腸胃科

止吐 Primperan (Metroclopramide) 1# ( 5 mg ) po , 1 Amp IM or q8h。

(Antiemetics) Buscopan (Hyoscine-anticholinegic ) 10 mg 1 # po qid , 1Amp IV st

解除腸胃、膽管、尿路、女性生殖器痙攣。

Novamin (Prochlorperazine) 1# po tid , 1 amp IM。

Costi , Motilium (Domperidone)1# po tid

IICP: Glycerol 500 mg V q8h drip for 1-2 hr

Decadron 10 V st, Decadron 5 mg V q6h

Prokinetic drugs Primperan 5 mg 1# po tid , 1 Amp IV st (使胃蠕動亢進，促進幽門通暢

促進蠕動劑 Costi , Motilium (Domperidone) 10 mg 1# po tid

Prepusid 5 mg 1 # po qid

胃藥 Antagel 1 # or 20 cc po qid (不可和 Ducolax 一起用)

Nacid or Strocaine 1 # po qid。Mucaine 20 cc po qid

消脹氣 Prepulsid ( Cisapride ) 1# po qid

Antiflatuent agent Biofermine 1# po tid。

Gascon , Simethicone (Dimethicone) 1 # po tid

Costi , Motilium (Domperidone) 10 mg 1# po tid

降低血脂 1. low fat diet

2. hypercholesterol: HMG-Co reductase: Mevacor(20) 1# po qN

Lescol(20) 1# po qN

3. hyperTG: Lopid 2# bid

腹瀉 DC 會 diarrher 的藥+給 fluid+NPO or clear liquid diet(acute 時不給藥)

Anti-diarrhea drug Kaopectin (成形)20 cc po st or q4h (Peptic ulcer 不用，會加重 ulcer

bleeding)。

Bismuth(吸附) 1# po qid。

Imodium ( Loperamide )2# po st, follow by 1#, up to total 16 mg a

day。 (Anti-secretary 及減少腸子蠕動 Hepatic toxicity)

軟便 MgO 2# po tid (uremia 的病人不用)。

Laxatives Ducolax (Bisacolax)促進大腸蠕動 2# po qN (不可和 Antagel 一起用)

Cascara 2# po qN。( NG feeding diet 時用)

Liquid paraffin 20 cc po qid。Castor oil 20 cc po qid。

Duphalac (Lactulose)10-30 cc po tid。

Normacol plus 1 pk po qd (禁用在 NG feeding)

灌腸 Glycerin ball 2# for enema

Caster oil 15 cc po st

H2-blocker Gaster ( Famotidine ) 1 amp IV q12h。

Proton-pump Losec (Omeprazole) 1# po qd

inbitors

GERD 1. antiacid: Mucaine 20ml, Antagel 20ml

2. Prepulside 1# qid & primperan 1# qid

3. Gaster, Losec

肝炎 Essentiale 1 Amp IV st , 1# po tid。

肝昏迷 Duphalac (Lactulose) 20 ml po st. and 10 cc po tid。

Ammonia↑ Neomycin 2 gm in warm N/S 200 ml for retention enema。

EV bleeding 1. Glypressin 2 amp V st

2. Pitressin 20 amp in D5W 500 ml with rate of 30 D/min

肝硬化 low fat low sodium low protein

BT c 4U FFP + Laxis 1# po qd + aldactone 1# po bid

Duphalac (Lactulose)10-30 cc po tid。Essentiale 1 Amp IV st

Pitressin 20 Amps (400 units)in N/S 500 ml IV drip c rate of 15 ml/ min

(0.2u/ min) with NTG 1# SL q 30 min for 6 hr

1
精神科
治 Depression Fluoxetine , Prozan 20 mg 1# po qd。Meyrel 50 mg 2# po qN。
Lexotan (Chlordiazepoxide) 5 mg 1 # po qN。
Venaflaxine (37.5mg) qd dN after one week 改 (75)1 qd qN
Alcoholic Ativan (1) 2 # po tid + Rivotril (2) 1# qd 1# qN+ Thiamine (100) 1# bid
withdrawal Naltreone 50 mg qd + Ativan 2 mg dN + Tofranil 50 mg qN
ICU syndrome Xanax (0.5 )1/2 # qdqN。Meyrel (50)1/2 #。Lexitin
(3)1#。Haldol(2)1#
Binin-U 2 Amp 、Dormicum 1-2 Amp M q4h p.r.n
Valium 30 mg in 500 ml V bottle slowly
Schizophrenia & Risperidol 1 mg qd 2 mg po qN + Ativan 0.5 mg po qN
Delusional disorder
Drug overdose prevent suicide & consult PSY。Anexate 1 Amp IV st。
Morphine overdose: Naloxane 0.4 mg/ ml 1 Amp
Fluoxetine , Prozan 20 mg 1# po qd。
Lexotan (Chlordiazepoxide) 5 mg 1 # po qN。
Fluoxetine 1# po qd ×3 days + Ativan 0.5 mg po qN
焦慮 Lexotan (Chlordiazepoxide) 5 mg 1 # po qN。
Librium 5 mg 1# po tid。Deanxit 1# po tid。
Holdol 2 mg 1# po qN ( Binin-U )
失眠 Ativan (Lorazepam 不經由肝臟代謝) 0.5 or 1.0 mg 、Eurodin
(Estazolam 憂鬱,hepatic)、Serenal、 Dormicum 1# po qN、
Deanxit 1 # po tid。Imovane 1# 、Wintermin 1/4 # po qN
Respiratory distress: Benadryl (50 mg) 1 # po qN(利用 drowsiness 的
S.E
Trazodone (Mesyrel)
Zolpidem 鎮靜 half life 短
晚上做惡夢 Dormicum 1 # po qN
EPS Akineton 1 amp M st
Xanax 0.5 mg 1 # po qN + PK-MERZ 100 mg 1 # po tid
鎮靜 Binin-U & Neuropan (2 mg ) 1 or 1/2 Amp IV st or q6h
Valium 5 mg or Domicum 5 mg IV st

