IM

Computation DM Basal/Bolus

(0.1-0.5)

Ex.

65 kg x (0.4) = 26 | 2 = 13 lantus (basal) | 3 = 4.3 rescue doses

HR SCALE

<50 1 vial d50/50

< 80 1/2 vial d50/50

> 180 2u HR

> 200 4u HR

>250 6u HR

>300 8u HR

>400 refer

apidra scale

140-180 2 u

181-220 4 u

221-260 6 u

261-300 8 u

301-340 10 u

>340 - refer
Insulin drip- 20 units of insulin(HR) in 100 cc pnss = 0.2unit ccg

Gi solution - mix 1amp d50-50 + 10 units humulin-r iv now then q6

Nicardipine drip - 10mg nicard + pnss to make 100cc (max dose 15mg/hr)

Gdm

Cbg monitoring

Pre breakfast 95, 2hrs lunch 120

Dm diet for 1 week

Nph sq if ang problem ay pre breakfast (weight x 0.2) to be given in the evening

Humulin r if problem ay lunch dinner

After receiving a diagnosis of GDM, patients should begin monitoring their blood glucose, initially with
fasting levels and one- or two-hour postprandial levels. Fasting glucose levels should be less than or
equal to 95 mg per dL (5.3 mmol per L), one-hour postprandial levels less than or equal to 140 mg per dL
(7.8 mmol per L), and two-hour postprandial levels less than or equal to 120 mg per dL (6.7 mmol per
L).2,21?No data suggest the superiority of one-hour vs. two-hour postprandial monitoring, so either is
acceptable. Less intensive glucose monitoring is appropriate for women with GDM that is well controlled
with diet and exercise.1,2

One approach to starting insulin therapy is to calculate a total daily dosage of 0.7 to 1.0 units per kg. Half
of the total daily requirement is administered as a single dose of long-acting insulin (e.g., glargine
[Lantus], detemir [Levemir]), and the other half is administered in three divided doses at mealtimes as
rapid-acting insulin (e.g., lispro [Humalog], aspart [Novolog]).2?Insulin dosing should be individualized
and adjusted as needed.?
Example 0.7x 50kg= 35

15 units lantus at bed time

5 units apidra premeals

Bowel prep for colonoscopy

Bowel prep.. buy 14 sachets surelax, 3 dulcolax tablets and 1 fleet enema

Instructions:

1. Dissolve 14 sachets surelax into 2 liters gatorade-- drink 1 glass every 30 minutes stsrting 6 pm tonight
until consumed..

2. Take 3 tablets dulcolax by mouth at 10 pm..

3. Liquid diet and gelatin only tonight.

4. Nothing by mouth after 12 midnight.

5. Fleet enema 6 am

Methlyprednisolone tapering dose

16mg 1 tab bid x 3 days

4mg 2 tabs bid x 3 days

4mg 1 tab bid x 3 days then d/c

Allergic reaction sec to food intake

- diphenhydramine 50mg/amp, 1 amp iv

- Hydrocortisone 100mg/amp, 1 amp iv

- Ranitidine 50mg/amp, 1 amp iv

Ats 4500 iu anst IM

Sodium Bicarbonate drip:

Sodium Bicarbonate 50megs + D5W 250cc x 6hrs

Dopamine drip:

Dopamine 250mg + D5W 250cc or 100cc PNSS X cc/hr to titrate by +/- cc/hr to maintain BP
>90/60mmHg

1 amp (200mg)

2 amp (400mg)

Drop Factor:

200mg=13.3

400mg=26.6

Amiodarone drip:

D5W 250 cc + Amiodarone 150-600 mg x 24 hours

Isoket drip:

90cc D5W + Isoket 10mg in soluset x 10 ugtts/min titrate by 5ugtts until chest pain free

Dobutamine drip:

200cc d5w + Dobutamine 1 aml (250/amp) x 10-60 drips/min

Dopamine and Furosemide drip:

