Useful Methods For Medical officer
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Medicine for Diseases of Eye မ်က္စိေရာဂါေဆးမ်ား
Hordeolum (Sty) မ်က္စိစြန္ျခင္း၊ = I & D + Erythromycin or Bacitracin ointment every 3 hours ခဲြစိတ္ရန္၊
Blepharitis မ်က္ခံြေရာင္ျခင္း၊ = Tetracycline 250 mg BD, Doxycycline 100 mg daily, Erythromycin 250 mg TDS + Prednisolone 0.125% BD
Dacrycystitis မ်က္ရည္လမ္း ေရာင္ျခင္း၊ = Ciprofloxacin 0.3% Eye ointment; Antibiotics + Surgery ခြဲစိတ္ရန္၊
Allergic Eye diseases အလာဂ်ီ ေၾကာင့္မ်က္စိနာျခင္း၊ = Antihistamine + Corticosteroid
Bacterial Keratitis မ်က္စိ အၾကည္လႊာေရာင္ျခင္း၊ = Cefazolin 100 mg/ml and Tobamycin 15 mg/ml, Ciprofloxacin 3 mg/ml, Ofloxacin 3 mg/ml
Gonococcal Corneal ulcer ဂႏိုပိုးေၾကာင့္ မ်က္ၾကည္လႊာေရာင္ျခင္း၊ = Ceftriaxone 1-2 Gm IM x 5 days + Erythromycin or Bacitracin E/o
Herpes Simplex Keratitis ေရယံုပိုးေၾကာင့္ မ်က္စိနာျခင္း၊ = Acyclovir 200-400 mg 5 times a day Orally ေကာ္တီဇုန္းမေပးရ၊
Acute Angle-closure Glaucoma (extreme pain and blurred vision + nausea) မ်က္စိေရတိမ္၊ Acetazolamide 500 mg IV followed by 250 mg QID Orally; 4% Pilocarpine Eye drop 1 drop every 15 minutes x 1 hour and QID; Open-angle Glaucoma (No symptom but increase intraocular pressure) = Timolol 0.25-0.5% or Carteolol 1% or Levobunol 0.5% or Metipranolol 0.3% BD
Gonococcal Conjunctivitis ဂႏုိးပိုးေၾကာင့္မ်က္စိနာျခင္း၊ = Ceftriaxone 1 Gm IM + Erythromycin or Bacitracin E/o; Chalamydial (Trachoma) = Tetracycline/Erythromycin 250 mg QID Orally or Doxycycline 100 mg BD x 3-5 weeks or Azythromycin 20 mg/kg stat + Surgery for Entropion မ်က္ေတာင္ေမႊးစိုက္ျခင္းအတြက္ခြဲစိတ္ရန္၊
Viral Conjunctivitis ဗိုင္းရပ္စ္ေၾကာင့္ မ်က္စိနာျခင္း၊ = Sulfonamide + Prednisolone 0.125% QID
Medicine for Diseases of Ear နားေရာဂါေဆးမ်ား
Acute Otitis Media ရက္တို နားျပည္ယိုျခင္း၊ = Carbamazepine 100-300 mg TDS; Amoxacillin 250-500 mg TDS x 7 days or Erythromycin 50 mg/kg/day + Sulfonamide 150 mg/kg/day x 10 days or Cefaclor 20-40 mg/kg/day; or Augmentin (Amoxacillin + Clavulanic acid) 500 mg TDS or Cefuroxime 500 mg Orally BD or Cefpodoxime 200-400 mg daily or Doxycycline 100 mg BD or (TMP 160 mg+SMZ 800 mg) BD x 10 days
Chronic Otitis Media နာတာရွည္ နားျပည္ယိုျခင္း၊ = Ciprofloxacin 500 mg BD x 1-6 week
Serous Otitis Media နားရည္ယိုျခင္း၊ = Prednisolone 40 mg/day + Amoxacillin 250 mg TDS x 7 days
Medicine for Diseases of Urinary Tract ဆီးလမ္းေၾကာင္းေရာဂါေဆးမ်ား
Urethritis and Cervicitis caused by Chlamydia (ကလာမိုင္ဒီယား)ေၾကာင့္ျဖစ္ေသာ သားအိမ္အဝ-ဆီးျပြန္အဝ ေရာင္ျခင္း၊ Erythromycin 250-500 mg QID, Doxycycline 100 mg BD or Azithromycin 500 mg OD
Acute Pylonephritis ေက်ာက္ကပ္ျပြန္ရက္တိုေရာင္ျခင္း၊ = Ciprofloxacin 400 mg IV BD or 750 mg BD Orally or Levofloxacin 500 mg IV OD or Ampicillin 1 Gm QID and Gentamycin 1 mg/kg TDS IV x 21 days Ciprofloxacin 500-750 mg BD Orally x 21 days or Ofloxacin 200-300-400 mg BD Orally x 21 days or Trimethoprim-Sulpfamethoxazole 160/800 mg BD x 21 days
