/Anti HBS/ Anti HCV
(Qualitative), VDLR
LYING IN CENTERS
OFFERED: Free NSD for G2, G3 and G4, uncomplicated HISTORY TAKING:
pregnancies, 1. GP(TPAL) Score
2. MIDAS -regular menstruation or not kasi magiiba
NOT ALLOWED IN LYING IN yung AOG by LMP vs AOG by ultrasound
No complicated pregnancies, No high risk pregnancies (<19 3. AOG, EDD
years old or >35 years old), No G1 or G5 and above. No 4. Past Medical History: Hypertension, Diabetes, Allergy
episiotomy done by midwife. to Food and Medication, Previous Surgeries
5. Vital Signs, Fundal Height, Fetal Heart Rate
Important Laboratories: 6. History of Previous Pregnancies
● 1st Ultrasound - for EDD a. G1 - Age/Gender, Papa (# - first, second or
● Next Ultrasounds - placement of placenta, position of third), Type of Delivery (NSD/CS), Location of
the baby, weight of the baby Birth (Lying in or hospital or home),
● CBC - for hemoglobin (if below 110 then consider as Complicated/Uncomplicated, Term/Preterm,
risk but give ferrous sulfate then repeat CBC) Birthweight
● Blood Typing - for Rhogram (negative mother then b. G2 - same as above
positive baby) c. Note: sometimes hard to recall ang mothers
● Urinalysis - glucose, protein, pus, bacteria (DM, so possible mali kung term or preterm yung
Preeclampsia, UTI) baby. Ask if 9 months or sa kabwanan yung
● STI - HIV, Syphilis, and Hbsag pinagbubuntis; if inicubator pa si baby or not;
if dumating sa lying in na fully dilated na or
Important Medication nagantay pa sa lying in ng a few hours (kasi if
● Ferrous Sulfate nakalabas na ulo ng baby syempre di na
● Folic Acid tatangihan ng lying in kahit preterm pa yan or
● Calcium Carbonate small for gestational age)
7. 10 danger signs: vaginal bleeding or discharge etc.
8.
Tagubilin:
1. Continue milk feeding on demand (Pasusuhin and
sanggol hanggat gusto)
a. Every 2 hours or less than
b. Correct Latching
c. Breast Feeding >> Colostrum
d. Positioning of head and abdomen
2. Burp baby after every feeding (Padighayin ang
sanggol kada matapos dumede)
a. Upright position
b. >15 min to prevent aspiration syndrome
3. Clean cord dally with 70% isopropyl alcohol (Linisin
ang pusod araw-araw gamit ang 70% isopropyl
alcohol)
a. Cotton/Cotton swab
4. Bathe baby daily (Paliguan ang sanggol araw-araw)
5. Expose baby to sunlight for 15 minutes daily between
6 am to 8 am (Ibilad and sanggol sa araw sa loob ng
15 minuto, mula ika-anim hanggang ika-walo ng
 umaga)
6. Immunizations (Bakuna): BCG and Hepatitis B
7. Newborn Screening:
8. Watch out for vomiting, decreased suck, diarrhea,
yellow discoloration of skin, seizure, and feve
(Bantayan kung may pagsusuka, mahinang pagdede,
pagtatae, paninilaw ng balat, kumbulsyon at lagnat)
a. Physiologic: Mabagal progression (Makikita
mo mother from head tapos chest then
abdomen then thighs and feet)
b. Pathologic: Mabilis progression (Makikita mo
mother head tas Thighs and Feet)
9. Medications Given, if any (Gamot na ibinigay, kung
meron):

Hypertension
Hypertension Workup
Lab Request: CBC, FBS, HbA1c, Lipid Profile, Crea, BUN, Na, K,
iCa, Uric Acid, TSH + Urinalysis
Diagnostics
Hypertension Medication (ABCD) Hypertension Staging
1. ARB - sartan ● Elevated 120-129/<80
2. ACEi - pril ● Stage 1 130-139/80-89
3. Beta Blockers - olol ● Stage II >140/>90
4. CCB - dipine
5. Diuretics: thiazides
Combination:
ARB + Beta Blocker (Losartan + Metoprolol)
ARB + Calcium Channel Blocker (Losartan + Amlodipine)
Calcium Channel Blocker + Diuretics (Amlodipine +
Furosemide)
May combine up to 4 HTN medication
Best given at night since cortisol is secreted at 2-4 AM

