Injections for Medicine Department - Government Hospital (Odisha)

from reportlab.lib.pagesizes import A5
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph, Spacer,
    HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.platypus import PageBreak

OUTPUT = "/tmp/workspace/pocket-guide/Emergency_IV_IM_Pocket_Guide.pdf"

# ------- Color Palette -------
RED       = colors.HexColor("#C0392B")
DARK_RED  = colors.HexColor("#922B21")
ORANGE    = colors.HexColor("#E67E22")
YELLOW    = colors.HexColor("#F9E79F")
GREEN     = colors.HexColor("#1A5276")
LIGHT_BLU = colors.HexColor("#D6EAF8")
TEAL      = colors.HexColor("#117A65")
TEAL_LITE = colors.HexColor("#D1F2EB")
PURPLE    = colors.HexColor("#6C3483")
PURP_LITE = colors.HexColor("#E8DAEF")
NAVY      = colors.HexColor("#1B2631")
WHITE     = colors.white
LIGHT_GRY = colors.HexColor("#F2F3F4")
MED_GRY   = colors.HexColor("#BFC9CA")
AMBER     = colors.HexColor("#F0B27A")

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A5,
    leftMargin=8*mm, rightMargin=8*mm,
    topMargin=10*mm, bottomMargin=8*mm,
)

W = A5[0] - 16*mm   # usable width

styles = getSampleStyleSheet()

def style(name, **kw):
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title_style  = style("Title2",  fontSize=13, textColor=WHITE,
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sec_style    = style("Sec",     fontSize=8.5, textColor=WHITE,
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note_style   = style("Note",    fontSize=6.5, textColor=colors.HexColor("#922B21"),
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warn_style   = style("Warn",    fontSize=6, textColor=DARK_RED,
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foot_style   = style("Foot",    fontSize=6, textColor=colors.HexColor("#555555"),
                     alignment=TA_CENTER, fontName="Helvetica-Oblique", leading=8)
cell_style   = style("Cell",    fontSize=6.8, fontName="Helvetica", leading=9)
cell_b_style = style("CellB",   fontSize=6.8, fontName="Helvetica-Bold", leading=9)
hdr_style    = style("Hdr",     fontSize=7, fontName="Helvetica-Bold",
                     textColor=WHITE, leading=9)

def section_header(text, bg=GREEN):
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    tbl.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
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        ("RIGHTPADDING",  (0,0),(-1,-1), 4),
        ("BOX", (0,0),(-1,-1), 0.5, bg),
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    return tbl

def drug_table(headers, rows, col_widths, alt_color=LIGHT_BLU, hdr_bg=GREEN):
    data = [[Paragraph(h, hdr_style) for h in headers]]
    for i, row in enumerate(rows):
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    tbl = Table(data, colWidths=col_widths)
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        ("FONTNAME",      (0,0), (-1,0),  "Helvetica-Bold"),
        ("FONTSIZE",      (0,0), (-1,0),  6.8),
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    tbl.setStyle(TableStyle(style_cmds))
    return tbl

# ============================================================
# DATA
# ============================================================

HDR = ["Drug", "Dose / Route", "Form", "Notes"]
CW  = [37*mm, 42*mm, 22*mm, 35*mm]  # total ~136mm ≈ W