Acute Cystitis and Acute Prostatitis ရက္တိုဆီးလမ္း၊ ဆီးအိမ္ေရာင္ျခင္း၊ က်ား-ဆီးႀကိတ္ ေရာင္ျခင္း၊ = Cephalexin 250-500 mg QID Orally x 1-3 days; Ciprofloxacin 250-500 mg BD x 1-3 days; Nitrofurantoin 100 mg BD-QID PC x 7 days; Ofloxacin 200 mg BD x 1-3 days; Trimethoprim-Sulfamethoxazole 160/800 mg stat
Chronic Prostatitis နာတာရွည္ ဆီးလမ္း၊ က်ား-ဆီးႀကိတ္ ေရာင္ျခင္း၊ = Ciprofloxacin 250-500 mg BD Orally x 1-3 months; Ofloxacin 200-400 mg BD Orally x 1-3 months; Trimethoprim-Sulfamethoxazole 160/800 mg BD x 1-3 months
Urethritis ဆီးလမ္းျပြန္အဝ ေရာင္ျခင္း၊ = Cefixime 400 mg Orally once; Ciprofloxacin 500 mg Orally once; Ceftriaxone 250 mg IM once
Acute Interstitial Nephritis (Penicillins, Cephalosporins, Sulfonamides, NSAIDs, Rifampin, Phenytoin, Allopurinol) ေဆးမ်ား ႏွင့္ Infections ေၾကာင့္ ေက်ာက္ကပ္ေရာင္ျခင္းမ်ား၊ = Methylprednisolone 0.5-1 Gm/day x 1-4 days or Prednisolone 60 mg/day x 1-2 weeks; Acute Glomerulonephritis (Hypertension, Edema, urinary RBC and Albumin) = High-dose Steroids
Urethritis and Cervicitis caused by Chlamydia (ကလာမိုင္ဒီယား)ေၾကာင့္ျဖစ္ေသာ သားအိမ္အဝ-ဆီးျပြန္အဝ ေရာင္ျခင္း၊ Erythromycin 250-500 mg QID, Doxycycline 100 mg BD or Azithromycin 500 mg OD
Acute Pylonephritis ေက်ာက္ကပ္ျပြန္ရက္တိုေရာင္ျခင္း၊ = Ciprofloxacin 400 mg IV BD or 750 mg BD Orally or Levofloxacin 500 mg IV OD or Ampicillin 1 Gm QID and Gentamycin 1 mg/kg TDS IV x 21 days Ciprofloxacin 500-750 mg BD Orally x 21 days or Ofloxacin 200-300-400 mg BD Orally x 21 days or Trimethoprim-Sulpfamethoxazole 160/800 mg BD x 21 days
Medicine for Diseases of Liver အသဲေရာဂါေဆးမ်ား
Pyogenic Hepatic Abscess အသဲျပည္တည္နာ၊ = 3rd generation Cephalosporin and Metronidazole
Alcoholic Hepatitis အရက္ေၾကာင့္ အသဲေရာင္ျခင္း၊ = Good Nutrition, vitamin supplement (40 kcal/kg with 1.5-2 G/kg as protein + Folic acid and B 1), Methylprednisolone 32 mg/day x 1 month
Cirrhosis Liver အသဲေျခာက္ေရာဂါ၊ = Nutrition (Adequate calories and protein (75-100 G/day) + Ascies treatment (Protein 60-80 G/day only + Low sodium intake + Spironolactone 100 mg daily every 3-5 days/Frurosemide 40-160 mg/day + Large volume paracentesis (4-6 L/day) + Surgery
Amebic Liver abscess အမီးဘား ပိုးေၾကာင့္ အသဲေရာင္ျခင္း၊ = Metronidazole [750 mg TDS x 10 days] or Tinidazole [800 mg TDS x 3-5 days] plus Diloxanide furoate [500 mg TDS PC x 21 days] or Idoquinol [650 mg TDS x 21 days] followed by Chloroquine [500 mg daily x 14 days]
Pneumonias and Respiratory Tract Diseases ႏူမိုးနီးယားအမ်ဳိးမ်ဳိးႏွင့္ အသက္ရွဴလမ္းေရာဂါေဆးမ်ား
