pcu manual treatment 1
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8/12/2019 PCU Manual Treatment 1
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( ill - defined symptoms) ( clinicaldiagnosis)
( ) ( )
1
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3
1. (emergency)2. (specific treatment)
3. (symptomatic treatment)
3.1 (self-limited)
3.2 , , (
2) ()3.3 (incurable)
/
2 1. 2.
3 2 ()
1. (disease) (conditions) 3 ( 1) ( 3.1 )
( 1) ( 3.1) ; ; ()
2. ( 6 ) ( 7 , ) 2
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( ) ( ) ( )
() (palliative care)
3.
() 4.
(dynamicity) ( 2 - 3 )
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2
s
s
s
s
s
s
s
s
s
s
?
3-7 /1-2
?
- - ?
(, , )
?
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/
/
3 1. 2. 3. 4.
1. 35
1. (Cardiopulmonary arrest)2. (Unconsciousness)3. (Shock)
4. (Seizure)5. (Anaphylaxis)6. (Syncope, Fainting)7. (Stroke, Cerebrovascular disease)8. (Drowning and Near drowning)
9. (Massive blood loss)10. (Electrical Injury)11. (Lightning Injury)12. (Falling)13. ( Fracture)14. (Eye emergency)15. (Ear emergency)16. (Throat emergency)
17. (Nasal emergency)18. (Zipper injury)19. (Head Injury) ()20. (Chest Injury)21. (Abdominal Injury)22. (Spinal Injury)23. (Burn) ()24. (Mass casualty)
25. (Toxic substance, Drug over dose)
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26. (Human bite)27. (Snake bite) ()
28. (Animal bite) 29. (Bee, Wasp, Hornet String) ()30. (Scorpion string, Centipede and Spider bite)
() 31. (Sea Urchins) () 32. (Jellyfish Dermatitis)
33. (Suicide)34. (Rape) ()
35. (Violence)
2.
1. 7 2. 3. 4.
5. 6. 7. 8. 9. 10. 11. 12. , 13. / 14. 15. ( )16. 17. / 18. 19.
20. 21. /
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22. 23. ()
24. 25. Condyloma ()
3.
1. - /
2.
- / /- //3.
- -
4. /- / -
5. - - /
6. -
7. ///- / - /
8. -
4.
1. 2.
3. 4.
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5. 6.
7. 8. 9. 10. 11.
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3.1
1. (Cardiopulmonary arrest)
:1.
2.
3. 4.
5. , , 6.
3
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/ /
1.
2. 3.
1.
2.
3. Head tilt chinlift Jaw thrust maneuver Jaw thrust maneuver
4.
5. mask
Mouth to Barrier device Pocket mask Faceshield Lite Key
6. (Externalcardiac massage) Cardiopulmonaryresuscitation Glide line (CPR 2000) 2
15 1 2 7.
8. bag 1
5 100 / bag
9. (Isotonic Solution)
10.
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2. (Unconsciousness)
(Reticular activation system) (Cerebral hemisphere):1. (Structural cause) ,
2. (Metabolic cause) ,
, ketone, carbondioxide
/ /1.
2. 3. 4. 5.
6.
, ABCs
(strip)
(Hypoglycemia) < 70 mg/dl 50% glucose
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3. (Shock)
:1. 2. , (Hypovolumic Shock)3. (Septic Shock)4. 5.
/ /
1. BP < 90/60 .Pulse pressure 20. mean arterialpressure < 60 .
2. , ,
3.
1. , ABCs
2. 10-20
3. 4.
(Isotonic Solution) NSS, Lactate RingerSolution
5% D/W5. 6. 7.
8.
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4. (Seizure)
(cerebral cortex) , , ,
1. Localization - related (focal, local, partial) Seizure
Simple partialseizure Complex partial seizure
2. Generalized Seizures 2
1. Idiopathic (Primary) 2. Symptomatic
, , 3. Cryptogenic
/ /
1. , ABCs
5 Diazepam 10 mg 5
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2.
(Postictal Confusion)
/ /
3.
3.1 3.1.1 3.1.2 3.1.3 15 3.1.4 3.1.5
Simple
Febrileconvulsion
ABCs
-- -- Clear airway
-- -- Positive Breathing
3.2 3.2.1 (Meningitis)- (Neck stiffnesspositive)- Kernigs sign positive
- Babinskrs sign positive
/
3.2.2 1 6 3.2.3 3.2.4 3.3
15
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0-5
- ABCs- air way - 6-10 5% D/NSS 5%D/NSS/2 50% glucose 2 ml/kg 25% glucose 2 ml/kg 10-30 Diazepam 0.2 mg/kg/dose 10 Gardinal
Na 10-15 mg/kg/dose rate 50 mg/min.
/ /
5. (Anaphylaxis)
(sensitized) (local) (systemic)
:1. antibiotics penicillin, sulfonamide group, NSAIDS,
Immunoglobulin2. -, 3. , , , 4. ,
/ /
1.
2.
3.
4. 5.
, ABCs
(Cardiopulmonary re-suscitation )
adrenaline 1:1000 0.3 -0.5ml IM, IV0.01 ml /kg/dose ( standing order)
Isotonic solution
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6. (Syncope, Fainting)
:1. 2. 3. 4. - 5.
6. 7.
/ /
1. 2.
3. 4.
5.
, ABCs
(Cardiopul-monary resuscitation )
6.
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7. (Stroke, Cerebrovascular disease)
1. (Cerebral ischemia)
- Transient ischemic attack (TIA)- Cerebral infarction
2. (Cerebral hemorrhage)3.
-
- - -
/ /
1. 2.
3.
4. 5.
6.
7. 8.
, ABCs
(Cardiopulmonary resusci-tation)
(Isotonic solution ) NSS,Lactate Ringer solution
5% D/W maintenance
maintenance ** ** x 21
x 35 fluid 1
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Holiday and Segar
~ 10 . 100 ./ . ~ 10 . 50./ . 20 . 20 . / . increase intracranial
pressure iv fluid rate KVO (Keep Vein Open)
/ /
8. (Drowning and Near drowning) 24 . Near
drowning 24 . :
/ /1. , 2.
3.
, ,
4. ,
, 5. (aspiration)
, ABCs , ,
(Cardiopulmonary resusci-tation)
(Spinal injury) (Head injury)
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9. (Massive blood loss) 40 %
(Hypovolumic shock) (Organ failure) :1. (External hemorrhage) 2. (Internal hemorrhage)
/ /
1.
2. 3. ()4.
Isotonicsolution Lactate Ringer solution Normal
saline
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/ /
1. , 2.
, 3.
4.
5.
, ABCs (Cardio pulmonary resusci-tation)
(Spinal injury) (Head injury)
6.
10. (Electrical Injury) :
1. 2. 3.
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11. (Lightning Injury):
1. Nervous system 2. Hearing system 3. Skin 4. Heart 5. Vascular system
/ /
1. 2.
3. 4. ,
, ABCs (Cardiopulmonary resusci-tation)
fracture
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1. 2. 3. 4. ,
, 5.
6.
7.
12. (Falling):
(Multiple injury)
/ /
, ABCs (Cardiopulmonary resus-citation)
** (
) **
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13. (Fracture)
1. (Incomplete fracture) 2. (Complete fracture) 1. (Close fracture)2. (Open fracture)
1.
2. 3.
4.
5. 6.
/ /
,ABCs .
(Splint)
normal saline
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14. (Eye emergency)
1. 2. 3. (Chemical burn)
/ /
1. (Blunttrauma)1.1
1.2 Fracture
1.3 anteriorchamber (hyphema)
Absolute bed rest 30 - 45
2
2. 2.1
()
2.2 -
3. (Chemicalburn) ( )
NSS 1/2 NSS 2 ()
4. (Subcon-
junctival hemorrhage)
2
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15. (Ear Emergency)
1. 2. 3.
/ /
5.
(Circumcorneal injection)
/ /
1.
2. C.S.F
Absolute bed rest
3. 3.1
ear forceps
3.2
4.
70% glycerine borax
( )
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6. -
/ /
5.