# ---- RESUSCITATION ----
resus_rows = [
    ["Adrenaline\n(Epinephrine)",
     "Cardiac arrest: 1 mg IV q3-5 min\nAnaphylaxis: 0.5 mg IM (lateral thigh)\nSeptic shock: 0.1-1 mcg/kg/min IV infusion",
     "Amp\n1 mg/ml (1 ml)", "Never give undiluted IV push in non-arrest"],
    ["Atropine",
     "Bradycardia: 0.5-1 mg IV, repeat q3-5 min (max 3 mg)\nOrganophosphate: 2-4 mg IV q5-10 min (titrate)",
     "Amp\n0.6/1 mg/ml (1 ml)", "Min dose 0.5 mg (paradox bradycardia <0.5 mg)"],
    ["Dopamine",
     "Shock: 5-20 mcg/kg/min IV infusion\nRenal dose: 1-3 mcg/kg/min",
     "Amp\n40 mg/ml (5 ml)", "Dilute in 250 ml NS/D5W. Central line preferred"],
    ["Noradrenaline",
     "Septic shock: 0.01-3 mcg/kg/min IV infusion",
     "Amp\n2 mg/ml", "Extravasation causes necrosis - use central line"],
    ["Dobutamine",
     "Cardiogenic shock: 2.5-20 mcg/kg/min IV infusion",
     "Vial\n250 mg/20 ml", "Titrate to HR & BP response"],
]

# ---- CARDIAC ----
cardiac_rows = [
    ["Adenosine",
     "SVT: 6 mg rapid IV bolus; if no response 12 mg after 1-2 min (max 18 mg)",
     "Amp\n3 mg/ml (2 ml)", "Flush immediately with 20 ml NS. Warn patient of flushing"],
    ["Amiodarone",
     "AF/VT: 300 mg IV over 20-60 min; then 900 mg over 24 hr",
     "Amp\n50 mg/ml (3 ml)", "Dilute in 5% glucose only. Phlebitis if peripheral"],
    ["Lignocaine",
     "VT: 1-1.5 mg/kg IV bolus; infusion 1-4 mg/min",
     "Amp\n20 mg/ml (5 ml)", "Monitor ECG. Max bolus 3 mg/kg"],
    ["Digoxin",
     "Load: 0.5 mg IV over 30 min; then 0.25 mg q6h x2\nMaint: 0.125-0.25 mg IV/IM OD",
     "Amp\n0.25 mg/ml (2 ml)", "Slow IV; monitor for toxicity (bradycardia, N/V, visual)"],
    ["Furosemide",
     "Pulm oedema: 40-80 mg IV bolus\nRefract: up to 200 mg IV infusion",
     "Amp\n10 mg/ml (2 ml)", "Monitor K+. Max rate 4 mg/min IV"],
    ["Labetalol",
     "HTN crisis: 20 mg IV over 2 min; repeat 40-80 mg q10 min (max 300 mg)\nInfusion: 2 mg/min",
     "Amp\n5 mg/ml", "Avoid in asthma, decompensated HF"],
    ["Esmolol",
     "HTN/Rate ctrl: 500 mcg/kg IV load, then 50-200 mcg/kg/min infusion",
     "Vial\n10 mg/ml", "Ultra-short acting. Titrate q4 min"],
    ["Hydralazine",
     "Hypertensive emergency: 5-10 mg IV slowly q20 min (max 40 mg)",
     "Amp\n20 mg/ml", "Rapid drop in BP - monitor closely"],
    ["Sodium Nitroprusside",
     "0.3-10 mcg/kg/min IV infusion (start low)",
     "Vial\n50 mg", "Wrap infusion in foil (light-sensitive). ICU use only"],
    ["Streptokinase",
     "STEMI: 15 lakh units IV over 60 min",
     "Vial\n7.5/15 lakh units", "Check contraindications strictly. Allergic reactions common"],
    ["Heparin",
     "UFH: 5000 IU IV bolus; infusion 1000-1500 IU/hr\nDVT prophylaxis: 5000 IU SC BD/TDS",
     "Vial\n5000 IU/ml", "Monitor APTT. Antidote: Protamine sulphate"],
    ["Enoxaparin\n(LMWH)",
     "ACS: 1 mg/kg SC BD\nDVT Rx: 1 mg/kg SC BD\nProphylaxis: 40 mg SC OD",
     "Pre-filled\n40/60/80 mg", "Avoid if CrCl <30. No routine APTT monitoring"],
]