Pneumonia ႏူမိုးနီးယား၊ = Erythromycin 500 mg IV QID or Doxycycline 100 mg IV or Orally BD + Cefotaxime 1-2 Gm IV TDS ; Clindamycin 600 mg IV QID or Amoxacillin 500 mg TDS Penicillin G 1.2 million units IV QID + Metronidazole 500 mg IV or Orally; Doxycycline 100 mg BD or Erythromycin 500 mg QID or Azithromycin 500 mg on day 1 and 250 mg on days 2-5; Amoxicillin 500 mg QID x 7-10 days or Fluoroquinolone (Levofloacin) 500 mg OD/Gatifloxacin 400 mg OD/Sparfloxacin 400 mg on day 1 and 200 mg OD/Moxifloxacin 400 mg OD x 10-14 days; Clarithromycin 500 mg BD x 10 days or Doxycycline 200 mg BD x 10 days; Cefotaxime or Cefipime 1-2 g IV 8-12 hourly
Anaerobic Pneumonia and Lung Abscess (ေလမႀကိဳက္သည့္ပိုး) ႏူမိုးနီးယား၊ အဆုုပ္ျပည္တည္ျခင္း၊ (1) Penicillins (Penicillin G 1-2 million units IV 4-6 hourly or Amoxacillin 500 mg TDS) + Metronidazole 500 mg IV or Orally BD/TDS (2) Clindamycin 600 mg IV TDS followed by 300 mg QID Orally or Amoxacillin 875 mg BD
Pneumonia ႏူမိုးနီးယား၊ = Erythromycin 500 mg IV QID or Doxycycline 100 mg IV or Orally BD + Cefotaxime 1-2 Gm IV TDS ; Clindamycin 600 mg IV QID or Amoxacillin 500 mg TDS Penicillin G 1.2 million units IV QID + Metronidazole 500 mg IV or Orally; Doxycycline 100 mg BD or Erythromycin 500 mg QID or Azithromycin 500 mg on day 1 and 250 mg on days 2-5; Amoxicillin 500 mg QID x 7-10 days or Fluoroquinolone (Levofloacin) 500 mg OD/Gatifloxacin 400 mg OD/Sparfloxacin 400 mg on day 1 and 200 mg OD/Moxifloxacin 400 mg OD x 10-14 days; Clarithromycin 500 mg BD x 10 days or Doxycycline 200 mg BD x 10 days; Cefotaxime or Cefipime 1-2 g IV 8-12 hourly
Aspiration Pneumonia အန္ဖတ္ဝင္၍ျဖစ္ေသာ ႏူမိုးနီးယား = Clindamycin 300 mg Orally TDS or (TMP 160 mg + SMZ 800 mg) BD x 10 days or Phenoxymethyl Penicillin 500 mg Orally QID x 10-14 days
Community-acquired Pneumonia လူစုလူေဝးမွ ရေသာ ႏူမိုးနီးယား (1) Clarithromycin 500 mg BD or Azithromycin 500 mg stat and 250 mg OD x 4 days (2) Doxycycline 100 mg BD (3) Fluroquinolones such as Gatifloxacin 400 mg OD or Moxifloxacin 400 mg OD, Eruthromycin 250-500 mg QID, Cefuroxime axetil 250-500 mg BD, Cefpodoxime proxetil 100-200 mg BD or Cefprozil 250-500 mg BD (4) Erythromycin (Azithromycin, Clarthromycin) 500 mg Orally or IV QID or Doxycycline 100 mg IV or Orally BD + Cefotaxime 2 Gm IV TDS or Ceftriaxone 1 Gm IV OD or Fluoroquinolone alone
Upper Respiratory Tract infections, Pneumonias အသက္ရွဴလမ္း အေပၚပိုင္း ပိုးဝင္ျခင္း၊ ႏူမိုးနီးယား၊ = Penicillin G, Amoxacillin, Doxycycline, Cefotaxime, Ceftriaxone, Azithromycin, TMP-SMZ, Clindamycin, Ciprofloxacin, Erythromycin
Chest infection အသက္ရွဴလမ္းေရာင္ျခင္း၊ Penicillin 2 million units IV every 4 hours followed by Amoxacillin 500 mg TDS Orally
Aphthous ulcer (အက္ဖ္သပ္စ္-အာလ္ဆာ)၊ Herpatic Stomatitis လွ်ာနာျခင္း၊ = Fluocinonide ointment 0.05% or Triamcinolone acetate 0.1% ointment; Diclofenic 3%; Acyclovir 200-800 mg x 5 times daily x 7-14 days; Ulcerative Gingivitis = Penicillin 250 mg TDS x 10 days
Laryngitis လည္ေခ်ာင္းနာ၊ = Erythromycin 250 mg QID; Benzarthine penicillin G 1.2 million units IM as a single dose; Penicillin VK 500 mg QID or Amoxacillin 750 mg BD