3-7 discharge
valsalva decongestant
16. (Throat emergency):
/ /
1.
/
Heimlich maneuver Abdominal Thrust
ABCs
2.
()
laryngealmirror
3.
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17. (Nasal emergency)
1. (Epistaxis)2.
/ /
1.
5-8
2. anterior septum
1 adrenaline 1 : 1,000 10 (HT)
3.
nasal forceps
18. (Zipper injury)
/ /1.
1. towel clips 2
2.
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19. (Head injury)
1. 2. 3.
2 Primary brain injury
concussion, contusion, epidural hematoma, intracerebral hematoma Secondary brain injury primary brain injury
/ /
1. 2.
3.
4. 5. 6. 7.
8.
, ABCs (Cervical spine)
(Stroke) Hypotension
NSS Lactate Ringers Solution
Cervical collar
1. 2. Glasgow coma score
15
3.
24 .
1.
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20. (Chest injury) 2
1. Blunt injury 2. Penetrating injury
- (Fracture ribs)- (Flail chest)- (Pneumothorax)- (Open pneumothorax)
- (Hemothorax)- (Cardiac temponade)- (Massive bleeding)
/ /
1. ,
2. 3. ,
4. 2 ,
5.
6. 2 (flail chest)
, ABCs
Open pneumothorax
sterile occlusivedressing
Flail chest Flail pressure dressing
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21. (Abdominal injury):
2 1. Blunt abdominal injury
2. Penetrating injury
/ /
1.
2.
3. (guarding)-
- ,
, ABCs
. Isotonic solution
normal saline
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22. (Spinal injury)
/ /
1. 2.
3. 4.
5. 6. 7.
-
, ABCs
- -
Cervical collar
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23. (Burn)
(Rules of nine) Lund and
Browder ( 1 1% )
1. (First degree burn)
2. (Second degree burn) 3. (Third degree burn)
/ /
1.
15% 2.
3. 5%
4.
5.
6. 7.
8.
, ABCs
, 20%
Hypovolumic shock Parklan
20%
NSS
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24. (Mass casualty)
1. 2.
/ /
(
10% Hypothermic shock )
9.
-
/ /
1.
, 2.
3.
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25. (Toxic substance, Drug over dose) (Toxic substance)
(Drug over dose)
1. (ingestion)2. (inhalation)
3. (absorption)4. (injection)
-
/ /
- - - ()
/ /
1.
2. - 3.
4.
, ABCs
(Cardiopulmonary resusci-tation)
1.
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26. (Human bite)
Aerobic Anaerobic bacteria HIV Hepatitis B
/ /
2.
3.
3-5
4. (activated charcoal)
5.
6.
/ /
normal saline
Amoxycillin Ampicillin Cloxacillin, Penicillin
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27. (Snake bite) 2
1. 3 1. (Neurotoxin) , , ,
2. (Hematotoxin) , , 3. (Myotoxin) , ,
2. , , ,
(), , , , , , ,
,
/ /
1.
2. -
3. 4. 5. 1.
2. , ,,
3. 4. 5.
6. 7.
1. , ABCs2.
(Cardiopulmonary resuscita-tion)
3. 4.
5. 6.
7.
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/ /
-
1.
2. 3.
4. 5.
()6.
8.
9. 10. 11.
-
Penicillin, Amoxycillin, Cotrimoxazole
5 - 10
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28. (Animal Bite)
/ /
1.
()
2.
(
)
3. -
4.
: 1.
2.
70%
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3. 3 - 4
4. 5.
1. 2. 2 2 3.
3 10
3 / 10
29. (Bee Wasp Hornet String) , ,
/ /
1. 2. 3.
4. ,
()
, ABCs
(Cardiopulmonaryresuscitation)
Anaphylaxis
-
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30. (Scorpion string, Centipede and Spider bite) ,
/ /
1. 2. Anaphylaxis3. 4.
5.
6.
()
,ABCs
(Cardiopulmonary resusci-tation)
Anaphylaxis
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31. (Sea Urchins)
/ /
1. Systemic reaction Anaphylaxis
, ABCs
(Cardiopulmonary resusci-tation)
Local presentation ()
2. Local presentation
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32. (Jellyfish Dermatitis)
/ /
1. Fatal reaction anaphy-laxis, cardio pulmornaryarrest
ABCs-
2. systemic reaction
local heat 39
( )
Anaphylaxic
systemic infection
3. local reaction / 1 - 4
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33. (Suicide)
- 80%
- 20% schizophrenia
/ /
1.
2.
3.
4. 5. 6.
1.
2.
3.
4.
5.
6. 7.
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34. (Rape)
/ /
1. 2.
3. 4.
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35. (Violence)
:- (Alcoholic intoxication)
(Alcoholic withdrawal)- (Personality disorder)- (Paranoid psychosis)
(Mania)-
- , , ,
/ /
1.
2. 3. 4. 5. 6. 7.
8.
8
1.
2.
3.
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3.2 /
1. 1.1 : ()
/ /
1. 1.1
1.2 1.3
(crepitation)
(ABCs)
2. 2.1 2.2 7
24
3. 1 23.1
Paracetamol
-----------------------------------------------------------------------------------------------------------------3.2
5 2 Chlorpheniramine 2-3 2-3
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1.2 /
/ /
3.3
3.4 4 24
(Amoxycillin Erythromycin)3 5-7 ( 10 )
3.5 7 1 2
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
/ /
1. 1.1 1.2
1 .1.3
1
2. 12.1 / Chlorpheniramine
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/ /
2.2
24
(Amoxycillin Erythromycin)3
5-7
2.3 ( )
Chlorpheniramine
2.4 / 1
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1.3 :
/ /
1. 1.1 1.2
1.3
(ABCs)
O2
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3. 3.1
/ /
2.
2.1 7 2.2 2.3 2.4
(crepitation) (wheezing)
24
(Paracetamol)
(Amoxycillin Cotrimoxazole Erythromycin) 3
5-7
3.2
Chlorpheniramine 1
4.
4.1 ,
4.2
4.3
4.4 7 , 3
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1.4 :
/ /1.
1.1 1.2 1.3 1.4
1.5 1.6
(ABCs)
NSS N/2
2. 12.1
Wheezing
1
2.2
- - 30
2.3
/
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-----------------------------------------------------------------------------------------------------------------
1.5 : / / /
/ /
1.
(ABCs)
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2. 2.1 :
:
/ /
2.
2.1 3 2.2
3
3. 1 2
,
5 2 Paracetamol
(Pen V Amoxycillin Erythomycin) 3 5 - 7
1. 3 2. 3
3. 1
/ /
1. 1.1 1.2 1.3
1.4 2
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/ /
2.
1
3. 1 23.1
2
3.2
1
3.3
1
2.2 : / / /
/ /
1.
Chlorpheniramine
1. 3 2. 3.
Chlorpheniramine /
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2.3 / :
/ /
2.
Chlorpheniramine
3
3. 1 2
( ) /
Chlorpheniramine 3
/ /
1. 1.1 1.2
-
2. 12.1
/
(Pen V Amoxycillin)
-
3-5
1. 3 2. 3.
4.
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2.4 / : /
/ /
2.2
1-2
/ /
1. 1.1 1.2
2.
24
- 3. 1 2
3.1
2
Aspirate I/C () /
Cloxacillin Erythromycin 3-5 3
3.2
3.3
2 3
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4.2
/ /
3.4
Paracetamol
Amitriptyline10 .
1. 2. 3 3. 40 4. SBP 140 DBP
90 .
3.5
(Amoxycillin Cotrimoxazole
Erythromycin) 3 - 5 14
4.
4.1 ,
1. 2. 3. 3
( )
3
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1. 1.1
/ /
2.5 : ( )
(ABCs)
2. 1 . 3
1
3. ()
(Penicillin V Erythromycih
Amoxycillin) 3 7
4. ()
(Penicillin V Erythromycin Amoxycillin)3-5
24 5. 1-45.1
1 10- 15 3
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2.6 // : 2
/ /
1. 1.1
()1.2
1.3 1.4
1.5 1.6
ear forceps
2. 2.1 2.2
ear wax impact
1
3. 1 23.1
(Cloxacillin Erythromycin) 3 5 - 7
3
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3. 3.1 :
/ /
1. 1.1 1.2 1.3
1.4 1.5
24
2. 1 2.1 2.2 2.3
(Penicillin V
Erythromycin Amoxycillin) 3-5
3.2 :
/ /
1.
