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A Pragmatic Guide To GP Locumship

In Singapore
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Latest update at http://locum.esaurus.org/ in pdf format
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General stuff

1) Common difficulties encountered by new locums

- Alien pharmacopoeia. Repertoire of medications and prescribing culture are


significantly dissimilar from that of government restructured hospitals

- Nurseless environment. Though often being fondly addressed as ‘missies’ by the


public, most clinic assistants in GP clinics are trained on-the-job and have no formal
medical background. There’s a wide variance in competency; experienced ones may be
very impressive. You are expected to perform tasks which will normally be done for you
in hospital wards (eg nebulising, taking hypocounts, interpret dipstix results) yourself
unless the clinic assistants of that particular clinic have been trained to do so.

- Pharmaco-economics. Most clinics participate in some form of corporate practice


scheme and the maximum fee per consultation for involved patients will be capped. Their
consultation cards will usually be labeled with notes like “IHP, cap: $25/visit” or “Aviva,
MHS --> $5 only! “. You have to work within the budget ie no ‘high-end’ antihistamines
like Telfast, no ‘high-end’ lozenges like Mac and consider giving I/I tds x 10 (even 6 or 8)
and not II/II tds x 20 for certain medications if possible.

2) Words of advice

- Self-orientation. Each time you step into a new clinic, take time to find out where the
equipment that you might need are placed : opthalmoscope/otoscope, spirit swabs,
syringes + needles, injectables/vaccines, ECG machine, surgical sets, dressing sets,
glucometer, memo pad for referrals, metal ear syringes, resus equipment etc. It would be
awkward to fumble in front of patients looking for these stuff.

- Locum folder. Most clinics which employ locums on a regular basis will provide a file for
your reference. It usually contains the clinic’s drug list, MOH guidelines, product inserts,
some specific advice regarding the practice culture of that particular clinic, the GP’s
personal contact numbers etc. Do look for or request for it such that you will not waste
time writing prescriptions for drugs that are not available in that particular clinic

3) Some technicalities on documentation/ prescription

- Long documentation generally not welcomed. Strike a good balance between protecting
yourself and saving paper. Examples below represent the max.
- Population psychology generally forbids monotherapy (Exceptions: Antihypertensives,
viagra etc)
- Do not write x 5/7, x 1/52 as in hospitals. For tablets/ capsules: Write the total number
of tab/cap you intend to give --> usually a nice number eg 10 and circle it (refer examples
below). For syrups/ suspensions: Except the high-end ones which are usually
dispensed in their original packaging, most syrups/ suspensions are re-distributed in 30ml,
45ml, 60ml or 90ml bottles. Some clinics have 120ml bottles. As a rough guide, if the
dosing of a certain syrup for a 2-year old kid is 2.5ml tds, a total amount of 30ml should
suffice. Write x 30 and circle the number. At the other end, an adult dosing of 10ml tds
would generally require a 90ml bottle. For creams that are not dispensed in their original
packaging, they are usually redistributed in 5g and 10g containers.
- Unlike hospital practice:
a) Do not write the dosing of any syrup/ suspension in mg. There is no pharmacist/ nurse to
do conversion for the patient. Instructions must be as layman-friendly as possible.
b) Work flow is usually smoother if u use the proprietary names available in that particular
clinic, rather than writing generic drug names which the clinic assistant may not be
familiar with. Even ‘paracetamol’ got bounced back once ‘cos that lady only recognises
‘Biogesic’. There is another reason. Both Augmentin and Curam are co-amoxiclav, but
the price is very different. Some clinics stock both. I shall not elaborate on who to give
what.
List of commonly used medications in local GP clinics

Cough suppressants (Anti-tussives)

