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This is the list of medicine to be used in camp tomorrow…give rationale behind the uses moa of each drug and its uses ci and everything when to give
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antibiotic stewardship ambulatory care
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WHO primary care prescribing antibiotics antimicrobial stewardship oral rehydration solution guidance
Before the camp: important safety points
This stock list includes antibiotics, antihypertensives, antidiabetic drugs, NSAID painkillers, steroid-containing eye drops, and paediatric syrups. These should not be distributed as “symptom-based kits.” A clinician should assess the patient, document allergies, pregnancy status, age/weight, blood pressure, glucose where appropriate, renal/liver disease, and current medicines.
Several entries are brand names and can vary by manufacturer. Confirm the generic composition on the actual strip/bottle before dispensing, especially: Go Acid, Gartronil, Mucoxl gel, Calciium, Nano Shot, Neuron Forte, Cetrazxine syrup, Alex syrup, Ecotear, and Lanzo Junior.
For antibiotics, use only for a reasonable suspected/confirmed bacterial indication, with a complete prescription and follow-up plan. Outpatient antibiotic stewardship means using the right drug, dose, and duration only when needed, as described in the CDC outpatient stewardship guidance and WHO stewardship resources. Recent reviews continue to support stewardship interventions, though they do not replace local prescribing guidance (PMID: 40179108).
1. Acidity, nausea, diarrhoea
| Medicine on list | Likely generic / MOA | Give for | Do not give / major cautions | Practical administration |
|---|---|---|---|---|
| Go Acid liquid | Usually an antacid, commonly aluminium hydroxide + magnesium hydroxide ± simethicone. Neutralises gastric acid; simethicone breaks up gas bubbles. | Short-term heartburn, dyspepsia, acid-related bloating. | Severe renal disease, unexplained severe abdominal pain, GI bleeding, persistent vomiting. Separates absorption of many drugs. | Usually after meals/at bedtime if prescribed. Keep a gap from iron, tetracyclines, quinolones and some other drugs. |
| Gartronil liquid | Verify composition. Often ondansetron. 5-HT3 receptor blocker in the vomiting centre and gut. | Nausea/vomiting, after ruling out surgical abdomen and dehydration needing referral. | Known QT prolongation, major electrolyte disturbance, concurrent QT-prolonging drugs, bowel obstruction. Caution with serotoninergic drugs. | Give only when a clinician identifies a suitable cause. Persistent vomiting, bilious/bloody vomiting or lethargy needs referral. |
| Mucoxl gel liquid | Often oxetacaine/oxethazaine + antacid gel. Antacid neutralises acid; oxetacaine gives local anaesthetic pain relief. | Severe burning epigastric pain from acid-peptic disease, only short term. | Suspected ulcer bleed, severe persistent pain, renal impairment depending on antacid content; avoid prolonged self-treatment. | Usually before meals if prescribed. It can mask serious disease. |
| Pantop DSR | Usually pantoprazole + domperidone SR. Pantoprazole irreversibly inhibits gastric H+/K+ ATPase; domperidone blocks peripheral dopamine D2 receptors, improving gastric emptying and reducing nausea. | Proven reflux/dyspepsia with nausea, as prescribed. | Domperidone: QT prolongation, arrhythmia, cardiac disease, severe liver impairment, interacting QT-prolonging drugs. PPI: caution if long-term/unreviewed. | Generally before food. Do not combine with separate domperidone without checking total dose. |
| Pantop 40 | Pantoprazole 40 mg, proton-pump inhibitor. | GERD, peptic ulcer disease, NSAID-related dyspepsia when clinically appropriate. | Alarm symptoms: GI bleeding, dysphagia, weight loss, recurrent vomiting, anaemia. Long-term use needs review. | Usually 30-60 minutes before breakfast. Not a quick painkiller. |
| Domperidone | Peripheral D2 antagonist, antiemetic/prokinetic. | Selected nausea/vomiting or gastroparesis, prescribed for the shortest time. | Avoid with known prolonged QT, arrhythmia, heart failure, significant electrolyte imbalance, severe liver disease, macrolides such as azithromycin, and many antifungals. | Check interactions carefully. Do not give routinely for vague gastritis. |
| ORS | Oral glucose-sodium cotransport enhances intestinal sodium and water absorption. | Acute diarrhoea, vomiting-related mild/moderate dehydration, heat-related fluid loss. | Shock, altered consciousness, inability to drink, persistent vomiting, severe dehydration, suspected cholera needing facility protocol. | Mix exactly as written with safe water. Give frequent small sips. Refer if reduced urine, sunken eyes, lethargy, blood in stool, or severe thirst. |
