TUVALU STANDARD TREATMENT GUIDELINESapps.who.int/medicinedocs/documents/s19761en/s19761en.pdf · Page 231 of 401 Tuvalu Standard Treatment Guidelines 2010 231 6.4 ANTIPROTOZOAL DRUGS

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TUVALU STANDARD TREATMENTGUIDELINES1ST EDITION

MINISTRY OF HEALTH, TUVALU2010


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TABLE OF CONTENTS

List of tables, boxes and figures……………………………………………..2

Foreword……………………………………………………………………..3

Abbreviations and acronyms……………………………………………...…4

Acknowledgements………………………………………………………….5

Introduction…………………………………………………………………..6

Chapters

Managing diabetes mellitus………………………………………………….7

Cardiovascular………………………………………………………….......34

Respiratory tract…………………………………………………………….90

Antibiotics………………………………………………………………....143

Gynaecology and obstetrics……………………………………………….194

Dental treatments………………………………………………………….206

Paediatrics…………………………………………………………………215

Essential Medicines List revised 2010……………………………………229

Essential Medicines List for Children 2010………………………………240

Sources…...………………………………………………………………..249

Recommendation for HIV Medicine & Sexual Health Care in Pacific Small

Island Countries &

Territories....………………………………………………………………250

Index…………………………………………………………………........398


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ESSENTIAL MEDICINES LIST REVISED 2010

2010 TUVALU ESSENTIAL DRUG LIST

WHO Drug name, strength and dosage form Outer Restrict use Cost $A COMMENTSIsland

1 ANAESTHETICS1.1 GENERAL ANAESTHETICS

Halothane inhalation 39Isoflurane inhalation 56Ketamine 50mg/ml injection 2.1Nitrous oxide gas inhalation

Oxygen gas inhalation yes 98(G)Need more Gsize

Soda lime powder 5.63Thiopentone 0.5% injection 1.1

1.2 LOCAL ANAESTHETICSBupivacaine 0.5% plain injection 1Bupivacaine 0.5% heavy (spinal) injection 1.3


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Lignocaine 2%plain injection Yes 1Lignocaine 2% + adrenaline 1:80,000 dental cart Yes 0.4Lignocaine 10% pump spray Anaesthetist 11.25

Ethylchloride spray dentist 2alt spray tolignocaine

1.3 PRE-OPERATIVE MEDICATIONAtropine 600mcg/ml injection 0.1Diazepam 10mg/2ml injection 0.15Droperidol 10mg/2.5ml injection Anaesthetist 3.38Diazepam 5mg tablet 0.01Fentanyl 100mcg/2ml injection 0.73Midazolam 15mg/3ml injection Anaesthetist 2.4Morphine 10mg/ml injection 0.34Pethidine 50mg/ml injection O&G only 0.3Promethazine 50mg/2ml injection 0.26

2ANALGESICS, ANTIPYRETICS,NSAID's, DRUGS TO TREAT GOUT

2.1 NON-OPIOIDSAllopurinol 100mg tablet yes 0.02 doctors orderAspirin 300mg tablet Yes 0.01Ibuprofen 400mg tablet Yes 0.01Paracetamol 500mg tablet Yes 0.01Paracetamol 500mg Suppos ICU only 0.95

Paracetamol 250mg SupposPaed, ICUuse only 0.1

Paracetamol 120mg/5ml elixir yes 0.42

Probenecid 500mg tablet 0.1Reducedusage

Diclofenac 25mg tablets yes donationColchine 600mcg tablets donation

2.2 OPIOID ANALGESICSCodeine 30mg tablet Yes 0.07Fentanyl 100mcg/2ml injection 0.73Morphine 10mg/ml injection Yes 0.34Pethidine 50mg/ml injection O&G only 0.3Morphine 10mg tablets SRMorphine 30mg tablets SR

3ANTI-ALLERGICS & DRUGS USED INANAPHYLAXISAdrenaline 1mg/ml injection Yes 0.43

Chlorpheniramine 4mg tablet Yes 0.01cheaper thanprom

Dexamethasone 4mg/ml injection yes 0.2Dexamethasone 500mcg tablet 0.07Hydrocortisone sodium succinate 100mginjection yes 0.46Promethazine 50mg/ml injection Yes 0.26Promethazine 10mg tablets yes


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4ANTIDOTES & OTHER SUBSTANCESUSED IN POISONINGS

4.1 GENERALCharcoal and Sorbitol Soln Yes 2-3 for OPD

4.2 SPECIFIC

Acetycysteine 200mg/ml injection 10mlParacetamolOD only 6.8 1 course only

Atropine 1mg/ml injection 0.1Naloxone 400mcg/ml injection 1.08

5 ANTIEPILEPTICS

Carbamazepine 200mg tabletIndivpatients 0.02

Diazepam 10mg/2ml injection Yes 0.15Diazepam 5mg tablet Yes 0.01Phenobarbitone 200mg injection Paed use 1.23Phenytoin 250mg/5ml injection 2.88Phenytoin 100mg tablet Yes 0.01