# ---- CNS / SEIZURES ----
cns_rows = [
    ["Diazepam",
     "Status epilepticus: 5-10 mg IV at 2 mg/min; max 30 mg\nMay repeat 10-15 min",
     "Amp\n5 mg/ml (2 ml)", "Respiratory depression - keep bag-valve-mask ready"],
    ["Lorazepam",
     "Status epilepticus: 4 mg IV over 2-5 min; repeat 4 mg after 10 min",
     "Amp\n2 mg/ml (1-2 ml)", "Preferred 1st-line IV benzodiazepine for status"],
    ["Midazolam",
     "Seizure: 10 mg IM (if no IV access)\nSedation: 0.05-0.1 mg/kg IV",
     "Amp\n5 mg/ml (5 ml)", "IM midazolam = as effective as IV diazepam in field"],
    ["Phenytoin",
     "Loading: 15-20 mg/kg IV at max 50 mg/min\nMaint: 5-7 mg/kg/day",
     "Amp\n50 mg/ml (5 ml)", "Dilute in NS only. ECG monitor during loading. Avoid glucose"],
    ["Phenobarbitone",
     "Status: 15-20 mg/kg IV at max 60 mg/min\nMaint: 60-180 mg OD",
     "Amp\n200 mg/ml (1 ml)", "Causes hypotension & respiratory depression"],
    ["Haloperidol",
     "Acute psychosis: 5-10 mg IM; may repeat in 1 hr\nIV: 2.5-5 mg slowly",
     "Amp\n5 mg/ml (1 ml)", "Monitor QTc. Avoid in Parkinson's"],
    ["Promethazine",
     "Sedation/nausea: 25-50 mg IM deep\nSlow IV: 25 mg diluted",
     "Amp\n25/50 mg/ml", "DO NOT give SC - tissue necrosis. IV must be diluted, slow"],
]

# ---- ANALGESICS ----
analg_rows = [
    ["Morphine",
     "Acute pain: 2-5 mg IV slowly q4h\nAMI pain: 2-4 mg IV q5-15 min (titrate)\nIM: 5-10 mg q4h",
     "Amp\n10 mg/ml (1 ml)", "Keep naloxone at bedside. Avoid in head injury"],
    ["Tramadol",
     "50-100 mg IV slow infusion (dilute in 100 ml NS over 15-20 min)\nIM: 50-100 mg q4-6h",
     "Amp\n50 mg/ml (2 ml)", "Max 400 mg/day. Lowers seizure threshold"],
    ["Diclofenac",
     "75 mg IM deep (gluteal); max 150 mg/day\n(Not for IV use)",
     "Amp\n25 mg/ml (3 ml)", "IM only. Avoid in renal impairment, GI bleed, asthma"],
    ["Paracetamol",
     "1000 mg (100 ml) IV over 15 min q6h\n(Max 4 g/day; 2 g/day if liver disease)",
     "Infusion\n10 mg/ml\n(100 ml)", "Hepatotoxic in overdose. N-Acetylcysteine is antidote"],
    ["Pentazocine",
     "30-60 mg IM/SC; 30 mg IV q3-4h\n(Max 360 mg/day)",
     "Amp\n30 mg/ml", "Mixed agonist-antagonist. Avoid with pure opioids"],
]

# ---- RESPIRATORY ----
resp_rows = [
    ["Aminophylline",
     "Acute asthma/COPD: Load 5 mg/kg IV over 20-30 min\nMaint infusion: 0.5-0.9 mg/kg/hr\n(Omit load if on theophylline)",
     "Amp\n25 mg/ml\n(10 ml)", "Narrow TI - cardiac arrhythmias, seizures. Monitor levels"],
    ["Hydrocortisone",
     "Asthma/COPD: 100-200 mg IV q6h\nAdrenal crisis: 100 mg IV stat",
     "Vial\n100/200 mg\n(dry powder)", "Reconstitute with water for injection"],
    ["Salbutamol\n(IV)",
     "Severe asthma: 5 mcg/min IV infusion; titrate up\n(Prefer nebulisation; IV only if life-threatening)",
     "Amp\n0.5 mg/ml (1 ml)", "IV route reserved for ICU/life-threatening bronchospasm"],
    ["Dexamethasone",
     "ARDS/edema/anaphylaxis: 4-8 mg IV/IM BD-QDS\nAnti-emetic: 8 mg IV",
     "Amp\n4 mg/ml (2 ml)", "Multiple uses. Store protected from light"],
]