Acute Sinusitis ဆိုင္းနပ္စ္၊ = Amoxacillin 500 mg Orally TDS or (TMP 160 mg + SMZ 800 mg) BD x 10 days or Augmentin (Amoxacillin + Clavulanic acid) 500 mg TDS or Cefuroxime 500 mg Orally BD or Cefpodoxime 200-400 mg daily or Doxycycline 100 mg BD; Pseudoephedrine 30-120 mg + Nasal Oxymetazoline 0.5% or Xylometazoline 0.05-0.1% sprays TDS/QID; Amoxacillin 500 mg TDS or (4 mg/kg TMP- 20 mg/kg SMZ) one double strength tablet = 80-160 mg TMP + 160-800 mg SMZ) BD x 10 days; Cephalexin 250-500 mg QID, Cefuroxime 250 mg BD, Cefaclor 250 mg TDS, Cefixime 400 mg/day, Ciprofloxacin 500 mg BD, Azithromycin 500 mg OD
Tonsillitis and Pharyngitis အာသီးေရာင္၊ အာေခါင္ေရာင္၊ = Benzathine Penicillin 1.2 million units IM or Procaine Penicillin Inj. 600,000 units IM x 5-10 days (or) Orally Penicillin V potassium 250 mg TDS (or) 500 mg BD x 5-10 days (or) Cefaclor 250-750 mg TDS (or) Erythromycin 500 mg Orally QID x 10 days (or) Azithromycin 500 mg on day 1 and 250 mg on days 2-5 or Clarithromycin 500 mg BD x 10 days
Allergic Rhinitis, Hay fever, Viral rhinitis အလာဂ်ီရၿပီး ႏွာေစးျခင္း၊ = Chlorpheniramines 4 mg BD/TDS; Cetirizine 10 mg OD
Medicine for Diseases of Women အမ်ိဳးသမီးေရာဂါေဆးမ်ား
Breast abscess/Puerperal Mastitis ရင္သားေရာင္ျခင္း၊၊ ရင္သားျပည္တည္ျခင္း၊ = Cloxacillin, Dicloxacilin, Oxacillin 250 mg QID x 7-10 days or Cephalosporin 500 mg QID x 5-7 days + Surgery
Dysmenorrhea ရာသီဆင္းခ်ိန္နာျခင္း၊ = NSAID (Ibuprofen 400-800 mg QID, Mefenamic acid 250-500 mg TDS/QID) ± Oral contraceptives
Premenstrual Tension ရာသီမဆင္းမီ ခံစားရသည့္ လကၡဏာမ်ား = High carbohydrate/sugar, no alcohol, low caffeine diet + Vitamin B6 100 mg/day +Exercise + Fluoxetine 20 mg/day
Medicine for Sexually Transmitted Diseases (STDs) လိင္မွတဆင့္ ကူးစက္သည့္ ေရာဂါေဆးမ်ား
Gonococcal Cervicitis, Urethritis, Pharyngitis ဂႏုိရီးယားေၾကာင့္ျဖစ္ေသာ ဆီးျပြန္ အဝေရာင္ျခင္း၊ သားအိမ္အဝ ေရာင္ျခင္း၊ အာေခါင္ေရာင္ျခင္း၊ = Ciprofloxacin 500 mg stat or Ofloxacin 400 mg stat
Uncomplicated Gonorrhea သာမန္ဂႏိုေရာဂါ၊ = Ceftriaxone 125 mg IM or Cefixime 400 mg Orally as single dose or Ciprofloxacin 500 mg or Ofloxacin 400 mg or Levofloxacin 250 mg or for Penicillin Allergic patients = Spetinomycin 1 Gm IM stat (or) Cefpodoxime 400 mg, (or) Levofloxacin 250 mg daily
Complicated Gonorrhea ရႈတ္ေထြးေသာ ဂႏိုေရာဂါ၊ = Penicillin G 10 million units IV daily x 5 days; Ceftriaxone 1 Gm IV daily x 5 days; Ciprofloxacin 500 mg BD or Levofloxacin 500 mg OD x 5 days; Endocarditis = Ceftriaxone 1 Gm BD IV x 3 weeks
Gonococcal Cervicitis, Urethritis, Pharyngitis ဂႏုိရီးယားေၾကာင့္ျဖစ္ေသာ ဆီးျပြန္ အဝေရာင္ျခင္း၊ သားအိမ္အဝ ေရာင္ျခင္း၊ အာေခါင္ေရာင္ျခင္း၊ = Ciprofloxacin 500 mg stat or Ofloxacin 400 mg stat