神內科
擴張腦血管 Nimotop 2 # po tid

peripheral vascular Bradilan 250mg 1/2 # po bid

disorder
間歇性跛行， Trantal 200 mg IV bid 三天後改 400mg po bid ,之後用 anti-platelet
腦血流不足 Bokey 1# po qd。Sincen 10 mg 2# po tid
hypertension after Trental 400 mg pobid + Nootropil 400 mg po tid
stroke
Lacular infarction Sibelium 5 mg 1# po bid。Licodin 1 # po bid。
肢體麻、抖 Quinidine 1# po qN。
hand tremor 緊張 Befon 1 # po bid
jerky Rivotril 1/2 # po bid
EPS 運動障礙 172 Akineton 1Amp IV st
三叉神經痛 B-12 2 cc IV st
post-occipital Norgesic 1 # po tid。Scanol 1# po qid。Ergotamine 1 # po qd
headache
muscle-contracture hot application c massage + NSAID for symptom relief
headache
post-op brain Nootropil 1 Amp IV q8h ×3 days,不用 Trantal。
hypoxia
MG Mestinan 1# po bid before lunch & dinner
low dose Aspirin 出血性中風 , 用於 cerebral infarction , TIA SE: Rey syndrome
75-300 mg
抗血栓 Persantin 25 mg 1# po tid ( dipyridamole )
Seizure
1. Early
¬Valium (Diazepam) 5 mg IV over 5 mins. Repeat 10 mg after 5 mins
if
seizure continue, or
Ativam (Lorazepam),0.07 mg/ kg.Usual adult dose, 4 mg IV. May
repeat after 10-20 mins。
®Thiamine if alcohol is implicated (Pabrinex vials 1 and 2 o.d. for 3
days, bear in mind anaphylaxis risk )

2. Established
¬Dilantin ( Phenytoin )
Initial: 1000 mg (20 mg/ kg) in VCB with N/S 100 ml for drip over 30
mins,
cardiac monitor: B/P and arrythmia
Maintain: 250 mg V qd (5mg/kg) or 1#(100) po tid

3. Resistant ；Transfer to ICU bed

¬Diprivan ( Propofol ) infusion,5-10 mg/ kg/ hr, with cerebral
monitoring。
General anaesthesia with thiopentone.( Ventilation may be necessary if
respiratory depression develops) 。

2
一般科
鎮痛 , 解熱 Scanol 1# po qid, Lonine 1# po tid(Cox-2 specificity)

Keto, Profenid、 1amp IM st (病人無法吃)

tumor fever Indocin 1 # po tid

止痛藥 Scanol , Lonine (不傷胃。傷肝)、Aspirin(傷胃)、Ponstan、Indocin(傷

胃)、

Clotan 1# po qid、Tiltotil 1 # po bid, Voren 1 # po tid

Norgesic(Scanol+Befon) 1# po qid

Demerol 50 mg IM or IV q4h p.r.n , Tilcotil 1 Amp IV st

Morphine 5 mg IV for 10` q4h p.r.n if pain、

(0.2×體重) add to D50W 20 ml rate 1-3 mg / hr

Relax gel 1 tube for topical use。Morphine 1/2 # po q4h except 1:00

Tramal 1# po bid + 1# po qN 。1 Amp IV q6 h

MST 30 mg 1# po q12h。 Deurogesic 1 path

Cancer pain Tramal 1 # tid + tilcotil 1 # bid

預防 stress ulcer Initial Weizip(Sucralfate) 1 gm po qid

Maintenance: Weizip 1 gm, po bid

香港腳 Tinea pedis 1. Ketona cream 1 tube for topical use

2. Clotri spray solution for topical use

3. Exelderm cream for topical use

4. 灰指甲： Lamisil(250) po Qd Note: follow GOT, GPT

小便痛 Uropyrin(100) 1# po tid( 對黏膜細胞產生麻醉作用，小便會呈橘紅

色)

