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Give prescription writing of these four questions in proper prescription format.

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hypertension AND treatment

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peptic ulcer AND treatment

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pulmonary tuberculosis AND treatment

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malaria AND treatment

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India National TB Elimination Programme drug sensitive pulmonary tuberculosis daily regimen 2025 adult weight band WHO malaria treatment India guidelines

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Below are exam-style prescription formats. In real practice, these require examination, allergy history, renal/hepatic function, pregnancy status, drug-interaction review, and follow-up.

1. Prasadi Devi, 48 years/F

Provisional diagnosis: Hypertension, BP 160/90 mmHg with vertigo/tinnitus.
Confirm persistent hypertension with repeat measurements. Assess urgently for focal neurological signs, chest pain, severe headache, or visual symptoms.
Date: //_____
Patient: Prasadi Devi, 48 years/F
Dx: Hypertension with vertigo
Rx
  1. Tab. Amlodipine 5 mg
    Take 1 tablet orally once daily, preferably at the same time each day.
    Dispense: 30 tablets.
  2. Tab. Betahistine 16 mg
    Take 1 tablet orally twice daily after meals for 5-7 days, then review.
    Dispense: 14 tablets.
Advice
  • Restrict salt intake, avoid tobacco/alcohol, maintain healthy weight and regular exercise.
  • Check BP after 1-2 weeks. Monitor for ankle swelling, flushing, or dizziness due to amlodipine.
  • Investigations: fasting blood glucose, lipid profile, serum creatinine/electrolytes, urine examination, ECG, and fundus examination.
  • Seek urgent care if neurological deficit, severe headache, chest pain, breathlessness, or BP ≥180/120 mmHg.
Follow-up: After 1-2 weeks.
Signature/Registration No.: ___________

2. Panna Lal, 56 years/M

Provisional diagnosis: Peptic ulcer disease / acid-peptic dyspepsia, likely H. pylori associated.
Date: //_____
Patient: Panna Lal, 56 years/M
Dx: Suspected peptic ulcer disease
Rx
Use eradication therapy only if H. pylori is confirmed or where an appropriate test-and-treat strategy is used.
  1. Tab. Pantoprazole 40 mg
    Take 1 tablet orally twice daily, 30 minutes before breakfast and dinner, for 14 days.
    Then take 1 tablet once daily before breakfast for another 2 weeks.
    Dispense: 42 tablets.
  2. Tab. Amoxicillin 1 g
    Take 1 tablet orally twice daily after meals for 14 days.
    Dispense: 28 tablets.
    Do not use if penicillin allergy.
  3. Tab. Clarithromycin 500 mg
    Take 1 tablet orally twice daily after meals for 14 days.
    Dispense: 28 tablets.
Advice
  • Test for H. pylori by stool antigen test or urea breath test where available. Confirm eradication at least 4 weeks after antibiotics and after withholding PPI for 2 weeks.
  • Avoid NSAIDs such as ibuprofen/diclofenac, smoking, alcohol, and foods that trigger symptoms.
  • Endoscopy is indicated for alarm symptoms: GI bleeding, vomiting, anemia, progressive dysphagia, weight loss, or persistent symptoms, especially at this age.
Acid suppression plus H. pylori eradication are the main medical treatments for uncomplicated ulcer disease, consistent with Bailey and Love’s discussion.
Follow-up: After 2 weeks, earlier if hematemesis or black stools occur.
Signature/Registration No.: ___________