Syrups

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Dhasedyl Codeine phosphate + >12yr: 10 ml tds x 90ml Single most frequently


ephedrine + prescribed drug in GP
Sunsedyl 8-11yr: 7.5 ml tds x 90ml
promethazine (in clinics. Addicts’ fav
SP-cosedyl slightly differing 4-8yr: 5 ml tds x 60ml too. Contra-indicated
Sedilix proportions amongst 3-4yr: 3.5 ml tds x 60ml in hypertensives,
Promedyl-B brands) 2-3yr: 2.5 ml tds x 30ml asthmatics and
patients on MAO-
Ephedyl inhibitors

Dhasedyl DM Dextromethorphan + >12yr: 10 ml tds x 90ml Dextromethorphan


ephedrine/ substituted for
Sedilix DM 8-11yr: 7.5 ml tds x 90ml
pseudoephedrine+ codeine. DMP is a
Ehedyl DM promethazine (in 4-8yr: 5 ml tds x 60ml narcotic too, but
slightly differing 3-4yr: 3.5 ml tds x 60ml problem with physical
proportions amongst 2-3yr: 2.5 ml tds x 30ml addiction much lower
brands) cf to codeine

Promethazine Promethazine HCL ( 5mg/5ml ) Antihistamine with


available in 2 antitussive and anti-
>12yr: 10 ml tds x 90ml
concentrations: emetic properties
5mg/5ml 7-9yr: 7.5 ml tds x 90ml
15mg/5ml 4-6yr: 5 ml tds x 60ml
2-4yr: 2.5 – 3.5 ml x 30/45ml
tds

( 15mg/5ml )
>12yr : 5 ml tds x 60ml
8-11yr: 3.5 ml tds x 45ml
4-7yr: 2.5 ml tds x 30ml
2-4yr: 1.5 ml tds x 30ml
Silomat Clobutinol 20mg/5ml >12yr: 10ml tds
9-11yr: 7.5 ml tds
6-9yr: 10 ml tds
3-6yr: 7.5 ml tds
1-3yr: 5 ml tds

Cough-en Dextromethorphan
15mg/5ml,
pseudoephedrine
30mg/5ml, triprolidine
1.25mg/5ml

Fedac Co
Levopront Levodropropizine > 12 yrs only: X 60ml/ Minimum of 6h
60mg/10ml 10ml bd-tds between doses. Not to
120ml
continue beyond 1
week.
LTR Codeine phosphate > 12 yrs only: X 90ml Pure codeine!
10mg/5ml 10ml tds
Metophan Dextrometophan HBr >12yr: 10 ml tds x 90ml
15mg/5ml
8-11yr: 7.5 ml tds x 90ml
4-8yr: 5 ml tds x 60ml
3-4yr: 3.5 ml tds x 60ml
2-3yr: 2.5 ml tds x 30ml
Actifed Co

Tablets

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Dexcophan Dextromethorphan Adult: x 10 Not to exceed


15mg 120mg/day for adults
Beathorphan I/I - II/II tds-qds
and 60mg/day for
Pusiran Children 7-12yr: children (7-12 yrs only)
½ tab to I/I tds

Lozenges

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Tussils Dextromethorphan Adult: x 10 Obviously not meant to


15mg be used like the
II/II tds-qds
antiseptic lozenges
Children 6-12yr:
I/I qds

Expectorants (Protussives)
Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Phenexpect Ammonium >12yr: 10 ml tds x 90ml See also


chloride ‘Phenexpect CD’
135mg/5ml;
8-11yr: 7.5 ml tds x 90ml
4-8yr: 5 ml tds x 60ml under ‘mixed cough
diphenhydramine
3-4yr: 3.5 ml tds x 60ml preparations’
12.5mg/5ml
2-3yr: 2.5 ml tds x 30ml

Benadryl Ammonium >12yr: 10 ml tds x 90ml


chloride
8-12yr: 7.5 ml tds x 90ml
125mg/5ml;
diphenhydramine 5-8yr: 5 ml tds x 60ml
12.5mg/5ml; 3-5yr: 3.5 ml tds x 45ml
alcohol 5% 1-3yr: 2.5 ml tds x 30ml