200 cc D5W + dopamine 250 + furosmide 250 x 15 ugtts

250cc D5W + 2g MgSO4 x12hours x 1 cycle

PPI Drip:

80 mg esomeprazole + pnss to make 100cc solution to run for 10 hours

Isoket drip

90cc D5W + isoket 10mg in soluset x 10 ugtts/min titrate by 5ugtts until chest pain free

Nicardipine drip

90cc PNSS + 10mg nicardipine to run at 10ugtts +/- 5ugtts/min to maintain SBP (MAP)

INSULIN DRIP

CBG monitoring q1h

Start insulin drip: 100units HR + 30meqs KCl + enough PNSS to make 100cc in a soluset. Discard the first
50cc of the solution and run the remaining at 2cc/hr using infusion pump

Ocreotide drip 0.5 mg/ml 0.2cc sivp then incorporate remaining 0.8 cc to d5lr 500cc x 16

Somatostatin drip (48-120hrs)

250mcg iv bolus 3mg/amp in 250cc d5wx12hrs

Desired FiO2:

[((Age x 0.43) -109 ) x actual fio2 ] ÷ actual PO2

Sodium deficit:
(Desired Na -actual Na) x BW in kg x 0.6

Potassium deficit:

(Desired K-Actual K)/0.27 ) x 100

Serum Osmolality:

2(Na+K) + RBS + BUN

Normal: 280 to 295mosmol/kg

Conversion factors:

RBS X 18

BUN X 2.8

Creatinine ÷ 8.4

Calcium ÷ 0.25

Mg ÷ 0.411

Bilirubin ÷ 17.10

Uric Acid 59.48

HDL/LDL ÷ 0.0259

Triglycerides 0.0113

If on NPO post midnight, do not give morning insulin.

Shift IVF to D5NSS and CBG Q6.

CBG <80 1/2 vial D5050 IV

>180 Insulin Aspart 4 units SQ

HBA1C, FBS, LP, Uric Acid, ALT

Hylocalcemia post thyroidectomy:

Start Calcitriol 0.25 mg BID after lunch and dinner.

Give Calcium carbonate soft gel 500 mg 2 caps after lunch and 2 after dinner.

Repeat Serum Calcium and albumin after 10 days.

Ex.

Serum Ca 2.07 L

Corrected Ca 2.13 L

Latent Autoimmune Diabetes in adult:

DPP4 has better role and SGLT2 Inhibitor (Insulin indepedent)

Insulin should be started. Workup for Anti-GAD 25 or ICA.

Hypocalcemia (<1)

Calcium gluconate 4 amps in 1L D5W x 12 hrs x 4 cycles

Calcitrate 2 tabs TID

Calcitriol

Antibiotics:

Cefuroxime 1.5g LD then 750mg Q8

Cefazolin 2g LD then 1g Q8

Ciprofloxacin 400mg Q12

Ampicillin Sulbactam 1.5g Q8

Metronidazole 500mg Q8

Clindamycin 300mg Q6

Cefoxitin 2g LD then 1g IV q8

Drips:

Ocreotide drip 0 5 mg/ml 0.2cc sivp then incorporate remaining 0.8 cc to d5lr 500cc x 16

Somatostatin drip (48-120hrs)

250mcg iv bolus 3mg/amp in 250cc d5wx12hrs

Heparin drip

D5w200cc +10k units hepatin @10-20 uggts/minC9nc 50units/min

4ampin 250ccd5w or 6amps in 500ccd5w x 24hrs

Vasopressin drip (0.2-0.4u/min)

100mgin d5wx15cc/hr (0.05u/hr)

Midazolam drip

Midaz 10vials +pnss to make a 100 cc start 0.5mg/kg/hr or

20amp of midaz (5mg/amp) in 250ccd5w to start infusion at 10-12uggts/min pls use infusion pump if
seizure recurs despite of current dose inc by 5 uggts/min

Aminophylline drip 500mg +500cc d5w to run at 14-16uggts/min

Terbutaline drip
D5w 250ml +5amp bricanyl at 10-30 uggts/min

esmolol

Immediate control: Initial bolus: 1,000 mcg/kg over 30 seconds, followed by a 150 mcg/kg/minute
infusion, if necessary. Adjust infusion rate as needed to maintain desired heart rate and/or blood
pressure (up to 300 mcg/kg/minute).

