1.

Question 1

Status Epilepticus

Answer 1

Rx
1. 20 – 50 ml of 50% DEXTROSE Intravenously (If hypoglycemia is present)
2. Inj. LORAZEPAM 4mg Intravenously at the rate of 2mg/min over one minute,
repeated once after 10 min if required
3. Inj. FOSPHENYTOIN 100mg/min intravenous infusion at the rate of 150
mg/min to a maximum of 1000mg under continuous ECG monitoring
General measures:
 Maintenance of airway
 Oxygenation
 Fluid and electrolyte balance
 BP
 Normal cardiac rhythm
 Euglycemia
 Care of the unco

Question 2

Acute Angina pectoris

Answer 2

1. Tab. GLYCERYL TRINITRATE 0.5mg Sublingual
   If the pain is relieved spit the tablet, if not repeat after 5-10min
   If the pain is not relieved with 1 tablet, another 0.5 mg tablet is given and wait for 5
   mins, a maximum of 3 tablets can be given with a gap of 10-15 mins
2. Tab. ASPIRIN 150mg stat followed by 75 mg/ day for 7 days
3. Tab. ATENOLOL 50mg Once daily (If there is Hypertension) for 7 days
4. Tab. ATORVASTATIN 5mg Once daily for 7 days
   ADVICE:
    Review after 1 week
    Stop smoking, Low cholesterol diet, Supervised Exercise

Question 3

Mild Hypertension

Answer 3

1. Tab LOSARTAN 50mg per oral after food Once daily for 7 days
2. Tab HYDROCHLOROTHIAZIDE 12.5 mg per oral after food Once daily for 7 days
   ADVICE:
    Weight reduction
    Salt restricted diet (6gm/day), Low-fat diet, Fiber diet- fruits, vegetables
    Brisk walking ½ hr, 5days a week
    Stop smoking, restrict alcohol
    Avoid stressful work
    Review after 7 days

Question 4

Hypertension in pregnancy

Answer 4

Rx
1. Tab. METHYLDOPA 250mg per oral after food twice daily for 15 days
ADVICE:
 Salt restriction, Monitor BP
 Review after 15 days

Question 5

Acute myocardial infarction

Answer 5

1. Oxygenation- 2-4 L/min.
2. Tab. GLYCERYL TRINITRATE sublingual 0.5mg repeat after every 5mins if pain
   persists up to 3 doses
3. If there is no pain relief with Sublingual GTN, then start, Inj. NITROGLYCERIN
   10-20mcg/minute IV infusion, increased 10 mcg/min to a maximum of 400mcg/min with
   BP monitoring.
4. Inj. 0.9% NORMAL SALINE 500ml Intravenous stat
5. Inj. MORPHINE 5mg IV Stat
6. Inj. METOCLOPRAMIDE 10mg IV stat
7. Tab. ASPIRIN 160mg stat followed by 80mg once daily for 10 days
8. Inj. METOPROLOL 5mg IV every 5mins for 3doses
9. Inj. ALTEPLASE 15mg IV bolus followed by 50mg over 30 minutes, then 35mg over
   the next 1 hour (within 2 hours)
10. Inj. FUROSEMIDE 40mg IV Stat
11. Tab. ENALAPRIL 5mg once daily for 10 days
12. Tab. ROSUVASTATIN 20mg once daily for 10 days
    General Measures:
     Hospitalize the patient
     Monitor BP, ECG
     Review after 10 days

Question 6

Acute pulmonary edema

Answer 6

Rx:
1. Oxygen 6-8L/min.
2. Inj. FUROSEMIDE 40mg IV stat, repeat every 30 minutes until diuresis starts
3. Inj. NITROGLYCERIN 10- 20mcg /min IV infusion, increased 10 mcg/min to a
maximum of 400mcg/min until clinical improvement occurs (check systolic BP,
should be more than 100mm of Hg)
4. Inj. MORPHINE 5mg IV bolus, repeat if required every 15 minutes up to 15mg
5. Inj. DOBUTAMINE 5mcg/kg /min. IV infusion stat
6. Tab. ENALAPRIL 5mg Once daily (if the patient is hypertensive)
General measures:
Continuous monitoring of BP, HR, and oxygen saturation

Question 7

Acute Bronchial Asthma

Answer 7

1. Inhaler SALBUTAMOL metered dose inhaler (MDI) - 4 to 6 Puffs (100 mcg/puff)
   every 30 minutes during the first hour followed by 2 to 4 puffs every 6 hrs
   (depending on clinical resolution) for 1 to 2 days
2. Tab. PREDNISOLONE 0.5mg/kg once daily for 5 days
   ADVICE:
    Review after 1 w

Question 8

Acute Bronchial Asthma

Answer 8

1. Inhaler SALBUTAMOL metered dose inhaler (MDI) - 4 to 6 Puffs (100 mcg/puff)
   every 30 minutes during the first hour followed by 2 to 4 puffs every 6 hrs
   (depending on clinical resolution) for 1 to 2 days
2. Tab. PREDNISOLONE 0.5mg/kg once daily for 5 days
   ADVICE:
    Review after 1 w

Question 9

Peptic ulcer

Answer 9

Tab. LANSOPRAZOLE 30mg orally half an hour before food twice daily for 2 weeks
Tab. AMOXICILLIN 1000mg orally after food twice daily for 2 weeks
Tab. CLARITHROMYCIN 500mg orally after food twice daily for 2 weeks
ADVICE:
 Avoid coffee, spicy and oily foods, control stress
 Eat smaller meals, and have your evening meals 3-4 hours before going to bed
 Avoid aspirin-like drugs that are available over the counter
 Review after two weeks
Rx:
1. Oxygen 6-8L/min.
2. Inj. FUROSEMIDE 40mg IV stat, repeat every 30 minutes until diuresis starts
3. Inj. NITROGLYCERIN 10- 20mcg /min IV infusion, increased 10 mcg/min to a
maximum of 400mcg/min until clinical improvement occurs (check systolic BP,
should be more than 100mm of Hg)
4. Inj. MORPHINE 5mg IV bolus, repeat if required every 15 minutes up to 15mg
5. Inj. DOBUTAMINE 5mcg/kg /min. IV infusion stat
6. Tab. ENALAPRIL 5mg Once daily (if the patient is hypertensive)
General measures:
Continuous monitoring of BP, HR, and oxygen saturation
15. VOMITING FOLLOWING THE ADMINISTRA

Question 10

Vomiting following an administration of CISPLATIN

Answer 10

1. NORMAL SALINE 1-2L - infused Intravenously before cisplatin to reduce its renal
   toxicity
2. Inj. ONDANSETRON 8mg Intravenously slowly over 15 minutes, ½ hour before
   Cisplatin administration followed by 2 similar doses 4 hours apart
3. Inj. DEXAMETHASONE 8mg intravenously before chemotherapy
4. Cap. APREPITANT 125mg on day one followed by 80 mg on second & third day