Diphen 10
Diphen 5

Mucolytics
Tab/ Capsules ( For > 12yrs unless otherwise stated )
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Vasican ‘Vasican’ generally


better known than
Bisolvon Bromhexine 8mg tab ‘bisolvon’ in GP clinics
Bromxine I/I tds X 10
SP-Mucosov
Mucolix
Mucosolvan
Ambroxol HCl 30mg
Polibroxol I/I tds X 10
Amxol
Rhinathiol Carbocisteine 375mg I/I – II/II tds X 10
Fluimucil N-acetylcysteine I/I OM or ON X 6, 8 or 10 Effervescent form of
600mg tablet available

Sachets (granules/ powder)


Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Fluimucil N-acetylcysteine in (100mg sachets) X 4, 6 or 8


100mg and 200mg >12yr: 1 sachet qds
satchets 6-11yr: 1 sachet tds
2-5 yr: 1 sachet bd

(200mg sachets)
>12yr: 1 sachet bd
6-11yr: ½ sachet tds
2-5 yr: ½ sachet bd

Mucotreis Carbocisteine >12yr: 1-2 sachet tds X 4, 6 or 8


300mg/sachet 6-11yr: 1 sachet tds
2-5 yr: ½ sachet tds

Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Vasican

Rhinathiol Rhinathiol Children


and Infant’s Syrup:
Carbocisteine
100mg/5ml
Rhinathiol
Expectorant:
Carbocisteine
250mg/5ml

SP-mucoplex Carbocisteine
250mg/5ml

Solmux Carbocisteine
200mg/5ml

Non-specific / Mixed cough preparations

Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Rhinathiol- ‘High-end’ cough


mixture popular with
promethazine young parents

Mucolexin 11-12yr: 10ml tds


* For kids only 7-10yr: 7.5ml tds
4-6 yr: 5ml tds
2-3 yr. 3.5 ml tds
< 1yr: 2.5ml tds
Phenexpect CD
Prospan
Sinupret

Anti-inflammatory enzymes
Tab/ Capsules ( For > 12yrs unless otherwise stated )
Common Generic Default dosage (s) Default amount Remarks
Proprietary Name(s) constituent(s)

Danzen Serratiopeptidase (5mg tab) 10 - 20


5mg or 10mg tabs I/I – II/II tds
Korzen
(10mg tab)
Serrazyme
Sinsia I/I tds

Neuflo Lysozyme 10mg tabs I/I – II/II tds 10 - 20


Neuzym
Leftose

Syrups
Common Generic Default dosage (s) Default amount Remarks
Proprietary Name(s) constituent(s)

Leftose Lysozyme 5mg/ml 10-12yr: 5 ml tds X 60ml Mainly for kids


6-10yr: 3.5 ml tds X 45ml
2-5yr: 2.5 ml tds X 30ml
<1 yr: 1 ml tds X 30ml

Antihistamines, sedating

Tab/ Capsules ( For > 12yrs unless otherwise stated )


Common Generic Default dosage (s) Default amount Remarks
Proprietary Name(s) constituent(s)

Fedac Triprolidine 2.5mg + I/I tds-qds X 10 Do not give with other


pseudoephedrine preps containing
30mg pseudoephedrine eg
Dhasedyl

Fenfedrin Chlorpheniramine I/I tds-qds X 10 Do not give with other


4mg + preps containing
pseudoephedrine pseudoephedrine eg
60mg Dhasedyl
Piriton Chlorpheniramine >12yr: I/I tds-qds X 10 Not to exceed 24mg/
4mg day for adults;
Allersin 6-11yr: ½ tab tds-
12mg/day for children
Chloramine qds
Alleryl
Allerphen
Polaramine Dexchlorpheniramine >12yr: I/I tds-qds X 10 Not to exceed
2mg 12mg/day for adults;
Dexchloramine 6-11yr: ½ tab tds-
6mg/day for children
Somin qds
Dextramine
Atarax Hydroxyzine in 10mg I/I on/bd/tds titrated X 10 Adults: Not to exceed
or 25mg to effects desired/ 100mg/day. Paeds (>
Hyzin 3yr): 1mg/kg/day in
severity of allergies
divided doses