Lidocaine 1gm +d5w 200cc x 15 ugtts/min

Diazepam

D5w 100ml +diazepam 10mg q6hr

1. Mannitol

- 20mg/100ml

- LD: 0.5-1mg/kg

- Wt x (0.5-1mg) x 100 ÷ 20

2. Dopamine: A, B, dopaminergic

- 0.5-20mcg/kg/min

- (1amp = 200mg)

- Wt x 10 ÷ 13.3 or 26.6

- D5w 250cc + dopa 200mg or 400mg x ugtts/min

- A1 and B1 receptor

- 5 renal, 10 cardiac, 10-20 peripheral

- 2-20mcg/kg/min

- (1amp = 250mg)

- Wt x 10mcg ÷ 16.6 or 33.2

- D5w 250cc + dobu 250mg or 500mg x ugtts/min

4. Norepinephrine (Levophed/Norepin): A1, some B2

- 0.5-50mcg/min

- 0.01-3mg

- Sd: 4mg (0.5 ÷ 16 x 60mins x kg = ugtts/m)

- Dd: 8mg (0.5 ÷ 32 x 60mins x kg = ugtts/m)

- Quadruple: 4amps = 64

- D5w 250cc + 1 or 2 amps levophed x ugtts/min

- dose (cc/hr/wt)+ conc (ug/kg)× wt xq 60min/hr

- cc/hr/wt x 16min/hr x 60

-(Flowrate ÷ wt) x .266

***wt x 0.5mcg x 60mins ÷ 16 or 32 or 64 ug/kg

5. Epinephrine: A, B

- 2-10mcg/min

- D5w 250cc + epi 1mg (1amp) x 15-150ugtts/min

6. Nicardipine

- 1mg/hr

- D5w or pnss 90cc + nicard 10mg x 10ugtts/min (10-20-30-40-50)

7. ISDN

- (Nitrates = preload unloader)

- D5w or pnss 90cc + 10mg isoket in soluset x - 10ugtts/min (1mg/hr)

-Double conc: 80cc + 20mg

-1-5mg/hr if single conc (10-50ugtts/min)

-1-5mg/hr if double conc (5-25ugtts/min)

8. Insulin

- Humulin r 100units + pnss 100cc x 0.1units/kg/hr

9. Precedex

- 2ml + pnss 48cc = 50cc

- 200mcg/2ml (100mcg/ml)

10. Tramadol

- D5w 250cc + 300mg tramadol x 24hrs

11. Nalbuphine

- D5w 250cc + 10mg nubain x 24hrs

12. Kcl (Potassium chloride)

- 40meqs kcl + pnss 1l x 8

- 10-20meqs kcl + pnss 100cc x 1hr x 3 cycles, repeat serum k after 3rd cycle
13. Amiodarone (vtach with pulse)

- Amiodarone 150mg SIVP x 10-15mins

- Amiodarone 300mg in 250cc pnss/d5w x 24hrs

14. Nahco3

- hco3 deficit: wt x 0.4 (d-a) / 2

- give 1/2 as bolus

- give 1/2: nahco3 + pnss 250cc to run for 24hrs

15. Hypomagnesemia

- Magnesium Sulfate

- 1-4gms or 8-32meqs + 100cc d5w or pnss x 10-60mins

- SE: flushing due to vasodilatation

- mgso4 2g + pnss 50cc x 20mins

16. Levetiracetam

- Levetiracetam 500mg or 1gm + 100cc pnss x 15mins

17. Hypocalcemia

- Calcium gluconate 10% (1amp)