Spasmo-Euvernil (sulfaurea: antibiotic+ phenazopyridine: uropyrin) 1#

tid

止血 Vit C.K and Tren aa 1 amp st or q8h 5 3 days

Transamine 1 # po tid

蛋白質 Human albumin , Biselco , Aminoflex。

PPN 4 set qd + Intralipid qod

Oral Ulceration 1. Betaiodine(1:30) for oral gangling

2. Scoro-orabase 1 tube for topic use

3. Candida: Mycostatin 5# in D5W 500 ml for oral gangling

鐵劑 Ferrous Hausmann Hgb 10-12 1# gd

9.10 Bid
8.9 tid
<8 qid

補維他命 B B-complex 2mg IV qd。

Kentamine(Vit B1, 2 ,6, 12) 1# po qd . tid

Thiamine(Vit B1) 1# po qd,

Essentiale(Vit B1, 6, 12 and nicotinamide, pantothenate) 1# po tid

Gout attack colchicine 2 # po st & 1 # po 1-2 h until pain release or nausea or

vomiting or diarrhea。alternative regimen；2 # po bid。

clotan 1# po qid 、allopurinol 1# po qd

Deuron 1# po qd (↓尿酸鹽的再吸收↑其排泄)

再不行 Decardron 1 Amp M st

輸血 BT c 2u PRBC .Benadryl 1 Amp & Rinderon 4 mg IV before BT

輸血過敏 Decadron 、Benadryl 1 Amp V st

BPH Hytrin 1# po Qn (antiadrenal agent)

Doxaben 1# po Qn

Urecholine 1# tid for acute urine retention without obstruction(刺激副交

感，膀胱收縮，括約肌放鬆)

暈車（motion 1. Buscopan 1# qid for anti-vomiting

sickness） 2. Bonamine(meclizine, antihistamine) 1# before travel and repeat

3
 12 hr

ICU sedation Diprivan 1-4 mg/ kg/ hr (for 70 kg , 5-15 kg 5-15 ml/ hr)

Dormicum 0.03-0.2 mg/ kg/ hr (for 70 kg , 2-10 mg/ hr)

1 Amp IV q4h p.r.n if RR > 30 /min

0-5 mg/hr to keep sedation score 3-4 at day time & 4-5 at night

Morphine 2 mg in Marcaine 2 ml via epidural injection q12h for pain

control

(morphine 1-3, Dormicum 3-10 )

暈眩 (R/O BPPV) Whirling sensation, nausea, vomiting, hearing impairment,

(Acute tinnitis, headache, numbness, SOB

vestibulopathy) Neurological examination

1. Cerebral sign: Babsinki sign、muscle power

2. Cerebral sign: fine movement、finger to

nose、dysdiadochokinesia

3. Vestibulospinal reflex: Past pointing、Rombag’s test、Tendon

gait

4. Vestibuloocular reflex: Doll’s eye test

Treatment:

1. 0..33% G/S 500 ml IV st (DM : N/S) IV round 快一點 + e +

EKG

2. Valium 10 mg add in IV bottle drip + Benadryl

(Diphenhydrane) 1 Amp

3. Euclidan + Cephadol 1 # po tid + Ativan ( 0.5 mg ) 1 # po qN

Euclidan 1 # + Valium 5 (1/2 #) po tid

Bonamin + Euclidan + Merislon 1# po tid + Sibelium 1# po qN

1.Xanax ( Valium ) & Merisolon (Euclidam ) 1# po tid

Thiamine 1 # po tid。Cephadol 1# po qid。Bonamin 1# po tid

2.Xanax 0.25 mg (valium 2 mg) po tid

Sibelium 2 # po qN Euclidan 1 # po tid

過敏性鼻炎 Clarityne 1 # po qd、Primalan 1# po bid、Zyrtec 1# po bid

Pulmicort nasal 1 bottle sig spray to nose (潤滑)

Instal nasal spray ×1 bot spray 2 puff to nose bid

3% ephedrine D to nose tid

S/p SMP with Merocel packing

流鼻血 Anterior nasal packing 、Liquid paraffin 1 bottle

Transamiine + Nacid + Danzen ( Varidase) + Vitamin C aa 1# po tid

Keflex 1# po qid + Primalan 1 # po bid + Transamiine 1 # po tid

孕婦流鼻水 Amocillin 2 # po qid + CTM 1# po qid

耳滴劑 Rinderon -A solution D- ear qid。Cortimycin sol D to ear qid

Pulmicort nasal 1 bottle sig spray to ear (潤滑耳垢 & 淹死蟲子)