Sod.Valproate 150mg tabletOthersineffective 0.11

6 ANTI-INFECTIVE DRUGS6.1.1 INTESTINAL ANTHELMINTICS

Mebendazole 100mg tablet Yes 0.01Pyrantel 250mg tablets

6.1.2 ANTIFILARIALS

Albendazole 400mg tabletYes -campaign

WHOFiliariasis

Diethylcarbamazine 50mg tabletYes -campaign

WHOFiliariasis

6.2 ANTIBACTERIALS6.2.1 Penicillins

Amoxycillin 250mg tablet?capsules Yes 0.02

Amoxycillin 500mg/Clavulanic acid 125mg tabletResistantcases only 0.24

Amoxycillin 125mg/5ml Susp yes 0.56Ampicillin 1g injection yes 0.18Benzathine penicillin 1.2 mega injection yes 0.16Benzyl penicillin 600mg injection Yes 0.08Fluc/Cloxacillin 500mg injection yes 0.23 flucloxacillin alt

Cloxacillin 250mg tablet Yes 0.02Replacesfluclox

Cloxacillin 500mg capsules YesPhenoxymethylpenicillin 250mg tablet Yes 0.03 Replaces syrupProcaine penicillin 4mega injection Yes 0.25

6.2.2 Other Antibacterials

Azithromycin 250mg/500mg tabletSTI forchlymydia 0.42 Stat dose


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Ceftriaxone 1g injection yesFor resistantorganisms 1.72

on doctosrsorder

Chloramphenicol 250mg capsule yes 0.02Chloramphenicol 1g injection yes 0.58

Chloramphenicol 125mg/5ml suspension yes 1.88Keep as onlycaps

Ciprofloxacin 500mg tabletSTI forgonorrhoea 0.07 Stat dose

Co-trimoxazole 480mg tablet Yes 0.01 delete syrupDoxycycline 100mg tablet / capsule Yes 0.02Erythromycin 250 tablet yes 0.12 Syrup deleted

Gentamicin 80mg/2ml injection yes 0.08on doctorsorder

Metronidazole 5mg/ml IV solution 100ml yes 1.3Metronidazole 200mg tablet Yes 0.01 MTZ Syrup delTinidazole 500mg tablet Yes 0.04 Stat dose MTZ

Vancomycin 250mg injectionRestricteditem Low doses only

6.2.3 Antileprosy drugs

Clofazimine 50mg tabletonlycombipacks Free WHO

combipacksonly

Dapsone 100mg tabletonlycombipacks Free WHO

Free fromWHO

Rifampicin 150mg/300mg capsuleonlycombipacks

Free WHO -need PB?

6.2.4 Anti-tuberculosis drugs

Ethambutol 400mg tabletYes, indivpatients TB 0.05

doctors orderonly

Isoniazid 100mg tabletYes, indivpatients 0.02

doctors orderonly

Pyrazinamide 4/500mg tabletYes, indivpatients TB 0.05

Rifampicin 150mg tablet / capsuleYes, indivpatients 0.05

Rifampicin 150mg/Isoniazid 75mg tabletYes, indivpatients TB 0.04

Streptomycin 1g injection TB 0.56

6.2.5 Antiviral Drugs

Aciclovir 200mg tabletSevereherpes 0.03

Aciclovir Eye Ointment Herpes of eye 0.56

HIV Drugs - as per Global Fund HIV/AIDS FreeGlobal Fundpays

6.3 ANTIFUNGAL DRUGSClotrimazole 500mg Pessary Yes 1.32 stat dosefluconazole 50mg tabets 0.34Griseofulvin 500mg tablet yes 0.04 on doctors onlyNystatin oral suspension 100,000 units yes 1.13


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6.4 ANTIPROTOZOAL DRUGS6.4.1 Antiamoebic

Metronidazole 5mg/ml IV solution 100ml yesWhere oralnot possible 1.3

Metronidazole 200mg tablet Yes 0.01Tinidazole 500mg tablet Yes 0.04 Stat doseMetronidazole suppos 500mg

6.4.2 Antimalarial Drugs

Chloroquine 150mg base tablet 0.01Doxycycline 100mg tab/cap 0.02Fansidar® tablet P.falciparum 0.05

Primaquine 15mg tabletP.vivaxeradication 0.02 for indiv patient

Quinine 300mg/ml injectionCerebralmalaria 0.23

Quinine sulphate 300mg tablet 0.05

7 ANTI-MIGRAINE DRUGS7.1 FOR TREATMENT

Aspirin 300mg tablet Yes 0.01Chlorpromazine 50mg injection 0.19 Low dose onlyMetoclopramide 10mg injection 0.15Paracetamol 500mg tablet Yes 0.01