(gingivitis)
(Penicillin V Erythromycin
Amoxycillin) 3-5
2. 1 .
TA oral paste 3 1
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/ /
3. 1 - 2
acyclovir cream 5
1
4. ( )
antibiotic cream 2 1
5. (
(clotrimazole)
6.
Mycostatin oral suspension
7
7.
1 - 6
1
3.3 :
/ /
1. 1.1 1.2 1.3 1.4 1.5
1.6
(ABCs)
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3.4
/ /
2.
2.1 2.2 2.3 2.4 2.5
3
Dimenhydrinate
3. 1 2
3.1
3.2
/
1. 24
2.
3.3 ()
Dimenhydrinate 30
3.5
24
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3.4 :
/ /
3.5
Dimenhydrinate
1. 24 2. 3. 4.
/ /
1.
1.1 :
1.2 / 6
1.3
1.4
1.5 ,
(ABCs)
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1.6
3-5
1.7 ()
/ /
2. 2.1
7 2.2 2.3 2.4 2.5
24
3. 3.1
() /
()
1 (antispas-
modic) ,
3.2
antispasmodic
1. 2. 3. 1 , 2
4. 25
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/ /
-----------------------------------------------------------------------------------------------------------------
3.3
antispasmodic
6
1, 2
4.
4.1
/ cimetidine 1
1 - 2
1. 2. 3.
4.2
1
5.
5.1
Amoxycillin
Cotrimoxazole 3
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5.2
-----------------------------------------------------------------------------------------------------------------
/ /
antispasmodic
1. 2. 1, 23. 25
5.3 5.1 5.2
6.
1,2
1 2
3.5 :
/ /
1. 1.1 1.2 1.3
1.4
(ABCs)
2.
2.1
2.2 7 2.3 2.4
24
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3. 7
/ /
1
4. 1 - 3
ORS Amoxycillin 500 . 6
. Tetracycline 2 6 . Cotrimoxazole 2 2 / 5
Nofloxacin 400 . 2 3
Cotrimoxazole 5
1. 2 2. 3. 1-2
5.
2-4 .
ORS absorpbent
kaolinpectal activated clacole
1. 48 .2. ORS 3. 1-2
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3.6 :
/ /1.
1.1 1.2 1.3
2.
2.1 2.2 1
2.3
3
3. 123.1
()
()
3.2
-
- - -
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3.3
/ /
(
milk of magnesia bisacodyl) 1
3.7 :
: ( )
1. 5% 10
/ /
1
2. 12.1
1. 1 2. 3.
-----------------------------------------------------------------------------------------------------------------
2.2 digitalis
propanolol, codeine
2.3
1
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4. / 4.1 / : () ( 1- 10 .)
( )
/ /
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-----------------------------------------------------------------------------------------------------------------
1. 1.1 1.2
1.3
4.2 :
24 (Hematocrit)
2. 12.1
/ 48
2.2
1
2.3
3
/ /
-----------------------------------------------------------------------------------------------------------------
1. 1.1 1.2 1.3 1.4
1.5 100 /
(ABCs)
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4.3 :
/ /
-----------------------------------------------------------------------------------------------------------------
2.
2.1 2.2 2.3 2.4
2.5 2.6
3
3. 1 23.1
()
Folic acid
3.2
1 Mebendazole 3 2
/ /1.
1.1 1.2 1.3 1.4
(ABCs)
-
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70
3.
/ /
1.5
1.6
3 - 5
2.
2.1 7 2.2 2.3 2.4
3
Cimetidine 1
1 -2
1.
2. 3. 4.
4.
3
-
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71
/ /
5.
() 1-4
Diazepam ()()
1. 7 2. 1-2
4.4 :
/ /
1. 1.1 1.2 1.3 1.4
1.5 1.6 1.7
(ABCs)
< 70 % 50% glucose
2. 2.1 2.2
2.3 2.4 100 /
3
3. 3.1
-
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72
1. 1.1 1.2
1.3
1.4 1.5
1.6
/ /
3.2 ,
, , ,
6
4. 1 -34.1
100 /
1 -----------------------------------------------------------------------------------------------------------------
4.2
1
5. 5.1 :
:
/ /
1
-
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73
5.2 :
/ /
2. 1
2.1
,, ,
,, 1
2.2
1
2.3
1
/ /
1. 1.1 1.2 1.3
24
2. 2.1
2.2
3
3. 1 23.1
3
-
-
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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74
5.3 :
/ /
3.2
Amoxycillin Cotrimoxazole3
2
/ /
1. 1.1 1.2 1.3
24
2. 1
[clotrimazole] 1 6 clotrimazole cream
1
3. 1
2-
1
-
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75
5.4 / :
/ /
1. 1.1
16
1 Paracetamol Hyoscine
1.2 1.1
16
2. 2.1
2.1.1 2.1.2 2.1.3 2.1.4
3
2.2 2.1
2.2.1
2.2.2 / /
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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76
6. 6.1 :
/ /
2.2.3 45
*
*
3. 2.1 2.2
* -* 6
/ /
1. 1.1 7 1.2
1.3 1.4
1.5
1.6 (
)1.7 1
3
2. 12.1
Chlorpheniramine 1- 2 7
Calamine lotion
-
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77
- 7 - Chlorpheniramine
/ /
2.2 , ,
( )
, ,
2 -
3
2.3 , , 2
Benzyl benzoate Chlorpheniramine Amoxicillin., Erythro-
mycin, Cloxacillin 1
2.4
1 - 2
3 - 4 1 - 2
2.5 2.5.1
2.4
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
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78
2.5.2
/ /
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
1 - 2
2.6 ( )
(Ketoconazole)
3 () 1 - 2
2.7 I/D, Wet dressing /
2.7.1
,Impetigo
(Pen V Cloxacillin) 3 5 - 7 1 - 2
2.7.2
2
(PaederousDermatitis)
10 2
- - ()-
2.8 2.8.1
2 - 3
Paracetamol Calaminelotion 2 - 3
1. ,
2. 3.
-----------------------------------------------------------------------------------------------------------------
-
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79
2.8.2
1 - 3 . (
) ()
/ /
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
Wet dressing Normal Saline 3% Boric acid
Acyclovir 5
1. 2. 3. 1
2.9
2.9.1
,
keratolytic agent (40 %) 2
2.9.2
6.2 : : 1.
2. 3.
/ /
-----------------------------------------------------------------------------------------------------------------
1. 1.1
1.2
3 Chlorpheniramine
Calamine lotion
2. 12.1 2.1.1
Benzyl benzoate
2.1.2
2
-
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80
2.1.3
/ /
1
Ketoconazole shampoo 2
2.1.4
2.2.3
2
2.2 2.2.1
3
2.2.2
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
Mebendazole
2
2.3 ()
2.3.1 ()
-----------------------------------------------------------------------------------------------------------------
Mebendazole
-----------------------------------------------------------------------------------------------------------------
2.3.2
1
2.4 ()
Calamine lotion Chlorpheniramine
1. 3
2. 3.
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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81
7. ///7. :
( )
1. 1.1 1.2 ()
1.3 1.4 1.5 /
1.6
/
1.7 SBP
210 DBP 120.
/ /
2. 2.1
40
2.2 3
2.3
2.4 SBP 160 DBP100 .
3 Paracetamol
-
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82
3.
3.1
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
/ /
, (Chlorpheniramine) (Amoxycilin Cortimoxazole Eryth-
romycin 3 )
3.2
(Amoxycillin Cotrimoxazole
Erythromycin) 3 2
3.3 ( 2
)
Paracetamol
1. 2. 3 3. 4. 40 5. SBP 140 DBP 90
.