- 10-30ml IV x 10-20mins

- repeated every 60mins

- infusion: 0.02-0.08ml/kg/hr (1.4-5.6ml/hr in a 70kg)

- 1amp x 10mins IV
18. Omeprazole drip

- omeprazole 80mg + 90cc pnss x 8mg/hr (10hrs)

19. Furosemide drip

- furosemide 200mg + pnss 100cc x 20mg/hr (10ugtts/min)

20. Midazolam drip

- midazolam 50mg + pnss to make 100cc to run at 3mg/hr

Seizure

Pedia

0.3mg/kg

Less than 5yo: Max of 5mg

More than 5yo: Max of 10mg

Sa mga magduduty sa primary hospital o clinics eto po codigo:

Medicines:

Metoclopromide 5 and 10mg

Cinnarazine 25 and 75mg

Betahistine diHCl (serc) 8 and 16mg

Ambroxol 15 and 30mg BID

Ambroxol 5mg/5
Montelukast + levocetirizine tab

Cetrizine 10mg ODHS

Cetirizine 5mg/5 or 10mg/5

Co amox 312.5/5

Co amox 625 TID

Cefu 500 BID (kahit nagbebreastfeed)

Cefu 125/5 or 250/5

Eryth 200/5

Metro 250/5

Metronidazole 500mg tab TID

Calcium tablet BID

Multivitamins tab OD

Ferrous sulfate tab OD after meals

Amlodipine 5mg and 10mg

Losartan 50mg and 100mg

Clonidine 75/150mcg SL

Atorvastatin 40mg/tab ODPM

Cipro 500mg BID x 7days

Hydroxyzine (Iterax) 10-25mg BID-TID

Hyoscine-N-Butylbromide(Buscopan)10mg TID

Loperamide 2mg OD after each bowel movement

Bisacodyl 5mg OD

Amoxicillin 500mg cap TID x10days

Azithro 500mg OD x3days

Ketoconazole 2% cream OD x2weeks

Omeprazole 40mg/tab OD 30mins before BF

Acetylcysteine(fluimucil) 200mg/sachet OD or 600mg/tab OD

Tobramycin + dexamethasone 1 to 2 drops per eye tid x7days

Folic acid tab OD

Racecadotril 100mg/cap TID x7days or until formed stool

Hydrocortisone 200mg IV

Diphenhydramine 50mg IV

Epinephrine 0.2 ml SQ anterior thigh (adult)

Epinephrine 0.01ml/kg (pedia)

Loratadine 5mg + Betamethasone 250mcg tab 1tab BID x5days

Mometasone cream thinly OD

Mefenamic acid 250mg/cap Q6

Combivent max 3doses

KCl tab 1tab q6

Eperisone 50mg/tab TID

Salinase nasal spray 2sprays TID

Tramadol 50mg IV

Ketorolac 30mg IV q6

Phenylephrine HCl + Chlorphenamine maleate (Disudrin) 5mg/5ml

Arcoxia 120mg/tab OD

Colchicine 500mcg/tab 2tabs initially then 1 tab every 3hours until symptoms relieved

Febuxostat 40mg/tab OD

Cloxacillin 500mg/tab q6 x7days

Dextrometorphan 15mg/tab q4
Dexketoprofen 25mg/tab q8

Furosemide 40mg IV q6

Diazepam 5mg IV

Midazolam 1/2 amp IV

Ferrous sulfate 10ml OD for 1month

Sambong 2tabs TID x 7 days (anti-urolithiasis)

Sambong 1 tab TID x 7days (diuretic, UTI)