| Metrogyl 400 | Metronidazole 400 mg. Reduced within anaerobes/protozoa to metabolites that damage DNA. | Only clinician-diagnosed amoebiasis, giardiasis, anaerobic dental/intra-abdominal infection, bacterial vaginosis, etc. | Alcohol during treatment and for at least 48 hours after, serious liver disease, prior neuropathy, interactions with warfarin. Not for uncomplicated watery diarrhoea. | Take after food if gastric upset. Complete prescribed course. Metallic taste and nausea are common. |
| Albendazole | Binds parasite beta-tubulin, disrupting microtubules and glucose uptake. | Documented or high-probability intestinal helminth infection; public-health deworming only under the relevant protocol. | Avoid in pregnancy, particularly first trimester, suspected neurocysticercosis without evaluation, significant liver disease. | Give according to age-specific/deworming programme prescription. Advise hygiene and treat household contacts only where indicated. |
2. Pain, fever, allergy, respiratory symptoms
| Medicine | MOA | Give for | Avoid / cautions | When/how |
|---|---|---|---|---|
| Aceclofenac SP | Usually aceclofenac + paracetamol + serratiopeptidase. Aceclofenac is an NSAID that inhibits COX and prostaglandin formation; paracetamol is analgesic/antipyretic; serratiopeptidase evidence for swelling is limited. | Short-term inflammatory musculoskeletal pain if prescribed. | Peptic ulcer/GI bleed, kidney disease, heart failure, uncontrolled hypertension, anticoagulants, NSAID allergy/asthma, pregnancy especially later pregnancy, liver disease. | After food, short duration. Do not combine with diclofenac, ibuprofen, naproxen, or additional paracetamol without checking total dose. |
| Diclofenac SP | Often diclofenac + paracetamol + serratiopeptidase. NSAID COX inhibition. | Short-term acute inflammatory pain only. | Same cautions as above. Diclofenac has meaningful GI, kidney, BP and cardiovascular risks. | Choose either Aceclofenac SP or Diclofenac SP, never both. |
| PCM 650 | Paracetamol/acetaminophen 650 mg. Central analgesic/antipyretic action. | Fever causing discomfort, mild/moderate pain. | Severe liver disease, heavy alcohol use, or duplicate paracetamol-containing products. | Check all combination products. Toxic overdose can cause delayed, fatal liver failure. Paediatric dosing must be weight-based, not a 650-mg adult tablet. |
| Cetirizine | Second-generation H1 antihistamine. | Allergic rhinitis, urticaria, itching. | Hypersensitivity; adjust/caution in renal impairment. May cause drowsiness despite being “non-sedating.” | Usually once daily. Avoid driving/alcohol if sleepy. Not treatment for anaphylaxis. |
| Cetrazxine syrup | Name uncertain, likely a cetirizine-containing paediatric antihistamine. | Allergy/urticaria only once composition and child’s age/weight are confirmed. | Do not estimate dose from brand name. Check renal disease and duplicate antihistamines. | Use the supplied measuring device and prescription. |
| Montair FX | Usually montelukast + fexofenadine. Montelukast blocks CysLT1 leukotriene receptors; fexofenadine blocks H1 receptors. | Allergic rhinitis, allergy-associated wheeze as an add-on where appropriate. | Not for acute asthma attacks or anaphylaxis. Montelukast can cause neuropsychiatric effects including nightmares, agitation, mood/behaviour changes and suicidal thoughts. | Usually scheduled, not “as-needed rescue” treatment. Stop and seek review if behavioural symptoms occur. |
| Alex syrup | Brand composition varies. Many formulations contain cough suppressants, antihistamines, bronchodilators or mucolytics. | Only after identifying type of cough and confirming ingredients. | Avoid empiric use in young children, wheeze/respiratory distress, pneumonia/TB warning signs, sedative interactions, and duplicate cold medicines. | Do not give until label composition, age indication and weight-based dose are checked. |
| Doxy 100 | Doxycycline 100 mg, tetracycline antibiotic. Binds 30S ribosomal subunit and inhibits bacterial protein synthesis. | Specific bacterial conditions such as rickettsial disease, selected respiratory/skin/STI infections, acne, and local guideline-directed infections. | Pregnancy, breastfeeding where alternatives exist, children under 8 years except specialist indications, oesophageal disease, severe liver disease. Avoid with iron/calcium/antacids. | Take with a full glass of water and stay upright 30 minutes. Separate from iron/calcium/antacids. Photosensitivity counselling is needed. |
3. Antibiotics and antifungal medicines