3.4
Paracetamol
1. 2. 1-2
-----------------------------------------------------------------------------------------------------------------
-
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83
7.2 :
/ /1.
1.1 1.2 1.3 1.4
1.5 1.6 1.7 1.8 SBP 210
DBP 120.
(ABCs)
2.
2.1 2.2 2.3 2.4 2.5 2.6
1
2.7 SBP 140 DBP 90 .
24
(Dimenhydrinate)
3. 1 2 3.1
(Dimenhyrinate)
1. 3
2. 3.
-
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84
-----------------------------------------------------------------------------------------------------------------
/ /
3.2
3.3
,
24
/
3.4 3.1 - 3.3
(Dimenhydrinate)
1
7.3 :
/ /
1.
2. 2.1 2.2 SBP
140 DBP 90
.2.3
2.4 2.5
2.6
,
1 1
-----------------------------------------------------------------------------------------------------------------
-
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85
2.7
2.8
/ /
3. 1 2
1 2
7.4 :
/ /
1. 1.1 1.2
1.3 ()1.4 (
)1.5
2. 2.1
/
2.2
-----------------------------------------------------------------------------------------------------------------
()
-
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86
7.5 :
/ /
3. 1 2
3.1 2
(Hyperventilationsyndrome)
30
3.2
-----------------------------------------------------------------------------------------------------------------
/ /
1. 1.1
ABCs
(Splint)
1.2
24
-----------------------------------------------------------------------------------------------------------------
-
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87
2.2
/ /
1.3 7
1
2. 1.1 -1.32.1
( 40
)
: ( ) ,
Paracetamol
1. 2. 3.
48 .
1. 2. 1
2.3
Paracetamol
1. 1 2. 1.2 - 1.3
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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88
7.6 :
/ /
1. 1.1 1.2 1.3
(ABCs)
2. ,
24 ,
3.
3.1 3.2 3.3
3.4 3.5 7
24
4. 1-34.1 4.2
//
! Paracetamol NSAID (
)
-
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89
7.7 / :
: 1.
2. 3.
/ /
1. 1 2. 3.
/ /
1. 1.1
1.2 1.3 3
1
2. 12.1
Paracetamol
NSAID ()
1. 1 2.
-
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90
8.
8.1 :
/ /
2.2
Paracetamol
1. 1 2.
/ /
1. 1.1
1.2 (crepitation)
1.3 6
1.4
(ABCs)
-
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91
2. 2.1 (
)
2.2
2.3 7
/ /
24
2.4 (eschar)
2.5 -
2.6 (R/OPyelonephritis)
2.7 (R/O DHF)
-----------------------------------------------------------------------------------------------------------------
3. 3.1
3.2
Cellulitis (Penicillin V, Amoxycillin Erythromycin) 3
7
3
-----------------------------------------------------------------------------------------------------------------
-
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3.5 ( 4 ) ( 4 )
/ /
3.3
24
3.4 3.3
1
CalamineLotion
1
3.6 -
Paracetamol
1. 4
2. 1 2
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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93
8.2 : -:
/ /
1. 1.1 1.2 1.3
3
2. 12.1 (
)
1 Mebendazole 3 2
2.2
2.3
1
2.4
1
2.5
1
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------------------------------
-
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:
: 110000-2590-1637-8
0-2590-1631http://www.203.157.3.100 ()
1 : 2546 12,000
:
200/198 ISBN 974-465-271-3
-
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( 2545 - 2546) / 6
..2545
2546
-
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1 1
2
4
3 93.1 9
(Cardiopulmonary arrest) 9(Unconsciousness) 11 (Shock) 12
(Seizure) 13 (Anaphylaxis) 15 (Syncope, Fainting) 16 (Stroke, Cerebrovascular disease) 17 (Drowning and Near drowning) 18(Massive blood loss) 19 (Electrical Injury) 20 (Lightning Injury) 21
(Falling) 22( Fracture) 23 (Eye emergency) 24(Ear emergency) 25 (Throat emergency) 26 (Nasal emergency) 27 (Zipper injury) 27 (Head Injury) () 28 (Chest Injury) 29 (Abdominal Injury) 30
-
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(Spinal Injury) 31(Burn) () 32(Mass casualty) 33 (Toxic substance, Drug over dose) 34 (Human bite) 35 (Snake bite) () 36 (Animal bite) 38 (Bee, Wasp, Hornet String) () 39
(Scorpion string, Centipede and Spider bite)() 40 (Sea Urchins) () 41 (Jellyfish Dermatitis) 42 (Suicide) 43 (Rape) () 44 (Violence) 45
3.2 46
46 51 58/ 68 72 76/// 81 90
3.3 94 94 96 98 100 102 103 105 108
111 112
-
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114 116 117
119 126
129Paracetamol 129Ibuprofen 130Acetylsalicylic acid (Aspirin) 131
132Chlorpheniramine maleate 132
133Adrenaline (Epinephrine) 133
134Dextromethorphan 134Mixt. Tussis 135Mist. Scill. Ammon 136
137Salbutamol 137
138Sodium bicarbonate : sodamint 137Mixture Carminative 139
140Antacid 140Cimetidine 141
142Dimenhydrinate 142Metoclopramide 143
144Hyoscine-n-butyl bromide 144Atropine sulfate 145
146Milk of Magnesia (MOM) 146
Bisacodyl 147
-
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147ORS 147 148
Absorbent : Kaolin 148 149
Vitamin B6 149Vitamin B complex 150Multivitamin 150
151Ferrous Fumarate 151Ferrous sulfate 152
153Albendazole 153Mebendazole 154
155Amoxycillin 155Penicillin V (Phenoxymethyl Penicillin) 156
Erythromycin 157Co-trimoxazole 158Doxycycline 160Cloxacillin Sodium 161Norfloxacin 162
163Benzyl Benzoate 163Gentian violet 164
Clotrimazole cream 165Calamine lotion 165Methyl salicylate 166Salicylic acid ointment 40% 166Triamcinolone acetonide 167
168Chloramphenical eye drop/ointment 168Hista-oph 168
169Antiviral cream : Acyclovir cream 169
-
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170 170 170 170
171Lidocaine HCI 171
172
Ethyl alcohol 172Povidone iodine 10% 173Cresol (Lysol) 174Glutaraldehyde 2% 175Sodium triazine-3-one (virkon) 176
176Glucose 50% 176D 5% NSS (5% dextrose + 0.9% NaCl) 177D 5% N/2 (5% dextrose + 0.45% Nacl) 178Lactate ringers solution 178
179 179
Methylergometrine 179 180
Cinarizine 180 181
Diazepam 181
182Thiazide 182
183Mycostatin oral Suspension 183
184 187 190 191
192 195
-
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196 196
198
.. 2543 199
200
-
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94
3.3
(Diabetes Mellitus)
1.
-
- - - -
2.
3.
1. 2. 3. 4.
-
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95
4.
1.
/
40 4
2 3
1) 10 2) ( 120)3)
3.1 3.2 3.3 (acanthosis
negricans)
(capillary blood glucose) 110 ./.
(capillary blood glucose)
110 ./. 1
3
2.
-
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96
3.
1 4 4 4
4.
(Hypertension)
1.
140/90.
2.
140/90 .
-
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97
3.
1.
2. 3.
4.
5.
6. 2-3 7. 8. 10
4.
1. /
40 40 40
1) 2) BMI 25 ./ 3) (130-139/85-89
.)4)
5)
-
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98
2. 3.
4.
5.
( Asthma)
1.
Asthma
(Bronchial hyper responsiveness) NSIAD, Beta blocker, ,
2.
-
COPD, , ,
-
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99
3.
1. ( . 1 ,, 3 )
1 2 1 1 2 (Beta 2 agonist nebulizer) 15 3
- -
- -
3-5 -
2. 2 (Beta 2 agonist)
- Salbutamol Ventolin, Butamol, Proventil, Reprtabs 1-2 puff 4-6 . 2-4 mg. (1-2 tablet) 6-8 .
0.1 mg/ 1 Kg. ( 2 mg) 6-8 .- Terbutaline Bricanyl, Ataline, Bucaril, Brethine
1-2 puff 6-8 . 2.5-5 mg. (1-2 ) 6-8 .