# ---- CORTICOSTEROIDS ----
ster_rows = [
    ["Methylprednisolone",
     "Asthma: 125 mg IV OD\nSpinal injury: 30 mg/kg IV over 15 min (within 8 hr)\nAutoimmune flare: 500 mg-1 g IV daily x3",
     "Vial\n40/125/500 mg\n1 g", "High dose: monitor glucose, BP, infections"],
    ["Hydrocortisone",
     "Adrenal crisis: 100 mg IV stat, then 100 mg q8h\nAllergic reaction: 100-200 mg IV",
     "Vial\n100/200 mg", "Add to normal saline for infusion"],
    ["Dexamethasone",
     "Cerebral oedema: 8-16 mg IV stat; 4 mg q6h\nCroup: 0.6 mg/kg IM single dose",
     "Amp\n4 mg/ml (2 ml)", "Long acting. Least mineralocorticoid activity"],
]

# ---- ANTIDOTES / POISONING ----
antidote_rows = [
    ["Naloxone",
     "Opioid OD: 0.4-2 mg IV q2-3 min (max 10 mg)\nIM: 0.4-2 mg if no IV access\nInfusion: 2/3 of effective dose/hour",
     "Amp\n0.4 mg/ml (1 ml)", "Short acting (30-90 min) - monitor for re-narcotization"],
    ["N-Acetylcysteine\n(NAC)",
     "Paracetamol OD: 150 mg/kg IV in 200 ml D5W over 1 hr;\nthen 50 mg/kg over 4 hr;\nthen 100 mg/kg over 16 hr",
     "Amp\n200 mg/ml\n(10 ml)", "Anaphylactoid reactions common in 1st bag. Slow rate"],
    ["Atropine\n(OP poisoning)",
     "Mild: 0.6-2 mg IV q5-10 min\nSevere: 2-4 mg IV q5-10 min\nEndpoint: drying of secretions",
     "Amp\n0.6/1 mg/ml", "Titrate to secretions NOT to heart rate. No ceiling dose"],
    ["Pralidoxime\n(PAM)",
     "Organophosphate: 1-2 g IV over 15-30 min; repeat 1 g q1-2h\nInfusion: 500 mg/hr",
     "Vial\n1 g", "Give within 24-48 hr of exposure. Use with atropine"],
    ["Calcium Gluconate",
     "Hypocalcaemia/Ca-channel blocker OD: 1-3 g (10-30 ml of 10%) IV slowly over 10-20 min\nHF fluoride/Hyperkalemia: 1 g IV",
     "Amp\n10% (10 ml)\n= 1 g", "Cardiac monitor during infusion. Extravasation causes necrosis"],
    ["Desferrioxamine",
     "Iron OD: 15 mg/kg/hr IV infusion (max 80 mg/kg/day)\nIM: 2 g IM if no IV",
     "Vial\n500 mg", "Urine turns orange-red (ferrioxamine). Refrigerate vial"],
    ["Snake Antivenom\n(Polyvalent)",
     "10 vials IV infusion in 100-200 ml NS over 30-60 min\nRepeat 10 vials if signs persist after 6 hr",
     "Vial\n(lyophilized\nor liquid)", "Pre-medicate: Adrenaline 0.25 mg SC, Promethazine 25 mg IM"],
]

