COMMON TREATMENTS OF MEDICINE WARD

COMMON TREATMENTS OF MEDICINE WARD

Concept & Edited by: Dr. Md. Shabbir Ahmad
Revised by: Dr. Biswojit Mandol Shovon (A/R); MU-1
Khulna Medical College Hospital

Cerebrovascular Disease (Stroke)

1. Diet: Soft & Liquid (If patient is conscious) Or,
     NG tube feeding (If patient is unconscious) [200 ml liquid food+50 ml water 2 hourly] in sitting
     positon & must be remain sitting posture at least 30 minites]
2. Inf. Normal Saline 1000 ml    
    i/v @ 10 drop/min stat & daily
3. If patient is unconscious & NG tube is given,   
    Inj. Ceftriaxone 2g (Ceftron/Axon/Traxon/Ceftizone/Dicephin/Exephin/Trizon/Trijet/Arixon)   
    1 vial i/v stat & Daily
   Or, If patient is able to take oral medication:   
    Tab. Cefuroxime 500 mg (Kilbac/Cefotil/Furocef/Kilmax/Famicef/Axim/Turbocef/Furex)   1+0+1
4. If Patient Unconscious: Inj. Pantoprazole 40 mg; 1 vial i/v stat & BD
   If patient Conscious: Tab. Pantoprazole 20 mg; 1+0+1 (A/C)
5. Tab. Atovastatin 20-40 mg (Avas/Taven/Atova/Angitor/Lipcon/Lipitor/Divastin/Tiginor   
    1 tab stat & then 0+0+1 (A/C)
6. If BP >160/90 mmHg, Tab. Olmesartan+Amlodipine Or, (Bizoran/Duopres/Amlosart/Disartan)       
    Tab. Amlodipine 5 mg Or, (Camlodin/Cardipin/Amlopin/Amdocal/Amocal/Amlotab/Amlocard/     
    Tab. Losartan Potassium 50 mg (Angiloc/Ostan/Losart/Osartil/Prosan/Osartan/Cardon)   
    1 tab stat & then 0+0+1
7. If CT Scan Shows Ischemic Stroke,
 [Antihypertensive Choice: According to rise of BP & Age]    
    Tab. Clopidegrel 75 mg (Anclog/plagrin/Lopirel/Odrel/Clont/Noclog/Dclot/Clopid/Clognil)   
    Or, Tab. Aspirin 75 mg (Carva/Ecospirin/Solrin/Aciprin/Monosprin)   
    Or, Tab. Aspirin+Clopidegrel (Odrel plus/Lopirel plus/Clopid as/Clontas/Plagrin plus/   
    0+1+0
8. If CT Scan Shows Ischemic Stroke/ Cerebral Edema,   
    Tab. Vinpocetine 5 mg (Vincet/Cerevas/Caviton/Camiton/Cereton/Cerivin/Vincetine/Cerevin)   
     1+1+1……………………………… 3 months

9. If CT Scan shows haemorrhagic stroke [Treatment plan may vary patient to patient]

  Inf. Mannisol 500 ml    ½ bag running stat & then ½ bag running 12 hourly for 3 days
10. If CT Scan Shows Haemorrhagic stroke with ventricular extention,   
     Tab. Nimodipine 30 mg (Nimocal/Nimodi)   2+2+2+2+2+0………………………….21 days
11. If Patient is unconscious, lying must be lateral & change posture 2 hourly
12. Continuous Catheterization
13. If Patient is restless, Inj. Haloperidol 5 mg (Halopid/Perol)    
      ½ amp. i/v stat or 1 amp. i/m stat & SOS/ 12 hourly   
     & 
     Inj. Procyclidine 10 mg (Cyclid/Perkinil)   
     ½ amp. i/v stat or 1 amp. i/m stat & SOS/ 12 hourly
14. If involves Cerebral Cortex, Tab. Phenytoin 100 mg (Diphedan)    
    1+0+0
    Or,  
    Inj. Fosphenytoin 150 mg (Fosfen)    
    1 amp i/v stat & daily
15. If convulsion present, Tab. Sodium valporate 200 mg (Valex/Proval/Valapi) 
   1+0+1