| Medicine | MOA | Appropriate uses | Do not give / major cautions |
|---|---|---|---|
| Azithromycin | Macrolide. Binds 50S ribosomal subunit, inhibiting protein synthesis. | Only confirmed/suspected susceptible bacterial disease according to local guideline, for example certain atypical respiratory infections, pertussis, selected STIs. | Viral cold/cough, uncomplicated diarrhoea, prior macrolide allergy, QT prolongation/arrhythmia, significant liver disease. Do not combine casually with domperidone because both can prolong QT. |
| Cefpodoxime VC 200 | Usually cefpodoxime proxetil + clavulanate. Cefpodoxime inhibits cell-wall synthesis; clavulanate inhibits some beta-lactamases. | Selected bacterial ENT/respiratory/urinary infections if guideline and clinical assessment support it. | Immediate severe beta-lactam allergy, prior cholestatic jaundice/hepatitis from penicillin/clavulanate, renal impairment needing adjustment. Not for viral syndromes. |
| Augmentin 625 | Usually amoxicillin 500 mg + clavulanate 125 mg. Cell-wall inhibition plus beta-lactamase inhibition. | Selected bacterial infections such as bite wounds, dental infection, bacterial sinusitis or other guideline-directed indications. | Penicillin/cephalosporin anaphylaxis; previous co-amoxiclav liver injury; serious liver disease. Common diarrhoea. |
| Cefixime syrup | Third-generation oral cephalosporin. Inhibits bacterial cell-wall synthesis. | Selected bacterial infections in children, based on weight, source, resistance patterns and prescription. | Severe beta-lactam allergy, significant renal impairment. Not for common viral URTI. |
| Augmentin syrup | Amoxicillin + clavulanate suspension. | Only paediatric bacterial infections with weight-based prescription. | As above. Verify concentration because formulations differ. |
| Levoflox 500 | Levofloxacin, fluoroquinolone. Inhibits bacterial DNA gyrase/topoisomerase IV. | Reserve for infections where safer first-line agents are unsuitable and local sensitivity supports it. | Pregnancy/breastfeeding, children unless specialist-directed, myasthenia gravis, prior tendon disorder from quinolone, aortic aneurysm/high risk, QT prolongation, seizure risk. |
| FCN 150 | Usually fluconazole 150 mg, triazole antifungal. Inhibits fungal ergosterol synthesis via CYP450-dependent 14-alpha-demethylase. | Confirmed uncomplicated vulvovaginal candidiasis or other prescribed candidal infection. | Pregnancy unless specialist-directed, liver disease, QT risk, interacting medicines including warfarin and some antidiabetics. |
Antibiotic rule for the camp
Do not give azithromycin, cefpodoxime, Augmentin, cefixime, doxycycline, metronidazole, or levofloxacin for a simple viral cold, uncomplicated sore throat, undifferentiated fever, or non-bloody watery diarrhoea. Record allergy, diagnosis, dose, duration, batch/expiry and follow-up. Reassess or refer when fever persists, the patient worsens, or there are red flags.
4. Diabetes, blood pressure, supplements
| Medicine | MOA and rationale | Give for | Do not give / cautions | Practical point |
|---|---|---|---|---|
| Gluconorm G1 | Commonly metformin + glimepiride. Metformin lowers hepatic gluconeogenesis and improves insulin sensitivity; glimepiride stimulates pancreatic insulin release. | Type 2 diabetes in an already assessed/prescribed patient. | Type 1 diabetes, DKA, severe kidney/liver failure, severe infection/dehydration. Glimepiride can cause hypoglycaemia. | Give with a meal as prescribed. Do not initiate casually at camp. If sweating, tremor, confusion or low glucose: treat as hypoglycaemia and refer if not promptly resolving. |
| Telma 40 | Telmisartan, angiotensin-II AT1 receptor blocker. Lowers vasoconstriction and aldosterone effects. | Established hypertension, diabetic kidney disease in selected patients, only under ongoing prescription. | Pregnancy, bilateral renal artery stenosis, hyperkalaemia, severe dehydration/AKI. | Do not newly start from a camp without BP, renal function/potassium plan and follow-up. |
| Telma AM | Usually telmisartan + amlodipine. ARB plus dihydropyridine calcium-channel blocker. | Hypertension already requiring combination therapy. | Pregnancy, hyperkalaemia/AKI for telmisartan; severe hypotension; caution with significant oedema or liver disease. | Not a treatment for an isolated anxiety-related high BP reading. Repeat BP correctly and assess symptoms. |
| Amlopress 5 mg | Amlodipine, dihydropyridine calcium-channel blocker causing arterial vasodilation. | Maintenance treatment of hypertension/angina. | Severe hypotension, shock; caution in severe aortic stenosis and liver impairment. | Can cause ankle oedema, flushing, headache, dizziness. Not for hypertensive emergency. |