7.2 FOR PROPHYLAXISPropranolol 10mg tablet Thyroid storm 0.01 40mg deletedPropranolol Injection or similar Thyroid storm 0.67 ?supplier

8ANTINEOPLASTICS &IMMUNOSUPPRESSANTS

8.1 IMMUNOSUPPRESSIVE DRUGSDexamethasone 500mcg tablet 0.07 not 2mg,4mgPrednisolone 5mg tablet 0.01 Not prednisone

8.2 ANTINEOPLASTIC DRUGSCyclophosphamide injection Indiv patients 7.68 Drug Comm5-Fluorouracil 500mg injection Indiv patients 7.34 Drug CommMethotrexate 50mg injection Indiv patients 5.56 Drug CommMethotrexate 2.5mg tablets Indiv patients 0.13

8.3 HORMONES AND ANTI_HORMONESTamoxifen 10/20mg tablet Indiv.patients 0.1

9 ANTIPARKINSONIAN DRUGSBenzhexol 2mg tablet 0.01

10 DRUGS AFFECTING THE BLOOD10.1 ANTI-ANAEMIA DRUGS

Ferrous sulphate 200mg tablet yes 0.01


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Ferrous sulphate/gluconate syrup preps. >1yr 5.54/100mlfor outerislands

Ferrous sulphate 200mg + folic acid 0.25mgtablet Yes 0.01Fe Dextran 5% InjFolic acid 5mg tablet yes 0.01 Small supplyHydroxocobalamin 1mg injection 0.45

10.2 DRUGS AFFECTING COAGULATIONHeparin sodium 5000iu/ml 5ml injection 1.53Phytomenadione 1mg in 0.5ml injection Yes 0.3 10mg deleted

Warfarin 1mg tabletindividualcases only 0.04

Keep samebrand

Warfarin 3mg tabletindividualcases only 0.06 Delete 2mg

Warfarin 5mg tabletindividualcases only 0.06

11BLOOD PRODUCTS & PLASMASUBSTITUTESPolygeline IV solution 500ml(Haemacel/Gelofusine) 5.93

12 CARDIOVASCULAR DRUGS12.1 ANTI-ANGINAL DRUGS

Atenolol 50mg tablet 0.02Glyceryl trinitrate 600mcg tablet Yes 0.06Isosorbide dinitrate 10mg tablet yes 0.01 doctors orderNifedipine 20mg SR tablet Yes 0.01 doctors order

Propranolol 10mg tablet 0.01change from40mg

Verapamil 40mg tablet 0.05

12.2 ANTI ARRHYTHMIC DRUGSAtenolol 50mg tablet 0.02Lignocaine 2% injection 10ml 0.42Propranolol 10mg tablet 0.01Verapamil 2.5mg/ml injection 2.7Verapamil 40mg tablet 0.05Amiodarone 50mg/ml injection small amount

12.3 ANTIHYPERTENSIVE DRUGS

Atenolol 50mg tablet yes 0.02on doctorsorder

Enalapril 5mg tabletsIndivpatient 0.02

Hydralazine 20mg/ml injection 7.16 Tabs deleted

Hydrochlorothiazide 25mg tabletIndivpatient 0.01

on doctorsorder

Methyldopa 250mg tabletIndivpatient 0.05

on doctorsorder

Nifedipine 20mg ST tabletIndivpatient 0.01

Prazosin 2mg tablet BPH


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treatmentPropranolol 10mg tablet Thyroid storm 0.01

12.4 DRUGS USED IN HEART FAILURE

Digoxin 500mcg/2ml injection yes 1.72on doctorsorder

Digoxin 250mcg tablet yes 0.04on doctorsorder

Enalapril 5mg tablet yes 0.02Isosorbide dinitrate 10mg tablet 0.01

12.5 DRUGS USED IN VASCULAR SHOCKAdrenaline 1mg/ml injection yes 0.43Ephedrine 30mg/ml injection 0.19

12.6 ANTITHROMBIC DRUGSAspirin 300mg tablet yes 0.01

Streptokinase 1,500,000 units injectionDocumentedMI 82 Keep 1-2 only

12.9 LIPID LOWERING AGENTSSimvastatin 20mg tablets Indiv patients Drug Comm

13 DERMATOLOGICAL DRUGS13.1 ANTFUNGAL DRUGS (TOPICAL)

Compound benzoic + salicylic acid oint(Whitfields) Yes 1.1/50gSalicylic acid 10% lotion YesMiconazole cream 2% Yes 0.34

13.2 ANTI-INFECTIVE DRUGSNeomycin + bacitracin + polymyxin ointment Yes 0.63

Silver sulphadiazine 1% cream Yes 0.67/50gOrder 50gpacks

Chlorhexidine 1% Cream Yes

13.3ANTI-INFLAMMATORY & ANTI-PRURITICDRUGSBetamethasone 0.1% cream 0.7Hydrocortisone 1% cream Yes 0.51Zinc Oxide oint Yes 1.23