Uncomplicated Gonorrhea သာမန္ဂႏိုေရာဂါ၊ = Ceftriaxone 125 mg IM or Cefixime 400 mg Orally as single dose or Ciprofloxacin 500 mg or Ofloxacin 400 mg or Levofloxacin 250 mg or for Penicillin Allergic patients = Spetinomycin 1 Gm IM stat (or) Cefpodoxime 400 mg, (or) Levofloxacin 250 mg daily
Complicated Gonorrhea ရႈတ္ေထြးေသာ ဂႏိုေရာဂါ၊ = Penicillin G 10 million units IV daily x 5 days; Ceftriaxone 1 Gm IV daily x 5 days; Ciprofloxacin 500 mg BD or Levofloxacin 500 mg OD x 5 days; Endocarditis = Ceftriaxone 1 Gm BD IV x 3 weeks
Primary Syphilis ပဌမဆင့္ ဆစ္ဖလစ္ = Benzathine penicillin G 2.4 million units IM once or for nonpregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks Benzathine penicillin G 2.4 million units IM once a week x 3 weeks; Procaine penicillin G 2-4 million units IM 10-14 days
Secondary Syphilis (Skin, Mucosal lesions; Memnigitis) ဒုတိယဆင့္ ဆစ္ဖလစ္၊ အေရျပား-ဦးေႏွာက္ေျမွး၊ = Benzathine penicillin G 2.4 million units IM once or Doxycycline for non-pregnant Penicillin Allergic patient 100 mg BD x 2 weeks or Tetracycline 500 mg QID x 2 weeks or Erythromycin 500 mg QID x 2 weeks
Tertiary Syphilis (Skin, Mucous Membranes, Eyes, Skeltal, Respiratory, GI, Cardiovascular) တတိယဆင့္ ဆစ္ဖလစ္၊ မ်က္စိ၊ အေရျပား-ဦးေႏွာက္ေျမွး၊ အရိုး၊ အစာလမ္း၊ အသက္ရွဴလမ္း၊ ေသြးလွည့္လမ္း၊ = Benzathine penicillin G 2.4 million units IM once or for non-pregnant Penicillin Allergic patient Doxycycline 100 mg BD x 2 weeks or more or Tetracycline 500 mg QID x 2 weeks or more or Erythromycin 500 mg QID x 2 weeks or more
Neurosyphilis ဦးေႏွာက္-အာရုံေၾကာ ဆစ္ဖလစ္ = Benzathine Penicillin 2.4 million units weekly x 3 weeks or Crystalline Penicillin G 3-4 million units IV 4 hourly x 10-14 days or Procaine Penicillin 2.4 million units IM OD + Probenacid 500 mg QID x 10-14 days (or) Chloramphenicol 2 Gm daily x 30 days, Doxycycline 200 mg BD x 21 days and Ceftriaxone 1 Gm daily x 14 days
Prostatitis က်ားဆီးႀကိတ္ ေရာင္ျခင္း၊ = Ceftriaxone 250 mg IV single dose + Doxycycline 100 mg Orally BD x 10 days
Chlamydia (ကလာမိုင္ဒီးယာ) = Azithromycin 1 Gm Orally (or) Doxycycline 100 mg BD Orally x 7 days
Lymphogranuloma Venereum (LGV) (လင္ဖိုဂရင္ႏူလိုမား) = Doxycycline 100 mg twice per day by mouth for 21 days
Genital Herpes လိင္လမ္းေရယံု၊ First Episode ျဖစ္ခါစ၊ Recurrent Infection ျပန္ျဖစ္ျခင္း၊ = Acyclovir 400mg three times/day or 200mg five times/day x 7-10 days; Acyclovir 400mg three times/day or 800mg three/day for 2 days x 3-5 days
Chancroid ရွန္ကာရြိဳက္ေရာဂါ၊ = Azithromycin 1 Gm stat or a single injection of Ceftriaxone (or) Ciprofloxacin 500 mg BD Orally x 3 days, or Erythromycin, 500 mg QID Orally x 7 days
Gonococcal pharyngitis ဂႏိုေၾကာင့္ အာေခါင္ေရာင္ျခင္း၊ = Ceftriaxone 125 Gm IM, Ciprofloxacin 500 mg orally, and Ofloxacin 400 mg orally