Became Carbinoxamine 4mg 6yr-adult: X 10 Do not give with other


+ pseudoephedrine I/I tds-qds preps containing
60mg 2-5yr: pseudoephedrine eg
Dhasedyl
½ tab tds-qds
Peacef Triprolidine 1.25mg + >12yr: I/I tds-qds X 10 Do not give with other
pseudoephedrine preps containing
6-11yr: ½ tab tds-
30mg pseudoephedrine eg
qds Dhasedyl

Syrups
Common Generic Default dosage (s) Default amount Remarks
Proprietary Name(s) constituent(s)

Chlormine Chlorpheniramine >10yr : 5 ml tds X 60ml Not to exceed


4mg/ 5ml 12mg/day for children
Chloramine 6-9yr: 3.5 ml tds X 45ml
(5ml tds is max!)
Antamin 3-5yr: 2.5 ml tds X 30ml
Allerphen 2-3yr: 1.5 ml tds X 30ml
Alleryl 1-2yr: 1.5 ml bd X 30mll
(to be continued)

Antihistamines, non-sedating

Tab/ Capsules ( For > 12yrs unless otherwise stated )


Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Clarityne Loratadine 10mg I/I OM x 5 - 10


Allertyn
Roletra
Ezede
Loratyn

Clarinase Loratadine 5mg + I/I bd X 10 Not to continue for > 3


pseudoephedrine weeks.
120mg per tab

Zyrtec Cetirizine 10mg I/I OM x 5 - 10


Allertec
Adezio
Alzytec
Terizin
Cirrus Cetirizine HCl 5mg + I/I bd X 10
pseudoephedrine
120mg per capsule

Telfast Fexofenadine 180mg I/I OM X 6 - 10 Esp good for chronic


idiopathic urticaria

Aerius Desloratadine 5mg >12yr: I/I OM X 10


Desalex 6-11yr: ½ tab OM

Xyzal Levocetirizine 5mg > 6yr: I/I OM X 10

Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
(to be continued)
Zyrtec Cetirizine 5mg/5ml
Rhizin

Alpha-adrenergic Nasal Decongestants


Tab/ Capsules
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Sudafed Pseudoephedrine I/I tds X 10 Do not give with


HCl 60mg dhasedyl, cirrus,
Pseudorine clarinase etc

Topical
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Iliadin nasal Oxymetazoline HCl <1 yr: 0.01% X 1 bottle Not to continue
available in 0.01%, 1-6yr: 0.025% beyond 5 days
drops 0.025% and 0.05% > 6yr: 0.05%

1 drop tds

Afrin nasal Oxymetazoline > 6yr: 1 drop tds X 1 bottle


0.05%
spray

Antiseptic lozenges/ Gargles

Lozenges
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
Difflam
Trachisan

MAC ‘High end’


lozenges; taste
like Hack’s.
Solution
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
Thymol gargle gargle tds x 1 bott Dilute 1 part with 3
parts of water before
use
Difflam gargle gargle tds x 1 bott

Antibiotics Æ Antibacterials
Tab/ Capsules
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Amoxil Amoxycillin 250mg or (250mg)


500mg capsules I/I - II/II tds
Ospamox X 20
(500mg)
Amoxicap
Aroxin I/I tds X 10
Moxipen
Celexin Cephalexin 250mg or (250mg)
500mg tab/capsules II/II bd-tds
Felexin X 20
(500mg)
Sofilex
I/I bd-tds X 10
Augmentin Amoxycillin 500mg + I/I bd X 10
Clavulanate
Curam potassium 125mg
Augmex
Moxiclav (Moxiclav also has a
325mg type where the
Amocla amoxicillin component is
250mg only)