13.5 SCABICIDES AND PEDICULOCIDESBenzyl benzoate 25% lotion Yes 4.42/1LPermethrin Lotion Yes Child, 3.67/100ml

pregnantwomen

13.6 OTHER DERMATOLOGICAL PREPARATIONSLubricating Jelly yes 1.76

14 DIAGNOSTIC AGENTS


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OPHTHALMIC DRUGSFluorescein ophthalmic strips 64/100Tropicamide 1% Drops 2.1

14.2 IMMUNOLOGICAL AGENTSPPD Human Tuberculin 100U/ml 44.84

14.2.1 Radiocontrast media

Barium sulphate aqueous solutionconsultradiographer

14.3 OTHER AGENTSECG Electrode Gel 3.34Ultrasound Gel

15 DISINFECTANTS & ANTISEPTICSCalcium hypochlorite/Milton for solutionChlorhexidine 1.5% + cetrimide 15% conc. Yes 3.3/500mlChlorhexidine 1% cream Yes 3.5/500gHydrogen peroxide 3% solution 1.27/100mlMethylated spirits 70% SVMPovidine iodine 10% aqueous solution Yes 6.97/500ml

16 DIURETICSAcetazolamide 250mg tablet Glaucoma 0.04

Frusemide 20mg/2ml injection yes 0.26on doctorsorder

Frusemide 40mg tablet Yes 0.01Hydrochlorothiazide 25mg tablet Yes 0.01Mannitol 20% injection 3.25Spironolactone 25mg tablet 0.04

17 GASTROINTESTINAL DRUGS17.1 ANTACIDS & OTHER ANTIULCER DRUGS

Magnesium trisilicate compound tablet Yes 0.01Omeprazole 20mg capsule 0.02

Ranitidine 50mg injection yesICU& OI useonly 0.38

doctors orderonly

Ranitidine 300mg tablets yes

17.2 ANTIEMETIC DRUGSMetoclopramide 10mg/2ml injection 0.09Metoclopramide 10mg tablet yes 0.01Prochlorperazine 12.5mg/ml injection 0.51Promethazine 50mg injection yes 0.26Prochlorperazine 5mg tabletsPromethazine tablets 10mg yes

17.3 ANTIHAEMORRHOIDAL DRUGSHaemorrhoidal ointment Yes 1.23

17.5 ANTISPASMODIC DRUGSHyoscine N Butylbromide 20mg injection 0.16


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Hyoscine N Butylbromide 10mg tablet yes 0.02

17.6 LAXATIVE DRUGSBisacodyl 10mg suppository 0.1Bisacodyl 5mg tablet yes 0.01Xray Prep Kits

17.7 DRUGS USED IN DIARRHOEACodeine phosphate 30mg tablet Yes 0.07Oral rehydration salts Yes 0.11Zinc sulphate 10mg tablet yes

18HORMONES, OTHER ENDOCRINEDRUGS & CONTRACEPTIVES

18.1ADRENAL HORMONES & SYNTHETICSUBSTITUTESDexamethasone 500mcg tablet 0.07Hydrocortisone sodium succinate 100mginjection 0.46Prednisolone 5mg, 20mg tablet 0.01

18.2 CONTRACEPTIVES18.21 Hormonal contraceptives

Ethinyloestradiol 30mcg + levonorgestrel 150mcg(Microgynon) Yes UNFPA

Eugynondeleted

Levonorgestrol 750mcg tablet (Postinor) yes UNFPAOn doctorsorder

Levonorgestrel 30mcg (Microlut) Yes UNFPAProvera 10mgdel

Medroxyprogesterone acetate 150mg/ml injection Yes UNFPA Progest Inj del

Medroxyprogesterone acetate implant (norplant) yes UNFPAUNFPAdonation

Medroxyprogesterone tablets Yes

18.22 Intrauterine DevicesPremarindonation

Copper-containing IUD UNFPA

18.23 Barrier MethodsCondoms with or without spermicide (nonoxicol) Yes UNFPAMale & Female condoms Yes UNFPA

18.4 Insulins and other Antidiabetic AgentsGlibenclamide 5mg tabs Yes 0.01Glipizide 5mg tablet renal pts 0.03Insulin soluble 100IU/ml 10ml yes 12.4 Doctors order

Insulin Isophane 100IU/ml 10ml Yes 12.4

Mixtard ifneeded/doctorsorder

Metformin 500mg tablet Yes 0.02

18.5 OVULATION INDUCERSClomiphene 50mg tablet O&G only


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18.6 PROGESTERONESNorethisterone 5mg tablet yes 0.02