# ---- ELECTROLYTES ----
elec_rows = [
    ["50% Dextrose",
     "Hypoglycaemia: 25-50 ml (12.5-25 g) IV bolus\nInsulin OD/prolonged hypoglycaemia: infusion in 10% Dextrose",
     "Amp\n50 ml\n(500 mg/ml)", "Flush vein with NS before & after. Tissue necrosis if extravasated"],
    ["Magnesium Sulphate",
     "Eclampsia: 4-6 g IV over 15-20 min; then 1-2 g/hr\nSevere asthma: 2 g IV over 20 min\nTorsades: 2 g IV over 5-15 min\nHypoMg: 1-2 g IV over 1 hr",
     "Amp\n50%: 10 ml\n= 5 g", "Antidote: Calcium gluconate 1 g IV. Monitor RR, knee jerk, UO"],
    ["Potassium Chloride\n(KCl)",
     "Severe hypokalaemia: add to 1 L NS/D5W\nMax peripheral rate: 10 mEq/hr\nMax concentration peripheral: 40 mEq/L",
     "Amp\n15%: 10 ml\n= 20 mEq", "NEVER give undiluted IV. Fatal arrhythmias. ECG monitoring"],
    ["Sodium Bicarbonate",
     "Severe metabolic acidosis (pH <7.1): 1-2 mEq/kg IV slowly\nHyperkalaemia (stabilize membrane): 50-100 mEq IV over 5-10 min\nTCA OD: 1-2 mEq/kg IV bolus",
     "Amp\n7.5%: 10 ml\n(~9 mEq)", "Do not mix with calcium (precipitates). Use only if truly indicated"],
    ["Calcium Gluconate\n(Hyperkalaemia)",
     "K+ >6.5 or ECG changes: 10-20 ml of 10% IV over 2-5 min\nRepeat in 5 min if no improvement",
     "Amp\n10% (10 ml)", "Cardiac membrane stabilizer. Does not lower K+. Effect 30-60 min"],
]

# ---- ANTIBIOTICS (emergency) ----
abx_rows = [
    ["Ceftriaxone",
     "Sepsis/meningitis: 2 g IV BD\nPneumonia/other: 1-2 g IV OD\nGonorrhoea: 500 mg IM single dose",
     "Vial\n1 g (dry powder)", "Reconstitute with Lidocaine 1% for IM (less pain)"],
    ["Piperacillin\n+Tazobactam",
     "Severe sepsis: 4.5 g IV over 30 min q6-8h\n(Extended infusion: 4.5 g over 4 hr q8h)",
     "Vial\n4.5 g", "Preferred for Gram-negative & Pseudomonas cover"],
    ["Meropenem",
     "Severe sepsis/meningitis: 1-2 g IV q8h\nFebrile neutropenia: 1 g IV q8h",
     "Vial\n500 mg / 1 g", "Last-line broad-spectrum. Reconstitute; stable 8 hr at RT"],
    ["Vancomycin",
     "MRSA/Gram+: 25-30 mg/kg IV loading; maint 15-20 mg/kg q8-12h\n(Target trough 15-20 mcg/ml)",
     "Vial\n500 mg / 1 g", "Infuse over min 60 min. Red man syndrome if too fast"],
    ["Gentamicin",
     "Sepsis: 5-7 mg/kg IV OD (once-daily dosing)\nEndocarditis: 1 mg/kg IV q8h",
     "Amp\n40/80 mg (2 ml)", "Monitor renal function & trough levels. Ototoxic"],
    ["Metronidazole",
     "Anaerobic/abdominal sepsis: 500 mg IV q8h\nC.diff: 500 mg IV q8h (if cannot tolerate oral)",
     "IV Bottle\n500 mg/100 ml", "Infuse over 30-60 min. Avoid alcohol"],
    ["Ciprofloxacin",
     "UTI/chest/GI: 400 mg IV q8-12h\nAnthrax/serious: 400 mg IV q8h",
     "IV Bottle\n200 mg/100 ml", "Infuse over 60 min. Prolongs QTc. Avoid with theophylline"],
    ["Artesunate",
     "Severe malaria: 2.4 mg/kg IV at 0, 12, 24 hr; then OD for 7 days\nIM: same dose",
     "Vial\n60 mg (dry powder)", "Reconstitute with 5% NaHCO3 first; then dilute in D5W"],
]