Ciprobay Ciprofloxacin 250mg I/I bd X 10


or 500mg
Serviflox
Ginorectol
Cirok
Enoxin

Bexinor Norfloxacin 400mg I/I bd X 10


Nolicin
Inoflox Ofloxacin 200mg I/I bd X 10
Oflox
Tarivid Ofloxacin 100mg I/I bd X 10
Avelox Moxifloxacin 400mg I/I OM X 1 pack (5tab)
Tequin Gatifloxacin 400mg I/I OM X 1 pack (7
tab)
(to be continued)

Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
(to be continued)

Anti-emetics/ Vestibular sedatives

Tab/ capsules ( For > 12yrs unless otherwise stated )


Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Dimenate Dimenhydrinate Nausea/vomiting/Meniere’s X 10 Antihistamine


Dramamine 50mg I/I tds
Motion sickness:
Novomin
1 tab half hr before
journey
Cinnaron Cinnarizine 25mg Nausea/vomiting/Meniere’s X 10
Stugeron I/I tds
Motion sickness:
Vertigon
1 tab 2 hrs before
journey; ½ tab q8h during
journey
Stemetil Prochlorperazine Nausea/vomiting/Meniere’s X 10 Not to exceed 30mg
5mg I/I tds (6 tab) per day
Dhaperazine
Prochlor
Maxalon Metoclopramide I/I tds X 10 Will worsen diarrhea
10mg if present
Primperan
Pulin
Motilium Domperidone I/I tds X 10 Will worsen diarrhea
10mg if present
Domper
Dompel
Merislon (to be continued)

Betaserc
Buclizine
Cyclizine

Syrups
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
(to be continued)

Suppository
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Domper Domperidone 10mg 2-3yr: I/I bd-tds


per suppository >3yrs: Up to
III/III bd-tds
Primperan (to be continued)

Injectables
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
(to be continued)

Gastrointestinal anti-spasmodics/ Anti-flatulents/ Motility regulators


Tab/ Capsules ( For > 12yrs unless otherwise stated )
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Buscopan Hyoscine-N- I/I tds X 10


butylbromide 10mg
Dhacopan
Fucon
Spasmoliv
Vacopan
Librax I/I tds-qds Can also be used
preprandial for ureteric spasm,
dysmenorrhoea
Debridat Trimebutine maleate I/I – II/II tds x 10-20
100mg
Cerekinon
Motilium Domperidone 10mg I/I tds X 10
Domper
Dompel
Meteospasmyl Alverine citrate 60mg I/I bd-tds x 10
+ simethicone 300mg

Syrup
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Buscopan
Colimix Dicyclomine HCl >10yr: 10ml tds x 90ml Best for ‘wind’
5mg/5ml, 5-10yr: 7.5ml tds x 90ml
simethicone 2-4yr: 5ml tds
50mg/5ml x 60ml
6mth-2yr: x 45ml
3.5ml tds

Dentinox Activated Infant colic


dimethicone, dill oil 2.5ml with or after
infant colic
drops each feed

Infacol Simethicone Infant colic


100mg/ml 8 drops per feed
Ridwind
Contraceptives

Oral combined contraceptives

Common Generic Administration Remarks


Proprietary Name(s) constituent(s)
Gynera Gestodene 75mcg +
ethinylestradiol
Minulet 30mcg
Marvelon Desogestrel 150mcg
+ ethinylestradiol
30mcg D1 to D21 of menstrual cycle
Mercilon Desogestrel 150mcg followed by 7 tab-free days
+ ethinylestradiol
20mcg
Yasmin Drosipirenone 3mg +
ethinylestradiol 0.03
mg
Microgynon Levonorgestrel D5 to D25 of menstrual cycle
150mcg +
Nordette ethinylestradiol followed by 7 tab-free days
30mcg

Emergency contraception (“Morning-after”)

Common Generic Administration Remarks


Proprietary Name(s) constituent(s)