0.1 mg./ 1 Kg. ( 2.5 mg.) 6-8 .
Nebulizer 1 ml Normal saline 3 m. 0.01-0.03 ml / Kg. ( 1 ml.) Normal saline 3 ml
-
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100
3.
4. (pulmonary rehabilitation)
4. 1.
2. 3. ()
1) ()
2) 3) 4) 5)
4. 5.
(Chronic obstructive pulmonary disease, COPD)
1.
-
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101
2.
barel shape ( APdiameter ) Tuberculosis, carcinoma, bronchiectasis
3.
( acute exac-erbation)
1. ( smoking cessation)
2. (pharmacological)- 2 (Beta 2 agonist) Salbutamo Terbutaline- (Anticholenergic) Ipratropium bromide
3.
3.1
3.2
3.3
3.4
3.5 3.6
purse lip
-
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102
30 / 110 /
(Pulmonary Tuberculosis)
1.
2.
2-3
3. 1.
/ 2 3-4
2. Isoniazid, Rifampicin,Pyrazinamide, Streptomycin, Ethambutol. 2-3 2 3 4
3.
4. 2 7
-
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103
5. 2-3
6.
4. 1. BCG 2.
3.
(Gouty Arthritis)
1.
( 3-7 . 100 .)
30
2.
1) ()
-
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104
2)
3)
3.
1. 2-3 ( ) 1-2 3
2. 1) 2
- (allopurinol)
- (colchicine)
2) 3) ()
( )
()
4) 10-15 5)
3.
4.
-
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105
4.
1.
2. 3. ()
1) ()2) 3) 4) 5) 6)
4. 5.
(Osteoarthritis Knee)
1.
40
( )
2.
( )
-
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106
3.
1.
2. 1)
( ) ( ) ( 40 2 )
2)
3) quad-riceps hamstring
3.1) Isometric quadriceps exercise (quadriceps retting)
1 - -
5 20 2
2 - - 45
5 20 2 3.2) Isometric hamstring exercise
5 20 2
3.3) Isotonic quadriceps exercise, ,
90 5 10 2
3.4) Isotonic hamstring exercise, 45 5 20 2
3.5) Progressive resistive exercise 3,4 1 10 10 . 15 .
-
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107
4)
( )3. 1 - 2
4. 1) 1
2)
3) 4) 5.
( )
6.
4. 1.
2. ( 3 )3.
1) 2) /
3) ( 3 )4)
4. 5. 6.
-
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108
1. (relaxation exercise)
1.
2. 3.
- 2
1- 3 1-10 -
- 10
-
2. (chest percussion) ,
1. , 2.
( Secretion sound)
1. ()
2. 2
3. cuppedhand 3 ,,
4.
-
8/12/2019 PCU Manual Treatment 1
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109
5. , - , , ,
6. 1 - 2 * 30 2 2
7.
8. NSS
1. 2. ,
, 3. , , 4.
5. 6. 7. , increase intracranial pressure
Lobe segment
Upper Apical
Anterior Rt.Lt.Posterior Rt.
Lt.
600
300 300
Middle Lt. Lingual lobeRt. Middle lobe
150 150
Lower Superior Rt, LtAnterior basalLateral basal
Posterior
300 -
,,
, 2
-
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110
1.
2.
1. ( Purse -lip breathing) (COPD)
2
2. (Diaphragmatic or abdominalbreathing )
1. 2.
3.
4.
5.
2
2 -3
2 -3
-
8/12/2019 PCU Manual Treatment 1
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111
1.
2.
3.
4.
5.
6.
7.
1. 5
5 20-30
2. 10
10-20 3.
10 10-20 4.
5 20-30
-
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112
5. 10
20-30 6. 5
20-30
1. 2. 3. 4. 5.
1.
2.
3.
1. 2.
-
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113
1. 2. 2-3 15-30 2-3
3. , 4. 5.
1. - -
2.
3.
-
- -4.
- -5.
-
1.
1
2.
-
8/12/2019 PCU Manual Treatment 1
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114
1.
,
2.
3.
4.
5.
1.
2. 3. /
24 10-15
24 15-20 4.
30 3-10 3
1.
-
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-
8/12/2019 PCU Manual Treatment 1
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-
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117
-
8/12/2019 PCU Manual Treatment 1
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-
8/12/2019 PCU Manual Treatment 1
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120
5. (
)
1.
1. 2. 3. 4.
5. 6. 7. 8.
6. 6.1
1.
2.
1. 3
2.
3. Xyphoid process
4. lubricated
5. Syringe gastric content
6. gastric content 7. (0.9% NSS) 200-400 cc
8. Larvage
9.
Larvage 100 cc/kg
-
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121
6.2 (NasogastricIntubation)
1. 1.1
() 12-18 120 . 5-12 45-75 .
1.2 50
1.3 2.
2.1 2.2
3.
3.1 3.2
3.3 6-8 Pharynx (Gagging) (Gasping) (Cyanosis)
-
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-
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123
6. urinary meatus7. 8.
7.2
1.
2.
1. 1-5 ( 7.1) plaster /
8. 1. 2. 3. 4.
1.
2.
1/3 3. 4.
5.
6. /
7.
8.
sterile
pressure dressing
-
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124
9.
1. 2.
1. 2.
70% 3. (forceps)
4. 5.
10. cyst(Excission)
1. 2.
1.
2. 3.
4.
5. 6. stterile11.
1.
2.
3. discharge4.
1.
2. 3% undine
3. 4.
5. undine
1-2
6. 7.
-
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125
12. papsmear
: 1. Contact bleeding2. Abnormal mass3. Abnormal vaginal
discharge
1.
2.
1. 2. 3.
labiamajora, mi-nora clitoris
4. 5. vaginal speculum
speculum
6. vaginal speculum spatula 95% alcohol
7. discharge
8. speculum
:
1. (IUD)2. (Nor plant)3. 4. Cyst5. VIA (Visual Inspection Using Acetic Acid)6. (Cryotherapy)
-
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126
1. (Analgesics, Antipyretic and NSAIDS)
1.1 (Analgesics, Antipyretics)1. Acetaminophen (Paracetamal)2. Acetyl salicylic acid (aspirin)
1.2 (Nonsteroidal Antiinflammatory Drugs)1. Acetyl salicylic acid2. Ibuprofen
2. (Antihistamines) Chlorpheniramine maleate3. / (Drug used in Anaphylaxis / Shock Epinephrine (adrenaline)4. (Respiratory drugs)
4.1 /
1. Dextrometrophan2. Mixt. tussis3. Scill Ammon mixt
4.2 (refill )1. Aminophyllin2. Salbutamol
5. (Gastrointestinal Drugs)5.1
1. M. Carminative2. Sodium Bicarbonate
5.2 (Antacids)1. Antacid : aluminium hydroxide and magnesium hydroxide2. Cimetidine
5.3 (Antiemetics)1. Dimenhydrinate2. Metochopramide
-
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127
5.4 (Antispasmodics)1. Atropine sulfate
2. Hyoscine-n-butylaromide (Buscopan)5.5 (Anticonstipations)1. Bisacodyl2. Magnesium hydroxide (milk of Magnesia)
5.6 5.6.1 (Replacement Solution)
Oral rehydralimsalts5.6.2 Absorbent : Kaolin
6. 6.1 (Multivitamin)6.2 (B. Complex)6.3 C (Vitamin C)
7. 7.1 Ferrous7.2 Ferrous sulfate
8. (Antihelmintic drugs)
8.1 Albendazole8.2 Mebendazole
9. (Antibacterial drugs)9.1 Amoxycillin9.2 Penicilin V.9.3 Erythromycin9.4 Co-trimoxazole9.5 Cloxacillin9.6 Tetracycline9.7 Norfloxacin
10. 10.1 Triamcinolone acetonide10.2 (Fungisides)
1. Gentian violet2. Clotrimazole
10.3 , , (Scabisides).Benzyl benzo.ate(Gposcabicide emul.)