# ---- ANTIEMETICS / GI ----
gi_rows = [
    ["Ondansetron",
     "Nausea/vomiting: 4-8 mg IV over 15 min q8h\nChemo-induced: 8 mg IV",
     "Amp\n2 mg/ml (2 ml = 4 mg)", "Slow IV; prolongs QTc. Max single dose 16 mg IV"],
    ["Metoclopramide",
     "Nausea/gastroparesis: 10 mg IV/IM q8h",
     "Amp\n5 mg/ml (2 ml)", "EPS side effects. Avoid in epilepsy, obstruction"],
    ["Pantoprazole",
     "GI bleed/PUD: 80 mg IV bolus; then 8 mg/hr infusion x72 hr\nSR: 40 mg IV OD",
     "Vial\n40 mg (dry powder)", "Reconstitute in NS. High-dose for active bleed"],
    ["Ranitidine",
     "PUD/stress ulcer: 50 mg IV q8h or 6.25 mg/hr infusion",
     "Amp\n25 mg/ml (2 ml = 50 mg)", "Give slowly IV over 5-15 min. (Less commonly used now)"],
    ["Vitamin K\n(Phytomenadione)",
     "Warfarin reversal: 5-10 mg IV over 20 min\nHepatic/coagulopathy: 10 mg IV/IM OD",
     "Amp\n10 mg/ml (1 ml)", "IV anaphylaxis risk. Slow infusion. For partial reversal"],
]

# ---- DIABETES EMERGENCIES ----
dm_rows = [
    ["Regular Insulin\n(Soluble)",
     "DKA: 0.1 U/kg/hr IV infusion\nHyperkalaemia: 10 U IV in 50 ml 50% Dextrose over 15-30 min\nSliding scale SC: per protocol",
     "Vial\n40 IU/ml (10 ml)\nor 100 IU/ml", "Dedicated line for insulin drip. Monitor glucose hourly"],
    ["Glucagon",
     "Severe hypoglycaemia: 1 mg IM/SC/IV\nRepeat in 15 min if no response",
     "Vial\n1 mg", "Turn patient lateral (vomiting risk). Check glucose in 15 min"],
    ["50% Dextrose",
     "Hypoglycaemia: 25-50 ml IV bolus\nThen 10% Dextrose infusion to maintain",
     "Amp\n50 ml", "See Electrolytes section above"],
]

# ---- ANTICOAGULATION ----

# ============================================================
# BUILD PDF
# ============================================================

story = []

# ---------- COVER PAGE ----------
story.append(Spacer(1, 8*mm))

cover_data = [[Paragraph(
    "🏥  EMERGENCY IV/IM DRUG\nPOCKET REFERENCE GUIDE",
    title_style)]]
cover_tbl = Table(cover_data, colWidths=[W])
cover_tbl.setStyle(TableStyle([
    ("BACKGROUND", (0,0),(-1,-1), DARK_RED),
    ("BOX",        (0,0),(-1,-1), 1.5, DARK_RED),
    ("TOPPADDING",    (0,0),(-1,-1), 10),
    ("BOTTOMPADDING", (0,0),(-1,-1), 10),
    ("ROUNDEDCORNERS", [4,4,4,4]),
]))
story.append(cover_tbl)
story.append(Spacer(1, 3*mm))

subtitle_data = [[Paragraph(
    "Medicine Department  |  Govt Hospital, Odisha\nDosages for IV & IM Administration",
    sub_style)]]
sub_tbl = Table(subtitle_data, colWidths=[W])
sub_tbl.setStyle(TableStyle([
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    ("BOTTOMPADDING", (0,0),(-1,-1), 5),
]))
story.append(sub_tbl)
story.append(Spacer(1, 3*mm))