Postinor Levonorgestrel 750 1st tab within 48 hour post-coitus


mcg x 2 tab per pack
( maximum 72 hours); 2nd tab 12
hours later

Depot contraceptives

Common Proprietary Generic constituent(s) Administration Remarks


Name(s)

Depo- provera Medroxyprogesterone 150mg 3-monthly intramuscular Glutes please


(50mg/ml x 3ml)
injection

Evra Norgestromin 150mcg/24hr + 1 patch weekly x 3 weeks Apply on hairless,


Ethinyl estradiol 20mcg/24hr dry skin (Eg buttock,
then 1 patch-free week
abdomen, lateral
aspect of upper arm)
Not over breast/
axilla

Ophthalmic and ear preparations

Eye-drops, for conjunctivitis of allergic/ irritant etiology


Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Allerex 2 drops qds X 1 bott

Spersallerg Antazoline HCl Adult: 1 drop X 1 bott


0.05%;
3hrly then wean
tetrahydrozoline HCl
0.04% to bd-tds
Children: 1 drop
bd
Naphcon-A Naphazoline HCl 1-2 drops 3-4hrly X 1 bott
0.025%, pheniramine
maleate 0.3%

Octilia Tetrahydrozoline 1-2 drops bd-tds X 1 bott


Vividrin Disodium 1 drop qds X 1 bott
cromoglycate

Eye-drops, for conjunctivitis of infective etiology

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Optodexine Chloramphenicol, 2 drops qds X 1 bott


dexamethasine and
tetrahydrozoline

Optomycin Chloramphenicol 2 drops qds X 1 bott Compare optomycin


0.5% ear drops
Xepanicol
Optomycin D Chloramphenicol + 2 drops qds X 1 bott
dexamethasone

Sofradex X 1 bott
Fucithalmic X 1 bott

Eye ointments, for conjunctivitis of infective etiology

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Chlortalim Chlortetracycline 1% Instil into MIMS says tds-qds but


conjunctival sac bd commonly prescribed
as on or bd, esp when
given together with
eye-drops

Fulcithalmic

Antibiotic ear-drops

Common Generic Default dosage(s) Default amount Remarks


Proprietary Name(s) constituent(s)

Optomycin ear
drops 5%
Hydrospor

Ceruminolytic ear-drops
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Cerumol Arachis oil, 5 drops bd x 3 x 1 bott CI: Perforated TM,


chlorbutol, days active otitis
paradichlorobenzne

Waxsol Docusate Na 0.5% 2 drops ON x 1-2 x 1 bott Not for more than 2
nights before nights. CI: Perforated
syringing TM, active otitis

Tropex Phenazone 0.5% 4-6 drops tds- x 1 bott Can use when there’s
concomitant otitis and
qds
ear wax impaction

Olive oil

Anti-obesity / Anorexiants
Tab/ Capsules ( For > 12yrs unless otherwise stated )
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)
2
Duromine Phentermine 15mg or I/I OM X 30 For BMI > 30kg/m .
30mg Follow-up: Monitor
Panbesy BMI, BP, HR and
whether have
insomnia, tremors,
palpitations etc.

Reductil Sibutramine HCl I/I OM X 28 As above


10mg or 15mg

Xenical Orlistat 120mg > 18yrs only: X 84 Known for its side
I/I tds with each effects of steatorrhoea,
faecal incontinence,
meal
greasy spotting etc

Drugs for erectile dysfunction


Tab/ Capsules
Common Generic Default dosage(s) Default amount Remarks
Proprietary Name(s) constituent(s)

Viagra Sildenafil citrate I/I ON/PRN 1 hr x 1 pack (4 tab) Not to exceed


50mg or 100mg in before sexual 100mg daily. CI: On
packs of 4 activity nitrates, recent CVA/
AMI, EF<40%,
retinitis pigmentosa

Cialis Tadalafil 20mg in I/I ON/PRN 30min- x 1 pack (4 tab) Need to determine
packs of 4 36hr before sexual individual window of
activity responsiveness. CI
as above.