-
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128
10.4 (Antipruritics).Calamine lotion
10.5 Antiviral cream.Acyclovir cream10.6 Kerratolytic agent
Salicylic acid ointment10.7
.Chloramphenical eye ointment10.8
.Chloramphenical eye drop
10.9 (Other agents).methyl salicylate (GPO Analgesic Balm)11.
11.1 11.2 11.3
12. (Local anasthetics).lido caine HCl 2%
13. (Disinfectant and Antiseptics)13.1 alcohol13.2 chlorhexidire gluconatl
(Hibiscrub)13.3 Povidone cline13.4 Sodium hypochlorite13.5 Chlorhexidinet cetrimide (Savlon)
14. 14.1 Glucose 50%14.2 D5% NSS14.3 D5% N/214.4 Lactate Ringers Solution
15. 16.
.Pregnancy test specific for HCG
17. (refill)
-
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18. Mycostatin Oral Suspension
19. Vaccine19.1 Immunoglobulin19.2 Rabies Vaccine
Paracetamal
1. 325 ., 500 .2. 120 . / 5 .3. 300 . / 2 .
:
- Hypothalamus Endogenous pyrogen
:1.
Aspirin Aspirin
2.
1. 650 - 1000 . 4 - 6 . 4 /
2. 10 - 15 ./. 4 - 6 . 5 dose
-
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10 - 15 20 - 25 24
1. 10 2. 3.
Ibuprofen
200 .
Prostaglandins
Cyclooxygenase Arachidonic acid Prostaglandins
1. , Osteoarthritis, gouty arthritis, tendinitis
2. 3.
1. 400 - 800 . 3 - 4 2. 200 - 400 . 4 - 6 3. 400 . 4
-
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Aspirin
-
- 3
Acetyl salicylic acid
(aspirin)
75 . (11/4 ) (Baby aspirin) 325 . (5 )
1. 2. , , , , ,
, ()3. 4. (TIA)
1.
- 1 - 5 1 1 ( 1 1 , 2 2 ) 1/4 (1 )
1 ( 1 )
-
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- 5 - 10 1-11/2 - 10 2
4 - 6 2. 11/2 3 4
3. (TIA) 1 2
1.
2.
3. (Salicylate poisoning)
4.
5. (Platelets aggregation)
6. 1 12
(Reyes Syndrome) 7. 3
Chlorpheniramine maleate
1. 4 .2. 2 ./5 . 60 .3. 10 ./1 .
H1-receptor
-
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- 1 1 . 2 1 - 5 1-2 . 3 6 - 12 2-4 . 3-4 4 . 3-4
(Anaphylactic shock)
10-20 . 40./ 0.2 ./.
- - - -
1.
2. 3.
Adrenaline (Epinephrine)
injection (aqueous Soln as HCI) 1 ./. (1:100)
1
2receptors
1receptor Myocardial Con-
tractility conductivity 2receptor bronchodilation vasodilation
-
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1. 2. 3.
1. Anaphylaxis
0.01 ./. 0.5 . 0.2 - 0.5 . 1 .
15 2 4
2. 0.005-0.1 ./. 0.1 - 1 . 5
3. 1 : 200000 - 1 : 20000 0.1 - 0.2 .
hyperthyroid
1. 2. 3. 4. Epinephrine -adrenergic receptor
Dextromethorphan
15 .
medulla Threshold
-
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10 - 20 . 4 30 . 6 - 8 120 . 2 - 6 2.5-5 . 4 30 .
6 - 12 5 -10 . 4 60 . 2
-
-
- 7
Mixt. tussis
Mixt. Tussis Camphorated opium tincture Glycyrrhiza fluidextract
-
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1 - 2 3 - 4
6
Glycyrrhiza
- - 7
Mist. Scill. Ammon(Squill and Ammonia Mixt.)
Mixture 100 . Camphorated opium tincture 13.00 .Ammonium carbonate 2 Squill tincture 3.2 .Serega tincture 12 .
1 3 6 1 3
-
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6
- 6
-
Phenothaizine, Barbiturates, Benzodiazepines
Salbutamol
Salbutamol
Syrup 2 ./5 .
direct acting sympathomimetic agents Beta-2-receptor
Beta-1-receptor ()
-
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2 - 4 . 6 - 8
0.1 - 0.2 ./ 6 - 8
1. Hyperthyroidism 2.
3. 12
Sodium Bicarbonate mixture
Sodamint
300 . 50 ./5 .
: 1 3 : 1 3
-
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-
- milk alkaline syndrome
pH
- -
Mixture Carminative
180 . 15 . - compound cardamom Tr. 1.80 .
- Weah ginger Tr. 0.12 .- Capsicum Tr. 0.12 .
: 1 3 - 4
:
8.5%
-
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Antacid
1. pH
2. pepsin pH 2
pH 5 pepsinogen 3. pH
40 - 80 mEq. (15-
30 .) 1 3 6-8
1. Aluminium Phosphate
Phosphate 2. Aluminium
3. Magnesium
Magnesium 4. pH pepsin
2 pH acid rebound
1.
(systemic alkalosis) 2.
3. antacid 1 - 2 antacid
-
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-
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1.
2. 3. B12
B12 1 B12
Dimenhydrinate
50 .
H
1 receptor
6 : 25-50 . 3
15-30 15-30
1 - 5 : 12.5-25 . 3
-
-
- narrow angle- -
-
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-
-
Metoclopramide
5 ./. in 2 .
:10 . 6
: 1 ./
-
- Prolactin
-
- 6-8 2-3
-
-
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Hyoscine-n-butyl bromide
20 ./1 . 10 .
anticholinergic
Muscarinic
20-
30 . 100 . 1-2 3-4
6-12 1 3-4 5 . 15 ./
anaphylactic reaction anaphylactic shock
1. 6 2.
-
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Atropine Sulfate
Injection 0.6 . in 1 .
Acetylcholine Muscarinic agonists Muscarinic
receptor .
1. Cholinesterase 2.
0.4 - 0.6 .
4 Acetylcholine (0.3-0.6 .) 1
0.01 ./.
Physostiine
40
Ulcerative Colitis, ileus, chronic lung disease, hyperthyroidism, neuropathy, hepatic renal disease
-
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Milk Of Magnesia (MOM)
250 .
Magnesium
15 - 30 .
Hypermagnesemia,
CNS depression, Hypertension Dehydration
- 1 - - Magnesium
-
- - 1 -
-
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Bisacodyl
5 . 10 . : Dulcolax
:
1 - 3 1 12
1 1 30
ORS
1 () 1 ( 150 )
-
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6 2-3
6 - 2 3 - 4 2 - 5 5 - 10 5
1. 2.
3. 4. 24 .
(Absorbent)Kaolin ()
1. 2. 3.
1 - 2 1/2 - 1 4 - 6
(Kaolin) 2
-
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Vitamin B6
10 .
Vit B6 Pyridoxal phosphate (PLP) ()
co-enzyme enzymes amino acid metabolism
Nutritional Supplement 2.5 - 10 . 3 2 - 5 . 10 - 20 . 3 2 - 5 .
B6 (2-6 2-40 ) , ,
1. Levodopa
Levodopa 2. B6 (2-6 /)
1. Isoniazid B6 10 - 50 .2. oral contraceptive B6 Co-enzyme
B6
-
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-
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151
1. 2.
pernicious anemia
Ferrous Fumarate
1 325 . ( iron 106 .)
- -
1-2
- - Antacid (), tetracycline, Norfloxacin, Ciprobay
2 .-
-
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Ferrous sulfate
Ferrous sulfate 300 . equivalent to 60 .iron
co-factor enzymes
haemoglobin myoglobin
1.
2.
4-6 ./ 3
50-100 . 3 30-60 .
/
1. 2. Hemolytic
3. 6
4. Tetracycline
- -
-
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Albendazole
1 Albendazole 200 . Albendazole 100 ./5 .
Albendazole Benzimidazoles
neurocysticercosis
2
- 400 . 3-4 - Neurocysticercosis 15 .//
8-30
1. 2 2. 3. 4.
1. 2. 3. 4.