Ofloxacin 400mg BID x 7days

Polynerv 1000, 1-2tab daily if prophylaxis; 2-4 tabs dajly if therapeutic

Domperidone 10mg/tab ODBF

Calmoseptine cream TID x5days

Ibuprofen 400mg q6

UTI

Pantoprazole 40mg OD 30mins before breakfast

Nitrofurantoin 100mg qid x 5 days or

Fosfomycin 300mg sachet single dose

Ciprofloxacin 500mg BID x 7 days OR

Cefuroxime 500mg BID x 7 days OR

Ofloxacin 400mg BID x 7days OR

Levofloxacin 500mg BID x 7 days

Sambong 1tab TID x 7 days

Buscopan Plus (HNBB + Paracetamol) 1tab TID x 3 days

Increase OFI
Headache

Norgesic forte

Viral flu

Sinupret

Abd pain

Metoc

Pantop

Trama

Face - Clindamycin 300mg q6 x 7 days

Interna - Coamox 625 mg q8 x 7days

Media- Coamox 625mg q8/ cefu 500mg BID

Externa - Polymoxin/Neomycin/Fluocinolone or Polymixin/Neomycin/Dexamethasone 2-3drops TID x 7

Rutured TM: Ciprofloxacin 500mg BID + dexa 3drops tid for 7 days

Mineral oil 3drops TID

ATP

Coamoxiclav 625mg q8 x 7days

Difflam throat spray 4puffs TID

Paracetamol 500mg tab q4

Chlorhexidine (Orahex) TID

Mefenamic 500mg cap q6

Do epley's maneuver

Betahistine (Serc) 24mg BID x PRN

Cinnarizine (Stugeron forte) 75mg 1 cap OD

Metoclopramide 10mg TID x PRN

TMJ dysfunction:

Barton's

Pain

Celecoxib 200mg cap BID x PRN pain

Ibuprofen 400mg cap q6

Norgesic forte: para + orphenadrine TID x 5days

Acute rhinitis

Disudrin 5mg/5ml 5ml TID x 7days

Multiple Aphthous ulcer

Carbenoxolone Na (Rowagel) BID x 1week

Paracetamol 500mg q4

Vitamin C 500mg OD

Chlorhexidine gargle TID

Anti tetanus

Ig tet 3vials (3000units children; 4500units adults) ( ) skin test

COUGH AND COLDS 🤧

Dynatussin (Chlorpheniramine maleate, dectromethorphan, guafenesin, paracetamol,

Mucobron Forte (Chlorphenamine maleate, dextromethorphan, guaifenasin, phenylpropanolamine)

Nafarin A (Phenylpropanolamine, Chlorphenamine, Paracetamol) 1 tab TID or 5-10mL TID

Nasatapp (Phenylpropanolamine, brompheniramine) 1 tab TID

Syrup: 2.5-5mL TID

Drops: 1mL TID

Neozep Forte (Phenylephrine, Chlorphenamine, Paracetamol) 1tab Q6

PAIN MEDS 😣

Celebrex (Celecoxib) 200mg cap BID x PRN pain

Faspic (Ibuprofen) 400mg cap q6

Norgesic Forte para + orphenadrine TID x 5days

Dolcet: paracetamol + tramadol TID x 5 days

Mefenamic Acid 500mg Q6 x pain

Naproxen Na 550mg 1 tab once then 275mg Q6

Alaxan (Paracetamol + Ibuprofen)

1g IV Para to run for 1 hour or pwede 15 mins

Paracetamol 300mg IV now

GOUTY ARTHRITIS 😖

Acute Attack:
Colchicine 500mcg 2 tabs now then 1 tab q3 hrs the give maintainance 1 tab TID for 2 days

Maintenance: Febuxostat (Atenurix) 80mg OD x 2-4 weeks

NEPHROLITHIASIS 💊

For asymptomatic nephrolithiasis, K citrate (Acalka) 1-2 tabs TID 30mins after meals.

Paracetamol + Tramadol (Dolcet) q6 PRN x pain

HNBB (Buscopan) 10mg 1 tab TID

For symptomatic neprholithiasis, refer to Surgery.

ACS ❤💘

Aspirin 80mg 3-4 tabs, chewed and swallowed. Then 1 tab ODPC.

ISMN 30-60mg 1 tab OD or ISDN 5mg SL 3-6 doses q5-10mins

Demerol 25mg IV Q6 PRN x severe