Ciloprine sol D→E qid

Otosporine Dur solution synp D to ear tid

Amoxicillin synp ×1 bottle syng 2 ml tid

sudden deafness 0.9% N/S 1500 ml IV qd

Rinderon 4 mg IV q8h + Heparin50000u IV q12h

Antagel + Varidase + Valium 2 mg + Euclidan aa 1 # po tid

AOE Clincin + Nacid + Scanol + Varidase 1 # po qid + Rinderon A solution

AOM Keflor BW/2 q8h + Scanol BW/4 qid + Actifed BW/4 qid

耳朵有異物 Liquid paraffin or Xylocaine 直接噴

眼藥水 Timolol 1 bot D→ou qid (降眼壓)。Tobrex oph. oint 1 tube

眼藥膏 0.25 % CM , Sinomin , 0.1% Flarex D→ ou qid (steroid)

Acute tonsillitis B/R + Observation

N/S 1000 ml + D5W 500 ml IV qd + Clincin 300 mg q6h

Scanol + Nacid + Varidase 1 # po qid

B-I (1:50) dilution with N/S 500 ml for grugling use qid

類固醇 Rinderon 1 # po bid or 4 mg IV st。

肌肉鬆弛劑 Befon 1# po tid ( 治打嗝 )。Solaxin (Benzoflex) 1# po qid。

Norgesic = Scanol + Solaxin 1 # po qid

4
 Norflex 1/2 # po bid

Hiccup Norflex 1 # po bid。Primperam 1 # po tid、Novamin 1 # po tid 、

Wintermin 1/2 # po st

減輕紅腫 Varidase 、Denzen 1# po qid。

pressure bed Fucidin ointment 1 tube，Medecassol powder。

Carbuncle I & D + Bactroban cream

OA Clinoril 1# po qd + Nacid +Rheumon gel

chronic SDH primarin 40 V st + DDAVP 16 ug V st + Burrer hole craniotomy drainage

胸腔科
止咳 Medicon-A & BM 1# po qid . Cough-mixture 15 cc po tid

Becantex 1# ( 30 mg ) po qid 。Codeine 1# po q12h。

Brown mixture 20cc po qid (含 opium+codeine)

化痰 Mucosolven、Bisolven、neuzyme 1# po qid

Danzen(proteolytic enzyme with anti-inflammatory function) 1 # po qid

On ventilator: Steam inhalation 15’ qid

↑lung perfusion Morphine

喘 GAS analysis .Berotec & Atrovent 2 puff st。 Rinderon 4 mg IV st。

Solu-cortef 200 mg IV st & q8h , Decardron 8 mg IV st

Aminophylline 1# ( 250 mg ) po bid or 250 mg IV q12h

500mg add in N/S 500 cc rate 10 MD/min

20min 內給 6mg / kg 的 loading dose，否則減半為 3mg / kg

¬1-9 歲的小孩 0.85mg/kg/hr

9 歲以上的小孩 0.7 mg/kg/hr

®抽煙的健康成人 0.7 mg/kg/hr

¯不抽煙的健康成人 0.4 mg/kg/hr

°老年人、肺心症的病人 0.3 mg/kg/hr

±心臟衰竭 or 肝機能不全的病人 0.2 mg/kg/hr

Ventoline (Salbutamol)5.0 mg or Bricanyl (Terbutaline) 2.5 mg in N/S

2.5 cc for neubrizer inhalation qid & q2h if SOB

Atronent(Ipratropium-B2) 1 Amp + Ventoline(Salbutamol) 1 Amp

inhalation c hand neulization qid

Bricanyl (Terbutaline sulfate)1 # po qid。Theolan(theophylline) 1# po

qd

Meptin & aminophylline & phyillocortin 1 # po bid

DVT(R/O arrange 核醫 ventilation (氣切不能做) & perfusion scan of lung

pulmonary 1. Heparin 2000 u IV push st

embolism) 10000 u + N/S 500 cc c rate of 21 Md/ day

Elevation and avoid massage of R’t lower limb. L’t lower 穿彈性絲襪

2. Heparin initial 5000 u

15000 u in N/S 500 cc c rate of 21 Md/ day (Keep INR: 1.5-2.0)×4 day

第 4 天 heparin dose 改 10000 u, check PT,PTT

INR:1.5-2.0 Coumardin 1# st & 1/2 # po qd ;( >2.0 DC heparin)

第 4 天 check PT,PTT arrange 核醫 lung scan

Coumardin 1/2 & 1 # intermediately po qd

heparin 15000 u-20000 u in N/S 500 cc c rate of 21 Md/ day (Keep

INR: 1.5-2.0)×3 day-----(3 day)----Coumardin 1# st & 1/2 # po qd

-----------(3 day)-------heparin 10000 u------( 2 days)------- check

PT,PTT if PT=1.5 DC heparin ; if 沒有,在加 Coumardin 1# &1/2#)

recurrent DVT Urokinase 4 vial in 500 cc N/S 10 drip qd-------3 days-------

heparin 18000 u in N/S 500 ccdrip c rate of 24 cc/hr + coumardin 1# qd

5
心臟內科 Bokey 100 mg 1 # qd + Capoten 1/2 # tid + Moduretic 1# qd

Fraxiparine 0.4ml H q12h (low molecular heparin)