Systemic gonorrheal infections involving the skin and/or joints အ႐ိုး-အဆစ္-အေရျပား ဂႏိုပိုးဝင္ျခင္း၊ = Ceftriaxone 1 Gm IM/IV every 24 hours, or Cefotaxime or Ceftizoxime 1 Gm IV TDS (or) Ciprofloxacin 500 mg BD or Orofloxacin 400 mg OD x 14 days, along with the treatment for Chlamydia. Human Immunodeficiency Virus (HIV); Hepatitis B = Hepatitis C; Human Herpes Virus 8 (HHV-8)
Medicine for Diseases of Digestive Tract အစာလမ္း ေလနာေရာဂါအမ်ိဳးမ်ဳိးေဆးမ်ား
A type of bacteria called Helicobacter pylori (H. pylori) causes many ulcers အစာလမ္း ေလနာေရာဂါ၊ = Treatment to get rid of H. pylori usually takes about 2 to 3 weeks ; Antacids = Aluminium Hydroxide and Oxide 250-1500 mg TDS; Bismuth Salts 530 mg QID; Calcium Carbonate 1250-1500; Magnesium Oxides and Hydroxides 200-400 mg TDS; H2 blockers = Ranitidine 150 mg TDS Oral/IV/IM; Cimetidine (HCl) 400 mg BD Oral; Proton Pump Inhibitor = Omeprazole; Amisulpride 0.714-4.285 mg/kg Daily Oral; Atropine (Sulphate) 0.5 to 1.0 mg IV/IM; Diclofenac (Na) 75 mg deep IM or 25-75 mg BD Oral
Duodenal ulcer အစာလမ္း အူသိမ္၏ အစပိုင္းရွိ ေလနာေရာဂါ၊ = Bismuth Salts 530 mg QID; Cimetidine (HCl) 400 mg BD Oral; Famotidine 20-40 mg Oral; Lansoprazole 15-30 mg Daily Oral; Nizatidine 150 mg OD or BD; Omeprazole 20-40 mg Daily Oral; Pirenzepine (di HCl) 0.238-0.714 mg/kg TDS; Propantheline (Br) 15 mg TDS; Ranitidine 150 mg TDS Oral/IV/IM
Esophagitis, Heartburn, Gastroesophageal Reflux အစာလမ္း အစာၿမိဳျပြန္ေရာင္ျခင္း၊ ရင္ပတ္ပူျခင္း။ အစာေျခရည္ အထက္တက္ျခင္း။ Mild cases = Antacids, Cemetidine 200-400 mg, Ranitidine and Nizatidine 75-150 mg, Famotidine 10-20 mg; Moderate cases = Ranitidine and Nizatidine 150 mg, Famotidine 20 mg or Cemetidine 400-800 mg BD; Omeprazole or Rabeprazole 20 mg, Lansoprazole 40 mg OD; Severe cases = Omeprazole or Rabeprazole 20 mg, Lansoprazole 30 mg OD, Pantoprazole or Esomeprazole 40 mg OD or BD
Stress Gastritis အစာလမ္း-အစာအိမ္ေရာင္ျခင္း၊ စိတ္-အလုပ္ ရႈပ္၍ေရာင္ျခင္း၊ = Cimetidine 900-1200 mg, Ranitidine 150 mg or Famotidine 20 mg infusion
Active ulcers and NSAID Gastric/Duodenal Ulcers အကိုက္ေပ်ာက္ေဆးမ်ားေၾကာင့္ ျဖစ္ေသာ အစာအိမ္ေလနာ၊ ရုတ္တရက္ျဖစ္သည့္ ေလနာ၊ = (1) Omeprazole 20 mg or Rabeparzole 20 mg, Lansoprazole 15-30 mg, Pantoprazole 40 mg 30 minutes before meals BD; Clarithromycin 500 mg BD Amoxacillin 1 Gm BD or Metronidazole 500 mg BD (2) Omeprazole 20 mg, Rabeparzole 20 mg, Lansoprazole 30 mg, Pantoprazole 40 mg 30 minutes before meals; Bismuth subsalicylate 2 QID (3) Trtracycline 500 mg QID/Metronidazole 250 mg QID Ranidine Bismuth citrate 400 mg BD; Claithromycin 500 mg BD (4) Amoxacillin 1 Gm/Tretracycline 500 mg/Metronidazole 500 mg BD; After 10-14 days course of above; Omeprazole 20 mg or Rabeparzole 20 mg, Lansoprazole 15-30 mg, Pantoprazole 40 mg 30 minutes before meals OD (or) Ranitidine and Nizatidine 300 mg, Famotidine 40 mg and Cimetidine 800 mg HS x 4-8 weeks
Medicine for Diseases of GI Tract ဝမ္းႏွင့္ပတ္သက္ေသာေရာဂါေဆးမ်ား
