Keep out of the reach of children.

1. A 4-year-old boy with meningitis due to pneumococcus. He is allergic to penicillin.

2. A 67-year-old man with a history of chronic bronchitis now suffering from pneumonia. The causative organism is resistant to tetracycline.

3. A 27-year-old woman with urinary tract infection in early pregnancy. She complains of nausea.

4. A 4-year-old girl with septic arthritis due to haemophilus influenzae.

5. An 18-year-old man with left leg amputation above the knee following a road traffic accident.

6. A 50-year-old woman with endocarditis caused by strep. viridans.

7. A 13-year-old girl with disfiguring acne.

8. An 8-year-old boy with tonsillitis due to B-haemolytic streptococcus.

9. A 43-year-old dairyman with brucellosis.

10. A 4-year-old unimmunised sibling of a 2-year-old boy with whooping cough.

AMPICILLIN

Indications: urinary-tract infections, otitis media, chronic bronchitis, invasive salmonellosis, gonorrhoea

Cautions; Contra-indications; Side-effects: see under Benzylpenicillin; also erythematous rashes in glandular fever and chronic lymphatic leukaemia; reduce dose in renal impairment.

Dose: by mouth, 0,25-1 g every 6 hours, at least 30 minutes before food

Gonorrhoea, 2g as a single dose with probenecid 1g; repeated for women

Urinary-tract infections, 500 mg every 8 hours

By intramuscular injection or intravenous injection or infusion, 500 mg every 4-6 hours; higher doses in meningitis

CHILD, any route, ½ adult dose

BENZYLPENICILLIN

(Penicillin G)

Indications: tonsillitis, otitis media, erysipelas, streptococcal endocarditis, meningococcal and pneumococcal meningitis, prophylaxis in limb amputation

Cautions: history of allergy; renal impairment

Contra-indications: penicillin hypersensitivity

Side-effects: sensitivity reactions including urticaria, fever, joint pains; angioedema; anaphylactic shock in hypersensitive patients; diarrhea after administration by mouth

Dose: by intramuscular injection, 300-600 mg 2-4 times daily; CHILD up to 12 years, 10-20 mg/kg daily; NEONATE, 30 mg/kg daily

By intravenous infusion, up to 24g daily

By intrathecal injection, 6-12 mg daily

Prophylaxis in dental procedures and limb amputation

CO-TRIMOXAZOLE

A mixture of sulphamethoxazole 5 parts, trimethoprim 1 part

Indications: invasive salmonellosis, typhoid fever, bone and joint infections due to H. influenzae, urinary-tract infections, sinusitis, exacerbations of chronic bronchitis, gonorrhoea in penicillin-allergic patients

Cautions: blood counts in prolonged treatment, maintain adequate fluid intake, renal impairment, breast-feeding; photosensitivity.

Contra-indications: pregnancy, infants under 6 weeks, renal or hepatic failure, jaundice, blood disorders

Side-effects: nausea, vomiting, rashes, erythema multiforme, epidermal necrolysis, eosinophilia, agranulocytosis, granulocytopenia, purpura, leucopenia; megaloblastic anaemia due to trimethoprim

Dose: by mouth, 960 mg every 12 hours, increased to 1,44g in severe infections; 480 mg every 12 hours if treated for more than 14 days; CHILD, every 12 hours, 6 weeks to 5 months, 120 mg; 6 months to 5 years, 240 mg; 6-12 years, 480 mg

Gonorrhoea, 1,92g every 12 hours for 2 days, or 2,4g followed by a further dose of 2,4g after 8 hours

By intramuscular injection or intravenous infusion, 960 mg every 12 hours

Note: 480 mg of co-trimoxazole consists of sulphamethoxazole 400 mg and trimethoprim 80 mg

ERYTHROMYCIN

Indications: alternative to penicillin in hypersensitive patients; sinusitis, diphtheria and whooping cough prophylaxis; legionnaires’ disease; chronic prostatitis

Cautions: hepatic impairment

Contra-indications: estolate contra-indicated in liver disease

Side-effects: nausea, vomiting, diarrhoea after large doses

Dose: by mouth, 250-500 mg every 6 hours; CHILD, 125-250 mg every 6 hours

Syphilis, 20 mg in divided doses over 10 days

By slow intravenous injection or infusion, 2g daily in divided doses, increased to 4g in severe infections; CHILD, 30-50 mg/kg daily in divided doses

GENTAMICIN

Indications: septicaemia and neonatal sepsis; meningitis and other CNS infections; biliary tract infection, acute pyelonephritis or prostatitis, endocarditis caused by Strep. viridans or faecalis (with a penicillin)

Cautions: increase dose interval in renal impairment.