高血壓 Adalat 1# ( 5 mg or 10 mg ) SL or Trandate 1 Amp IV q4h p.r.n if BP>

控制高血壓可 180/110mmHg or 1 # po tid。

↓stroke Capoten 1/2 po tid , Tenormin (B-blocker) & Norvasc 1# po qd。

但不能↓MI Adalat ORAS 1# qd 、Lisinopril (ACEI)

Ca channel blocker Herbesser 1 # po tid。Inhibace 1# po qd。Apresoline (10 mg)1 # po qid

reflex tachycardia Inderol (Propranolol) 20 mg 1/2# po tid

ACEI:52%乾咳 Monopril 1# po qd。Renitec (ACEI)5 mg 1 # po qd。

Minipress (Prazosin)1 mg 1# po qN 、Moduretic 1 # po qd

Doxazosin ( Doxaben ) 2 mg 1# po qN 治療 BPH。

Hytrin ( 2mg ) 1/2 # HS ×1 , 1/2 # qd×2 , 1 # qd

Trendate 200 mg IV drip for 1 hr q8h for 3 days,400 mg 1 # po bid。

Losartan : Anginotension 2 antagonist 沒有乾咳，肝臟代謝。

單純:diuretic ↓老年高血壓之死亡率

Dihydropyridine + Ca cannel blocker →↓stroke。

年輕；B-blocker、ACEI、年老 : thiazide、calcium channel blocker

ESRD:ACEI , DM & CHF : Angiotension 2 antagonist

MI:B-blocker, ACEI

低血壓 Dopamine 500 mg in N/S 500 ml c rare of 20 (6-40) Md/ min

Levophed 8 mg in N/S 500 ml c rate to keep BP >90/ 60 mmHg

Dobuject 500 mg in N/S 500 ml c rate of 20 (6-40) Md/ min

Epinephrine 10 mg in D5W 500 cc 4” (0.02 mg/kg/min)

500×滴數 / 60×體重

1. Fluid supplement

2. Septic workup including B/C

3. Oxygen supplement

4. Nutrition support

5. Administruction of empiric antibiotics

I/O imbalance Haes steril I bottle st

Chronic stable AP Perdipine 20 mg 1 # po q8h

He developed chest pain c radiation to back & cold sweating twice in

recent 6 months,relieved by NTG

unstable angina Iso dril 1 # tid + Norvasc 1 qd + Licodin 1 # tid + Trental 1 # bid

CHF Lidocin 1# po tid + Persantin + Bokey

Af 不補 calcium, Digoxin 0.25 mg IV push

tachycardia Inderol 1 # (10 mg ) po bid

6
VPC check potassium 、calcium level。Digoxin 0.125 mg po qd

Cordarone 500 mg rate 30 Md /min。不用 EP 及 Dubuject。

xylocaine100 mg IV st + xylocaine 2.0 mg in N/S 500 cc 30 MD/min

bleeding post open DDAVP 4 mg IV q12h drip 1/2 hr

heart Premazine 4 mg qd ×5 days

post open heart Bokey 1# po qd + persantin 75 mg po tid + MgO 1 # po tid

Capoten 1/2 # po tid AC + Isodril 1# po tid

Atrial flutter & follow 12 lead EKG + cardioecho

tachycardia Cardioversion 80-100 J syntronized if tachycardia again & BP drop

心室心率不整 Cordarone 1# po tid、500 mg rate 30 Md /min

Acute angina attack Millisorol 25 mg + 0.9 % N/ S 200 ml c rate of 6 Md/ min。

Morphine 4 mg IV st , EKG , Cardiac enzyme

Heparin 20000 units in 500 ml N/ S IV drip st & rate of 20 Md/ min

Heparin 5000 units IV st

Isoket 100 mg in 400 ml half saline IV drip c rate of 2 mg/ hr & 2-

5mg/min

Ismo 20 mg 1# po bid。

arrange CAG as soon as possible.

Anterior MI Morphine 2-5 mg V st q5-10 min ,but BP & PR↓

Leg elevation , fluid supple , Atropine ( if nausea or vomiting )