# Warning box
warn_data = [[Paragraph(
    "⚠  FOR TRAINED HEALTHCARE PROFESSIONALS ONLY  ⚠\n"
    "Verify all dosages before administration. Adjust for renal/hepatic impairment, weight & age.\n"
    "This guide does not replace clinical judgment.",
    warn_style)]]
warn_tbl = Table(warn_data, colWidths=[W])
warn_tbl.setStyle(TableStyle([
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    ("BOTTOMPADDING", (0,0),(-1,-1), 5),
    ("LEFTPADDING",   (0,0),(-1,-1), 6),
]))
story.append(warn_tbl)
story.append(Spacer(1, 2*mm))

# TOC
toc_items = [
    "1. Resuscitation & Shock Drugs",
    "2. Cardiac Drugs",
    "3. CNS / Seizure Management",
    "4. Analgesics",
    "5. Respiratory Emergencies",
    "6. Corticosteroids",
    "7. Antidotes & Poisoning",
    "8. Electrolytes & Metabolic",
    "9. Antibiotics (Emergency Use)",
    "10. Antiemetics & GI",
    "11. Diabetes Emergencies",
]
toc_data = [[Paragraph("CONTENTS", style("toch", fontSize=7.5,
    fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER, leading=10))]]
for i in range(0, len(toc_items), 2):
    row = [toc_items[i]]
    if i+1 < len(toc_items):
        row.append(toc_items[i+1])
    else:
        row.append("")
    toc_data.append([Paragraph(row[0], style(f"tc{i}a", fontSize=6.5,
        fontName="Helvetica", leading=9)),
        Paragraph(row[1], style(f"tc{i}b", fontSize=6.5,
        fontName="Helvetica", leading=9))])

toc_tbl = Table(toc_data, colWidths=[W])
# rebuild as 2-col table for items
toc_data2 = [[Paragraph("CONTENTS", style("toch2", fontSize=7.5,
    fontName="Helvetica-Bold", textColor=WHITE, alignment=TA_CENTER, leading=10)),
    Paragraph("", style("empty", fontSize=7.5, leading=10))]]
half = W/2
for i in range(0, len(toc_items), 2):
    a = Paragraph(toc_items[i], style(f"ta{i}", fontSize=6.5, fontName="Helvetica", leading=9))
    b = Paragraph(toc_items[i+1] if i+1 < len(toc_items) else "",
                  style(f"tb{i}", fontSize=6.5, fontName="Helvetica", leading=9))
    toc_data2.append([a, b])

toc_tbl2 = Table(toc_data2, colWidths=[half, half])
toc_tbl2.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),(-1,0), NAVY),
    ("BACKGROUND",    (0,1),(-1,-1), LIGHT_BLU),
    ("SPAN",          (0,0),(-1,0)),
    ("GRID",          (0,1),(-1,-1), 0.3, MED_GRY),
    ("TOPPADDING",    (0,0),(-1,-1), 2),
    ("BOTTOMPADDING", (0,0),(-1,-1), 2),
    ("LEFTPADDING",   (0,0),(-1,-1), 4),
]))
story.append(toc_tbl2)
story.append(Spacer(1, 2*mm))

foot_data = [[Paragraph(
    "Based on District Hospital EML (India, Jan 2024) & OSMCL Odisha | Compiled July 2026",
    foot_style)]]
foot_tbl = Table(foot_data, colWidths=[W])
foot_tbl.setStyle(TableStyle([
    ("TOPPADDING",    (0,0),(-1,-1), 2),
    ("BOTTOMPADDING", (0,0),(-1,-1), 2),
]))
story.append(foot_tbl)