ဝမ္းေလ်ာျခင္း၊ = Diphenoxylate (Lomotil) 5 mg TDS for adult; For children 0.166 mg/kg TDS
ခရီးသြားဝမ္းေလ်ာျခင္း၊ = Fluoroquinolones, e.g. Ciprofloxacin 500 mg Ofloxacin 400 mg Norfloxacin 400 mg BD; Trimethoprim-Sulfamethoxazole 160/800 mg BD; Erythromycin 250-500 mg QID; Metronidazole 250 mg TDS
Bacillary Dysentery, Diarrhea caused by E-coli, Salmonella, Shigella, Giardia, Traveler's diarrhea (ဗက္ဆလရီ) ဝမ္းကိုက္ ေရာဂါ၊ ခရီးသြားဝမ္းပ်က္ျခင္း-ဝမ္းကိုက္ျခင္း၊ = Furazolidone 25-50 mg QID
Amebic Dysentery (အမီးဘားပိုး) ဝမ္းကိုက္ျခင္း၊ = Metronidazole 500-750 mg TDS x 10 days or Tinidazole 800 mg TDS x 3-5 days (plus) Diiodohydroxyquin 650 mg TDS x 21 days or Paromomycin 25-30 mg/kg (max. 3 Gm) in divided doses after meal x 7 days
Shigella Dysentery (Shigellosis) (ရွီဂဲလား) ေၾကာင့္ ဝမ္းပ်က္ျခင္း-ဝမ္းကိုက္ျခင္း၊ = TMP-SMZ 160/800 mg BD x 7-10 days or Ciprofloxacin 750 mg BD x 7-10 days
Food Poisoning and Traveler’s Diarrhea အစာဆိပ္သင့္ျခင္း၊ ခရီးသြားဝမ္းပ်က္ျခင္း၊ = Clostridium = Vancomycin, Metronidazole; E. Coli and Salmonella = Fluoroquinolone ; Yersinia = Tetracycline or Gentamycin
Giardiasis (ဂိုင္ယာဒီးယား) ပိုးဝင္၍ ဝမ္းပ်က္ျခင္း၊ = Tinidazole 2 Gm stat or Metronidazole 250 mg TDS x 5-7 days or Furazolidone 100 mg QID x 7-10 days or Quinacrine 100 mg TDS PC x 5-7 days or Albendazole 400 mg daily x 5 days
Gastroenteritis (GE) အစာလမ္း (အူ) ေရာင္ျခင္း၊ = For Salmonella TMP-SMZ double strength BD x 5 days or Ampicillin 500 mg QID x 5 days or Ciprofloxacin 500 mg BD x 5 days or For E histolytica Metronidazole 750 mg TDS x 5-10 days followed by Diiodohydroxyquin 600 mg TDS x 3 weeks
Medicine for Emergencies and Acute Diseases ရုတ္တရက္ ႏွင့္ အေရးေပၚေရာဂါေဆးမ်ား၊
Seizures and Epilepsy အတက္ေရာဂါ၊ ဝက္႐ူး ျပန္ေရာဂါ၊ = Phenytoin 200-400 mg , Carbamazepine 600-1200 mg, Phenobarbital 100-200 mg
Peritonitis ဝမ္းတြင္းေျမွး ေရာင္ျခင္း၊ = Ampicillin 1-2 Gm QID + Gentamycin 2 mg/kg TDS + Metronidazole 500 mg IV TDS; Cefotaxime 2 Gm IV BD/TDS
Intra-Abdominal Sepsis ဝမ္းဗိုက္အတြင္း ပိုးဝင္ျခင္း၊ = Ampicillin 1-2 Gm QID + Gentamycin 2 mg/kg TDS + Metronidazole 500 mg IV TDS
Intra-Abdominal Anaerobic infections ဝမ္းဗိုက္ထဲ ေလမႀကိဳက္သည့္ ပိုးဝင္ျခင္း၊ = Ciprofloxacin 750 mg BD + Metronidazole 500 mg TDS
Septic Thrombophlebitis ေသြးျပန္ေၾကာေရာင္ျခင္း၊ = Vancomycin 15 mg/kg BD + Gentamycin 2 mg/kg TDS or Tobamycin 5 mg/kg or Amikacin 15 mg/kg
Tetanus ေမးခိုင္ေရာဂါ၊ = Tetanus Immune Globulin 5,000 units IM followed by ATT 2 doses and symptomatic treatments
ခဲြစိတ္လူနာမ်ားအား ေရာဂါပိုးမဝင္ ေစရန္ ႀကိဳတင္ေပးမည့္ေဆး၊ = Cefazolin 1-2 Gm IV (Head & Neck, Neurologic, Thoracic, Orthopedic, LSCS, Hysterectomy, Gastroduodenal, Biliary, Urologic, Appendectomy, Breast, Hernia); Neomycin + Erythromycin 1 Gm Orally each at 19, 18, 9 hours before surgery (or) Cefotetan or Cefoxtin 1-2 Gm IV