Actilyse 50 mg 2 vial + Aspirin bayer 0.5g + Isoket 5 Amp + Morphine 3

mg

Inferior MI Demoral 因 vagolytic effect

Isoket 50 mg in N/S 200 rate 10 MD/min

heparin 5000 u IV push + 20000u in N/S 500 cc rate of 20 MD /min

CAD ischemic HD cardioecho + check CPK & MB q4-6 h

Af RVR VPC IV Millisorol V drip c rate 1-3 ml/hr but present SBP < 100 mmHg

50 mg in N/S 400 ml c rate of 6-30 Md/ min

Bokey 1# po qd

Digoxin 0.125 mg po qD & check Digoxin level

PSVT Isoptin 5 mg + Adenocor 6 mg + 12 mg + 12 mg

Didoxin AMI、Af、AF、SVT

在 Diuretic 及 vasodilator 使用下仍無法控制的 morderate - severe CHF

Xylocaine VPC frequent > 6 / min , R on T , Multifocal short run VT

降血壓的利尿劑 moduretiic 1/2 # po qd

血液腫瘤
1. Alklating Cross-link 和 DNA 結合妨礙 cell 分裂

agent 插入鹼基間，阻斷 RNA 的製造

2. Antitumor 5-FU , Methotrexate

和 tubulin 結合，破壞紡錘絲使細胞分裂停止
antibiotics

3. Anti-

metabolites

4. Plant

Alkaloids

lung Cisplantin 30.8 mg in manitol 300 ml drip 6 hr。EPS , vomiting。

adenocarcinoma Gemcitabine

SCC of rectum Mitomycin-C 19.44 mg in VCB 100 mg IV drip 1 hr

5-FU 121.5 mg in N/S 500 ml IV drip 24 hr

升白血球 GCSF 150 ug c 50 cc G/ S in VCB drip IV qd

降白血球 Hydrea 500 mg po tid

缺鐵性貧血 FeSO4 1# po bid

升血小板 Danazol 2 # po bid。

乳癌 Tamoxifen 2 # po qd

CLL, malignant Leukeran 2 mg po qid。

lymphoma

皮膚科

止癢 Harnic 1# po bid . Clarityne 1# po qd or bid

Primalan 1 # po bid . Periactin / Actifed / CTM 1# po tid

zyrtec 1 # po qd

7
香港腳 Sporonox 2# po qN 57 days . Clomazole solution 1 bottle

白癬 Travogen cream (Exelderm)1 tube

Pyoderma (IV site) Funcidin cream 1 tube

股癬 Travogen cream 1 tube

wound Bactroban cream 1 tube

汗皰,手,足溼疹 Dermovate oint 1 tube (比 Funcidin 好)

溼疹癢 NRS cream 1 tube

頭皮溼疹 Polytar shampoo 65 ml ; Septon solution 50 ml

尋常疣 Cryotherapy + Funcidin cream 1 tube

青春痘 Minocin 50 mg po bid 57 days、Skinore cream 1 tube

保護皮膚 Zinc oxide oint for topical use

帶狀皰疹 Calamine lotion 53 ml (沒破) , Zinc oxide ( 已破)

Scanol , Antagel , Ativan 未改善 prednisolone 1 # po bid

Scalding burn injury CD c Fucidin & wet dressing

尋麻疹 Decadron 8mg IM st。Benadryl 1 amp IM st

Clarityne 1# po qd。Primalan 1# po qN

Calamin lotin 1 bottle

恉漏性皮膚炎 Rinderon-V 20 gm + HB qsad 30 gm to face & neck bid。

Rinderon-V 20 gm + 10% S-A cream qsad 30 gm to scalp bid。

Bullous pemphigoid Prednisolone 30 mg po qd (2 # tid) + Fucidine cream

嬰兒尿布疹 Kenacomb oint 1 tube

Hemorrhoid Alcos-anal supp 1 qN + Hirudoid cream for anal wound bid

Asacol 1# po ( 塞劑) tid

乾癬 Phototherapy. NRS cream 1 tube

褥瘡 Madecassol 2 mg powder for topical use

凡士林 or Funcidin

婦產科

陰道塞劑 Clotry VT 1# qN + Flagyl 1# po tid ×7 days

Vaginal douch at 8:30 PM & Metron VT 1 # st

墮胎藥 1. High dose estrogen 30 mg po q12h（三天內用家計三號 2 顆

q12h）

2. Dianzole (200 mg) 4 # ×5 day

3. Methotreate

4. RU486 200 mg 1 # po q12h

安胎藥 Yutopar 20 mg add in N/S 500 cc with rate 15 MD/min

催生藥 Cytotec (PGE1)1/4 # po st

Prostarmine(PGE2)

Pitocin

停經藥 Estadron 1Amp IM st

妊娠劇吐 Vitamin B6 100 mg po tid + B-complex 2cc st

DUB Premarin 0.625 qd ---1.25 mg qid ×3 days

Progestin 10 mg qd ×7-10 days

Chronic PID with Uzolin 1.0 g+GM 80 mg+Metronidazole (Medazole)(Anegyn)500mg IV

acute exacerbation q8h×10 days, then Ceflexin 500 mg qid + flagyl 1# tid ×7 days.

Blasec 1 # qid 合成抗膽鹼激素劑，直接作用於膀胱平滑肌上，使其不會產生

Muscarinic action (增加排尿時的尿量，減低排尿的次數)

術後排便不適 Urocholine 25 mg po qid

Endometrioma of 1. Danzole 200 mg po tid - qid (anti-estrogen)

ovary /p LAOC 2. GnRH-A 3.Progestin

Ectopic pregnancy The patient had a regular menstrual cycle with a duration of 3 days at 28

day intervals. She had history of RSO for an ovarian cyst 13 years ago.

Her mense was overdue with her LMP on Jan 6 ‘1999.Vaginal spotting

develop a few hours prior to her admission to our ER. Pregnancy was

documented by urine HCG test. Pelvic sonography showed a

heterogenous mass about 4 cm with lifting tenderness at left tenderness at

left adnexal area. Accordingly she was admitted for further management.