Levitra Vardenafil 10mg or I/I ON/PRN 25- x 1 pack (4 tab) Not to exceed 20mg
20mg in packs of 4 60min before daily. CI as above.
sexual activity

Annex A: Executive Summary of Paediatric Syrup Dosings


AGE WT PIRITON DMP PMZ PARACET PARACET PARACET DHASEDYL FEDAC TDS VASICAN PHEN- COUGHLAX NAPAN NUROFEN
4MG/5ML 15MG/5ML 5MG/5ML 125MG/5ML 250MG/5ML 500MG/5ML TDS (ML) (ML) 4MG/5ML EXPECT CD TDS (ML) 125MG/5ML 100MG/5ML
TDS (ML) TDS (ML) TDS (ML) QDS (ML) QDS (ML) QDS (ML) TDS (ML) TDS (ML) TDS (ML) QDS (ML)
3 MTH 6 - - - 2.5 - - - - - - -
6 MTH 8 - - - 2.5 - - - 2.5 bd - - 2.5 2.5 tds
9 MTH 9 - - - 2.5 - - - 2.5 bd - - 2.5 2.5 tds
1 10 1.25 bd - - 5 2.5 - - 2.5 bd 2.5 - 1.25 2.5 2.5
2 13 1.25 bd - 2.5 5 2.5 - 2.5 2.5 2.5 2.5 1.25 2.5 2.5
3 15 1.25 - 3.5 5 2.5 - 2.5 2.5 2.5 2.5 2.5 5 2.5
4 17 1.25 - 5 7.5 3.5 - 2.5 2.5 2.5 2.5 2.5 5 2.5
5 19 1.25 - 5 7.5 3.5 - 2.5 2.5 2.5 2.5 2.5 5 5
6 21 2.5 - 5 10 5 2.5 5 5 5 5 2.5 5 5
7 23 2.5 2.5 7.5 10 5 2.5 5 5 5 5 2.5 7.5 5
8 25 2.5 2.5 7.5 10 5 2.5 5 5 5 5 2.5 7.5 5
9 27 2.5 2.5 7.5 - 7.5 3.5 5 5 5 5 2.5 7.5 5
10 30 5 5 10 - 7.5 3.5 5 5 5 5 2.5 10 10
11 34 5 5 10 - 10 5 5 5 10 5 2.5 10 10
12 38 5 5 10 - 10 5 10 10 10 10 2.5 10 10

AGE WT AMOXIL AMOXIL ERYTHROMYCIN CEPHALEXIN CEPHALEXIN AUGMENTIN AUGMENTIN CEFACLOR KLACID BACTRIM BD (ML)
125MG/5ML TDS 250MG/5ML TDS 200MG/5ML QDS 125MG/5ML TDS 250MG/5ML TDS 156MG/5ML TDS 228MG/5ML BD 125MG/5ML TDS 125MG/5ML BD
(ML) (ML) (ML) (ML) (ML) (ML) (ML) (ML) (ML)
3 MTH 6 2.5 - 1 2.5 1.25 1.5 1.5 1.5 - 2.5
6 MTH 8 2.5 - 1 2.5 1.25 1.5 1.5 1.5 - 2.5
9 MTH 9 5 2.5 1 2.5 1.25 2.5 2.5 1.5 - 2.5
1 10 5 2.5 2.5 5 2.5 2.5 2.5 2.5 2.5 2.5
2 13 5 2.5 2.5 5 2.5 5 5 2.5 2.5 2.5
3 15 7.5 3.5 2.5 5 2.5 5 5 2.5 5 2.5
4 17 7.5 3.5 5 5 2.5 5 5 5 5 5
5 19 7.5 3.5 5 10 5 5 5 5 5 5
6 21 10 5 5 10 5 5 5 5 5 5
7 23 10 5 5 10 5 10 10 5 7.5 5
8 25 10 5 5 10 5 10 10 5 7.5 5
9 27 10 5 5 10 5 10 10 7.5 7.5 10
10 30 10 5 7.5 10 5 10 10 7.5 10 10
11 34 10 5 7.5 10 5 10 10 10 10 10
12 38 10 5 7.5 10 5 10 10 10 10 10