Crisis: Hypertensive urgency or emergency

Urgency: Acute rise in blood pressure without acute
end-organ damage; diastolic blood pressure usually >120
mmgHG
● No symptom = Deliks kasi sanay na yung body with
that elevated BP
Emergency: Acute rise in blood pressure with acute
end-organ damage; diastolic blood pressure usually >120 mm
bg but Hg
● Symptom = end organ damage
Home Management of elevated BP:
DONT GIVE CLONIDINE/CATAPRES
- X sublingual: can cause rebound HTN
GIVE Maintenance, rest, then repeat BP
Safe BP - 160/90
Dyslipidemia Things to look for for Risk Stratification:
General Data: M: >=45; F>=55
 Family History: Age on 1st CAD Attack: M <= 55; F <= 65
PMH: HTN, DM
Smoker
Decreased HDL

Diabetes
THE OMINOUS OCTET Diabetes Medication
1. Liver: insulin resistance and increased glucose 1. First line: Metformin
production a. 500 mg
2. Muscle: insulin resistance and reduced peripheral b. Max: 3000 mg
glucose uptake 2. Second line:
3. Brain: insulin resistance and CNS dysfunction a. DPP4 - gliptin
4. Adipose tissue: insulin resistance, lipotoxicity, and i. Dose adjustment for renal failure pxt
proinflammatory markers b. SGLT 2 - gliflozin
5. Kidneys: increased glucose production and i. Urinalysis with +3/+4 glucose
reabsorption ii. May cause UTI
6. GI tract: incretin hormone dysfunction and resistance iii. En hances urine excretion
7. Pancreatic b cells: failure and dysfunction “mapapadalas po ang pagihi niyo”
8. Pancreatic a cells: hyperglucagon see emia c. Insulin
i. Basal Insulin (long acting)
1. 10 unit SQ starting
2. Or compute 0.2 units/kg/day
(wt in kg x 0.2)
3. Sample: 10 units start →
mataas parin edi 12 unit →
then 14 units until masatisfy
yung goal na sugar level
a. Pabalikin 3 weeks
ii. Regular insulin (short acting)
1. 30 min; used in ER or wards
2. Not maintenance
iii. Intermediate acting insulin
1. 10-12 hours
2. Compute 0.5 to 1
units/kg/day (Wt in kg x 0.5)
3. Use lowest possible dose
4. Ex. 45 kg x 0.5 = 22.5 units
(daily dose) → 22.5 / 3 = 7.5
units → given 2x a day. 7.5 x
2 = 15 units (⅔) to be given
pre breakfast (waking hours)
and 7.5 units (⅓) 20 mins
before dinner (sleeping
hours)
5. ⅔ given waking hours ->
MONITOR PRE-DINNER
6. ⅓ given sleeping hours ->
MONITOR PRE-BREAKFAST

Note: Symptom >> Sugar Goal

If with the given medications nag okay yung sugar level pero
110 hilong-hilo na; better na ireduce mo yung medication.
Check first nga lang if there are other causes of dizziness.
COMPLICATIONS
1. Basal Fundoscopy - retinopathy
2. Foot Exam - peripheral neuropathy
 a. Pregabalin and Vit B complex (Neurobion)
3. Proteinuria (Quali then Quanti)
a. Micral Test
b. 24 hr Albumin Test
c. Urine Albumin Crea ratio
d. GFR
i. AV fistula: Dialysis
PEDIA

COMPUTATION 101 Vaccination (Tatlo lang imemorize)

1. First vacc 2 = BCG and Hep B
Pag Per Dose: 2. 2nd vacc 3 = OPV, Penta, and PVC
Dose: Weight x TD x Inverse Prep 3. 3rd vacc 1 = MMR
TD: Dose x Prep/ Weight
Types of Completion
Pag per day 1. Fully Immunized = 1 years old
Dose: Weight x TD x Inverse Prep / Frequence 2. Complete Catch-up I
TD: Dose x Prep x Frequency / Weight

Shortcut value is 40 (used by health centers)

Weight x 40 x Inverse prep (sample 5/250)