18.7 THYROID HORM & ANTITHYROID DRUGSCarbimazole 5mg tablet 0.02Thyroxine 100mcg tablet 0.02

18.8 OTHERFinasteride 5mg tablet Indiv pat only 1.2 Very expensive

19 IMMUNOLOGICALS19.1 SERA & IMMUNOGLOBULINS

HBV immunoglobulin 400U/ml

19.2 For universal immunisationBCG Vaccine Yes Pub HealthDPT Vaccine Yes Pub HealthHepatitis B Vaccine Yes Pub HealthMeasles-Rubella Yes Pub HealthPolio (Sabin) Yes Pub HealthTetanus Toxoid Adsorbed Yes Pub HealthPentavac(Hep B/Hib/HBV) yes Pub Health

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MUSCLERELAXANTS(PERIPHERALLY ACT) &C'ESTERASE INHIBITORS

Atracurium 25mg/2.5ml injection 6.77small supplyonly

Neostigmine 2.5mg injection 0.47Suxamethonium 100mg/2ml injection 0.55 Pancur deletedVecuronium 10mg injection 5.56

21OPTHALMOLOGICAL & ENTPREPARATIONS

21.1 ANTI-INFECTIVE AGENTSAciclovir Eye Ointment Ocular herpes 0.56Chloramphenicol 5% ear drops Yes 0.59Chloramphenicol 0.5% eye drops Yes 0.38Chloramphenicol 1% eye ointment Yes 0.3Gentamicin 0.3% eye drops 0.58Tetracycline 1% eye ointment Yes 0.18Gentamicin ear dropAntifungal ear drops

21.2 ANTI-INFLAMMATORY AGENTSDexamethasone 1mg/ml eye drops 1.83Prednisolone eye drops

21.3 LOCAL ANAESTHETICSAmethocaine 0.5% eye drops 2.27


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21.4 MIOTICS & ANTIGLAUCOMA DRUGSAcetazolamide 250mg tablets 0.04

Pilocarpine 2% eye drops 1.28Timolol -indiv.pat

21.5 MYDRIATICSTropicamide 1% eye drops 1.05Phenylephrine 10% Drops/Minims 1.26

22 OXYTOCICS & ANTIOXYTOCICS22.1 OXYTOCICS

Ergometrine 500mcg + oxytocin 5iu injection Yes 1.84Oxytocin 10iu injection Yes 0.23Misoprostol 200mcg tablet O&G only 0.32

22.2 ANTIOXYTOCICSNifedipine 20mg SR tablet Yes 0.01Salbutamol 500mcg/ml injection 0.25

23 PYSCHOTHERAPEUTIC DRUGSAmitriptylline 25mg tablets 0.01Chlorpromazine25mg tablets 0.02Chlorpromazine 50mg injection 0.1Diazepam 5mg tablets Yes 0.01

Fluphenazine Depot 25mg/ml injectionIndivpatient 0.99

Haloperidol 5mg injection 0.33Haloperidol tablets 500mcg

24DRUGS ACTING ON THERESPIRATORY TRACTAdrenaline 1mg/ml injection Yes 0.43

Aminophylline 250mg/10ml injection 0.72Deltheophylline

Beclomethasone 50/100mcg inhaler 4.42 Del BeconaseSalbutamol 100mcg Inhaler Yes 2.16Salbutamol 5mg/ml Resp.Soln 30ml 5.75

Salbutamol 500mcg/ml injection 0.1DeleteFenoterol

Salbutamol 4mg tablet 0.01Delete overtime,encouragespray

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SOLNS CORRECTING WATER,ELECTROLYTE & ACID BASEDISTURB

25.1 ORALOral rehydration salts Yes 0.11Potassium chloride SR 600mg tablet 0.01 Limit supplySod.citrotartrate sachets (Ural)

25.2 PARENTERAL


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Calcium gluconate 100mg/ml 3.62Compound solution of sodium lactate(Hartmanns) 1L Yes 1.3

Dextrose 10% injection 1L yesO&G/neonataluse

doctors adviceonly

Dextrose 5% 1L Yes 1.3Dextrose 50% 50ml 1.5Dextrose 3% in 1/3 NS 1L yes 1.4Gelofusine Plasma Expander 500ml 5.93Magnesium Sulphate 50% injection Eclampsia 1.33Mannitol 20% 500ml 3.25Potassium chloride 1.5g/10ml 0.5Sodium bicarbonate 8.4% 10ml 0.86Sodium chloride 0.9% 1L Yes 1.3Water for injection 10ml Yes 0.07 Keep only 10ml

26 VITAMINS & MINERALSHydroxocobalamin 1mg/ml injection (VitB12) 0.45Multivitamin tablet Yes 0.01Pyridoxine 50mg tablet 0.02Phytomenadione 1mg in 0.5ml injection (Vit K1) Yes 0.3Vitamin B1 inj

