Victor's General Medical Practitioner

  Tranexamic Acid is an anti-fibrinolytic. It works by preventing the breakdown of blood clots to control excessive bleeding during periods, or after surgery. Mechanism of action Prevents clot dissolution hence controls excessive blood loss. Dose 500mg orally 3-4 times a day 650mg orally twice daliy BD 1 gram bolus in 100ml normal saline over 10 minutes (slow intravenous push) 8th hourly 500mg in 100ml of normal saline IV 8th hourly. ( do not exceed a total of 3 grams/day) Uses 1) Menorrhagia - 1st line non hormonal therapy Uterine Fibroids Adenomyosis DUB Puberty Menorrhagia Post IUCD Endometriosis 2) Haemorrrhagic shock and PPH 3) Excessive Intraop Bleeding in Obstetrics and Gynecology 4)Threatened Abortion and APH 5) Nose bleed 6) After Tooth removal 7) Skin hyperpigmentation 8) Following prostate surgery Contraindications If allergic to tranexamic acid kidney diseases h/o convulsions or fits blood disorders smokers morbid obesity h/o gastric ulcers dialysis patients

 Mefenamic Acid dosages are mentioned below In Paediatrics For oral administration in children above 6 months.  Recommended dosage based on body weight Mefenamic acid is usually administered in a dose of 4 to 6.5 mg/kg body weight every 8 hours  or  25 mg/kg/day in three divided doses, as needed.  Recommended dosage based on age group Mefenamic acid suspension 100 mg/5 ml   6 months to 1 year: 2.5 ml three times daily.   2 to 4 years: 5 ml three times daily.   5 to 8 years: 7.5 ml three times daily.   9 to 12 years: 10 ml three times daily. Do not exceed the recommended dosage in children. Infants over 6 months to children 12 years Mefenamic acid suspension 50 mg/5 ml is licensed in infants over 6 months. Infants over 6 months 25 mg/kg of bodyweight daily in divided doses or: The following doses can be used in specific age ranges: 9 years to 12 years: four 5 ml spoonfuls. 5 years to under 9 years: three 5 ml spoonfuls 2 years to under 5 ...

Links to all the dosages and usage are below   Oral Drugs IV Drugs (Intravenous drugs) IV Fluids (Infusion)

Oral route 15mg/kg every 4 hours upto maximum of 1gm and not to exceed 4gm/day or 4gm/24hrs suspension Dosage Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily)  Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily) Adult: 1 g 3 or 4 times daily (max. 4 g daily)   Age Weight 120 mg/5 ml susp. 100 mg tablet 500 mg tablet < 1 month < 4 kg 1.5 ml x 3 − − 1 to < 3 months 4 to < 6 kg 2.5 ml x 3 ½  tab x 3 − 3 months to < 1 year 6 to < 10 kg 4 ml x 3 1 tab x 3 − 1 to < 3 years 10 to < 15 kg 6 ml x 3 1 ½  tab x 3 − 3 to < 5 years 15 to < 20 kg 8 ml x 3 2 tab x 3 − 5 to < 9 years 20 to < 30 kg 12 ml x 3 3 tab x 3 − 9 to < 14 years 30 to < 50 kg – – 1 tab x 3 ≥ 14 years and adult ≥ 50 kg – – 2 tab x 3 Intravenous route Forms and strengths, route of administration 500 mg (10 mg/ml, 50 ml) and 1 g (10 mg/ml, 100 ml) vials, for infusion Dosage Neonate : 7.5 mg/kg (0.75 ml/kg) e...

  Most commonly used medications are by Dr.Adarsha Hebbar Tab Gliptiwak M 50/500 1-0-1 or 1-0-0 Tab Gliptinext M 1000 0-1-0 Tab Triglynase 2 Forte 1-0-0 or 1-0-1 Tab Glycomet GP1 1-0-0 or 1-0-1 Tab Glycomet GP2 1-0-0 or 1-0-1 Tab Tenglyn 20 1-0-0 or 0-0-1 Tab Metformin 500 1-0-1 Tab Vogs 0.3mg 0-0-1 or 1-0-0 or 1-1-1

Chief Complaints  c/o severe pain in right illac fossa or left illiac fossa radiating to back with vomiting,nausea and fever. Burning micturition / Dysuria / Hemaruria Treatment Protocol Inj BUSCOPAN 1amp IV/IM STAT or Inj TRAMADOL 50mg or 100mg IV/IM STAT or  Inj DICLOFENAC 75mg IM STAT (In Younger Patients and avoid in Renal impairment and high BP) Tab HYOCIMAX MF 1-1-1 x 7 days Tab DOSIN 8mg 0-0-1 x 7 days Tab LASIX 40mg 1-0-0 x 7 days Plenty of fluids orally To come after 7 days with repeat USG reports. Tab CYSTONE 1-1-1 x 7 days can be given and also can be given for one month as a preventive measure. Needs surgery (URSL+DJS) for ureteric calculus of size of more than 9-10mm. Dietary Recommendations

  Azithromycin It belongs to a group of antibiotics called Macrolides. They end up with suffix -thromycin like erythromycin, clarithromycin, etc. It inhibits protien synthesis. Acts on both gram positive and gram negative bacteria. Also very helpful in atypical bacteria. PROPERTIES Bacteriostatic. Bacteriocidal if given in higher concentrations. Also has anti inflammatory properties - good in reccurrent COPDs Excreted mostly from liver and only 12% from kidney. So it should be avoided  in impaired liver functions and can be given in impaired kidney functions (No need to alter dosage in impaired renal functions) INDICATIONS Upper respiratory tract infections like Pharyngitis/ Laryngitis/ Tonsilitis/ Sinusitis Good for Atypical Pneumonia Skin Infections by Staph Middle ear infections Vaginitis/Urethritis in pregnancy ( Because Aminoglycosides cannot be used in pregnancy) STD like Chlamydia/Gonorrhea Preffered in Enteric Fever. DOSAGES Pediatric dose 10mg/kg on Day 1...