Sample: Co-Amoxiclav 250/5ml

12.2 kg
12.2 kg x 30 (TD) x 5 (ml)
--------------------------------- = 7.32 / 3 (frequency) = 2.44
250
2.5 per dose x 250/5ml x 3 (frequency)
-------------------------------------------------- = 30.7 → TD=30
12.2
Rx:
Co-amoxiclav 250mg/5ml
Sig: Give 2.5 ml every 8 hours for 7 days
Note:
Low TD = 10
Highest TD = 40
Dehydration FLUIDS 101
Maintenance + Deficit ---> Fluids
MAINTENANCE
Holliday Segar
0-10kg (1st 10 kg) x 4ml/kg/hr = _______
10-20 (2nd 10 kg) x 2ml/kg/hr = ________
Remaining Kg x 1 ml/kg/hr = ________
Sample = 45 kg
10kg x 4 = 40 ml
10 kg x 2 = 20 ml
25 kg x 1 = 25 ml
Total maintenance: 85 ml/hr
IVF: PNSS 1L to run at 85 ml/hr
OR
0-10 kg (1st 10 kg) x 100 = _______
0-10 kg (2nd 10 kg) x 50 = _______
Remaining kg x 10 = ________
DEFICIT
mild moderate severe
Infant 5% 10% 15%
Child 3% 6% 9%
Compute: wt in kg x % x 10 =
% x 10 ml x wt in kg
KG x (Deficit) = _________ / 2 =
1st half: for 8 hours ----> divide by 8 =
2nd half: for 16 hours ------> divide by 16 =

Sample
45 kg x 3 x 10 =1350 / 2 = 627
627 / 8 = 85 Mild dehydration:
627 / 16 = 40 1. Compute for maintenance rate:
- 4ml/kg/hr for the 1st 10kg
Order: - 2ml/kg/hr for the next 10kg
PLR 1L to run at (Maintenance + deficit) - 1ml/kg/hr for the remaining kg
- Add them up to get the maintenance rate
PLR 1L to run at ( 84 +85 ) for the first 8 hours then (84 + 40)
for the next 16 hours 2. Compute for the fluid deficit rate:
- Fluid deficit: 3% for infants, 5% for older children
- % x 10ml/kg x wt in kg
- 1/2 of total deficit to be given in 8 hours then 1/2 to be
given for 16 hours
3. Add maintenance rate to the deficit rate
Example 14kg with 5% water loss
1. Maintenance rate:
- 1st 10kg: 10kg x 4ml/kg/hr= 40ml/hr
- Next 4kg: 4kg x 2ml/kg/hr= 8ml/hr
- Total maintenance rate= 48ml/hr
2. Fluid deficit:
- 5 x 10ml/kg x 14kg= 700ml
- 1/2 of 700ml= 350ml/ 8 hrs= 43.75=44ml/hr
- 1/2 of 700ml= 350ml/ 16hrs= 21.875= 22ml/hr
3. First 8 hours= 44ml/hr + 48ml/hr= 92ml/hr
4. Next 16 hours= 22ml/hr + 48ml/hr= 70ml/hr
5. After 24 hours= 48ml/hr as maintenance rate
PCAP
Clinical Signs and Symptoms: Fever or Cough
PLUS:
● Tachypnea, Retractions, Nasal Flaring, <95 O2sat,
Grunting
(C or D) Severe if: Respiratory signs, altered sensorium,
convulsions, circulatory signs, dehydration, age less than 6
months, chest radiograph findings, Unsustained O2sat <93%
Advise Admission
CPG TX:
 ● NON-SEVERE
○ Amoxicillin Trihydrate OR Amoxicillin
Clavulanate
● SEVERE
○ Penicillin G
○ Cefuroxime OR Ampicillin-sulbactam
○ Clindamycin
ER: Amoxicillin, Co-Amoxiclav, Cefuroxime, Cefaclor,
Azithromycin
Admitting Orders 101
● Please admit to the room of choice (or isolation
room) under the services of Dr. Full name/HMO
Coordinator
● Secure consent for admission and management
● Monitor vital signs every shift and record
● Monitor input and output every shift and record
● Please weight patient now and record
● Diet: _____
● IVF: ______
● Diagnostics:
● Therapeutics
● Monitor vital signs ever ____ hours care of Junior
Interns
● Complete history and physical examination cate of
PGI
● Watch out for signs of ______
● Refer Accordingly