MTX (hepatoxity)

腎臟科 1cc= 60 小滴=15 大滴=0.2 mg

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中毒 Naloxone hydrochloride 2 Amp(0.8 mg)+50 mg glucose+Thiamine

100mg

Syrup of ipecac 催吐

ARF On low K+ high protein (2000 cal /day)

高血鉀 Check digoxin TDM+Ca+Mg+CPK (with bradycardia) + EKG+low K

diet

Calcium gluconate l amp IV st。Sodium bicarbonate 1 amp IV st。

不用 ACEI

D50W 1 Amp + RI 6 u V slowly push for 3 min. Lasix 40mg V

RI 10u + D50W 2 amp。Bricanyl + Ventoline aa 1 Amp inhalation qid

Kayexalate 30 gm + water 200 cc po st。Kalimate 1 pack bid

低血鉀 15% KCl 5 cc in IV bottle st & in each IV bottle

Slow-K 1# po tid + Inderol 10 mg po bid

K = 1 cc = 2 meq 60×0.6×(3.5-2.0 ) = 54 meq = 27 cc

合併低鎂 補 MgSO4 1 Amp IV st、Adalctone 1 # po qd

Complicating digitalis

高血糖 D5W 500 ml + RI 10u ( in each bottle)

Euglucon , Daoril 1# po AC 。Glucophage 1# po PC

Glidiab 1/2 # po qd (uremia 的病患)、

NPH 20 u + RI 10 u V qd

RI 50 u add in 0.9 % G/ S to keep blood sugor 150-200 mg/ dl

DM 病人的 preop order 0.33% + RI 5u 250ml (500ml 倒掉一半)

避免使用 thiazide、B-blocker。

DM neuropathy: Tofranil、Dilantin 1 # po qd

organophosphate PAM 500 mg V q6h drip for 30 min

intoxication

uremia 營養劑 Nephrosteril-A 1 bottle V qd ×5 days

不用 Euglucon、ACEI(hyperkalemia)、NSAID、allopurinol

Restless leg syndrome 可用 Quinine、Muscular twitching 用 Diazepam

Hypertension 用 prazosin，避免用 thiazide。

Uremia c 副甲狀腺 Vitamin D3 (calcitriol) 0.25 ug qoN(W2.4.6)

機能過高症 但 P×Ca > 70 則不用，因會軟組織鈣化。

↑PTH, alkpatse

hyperlipidemia(和中 Mevacor ( Lovastatin) 1# po qN

風無關) Bradilan (250mg) 2 # po tid

hypercholesterol (和 Lipod (Gemfibrozil) 2 # po bid

動脈硬化有關) LDL=TC- HDL-VLDL(TG/5) 1.>130+CAD 2.>190 須治療。

CAPD Tenchoff’s catheter

低血醣 D50W 3 Amp IV st , D10W 500 cc IV bottle

puncture rupture DDAVP 1 amp V q12h+ Scanol 1# po qid+ 冰敷 over r’t neck.

鋁中毒 Deferroxamine

低血鈣 Calcium gluconate & NaHCO3 1 amp IV st or q12h

Calcium carbonate 1# po tid。Cs-cal 1# ( 250mg ) po tid

Calcitriol=Rocaltrol 1 # PO qd 。CaCO3 2 # po tid

panhypopituitary Solu-cortef 200 mg V q8h + NaCl 2 # po tid

tumor Eltroxin 1 # po qd

利尿 Laxis (Furosemide) 20 mg po or IV

Diamox 1# po bid。Laxis 1 # po bid。Aldactone 1 # po bid

低血鈉 3 % saline 300 ml for drip 8 hr or 500 ml for drip 12 hr

NaCl 1# po tid 收 24 hr urine for e - , Osmolality。

3 %: 2 ml=1 meq ; 500 % = 154 meq ( 0.5-1.0 meq/ g/ hr )

60×0.6×0.5=144 meq=288 ml →3 % saline 300 ml for drip 8 hr

SIADH 限水+ Lasix + Aldactone

NEP consultation The patient has received regular hemodialysis for about one year,she was

admitted to GYN division, due to vaginal bleeding and will undergo

surgical intervention tomorrow. There was no nausea, vomiting, anexia,

legs edema or SOB lately. Her uremic condition was relatively

stable(BUN=39,creatinine=5.16,Na=140,K=4.7,Cl=104).Regular

hemodialysis will be scheudled during hospitalization and well take of

hervrenal problem.