Heart attack or Stroke (Myocardial infarction) ႏွလံုး ေသြးေၾကာပိတ္ျခင္း၊ = Alteplase 0.75 mg/kg; Aspirin 300-600 mg QID; Atenolol 5 mg IV or 50-100 mg Oral Daily; Atropine (Sulphate) 0.5 to 1.0 mg IM/IV; Camylofin 0.285-0.857 mg/kg TDS Oral; Diltiazem (HCl) 30-60 mg TDS Oral; Glyceryl Trinitrate 0.5 to 1.0 mg Sublingual; Heparin (Na) and Heparin (Cl) 5,000 IU IV, 20,000-30,000 IU IV Infusion, 5,000 IU TDS S/C; Metoprolol (Tartrate) Orally and IV. 100-200 mg BD Oral; Mexiletine (HCl) 2.857-5.714 mg/kg TDS Oral; Morphine 5-15 mg 4 hourly IM; Nadolol 40-240 mg Oral; Nicoumalone 0.114 to 0.171 mg/kg Oral; Sodium Nitroprusside 20-400 ug/min IV Infusion; Streptokinase 250,000 IU IV or 1.0 mlU/hour IV Infusion
Acute Endocarditis ႏွလံုး အတြင္းသား ေရာင္ျခင္း၊ = Vancomycin 15 mg/kg BD + Gentamycin 2 mg/kg TDS
Acute Pancreatitis (Severe pain, nausea and vomiting, weakness, sweating, anxiety, tender and distended abdomen absence of bowel sounds, mild jaundice) ရုတ္တရက္ သရက္ရြက္ေရာင္ျခင္း၊ = Meperidine 100-150 mg IM every 3-4 hours + Calcium Gloconate IV if tetany is present + Serum or plasma albumin infusion + IV fluids + Tube feeding + Imipenem 500 mg TDS or Cefuroxime 1.5 Gm IV followed by 250 mg Orally BD + No alcohol, low fat, no narcotics
Meningitis bacterial ဦးေႏွာက္ေျမွးေရာင္ျခင္း၊ = Cefotaxime (Cetriaxone 4 Gm, Ceftazidime or Ceftizoxime) 2-3 Gm IV QID or Ceftrixone 2 Gm IV BD + Vancomycin 10 mg/kg TDS ± Rifampin; Meningitis bacterial age > 50 = Ampicillin 2 Gm IV every 4 hours + 2-3 Gm IV QID or Ceftrixone 2 Gm IV BD + Vancomycin 10 mg/kg TDS; Meningitis postoperative = Vancomycin 10 mg/kg TDS + Ceftazidime 3 Gm IV TDS; Dexamethasone 0.15 mg/kg IV QID for coma cases; TB Meningitis = Rifampin, INH, Pyrazinamide + Dexamethasone 0.15 mg/kg QID x 1-2 weeks
Brain abscess ဦးေႏွာက္ျပည္တည္ျခင္း၊ = (1) Penicillin G 4 million units IV every 4 hours or Penicillin G 2 million units every 2 hours IV + Metronidazole 750 mg IV every 6 hours (or) + Chloramphenicol 1-2 Gm IV every 6 hours x 6-8 weeks plus Dexamethasone 4-25 mg QID + Surgery; (2) Cefotaxime 2-3 Gm IV QID or Ceftriaxone 2 Gm IV BD + Metronidazole 500 mg IV/Orally TDS + Surgery
Bell’s Palsy မ်က္ႏွာတျခမ္း အေၾကာေသျခင္း၊ = Prednisolone 60-80 mg daily in divided doses x 4-5 days followed by tapering of dose x next 7-10 days
Acute Cholecystitis ရုတ္တရက္ သဲေျခလမ္းေရာင္ျခင္း၊ = Morphine for pain + Surgery ခဲြစိတ္ရန္၊
Cholangitis & Choledocholithiasis (Pain/colic over RHC, Fever and chills, history of jaundice, Hepatomegaly) သဲေျခအိပ္ ေရာင္ျခင္း၊ = Surgery + Ciprofloxacin 250 mg IV BD or Mezlocillin 3 Gm IV every 4 hours plus Metronidazole 500 mg IV QID and or Gentamycin 2 mg/kg IV loading dose followed by 1.5 mg/kg TDS; Post-operative = Ampicillin 500 mg IV QID or Ciprofloxacin 250 mg IV BD or Cefoperazone 1-2 Gm IV BD
Dr.T S;;;
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