-
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Mebendazole
1 Mebendazole 100 . 500 . 100 ./5 . (1 )
, , ,
12 - 1 (100 .) 2 - 3 (
) 500 / 1 1 ()
2 - 12 - 1 2 - 3
- , - 1-2 - 3
,
-
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-
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156
Penicillin V(Phenoxymethyl Penicillin)
250 . (4 ) 125 ./5 . (2 )
250
. (4 ) 1 4 3 7 - 10 50,000 . 3 - 4
(Anaphylactic shock)
-
- -
1. 2.
3.
-
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4.
- - 7
Erythromycin
250 . 125 ./5 .
1.
2.
: 250-500 . (1-2 ) 6
4
7.5-25 . 1 6 15-50 . 1 12
10-14
1. 2.
-
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158
1.
2. Theophyline Digoxin Carbamazepine Methylprednisolone Erythomycin
Co-trimoxazole
- 1 - Sulfamethoxazole 400 .
- Trimethoprim 80 .- 1 - Sulfamethoxazole 200 .- Trimethoprim 40 .
Streptococci, Sta-
phylococci, Pneumococci, Haemophilus influenzae, Neisseria, E. coli, Salmonella,Shigella, Vibrio
cholerae
- :-
- :-
- Gonococci- Typhoid paratyphoid Typhoid
Bacillary-
- 12 2 2
- - 6 - 12 1 2 -
-
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- 6 - 5 2 -
- 6 - 5 2 - - 6 - 5 1 2 - - 6 - 12 2 2 -
- Sulfa, Trimethoprim- ,
- - - G6PD
-
- () () - Pseudomembranous
- Erythema multiform, Stevens-Johnson Syndrome
- Neutrophil Agranulocytosis, Megaloblastic anemia, Purpura
- -
-
-
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160
Doxycycline
100 .
Oxytetracycline
anaerobes Protozoa
- Mycoplasma
,
-
-
- 100 . 12 100-200 . 50 - 100 . 12
- 2.2 ./. 12 2.2 - 4.4 ./. 1.1 - 2.2 ./. 12 ( 745 . )
-
Photosensitive
- 8
-
-
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161
-
Doxycycline Anticoagulants, Penicillins, Antacid,
Alcohol CNS depressant
Cloxacillin Sodium
- 250 . (Dry syrup) 125 ./5 .
- Staphylococci, Streptoccocci Pneumococci
- 250 - 500 . 4 1
2 1 (62.5 -125 .)2 - 10 1 - 2 (125 - 250 .) 10 2 - 4 (250 - 500 .)
20 50 ./. 4
1. Penicillins
2. eosinophillia SGOT
3.
-
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162
1.
2. Penicillins Cephalosporins3. 4.
1
Norfloxacin
:- 100, 200 400 .
:- DNA gyrase DNA
Mycoplasma, legionella Mycobacterium Pseudomonas-
:- -
-
:-
200 - 400 . 2 7-10 -
400 . 2 10-21 1 2
- 800 .
-
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163
- 400 . 2 3 - 5
:
:
1. Norfloxacin
2. probenecid Norfloxacin Norfloxacin 3. Theophylloine, Phenytoin Norfloxacin
Theophyline, Phenytoin
Benzyl Benzoate (25%, 12.5%)
Lotion Benzyl Benzoate 25% () 12.5%
(Lotion 25 - 28%)1.
2. Lotion 3. 1-2
-
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-
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lotion
Methyl salicylate
ointment
Methyl salicylate
40% Salicylic acid ointment
-
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167
() -
5
-
- - - ()
Triamcinolone acetonide
0.1% in oral paste
Phagocytosis
Lysosome Prostaglandin- thromdoxane
3 - 4
Herpeslabialis, Herpangina
-
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Chloramphenical eye drop/ointment
eye drop solution 0.5% eye ointment 1%
1-2 3 -6
48 5-10 5-10
Chloramphenical eye drop 2-8 C 1
Hista - oph
Eye drop 5, 10 Antazolin HCI 0.05% + Tetrahydrozolin HCI
0.04%
- Antazolin HCI 0.05%
- Tetrahydrozoline HCI 0.04% Alpha-adrenergic receptor (conjunctival decongestant)
-
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Ocular allergic Ophthalmic decongestion Conjunctivitis ()
1-2 4-6
5-10 5-10
1. Anticholinergic Atropine
2. 2 - 4 -
3. 1
Acyclovir cream
(Acyclovir 5 /100 )
(Herpes Simplex virus infection)
(herpes labialis)
5 4 5
5
acyclovir propylene glycol
-
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170
250 .
2 - 4 4
Capsule / / 250 , 500
- - (pharyngo tonsillitis)
0.5-2 4
14%
-
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171
2-3
1. 2. 3.
Lidocaine HCI
injection Lidocain HCI 2%
200 .
(3./.) 500 .
Lidocaine
-
-
-
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172
1. 6 .. 4 ..-
2. Laryngocope,, , ,
3.
1. Amide (Lidocaine, Prilocaine, Bupivacaine)2.
3. 4. 5. -
Ethyl alcohol
Ethyl alcohol 60-90% (v/v)
70%
: 10
: 90% 2 : 15 : 20 : 10
HIV : 5 : 20% Formalin
30
1. 70% Skin antiseptic 2. 70% Disinfectant 3.
-
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173
1.
2. 0.2-0.4 Sodium nitrite
3. 4. 5.
Povidone iodine 10%
Povidone iodine 10% iodine 1% (10,000 ppm) Povidone iodine 10%
: 85%
Clostridium Pseudomonas cepacia Staphylococcus aureus : : : 80 ppm 10 HIV : 80 ppm 10 :
7.5 %, 10% Povidone-iodine solution Pack
1. 2. 3. 4. 1
5.
-
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Cresol (Lysol)
Phenol Phenol 3-10 Phenol Cresol 0.3-0.6% 10
: : : :
HIV: 0.5% 10 :
1. 2% 2. 5% 3.
1. (Hy-
perbilirubinemia)2. 3. 4.
Lysol 50% Cresol Soap solution 1 : 40
1 : 100
-
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175
Glutaraldehyde 2%
: 12 : 1 : 10 : 10 HIV : 10 : 10
1. Sterilization 3 -
10 2. Disinfection
3 - 10 3. Decontamination Secondary use HIV , HBV
30
1. 2.
3 3. 4. Glutaraldehyde Acid form
Activate
5. Glutaraldehyde 28 Activator
6. Disinfection Glutaraldehyde 10 Sterile
-
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Sodium trizaine-3-one (virkon)
0.5% Chlorine 5,000 ppm (Sodium Hypochlorite 5%)
: 100 ppm 10 : 125 ppm 3-10 : 100 ppm 1 : 500 ppm 10 HIV: 50 ppm 10
:
1. 2. 7 3. 4. 5. 6. .
Glucose 50%
: 50% Glucose in 50 .
: Hypoglycemia
: Hypoglycemic coma 50% Glucose solution 50 .
1. Diabetic coma GlucoseGalactose malabsorption syndrome
-
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2. Insulin Insulin
3. Anuria4. Whole blood Haemolysis Clumping5. Hypertonic solution Glucose
Hyperosmola syndrome ()6. Local pain, Vein irritation Thrombophle-
bitis ()7. edema, Hypocalcemia, Hy-
pomagnesemia Hypophosphataemia.
D 5% NSS (5% dextrose+0.9% NacI)
:Injectable solution
: -
1. 2. 3.
: -
1.
2.
-
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D 5% N/2 (5% dextrose+0.45% Nacl)
:Injectable solution
: 1. 2. 3.
:
1. Dextrose Blood sugar
Blood sugar Insulin
2. 3.
4.
Lactate ringers solution
:Injectable solution Electrolyte Extra cellular fluid
1. 2. Systemic alkalinizer
:
-
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1.
2. Lactic acidosis3. Lactate Bicarbonate Lactate ion Lactic acidosis
4. shock Lactic acid
- 0.9% NSS Lactate Ringers solution 20 ././- 1 NSS/2 Loctate Ringers solution 0.9% NSS 1,000
- 2,000 ./1/2 - 1 Hypovolemia
(Keep vein open) 0.9% NSS
Methylergometrine
injection 0.2 ./. in 1 .