AGE WT VENTOLIN KETOTIFEN BRICANYL DIMENATE BUSCOPAN MAXALON COLIMIX TDS LOPERAMIDE KAOLIN QDS POT CITRATE AGAROL TDS VENTOLIN
2MG/5ML TDS 1MG/5ML BD 1.5MG/5ML 15MG/5ML 5MG/5ML TDS 5MG/5ML TDS (ML) 1MG/5ML TDS (ML) TDS (ML) (ML) NEB (ML)
(ML) (ML) TDS (ML) TDS (ML) (ML) (ML) (ML)
3 MTH 6 - - - - 2.5 1 bd 2.5 - - 2.5 - 0.15
6 MTH 8 1.5 2.5 2.5 - 2.5 1 bd 2.5 - - 2.5 - 0.20
9 MTH 9 1.5 2.5 2.5 - 2.5 1 bd 2.5 - - 2.5 - 0.25
1 10 2.5 2.5 2.5 2.5 2.5 1 2.5 - - 2.5 - 0.25
2 13 2.5 2.5 2.5 2.5 5 1 5 - - 5 - 0.25
3 15 2.5 2.5 2.5 2.5 5 2 5 - - 5 2.5 0.5
4 17 3.5 5 5 5 5 2 5 - - 5 2.5 0.5
5 19 3.5 5 5 5 5 2.5 5 5 - 5 2.5 0.5
6 21 3.5 5 5 5 10 2.5 5 5 10 10 5 0.5
7 23 5 5 5 5 10 2.5 5 5 10 10 5 0.75
8 25 5 5 5 10 10 2.5 10 5 10 10 5 0.75
9 27 5 5 5 10 10 5 10 5 10 10 5 0.75
10 30 7.5 5 5 10 10 5 10 10 10 10 5 0.75
11 34 7.5 5 5 10 10 5 10 10 10 10 10 0.75
12 38 10 5 5 10 10 5 10 10 10 10 10 0.75

Annex B:

POTENCY OF TOPICAL STEROIDS AND CLINICAL USE

POTENCY GRADE STEROID TYPES OF DERMATOSES

Lichen simplex chronicus


Discoid lupus erythematosus (non-facial)
Hypertrophic lichen planus
HIGH POTENCY Clobetasol propionate 0.05%
Recalcitrant psoriasis (hair line, legs)
Recalcitrant hyperkeratotic eczema of palms
and soles
Betamethasone dipropionate
0.05%
Betamethasone valerate
0.1% Contact dermatitis
Desoxymethasone 0.25% Atopic dermatitis (lichenified areas)
Diflucortolone valerate 0.1% Lichen planus
HIGH MODERATE
Fluclorolone acetonide Hand / feet eczema
POTENCY
0.025% Discoid lupus erythematosus (face)
Fluocinolone acetonide Acute sunburn
0.025% Insect bite reactions
Fluocinonide 0.05%
Hydrocortisone butyrate 0.1%
Mometasone Furoate 0.1%
Betamethasone valerate
Atopic dermatitis
0.025%
Extensive contact dermatitis
Clobetasone butyrate 0.05%
Intertrigo
Flucinolone acetonide
MODERATE Stasis eczema
0.00625%
POTENCY Seborrhoeic dermatitis
Triamcinolone acetonide
Psoriasis on face and flexures
0.1%
Pityriasis rosea
Fluocinolone acetonide
Discoid eczemas
0.01%

Facial eczema
Fluocinolone acetonide
Anogenital lesions
0.0025%
MILD POTENCY Intertrigo
Hydrocortisone 0.5% / 1%
Eczema in children and elderly
Hydrocortisone acetate 1%
Xerotic eczema

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