ESSENTIAL MEDICINESFOR CHILDREN 20102010 TUVALU ESSENTIAL MEDICINE LISTFOR CHILDREN

WHO Drug name, strength and dosage form Outer Restrict use Cost $A COMMENTSIsland

1 ANAESTHETICS1.1 GENERAL ANAESTHETICS

Ketamine injection 50mg (as HCL)/ml in 10mlAnaesthetistuse only

Nitrous oxide inhalationAnaesthetistuse only

Oxygen yes

Thiopental injection 0.5gAnaesthetistuse only

Fentanyl 100mcg/2ml injectionAnaesthetistuse only

Isophane/Halothane inhalationAnaesthetistuse only


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1.2 LOCAL ANAESTHETICSBupivacaine plain injection 0.5%Lignocaine 1% plain injectionLignocaine 2% + adrenaline 1:80,000 dentalcartidege yesLignocaine pump

Lignocaine gel yesdentist adviceuse

1.3 PRE-OPERATIVE MEDICATIONAtropine 600mcg injectionDiazepam injection 5mg/2mlDiazepam tablets 5mgMorphine (SO2/HCL) injection 10mgMidazolam 15mg/2ml injectionKetamine injection 50mg (as HCL)/ml in 10mlChloral hydrate 100mg/ml mixture

2ANALGESICS, ANTIPYRETICS, NSAID's,DRUGS TO TREAT GOUT

2.1 NON-OPIOIDSIbuprofen tablets 200mg Use >3monthsParacetamol Oral liquid 120mg/5mlParacetamol Suppository 100mg

Paracetamol tablets 500mg100mg if cansource

Aspirin tablets 100mg

Use forrheumaticfever, juvenileathritis,kawasakidisease

2.2 OPIOID ANALGESICSMorphine injection 10mgMorphine Oral (HCL/SO4) liquid 10mgMorphine 10mg tablets SR

3ANTI-ALLERGICS & DRUGS USED INANAPHYLAXIS

Chlorpheniramine injection 10mg/ml yeson doctorsorder

Chlorpheniramine tablet 4mg yes Use >1yr

Dexamethasone (HCL) injection 4mg/ml yeson doctorsorder

Adrenaline 1mg/ml yeson doctorsorder

Hydrocortisone 100mg/ml (sodium succinate) yeson doctorsorder

Prednisolone oral liquid 5mg/ml yeson doctorsorder


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4ANTIDOTES & OTHER SUBSTANCES USEDIN POISONINGS

4.1 GENERALcharcoal activated powder yes

4.2 SPECIFICAcetylcysteine injection 200mg/ml

Atropine injection 1mg/ml yeson doctorsorder

Calcium gluconate 100mg/ml

5 ANTICONVULSANTS/ANTIEPILEPTICSCarbamazepine oral liquid 100mg/5mlCarbamazepine (chewable) 100mg tablet

Diazepam injection 5mg/ml yeson doctorsorder

Phenobarbitone injection 200mg/ml yeson doctorsorder

Phenytoin injection 50mg/ml yeson doctorsorder

Phenytoin Oral liquid 25mg/ml

Valproic acid tablet (crushable) 100mgas sodiumvalproate

Phenobarbitone 3mg/ml oral liquid6 ANTI-INFECTIVE DRUGS

6.1.1 INTESTINAL ANTHELMINTICSPyrantel Oral liquid 50mg/ml yes as embolateMebendazole tablets 100mg yes

6.1.2 ANTIFILARIALS

Albendazole tablets 400mgWHO Filarisisprog

Diethylcarbamazepine tablet 50mgWHO Filarisisprog

6.2 ANTIBACTERIALS6.2.1 Beta lactam medicines

Amoxycillin oral liquid 125mg/5ml (powder for liq) yesAmoxycillin capsules 250mg yesAmpicillin injection 500mg yesBenzathine benzylpenicillin inject.900mg(1.2mIU) yesBenzylpenicillin injection 600mg yesCloxacillin oral liquid 125mg/5ml yesCloxacillin injection 500mg yesCloxacillin capsules 500mg yesPhenoxylmethylpencillin oral liq. 125mg/5ml yes

Procaine Benzylpenicillin inj. 1g (1mIU) yes

Not recom. As1st line forneonatalsepsis


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6.2.2 Other Antibacterialschloramphenicol Oral liquid 150mg/5ml yes as palmitatechloramphenicol capsules 250mg yesDoxycycline Oral liquid 25mg/ml yesDoxycycline capsules 100mg yes

Erythromycin oral liquid 125mg/5ml yes

asstearate/ethylsuccinate

Erythromycin tablets 250mg yes

asstearate/ethylsuccinate

Gentamicin injection 40mg (as sulphate) yesMetronidazole injection 500mg yesMetronidazole oral liquid 200mg/5ml yes as benzoateSulfamethoxazole + trimethoprim Oral Liq.240mg/5ml yes