- 0.2 .
2 - 4 5 - 0.2 .
1 ( 5 . 0.9% N.S.S)
-
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180
-
- - -
1. ergot
2. cerebrovascular accident 60
3. obliterative vascular disease
4.
8 c
Cinnarizine
25 .
cinnarizine (calcium channel blockers)
diphenylpiperazine (Ca2+)
(dizziness), (vertigo),
(cerebral or - peripheral circulatory disorder), (ves-tibular disorder),
-
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181
25-50 . 3
(peripheral -Circulatory disorder) : 50-75 . 3 (cerebral circulatory disorder) :25 . 3 : 25 . 6
(CNS depressants)
Diazepam
(10 . / 2 .)
- - - GABA
-
(Status epilepticus)
-
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- - Status
epilepticus 0.1 - 0.5 ././
-
- -
- - -
Diazepam 5 .
apnea
Thiazide
50 . : Hydrochlorothiazide (HCTZ)
1.
2. 3. (Pulmonary edema)
1 - 2 1/2 - 1
-
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183
1.
()2.
Mycostatin Oral Suspension
12 .
-
(Candrda or Monilia)
- -
1 . 4 1 . 4
1. 2.
3. 1%
2
-
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184
21 22 28
1. 2. 3.
1. FSH Follicle
2. 3.
:
- 21 , 22
7 21 6 22
- 28
-
1. 2. 3.
4. 5.
-
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186
1, 6
:
1. 1 5
2. 4 - 6 3. 2
1. 2.
1 3 3. 4. 7
5. 24 6. 7 7. 6 - 1 8. 5
1. 5
5
2. 7 3. 7 4.
7
-
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5.
1.
3 - 6 2.
3.
(over stock)(expired)
3
1. .........2. .......... (.301 stock card)3.
-
1. ()
(.301 stock card)
1 x 1000 1 12 x 1000
-
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188
.301 stock card z 6
3 -
()
.301 stock card 1 - ()
1 = () ( - )(+) ()(-)
2. ()
2 1 ( 1 )
3.
() stock -
3.1 .301 stock
card -- - 1 1
stock card
stock card
-
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189
stock card 2 - 2 stock card1
stock card stock card
(.) stock card
3.2
3.2.1 3.2.2 3.2.3 3.2.4 3.2.5
3.3 .
(dosage form)
-
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(thera-peutic action)
() A Z
,
.
5 (manufac-turing date)
- Ampicilin 25 , Penicillin 30, Tetracyclinc
- 2 - 8
-
4. 2
4.1 4.2 ..2535
(Drug Interaction)
2 1-2 .
Antacid Cimetidine Tetracycline, Doxycycline Ferrous Sulfate, Folic Acid Tetracyclin, Doxycy-
-
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191
cline Sodium bicarbonate pH Tetracycline Cimetidine, Erythromycin Theophylline
Theophyne (Aminophylline Ethylenediamine Theophylline) Hyoscine dyspeptic Domperidone Antacid, Milk of magnesia enteric coatcd Bisacodyl, Erythromycin Penicillin Tetracycline Penicillin Tetracycline
(Drug interactions)Alcohol :
- Antihistamines, Antipsychotics, Methyldopa, RopectAmpicillin :
- AllopurinolAspirin :
- , Steroids
Chlorpropamide, Glibenclamide :- Alcohol, HCTZ, Propranolol, Rifampicin, Thyroxin
Digoxin :- , HCTZ, Furosemide, Steroids
Gentamicin, Kanamicin :- Furosemide, Muscle relaxants, Penicillins
HCTZ : - IndomethacinPhenytoin
- INHPropranolol :
- IndomethacinTetracycline :
- , , :
- Ampicillin, Rifampicin, Tetracycline
-
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:Aspirin Spontaneous onset
Aspirin
Paracetamol
: Ibuprofen Indomethacin Mefenamic Naproxen
ductus ateriosus pulmonary circulation persistant pulmonary hypertension
(Morning sickness) 80 vitamin B6 (Pyridoxine) 50-200 ./
Dimenhydrinate
(Heart burn)
(Constipation)
Saline laxative Ex. .. Salt, Na. Salt. Electrolyte imbalance, fetal dehydrationEmollients eg. Mineral oil. Castor oil Fatty soluble vitamin absorption
disturbanceStimulants eg. Bisacodyl, Senna extract uterine stimulant
bulk laxative Psyllium seed (Metamucil ) Lactulose (Duphalac ) Lactitol(Importal )
(Vaginal irritation) Candida albicans Trichomonasvaginalis Candidiasis Clotrimazole
-
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Trichomonas Metronidazole 200 . 3 7
Penici llins Spiramycin
Erythromycin ( Erythhromycin estorate Hepatotoxic
Alcohol
Aminoglycosides (:- Gentamicin, Kanamycin)
Antineoplastic & Cytotoxic agents ,
(:- Cyclophosphamide,Methotrexate, Fluorouracil)
Antithyroid drugs (:- PTU)
Benzodiazepines (:- Diazepam) ,
Chloramphenical Grey syndrome
Corticosteroids
NSAIDs Premature closure of Ductus arteriosus(:- Indomethacin, Ibuprofen)
Oral hypoglycemic drugs
(:- Chlorpropramide, Metformin,Glibenclamide)
-
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Sex hormone
(:- Estrogen, Progestogen)
Sulfonamide Kernicterus
Tetracyclines , (:- Tetracycline, Doxycycline)
Furosemide
Hydrochlorothiazide Aspirin (high dose)
, ,
Carbamazepine
Phenobarbitone
Phenytoin
Propranolol
Quinine
-
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1.
2.
3. active metabolite
4. corticosteroid, Decongestant Topical steroid Inhalation nasal spray decongestant
5. peak drug concentration half life sustained release peak drug concentration 1-3
peak concentration Tricyclic anti-depressant
6. sedatives anesthetics
-
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half life 4-5 half life
( 95%) 1-2 half life ( 50-75%)7.
Alcohol Diazepam* Phenobarbital*Aspirin Diuretics PhenytoinAmpicllin Ergotamine Prednisolone*Amitryptyline* Haloperidol* PropranololBisacodyl Hexoprenaline (Ipradol) ReserpineChloramphenical* Indomethacin StreptomycinConjugated estrogen* Lorazepam* Sulfa drugs(Premarin )
Cotrimoxazole* Mefenamic acid TetracyclineCyproheptadine Metronidazole*Note : * =
(Adverse drug reations)
:- :-- Penicillins ( , , )- Tetracycline - Hormones- Sulfa drugs - Sulfa drugs- TB drugs - Tetracycline- Antimalarial drugs - Thyroid- - - -
- : -- Steroids (, )
-
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:- - Aspirin- - Gentamicin
- - Kanamycin- - Sulfa drugs : - - Streptomycin( ) :-
- Chloramphenical - Chloroquin- Chloroquin - Ethambutol- Chlorpromazine - INH- Phenytoin - Steroids
- PTU - Quinine- Primaquine : -- Phenylbutazone - Furosemide
:- - Gentamycin(, ) - Kanamycin
- Aspirin - Quinine- NSAIDs - Streptomycin- Steroids
:-- Aspirin- Indomethacin
-
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198
1. 2. 3. 4. 5. .. 6. .. 7. .. 8. .
9. . 10. . 11. 12. 13. .14. .15. 16. 17. 18. 19. 20. 21. 22. 23.
24. 25. 26. 27. .28.
-
8/12/2019 PCU Manual Treatment 1
208/209
199
.. 2543
1. . . 2. . 3. . . 4. . . 5. . 6. . 7. . 8. 9. . 10. . 11. . 12. . 13. 14.
15. 16. 17. 18. 19. 20. 21. 22.
23. 24. 25. 26. 27. 28. 29. 30.
31.
-
8/12/2019 PCU Manual Treatment 1
209/209
200
32. 33.
34. 35. 36. 37. 38. 39. . 40. . 41. . .
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