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 Recommendation:

1. CaCO3 2 # po tid

2. Eprex 2000 units hypo biw /p HD

3. Review the regular medications at local hemodialysis center

酸血症 NaHCO3 1Amp 7 % = 44 meq = 20 ml

60×0.6×(22-10)=432 補 20 Amp

看 BE 負多少就給多少 NaHCO3，前 4 hr 給一半

Gas analysis RA PCO2↑ acute 1 (HCO3 - ↑)

10mmHg chronic 3.5

Ralk PCO2 ↓ acute 2

10mmHg chronic 5

MA HCO3 ↓ PCO2 =15+HCO3- ( CO2↓)

1 mmHg

Malk HCO3 ↑ PCO2 =15+HCO3-

1 mmHg

Nephrotic syndrome Solu-cortef 500 mg V qd for 3 hr + lasix 40 mg bid + human albumin

Prednisolone 2 # po tid

DI Pitressin DDAVP 2 Amp st

DDAVP 3ug intranasal q12h

代用血漿 Gelifundol 1 bottle 500 mg IV

Haes steril ×1 bottle

感染科

UTI Bartar & Ciproxin 500 mg 2 # (不能和 Antagel 一起用) po bid

Tarivid 2# po tid 。Keflex 500 mg po q8h。Nitrofurotoin 1 # po q6h

Naxacin (Baccidal) 100mg po tid (2 # po bid)

uremia c HD Uzoline 1.0 V q8h + GM 80mg /p HD tiw

廣效抗生素 Klaricid 1# ( 250 mg ) 紅黴素 po bid

Zithromax 2 # po qd ×3 days（不可和 clarityne 一起服用）

Clincin、Augmentin、Keflor 1# po q8h .Ulex 500 mg po tid

Ampicillin、Amocillin (孕、Ilosone、Keflex、Keflor 1# po qid

Cefspan 1# po bid。Augmentin 1# po q8h。Ciproxin 2 # po bid。

Prostaphyllin 1 # po q6h

Klaricid 1 po bid。Ceflexin 1 # po qid

Cephalosporine

1` Uzoline & cefazoline 1.0 gm IV q8h , Clincin 300 mg IV q8h

Aminoglycoside

Gentamycin 80 mg IV q8h (依 creatinine ×8 而定)

Prostaphllin (Oxacilline) 2 gm IV q4h

Medazole 500 mg IV q8h 膽道感染

Unsyn 1.5 mg IV q6h + Amikin 500 mg IV qd

APN: Flumarin 2.0 gm V qd

Severe pneumonia,bil. + Cervix Ca + ascites

Pitamycin 4 mg IV st & q6h + Amikin 500 mg IV st & 375 mg IV qd

1. Collect sputum for bacterial culture & Gram stain

2. Blood culture ×3

3. O2 therapy to keep sO2 >90%

4. If acute respiratory failure developes, endotracheal intubation

with mechanical ventilation is necessary.

5. Control infection(pneumonia + UTI)

6. Stabilize hemodynamics with adequate fluid therapy

7. Respiratory physical therapy, such as chest percussion,postural

drainage,etc.

8. Relieve the distention of abdomen. Because massive ascites

will displace diaphragm,upward and lead to hypoventilation that will

precipitate to the SOB.

TB INH 300 mg qd AC , EBM 800 mg qd AC , RIF 600 mg qd AC ,

PZA 1000 mg qd AC , Vitamin B6 1# qd AC

PID with pyometria Tetracycline 500 mg po qid , flagyl 1# po qid

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(pus inside uterine

cavity)

1. Introtropic agent to keep vital sign

2. Consultation of INF emergency for antibiotics

3. Critical condition explained to patient’s family

The acidosis was noted. The supplement of NaHCO3 5 Amp V push and NaHCO3 5 Amp V st had be presribed for the patient.

The family asked to take him home,so he was discharded C critical condition and A-A discharge today.

已予病人家屬解釋病人情況危急，如果情形繼續惡化，家屬為避免病人痛苦，同意放棄進一步的急救措施，包括心肺復甦術、電極、心外按摩等。
We had explained the condition of the patient to his family.

They agree to left the patient by nature. The significantly decreasing BP & HR was noted. He is expired at 2:45 PM.

Sudden onset of consciousness change and cyanosis were noted by nurse at 10 pm this evening. Immediately endotracheal intubation and intravenous dapamine

admistration were given. Also family were noticed informed to come to be side the patient who is under critical ill conditions. The poor progress of this patient had been

explained to the family and they all refused the medical stuff not to make further advanced management. Considering of the patient’s advanced cancer condition. They had

signed the NO CPR form.

The patient was noticed with no spontaneous breath and heart beat, EKG revealed stand-still. No CPR procedure was performed as family request. He expired at 1: 05 AM

by nature.

拒心肺復甦術同意書

病患 顏鳳琴 因罹腦出血而於本院之神經加護病房治療。然目前病情惡化 , 神經功能已臨不可逆之損壞 , 心肺之衰竭亦緊接於後 , 短期間病人之生命跡象只能靠

藥物及心肺復甦術維持。在不違反醫療之立場 , 心肺復甦術勢在必行。但家屬可要求為病患之生命尊嚴、為避免病患進一步之痛苦 , 特拒絕心肺復甦術之施行。

立此同意書為證
於八十七年二月二時五日

立同意書

同意人

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