6.2.3 Antileprosy drugsDapsone tablets 25mgRifampicin tablets 150mgClofazimine capsules 50mg

6.2.4 Anti-tuberculosis drugsWHO tbProgram

Ethambutol tablet 100mg Global fundIsoniazid tablet (scored) 100mg tablet Global fundPyrazinamide (dispersable) 150mg tablet Global fundRifampicin tablet 150mg Global fund

6.2.5 Antiviral DrugsAbacavir (ABC) oral liquid 100mg/5ml (assulphate) Global fundDidanosine (ddl)(dispersable) 100mg Global fundLamivudine (3TC) oral liquid 50mg/5ml Global fundStavudine (d4T) oral liquid 5mg/5ml Global fundZidovudine (ZDV or AZT) oral liquid 50mg/ml Global fundAciclovir tablet 200mg Global fundAs per Global Fund Global fund

6.3 ANTIFUNGAL DRUGSFluconazole 50mg tabletGriseofulvin tablet 125mgNystatin Oal liquid 100,000IU/ml yes

6.4 ANTIPROTOZOAL DRUGS6.4.1 Antiamoebic

Metronidazole injection 500mg yesMetronidazole oral liquid 200mg/5ml yes as benzoate

6.4.2 Antimalarial DrugsChloroquine 50mg capsuleDoxycycline capsule 100mg


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Primaquine tablet 7.5mgQuinine HCL injection 300mg/ml

7 ANTI-MIGRAINE DRUGS7.1 FOR TREATMENT

Ibuprofen tablet 400mgParacetamol 120mg/5ml Oral liquid

8ANTINEOPLASTICS &IMMUNOSUPPRESSANTS

8.1 IMMUNOSUPPRESSIVE DRUGSAzathioprine injection 100mgCiclosporin capsule 25mg

8.2 ANTINEOPLASTIC DRUGSAllopurinol tablet 100mgAsparaginase injection 10 000 IUBleomycin injection 15mgMethotrexate injection 50mg

8.3 HORMONES AND ANTI_HORMONES

Dexamethasone injection 4mgas disodiumsalt

Hydrocortisone injection 100mgPrednisolone oral liquid 5mg/ml

9 Medicines used in palliative careAmitriptylline tablet 10mgDexamethasone injection 4mgDiazepam injection 5mg/mlHyoscine hydrobromide injection 400mcg/mlMidazolam injection 1mg/mlMophine tablet 10mg SRSenna oral liquid 7.5mg/ml

10 MEDICINES AFFECTING THE BLOOD10.1 ANTI-ANAEMIA DRUGS

Ferrous sulphate oral liquid 25mg/ml yes as sulphateFolic acid tablet 5mg yesHydroxycobalamin injection 1mg/ml

10.2 DRUGS AFFECTING COAGULATIONPhytomenadione injection 1mg/ml yesHeparin sodium injection 1000IU/ml

11 CARDIOVASCULAR DRUGS

11.1Requesting review whether or not thesemedicines

11.2 ANTI ARRHYTHMIC DRUGS


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Digoxin 250mg/ml injectionLignocaine 2% injectionPropranolol 10mg tablet

11.3 ANTIHYPERTENSIVE DRUGSEnalapril tablet 5mg

11.4 DRUGS USED IN HEART FAILUREDigoxin injection 250mcg/mlDigoxin tablets 250mcgFrusemide oral liquid 20mg/5mlFrusemide injection10mg/ml

12 DERMATOLOGICAL DRUGS12.1 ANTFUNGAL DRUGS (TOPICAL)

Benzoic acid+salicylic acid cream/ointment yesMiconazole cream 2% yes

12.2 ANTI-INFECTIVE DRUGSNeomycin sulphate + bacitracin yesSilver sulphadizine cream 1% yes

12.3ANTI-INFLAMMATORY & ANTI-PRURITICDRUGSBetamethasone cream/ointment 0.1% yesCalamine lotion yesHydrocortisone 1% cream/lotion yes

12.4 SCABICIDES AND PEDICULOCIDESPermethrin cream 5% yes

13 DIAGNOSTIC AGENTSOPHTHALMIC DRUGSTropicamide eye drops 0.5%

13.1 Radioconrtast media

Barium sulphate aqueuos solutionDoctorsupervision

13.2 IMMUNOLOGICAL AGENTSPPD Human Tuberculin 100

14 DISINFECTANTS & ANTISEPTICSChlorhexidine solution 5%(digluconate) yesEthanol solution 70%(denatured)Povisone iodine aquous 10% yes

15 DIURETICS

Frusemide injection 10mg/ml yeson doctorsorder


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Frusemide oral liquid 20mg/5ml