| Calciium | Likely calcium ± vitamin D preparation, but confirm. Calcium supports bone mineralisation; vitamin D supports calcium absorption. | Documented deficiency/risk or prescribed supplementation. | Hypercalcaemia, renal stones, severe renal disease, sarcoidosis depending on product. | Separate from doxycycline, levofloxacin, iron and levothyroxine. |
| Nano Shot | Brand unclear, commonly vitamin D3 oral shot/sachet in some markets. Vitamin D increases calcium/phosphate absorption. | Documented vitamin D deficiency or clinician-directed supplementation. | Hypercalcaemia, kidney stones, granulomatous disease, severe renal impairment without guidance. | Confirm units and formulation. High-dose vitamin D must not be given as a casual “energy shot.” |
| Vitamin B complex / Neuron Forte | B-group vitamin supplements, composition varies; some include high-dose B6, B12, folate and other nutrients. Cofactors for energy metabolism and nerve/haematopoietic function. | Proven or likely dietary deficiency, selected neuropathy as an adjunct, alcohol-related deficiency under supervision. | Do not use as a substitute for investigating anaemia, neuropathy or weakness. Chronic high-dose B6 can itself cause neuropathy. | Confirm contents and avoid duplicate B-complex products. |
| Multivitamin syrup | Mixed vitamins, sometimes minerals. | Dietary supplementation only where indicated. | Avoid duplicating vitamin A/D/iron products or using as treatment for serious malnutrition/anaemia without evaluation. | Use age-appropriate formulation and measuring device. |
| Iron syrup | Elemental iron salt, replenishes iron for haemoglobin synthesis. | Confirmed/suspected iron-deficiency anaemia after appropriate assessment. | Haemochromatosis/iron overload, non-iron deficiency anaemia, acute infection depending on context. Dangerous if accidentally ingested by children. | Dose by elemental iron, not total syrup volume. Can cause constipation, dark stools, nausea and tooth staining. Keep locked away. |
| Folic acid | Converted to tetrahydrofolate for DNA synthesis and erythropoiesis. | Folate deficiency; preconception/pregnancy supplementation as prescribed. | Do not treat unexplained macrocytic anaemia with folate alone because it can mask B12 deficiency while neurological damage progresses. | Pregnancy-related dosing should follow antenatal protocol. |
5. Eye medicines
| Medicine | MOA / use | Do not give or refer when |
|---|---|---|
| Ecotear eye drops | Likely lubricating drops, often carboxymethylcellulose/hypromellose. Replaces tears and reduces dry-eye irritation. | Useful for uncomplicated dry-eye symptoms. Do not use as treatment for painful red eye, trauma, chemical exposure, visual loss, corneal ulcer or contact-lens-related infection. |
| Nepac eye drops | Likely nepafenac, topical NSAID converted to amfenac. Reduces prostaglandin-mediated ocular inflammation and pain, commonly after ophthalmic surgery. | Usually postoperative use under eye specialist direction. Avoid in suspected infection/corneal epithelial defect, NSAID hypersensitivity, bleeding risk; can delay healing and rarely contribute to corneal complications. |
| Moxiflox eye drops | Moxifloxacin, topical fluoroquinolone antibiotic inhibiting DNA gyrase/topoisomerase IV. | Selected bacterial conjunctivitis or corneal infection under clinical assessment. |
Eye-drop technique: wash hands, avoid touching the tip to eye/skin, instil one drop, close the eye gently, and wait 5-10 minutes between different drops. Avoid sharing bottles.
Immediate referral rather than camp medication
Refer urgently for:
- Chest pain, breathlessness, syncope, stroke symptoms, BP with acute neurological/chest symptoms
- Very high or low blood glucose with confusion, vomiting, dehydration or ketones
- Anaphylaxis, facial/tongue swelling, wheeze, hypotension
- GI bleeding, severe/localised abdominal pain, persistent vomiting, severe dehydration
- Fever with altered consciousness, neck stiffness, petechial rash, severe weakness, or persistent fever
- Eye pain, photophobia, loss of vision, chemical injury, trauma, or contact-lens red eye
- Pregnancy with bleeding, abdominal pain, fever, severe vomiting, or need for antibiotics/anthelmintics
- Children with lethargy, poor feeding, fast breathing, chest indrawing, seizures, or inability to drink
If you share a clear photo of the front and back of the ambiguous brands, I can convert this into an exact camp dispensing sheet with verified compositions, contraindications, interaction warnings, and age-specific checks.
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