Contra-indications: pregnancy, myasthenia gravis

Side-effects: vestibular damage, reversible nephrotoxicity

Dose: by intramuscular injection or slow intravenous injection or infusion, 2-5 mg/kg daily, in divided doses every 8 hours. In renal impairment the interval between successive doses should be increased to 12 hours when the creatinine clearance is 30-70 ml/minute, 24 hours for 10-30 ml/minute, 48 hours for 5-10 ml/minute, and 3-4 days after dialysis for less than 5 ml/minute

CHILD, up to 2 weeks, 3 mg/kg every 12 hours; 2 weeks-12 years, 2 mg/kg every 8 hours

By intrathecal injection, 1 mg daily, with 2-4 mg/kg daily by intramuscular injection in divided doses every 8 hours

PHENOXYMETHYLPENICILLIN

(Penicillin V)

Indications: tonsillitis, otitis media, erysipelas, rheumatic fever prophylaxis, endocarditis prophylaxis

Cautions; Contra-indications; Side-effects: see under Benzylpenicillin

Dose: 250-500 mg every 6 hours, at least 30 minutes before food; CHILD, every 6 hours, up to 1 year 62.5 mg, 1-5 years 125 mg, 6-12 years 250 mg

TETRACYCLINE

Indications: exacerbations of chronic bronchitis; infections due to brucella, chlamydia, mycoplasma, and rickettsia; severe acne vulgaris

Cautions: breast-feeding; rarely causes photosensitivity. Avoid intravenous administration in hepatic impairment.

Contra-indications: renal failure, pregnancy, children under 12 years of age

Side-effects: nausea, vomiting, diarrhea; super-infection with resistant organisms; rarely allergic reactions

Dose: by mouth, 250-500 mg every 6 hours

Syphilis, 30-40g in divided doses over 10-15 days

Non-gonococcal urethritis, 500mg 4 times daily for 10-21 days

By intramuscular injection, 100 mg every 8-12 hours, or every 4-6 hours in severe infections

By intravenous infusion, 500 mg every 12 hours; max. 2g daily

DIALOGUES

At the Chemist’s

1. Petrov enters the chemist’s shop with a prescription, which he has just received.

Petrov—I have a prescription for some medicine. Can I have it right away?

Chemist—Sorry, it must be made up. It has been in great demand lately.

Petrov—Then I’ll leave the prescription. Will it be ready in a couple of hours?

Chemist—I’m afraid it will not be ready before this evening.

Petrov—Well, then I’ll come in the evening.

2. A young woman enters the drugstore.

Woman—Be so kind as to advise something for a headache.

Chemist—These pills are very effective. They will stop your headache at once.

Woman—Have you any antibiotics?

Chemist—We have a lot of them at present. Here are some new antibiotics: albumycin, monomycin and mycerin.

Woman—I have a prescription for albumycin.

Chemist—Here you are.

3. A middle-aged man enters the pharmacy, he comes up to the chemist and greets her.

Man—Good afternoon.

Chemist—Good afternoon. You are looking rather seedy today. What is the matter with you?

Man—I am feeling rather out of sorts. I have a headache and a sore throat. I am afraid I’ve got a temperature.

Chemist—Why aren’t you in bed?

Man—I have just finished my work. I am going home.

Chemist—I’ll give you some powders for stopping your headache and phuracylin to gargle your throat with. Go home and get into bed immediately. Call the doctor, if you are not well tomorrow.

Man—I hope for the better. I have to deliver a report tomorrow, so I must be as sound as a bell. Good-bye.

Chemist—Good afternoon. Be sure and follow my advice. Better stay in bed.

4. Just at that moment an old woman comes in, she hands a prescription to the chemist.

Chemist—You need cardiomin and cardiovalen. You may have them right away.

Woman—Thank you. Be so kind, have you got cholelitin or allochol? My liver troubles me, I was told you have these medicines ready.

Chemist—Sorry, we had them, but they are sold out at present. Come in a day, or two. We are expecting them any day.

Woman—Give me a pair of washing gloves and a cake of soap.

Chemist—Here they are. Anything else?

Woman—No, thank you. I’ll come in to days to buy some liver drugs. I need them badly. Good - bye.

Chemist—Good - bye.

Vocabulary Notes

to have the medicine right away - получить лекарство тотчас же

to be in great demand - пользоваться большим спросом

here you are - пожалуйста

to look seedy - плохо выглядеть

I am feeling rather out of sorts - мне не по себе

in consequence of - в результате чего

FOREIGN HUMOUR

* * *

A man went into a chemist’s and asked for something to cure a headache. The chemist held a bottle of ammonia to the man’s nose, in consequence of which the customer nearly fainted. As soon as he had recovered he began to rail at the chemist.

“But didn’t it help your headache? asked the chemist.

“Help my headache!” screamed the man, “I haven’t any headache, it’s my wife that’s got the headache.”

Note

ammonia –нашатырный спирт

* * *

The doctor smiled as he entered the room.

“You look much better today.”

“Yes, I followed the directions on your medicine bottle.”

“What were they?”

“Keep the bottle tightly corked.”

Note

to keep the bottle tightly corked –держать бутылку плотно закупоренной

INSTRUCTIONS

1. MEDI-FLEX