Frusemide tablet 40mg yeson doctorsorder

16 GASTROINTESTINAL DRUGS16.1 ANTACIDS & OTHER ANTIULCER DRUGS

Aluminium hydroxide oral liquid 320mg/5ml

Magnesium hydrochloride oral liquideq. to 550mgMgO2/10ml

Ranitidine (as HCL) tablet 150mg

yeson doctorsorder

16.2 ANTIEMETIC DRUGSMetoclopramide tablet 10mg yes doctors order

Metoclopramide oral liquid 5mg/5mlNot forneonatal use

Dimenhydrinate oral liquid 2.5mg/ml

16.3 LAXATIVE DRUGSBisacodyl suppository 10mgGlycerine suppository yes

16.4 DRUGS USED IN DIARRHOEAOral rehydration salts yes

Zinc sulphate tablet 10mg

In acutediarrhoeazincsulphateshould beusedas anadjunct toORS

17HORMONES, OTHER ENDOCRINE DRUGS &CONTRACEPTIVES

17.1ADRENAL HORMONES & SYNTHETICSUBSTITUTES

prednisolone 5mg yeson doctorsorder

Hydrocortisone injection 100mg yesas sodiumsuccinate

on doctorsorder

17.2 Insulins and other Antidiabetic Agents

Insulin soluble 100IU/ml 10ml yeson doctorsorder

Insulin isophane 100IU/ml 10ml yeson doctorsorder

17.3 THYROID HORM & ANTITHYROID DRUGSLevothyroxine tablet 50mcg small amount


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18 IMMUNOLOGICALS18.1 SERA & IMMUNOGLOBULINS

HBV immunoglobulin 400U/ml

18.2 For universal immunisationBCG Vaccine Yes Pub HealthDPT Vaccine Yes Pub HealthHepatitis B Vaccine Yes Pub HealthMeasles-Rubella Yes Pub HealthPolio (Sabin) Yes Pub HealthTetanus Toxoid Adsorbed Yes Pub HealthHaemphilus influezae type b vaccine Yes Pub Health

19MUSCLE RELAXANTS(PERIPHERALLY ACT)& C'ESTERASE INHIBITORS

Neostigmine injection 500mcg/mlAnaesthetistadvice

Suxamethonium injection 50mgAnaesthetistadvice

Vercuronium injection 10mgAnaesthetistadvice

20 OPTHALMOLOGICAL & ENT PREPARATIONS20.1 ANTI-INFECTIVE AGENTS

Aciclovir ointment 3%w/wGentamicin solution eye drops 0.3% (sulphate)Chlorampenicol eye dropsChlorampenicol eye ointment

20.2 ANTI-INFLAMMATORY AGENTSPrednisolone solution eye drops 0.5% (sod.phos) Specialist use

20.3 LOCAL ANAESTHETICSAmethocaine 0.5% eye drops Specialist use

21 PYSCHOTHERAPEUTIC DRUGSChlorpromazine injection 25mg Specialist useChlorpromazine tablet 10mg Specialist useHaloperidol tablet 0.5mg Specialist use

22DRUGS ACTING ON THE RESPIRATORYTRACTAdrenaline injection 1mg/ml yesSalbutamol injection 50mcgSalbutamol meter dose inhaler 100mcg/dose yesSalbutamol oral liquid 2mg/ml yesSalbutamol solution for use in nebulizer 5mg/ml yesSalbutamol tablet 5mg yesIpratropium meter dose inhaler 20mcg/dose yes doctors adviceIpratropium solution for nebulizer 250mcg/mlBeclomethasone meter dose inhaler yes


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23SOLNS CORRECTING WATER,ELECTROLYTE & ACID BASE DISTURB

23.1 ORALOral rehydration salts yesPotassium chloride

23.2 PARENTERALGlucose 5% injectable solution yes Infusion pumpsGlucose with sodium chloride inj. Solution5%/0.9% yes to be used onPotassium chloride solution 7.5% doctors adviceSodium chloride inj. 0.9% solution yesWater for injections 2ML yesDextrose 10% injectable solution yes

24 VITAMINS & MINERALSAscorbic acid tablets 50mgCholcalciferol tablet 400IUIodine capsule 200mgPyridoxine (HCL) tablet 25mgMultivitamin syrup yesThiamine tablet 50mg

25EAR, NOSE AND THROAT CONDITION INCHILDRENAcetic acid topical 2% in alcoholWax Removal ear drops yesBudesonide nasal spray 100mcg/spray Specialist use


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References

1. Tonga Standard Treatment Guidelines 20072. Fiji Standard Treatment Guidelines:

-Respiratory-Cardiovascular-Antibiotics 2004-Managing diates mellitus

3. AMH 20104. WHO Model list for Essential Medicines unedited version 20095. WHO Model List for Essential Medicines for children unedited version

2009

Documents

TUVALU STANDARD TREATMENT GUIDELINESapps.who.int/medicinedocs/documents/s19761en/s19761en.pdf · Page 231 of 401 Tuvalu Standard Treatment Guidelines 2010 231 6.4 ANTIPROTOZOAL DRUGS