3. Vikram Yadav, 34 years/M

Diagnosis: Microbiologically confirmed pulmonary tuberculosis, presumed drug-sensitive.
Important: Start treatment under the National TB Elimination Programme (NTEP) after checking for rifampicin resistance, HIV, diabetes, liver disease, body weight, and baseline visual status.
Date: //_____
Patient: Vikram Yadav, 34 years/M
Dx: Drug-sensitive pulmonary TB
Rx
NTEP daily, weight-band based fixed-dose combination regimen
  1. Intensive phase: 2 months
    Tab. HRZE fixed-dose combination
    Each tablet contains: Isoniazid 75 mg + Rifampicin 150 mg + Pyrazinamide 400 mg + Ethambutol 275 mg.
    Take the number of tablets once daily according to body-weight band, on an empty stomach or as directed by the TB programme.
  2. Continuation phase: 4 months
    Tab. HRE fixed-dose combination
    Isoniazid + Rifampicin + Ethambutol, in weight-band based daily dose, as supplied through NTEP.
  3. Tab. Pyridoxine 10-25 mg
    Take 1 tablet orally once daily throughout isoniazid therapy.
    Dispense: As per treatment duration.
Advice
  • Enrol in NTEP and use directly supported treatment.
  • Do not miss doses or stop treatment when symptoms improve.
  • Rifampicin can cause orange-red discoloration of urine, tears, and sweat.
  • Report jaundice, severe nausea/vomiting, visual blurring or impaired color vision, rash, tingling/numbness, or severe weakness immediately.
  • Screen household contacts and counsel on cough hygiene, ventilation, and nutrition.
  • Test for HIV and diabetes mellitus.
Follow-up: Monthly through NTEP, with sputum follow-up as per programme protocol.
Signature/Registration No.: ___________

4. Rambha Bai, 45 years/F

Diagnosis: Smear-confirmed uncomplicated malaria.
The species must be written on the smear report before choosing the final prescription. Treatment differs for P. vivax and P. falciparum. Also document body weight, pregnancy status, and G6PD status before primaquine.

A. If smear shows Plasmodium vivax

Date: //_____
Patient: Rambha Bai, 45 years/F
Dx: Uncomplicated P. vivax malaria
Rx
  1. Tab. Chloroquine 250 mg
    Take 4 tablets immediately, then 2 tablets after 24 hours, then 2 tablets after 48 hours.
    Total chloroquine dose is approximately 25 mg base/kg over 3 days.
    Dispense: 8 tablets.
  2. Tab. Primaquine 15 mg
    Take 1 tablet orally once daily after food for 14 days.
    Dispense: 14 tablets.
    Do not give primaquine in pregnancy, during breastfeeding of an infant with unknown G6PD status, or in confirmed G6PD deficiency.
  3. Tab. Paracetamol 500 mg
    Take 1 tablet orally every 6-8 hours if fever/body ache occurs.
    Maximum 3 g/day.
    Dispense: 10 tablets.

B. If smear shows Plasmodium falciparum

Rx
  1. ACT as per local/national malaria programme policy
    For example, in many areas: Artesunate + sulfadoxine-pyrimethamine (ACT-SP) for 3 days, in weight-appropriate doses.
    In areas with SP resistance, including parts of north-eastern India, artemether-lumefantrine (ACT-AL) is used instead.
  2. Tab. Primaquine 45 mg single dose
    Take once after food on Day 2, for transmission blocking.
    Do not give in pregnancy, infants, or G6PD deficiency.
  3. Tab. Paracetamol 500 mg
    Take 1 tablet every 6-8 hours if needed for fever/body ache.
    Maximum 3 g/day.
Advice for either type
  • Take adequate oral fluids and complete every dose.
  • Review within 48-72 hours, with repeat smear as per programme policy.
  • Refer urgently for persistent vomiting, confusion, jaundice, bleeding, breathlessness, oliguria, severe weakness, or inability to drink, because these may indicate severe malaria.
  • Current WHO recommendations emphasize species-specific, complete treatment, while India’s NCVBDC malaria strategy directs treatment through the national drug policy.
Signature/Registration No.: ___________

ACT full form

ACT = Artemisinin-based Combination Therapy.
It combines an artemisinin derivative with another antimalarial medicine to treat uncomplicated Plasmodium falciparum malaria and reduce drug resistance.
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