# ---------- SECTIONS ----------

def add_section(title, rows, bg_color=GREEN, alt=LIGHT_BLU):
    story.append(Spacer(1, 2*mm))
    story.append(section_header(title, bg=bg_color))
    tbl = drug_table(
        ["Drug", "Dose / Route", "Form", "Key Notes"],
        rows, CW, alt_color=alt, hdr_bg=bg_color
    )
    story.append(tbl)

story.append(PageBreak())
add_section("1.  RESUSCITATION & SHOCK", resus_rows, bg_color=RED, alt=colors.HexColor("#FADBD8"))
add_section("2.  CARDIAC DRUGS", cardiac_rows, bg_color=colors.HexColor("#1A5276"), alt=LIGHT_BLU)

story.append(PageBreak())
add_section("3.  CNS / SEIZURE MANAGEMENT", cns_rows, bg_color=PURPLE, alt=PURP_LITE)
add_section("4.  ANALGESICS", analg_rows, bg_color=colors.HexColor("#784212"), alt=colors.HexColor("#FDEBD0"))

story.append(PageBreak())
add_section("5.  RESPIRATORY EMERGENCIES", resp_rows, bg_color=TEAL, alt=TEAL_LITE)
add_section("6.  CORTICOSTEROIDS", ster_rows, bg_color=colors.HexColor("#0E6655"), alt=colors.HexColor("#D5F5E3"))

story.append(PageBreak())
add_section("7.  ANTIDOTES & POISONING", antidote_rows, bg_color=colors.HexColor("#7D6608"), alt=colors.HexColor("#FDFDE7"))

story.append(PageBreak())
add_section("8.  ELECTROLYTES & METABOLIC", elec_rows, bg_color=colors.HexColor("#154360"), alt=colors.HexColor("#D6EAF8"))
add_section("9.  ANTIBIOTICS (Emergency Use)", abx_rows, bg_color=colors.HexColor("#4A235A"), alt=PURP_LITE)

story.append(PageBreak())
add_section("10. ANTIEMETICS & GI", gi_rows, bg_color=TEAL, alt=TEAL_LITE)
add_section("11. DIABETES EMERGENCIES", dm_rows, bg_color=colors.HexColor("#922B21"), alt=colors.HexColor("#FADBD8"))

# ---------- LAST PAGE: Quick Reference Card ----------
story.append(PageBreak())
story.append(section_header("CRITICAL REMINDERS  -  Always Verify Before Use", bg=DARK_RED))
story.append(Spacer(1, 2*mm))

reminders = [
    ["NEVER give KCl undiluted IV", "ALWAYS cardiac monitor for antiarrhythmics"],
    ["Sodium Nitroprusside: wrap in foil", "Streptokinase: check contraindications"],
    ["Vancomycin: infuse >60 min (Red Man)", "MgSO4 antidote = Calcium Gluconate 1 g IV"],
    ["Phenytoin: NS only, NOT glucose", "Opioids: keep Naloxone at bedside"],
    ["Atropine min dose 0.5 mg IV", "OP poisoning: no ceiling for atropine"],
    ["Artesunate: bicarb reconstitution first", "Snake antivenom: pre-medicate with adrenaline SC"],
    ["Promethazine: NEVER SC (necrosis)", "Noradrenaline: central line preferred"],
    ["Insulin: dedicated IV line; monitor glucose hourly", "Amphotericin B: slow infusion, test dose first"],
]
rem_tbl = Table(
    [[Paragraph(a, style("ra", fontSize=6.5, fontName="Helvetica-Bold",
                          textColor=DARK_RED, leading=9)),
      Paragraph(b, style("rb", fontSize=6.5, fontName="Helvetica-Bold",
                          textColor=colors.HexColor("#1A5276"), leading=9))]
     for a, b in reminders],
    colWidths=[W/2, W/2]
)
rem_tbl.setStyle(TableStyle([
    ("ROWBACKGROUNDS", (0,0), (-1,-1), [YELLOW, WHITE]),
    ("GRID",           (0,0), (-1,-1), 0.3, MED_GRY),
    ("TOPPADDING",     (0,0), (-1,-1), 3),
    ("BOTTOMPADDING",  (0,0), (-1,-1), 3),
    ("LEFTPADDING",    (0,0), (-1,-1), 4),
    ("VALIGN",         (0,0), (-1,-1), "TOP"),
]))
story.append(rem_tbl)
story.append(Spacer(1, 3*mm))

# Abbreviations
abbr_data = [
    [Paragraph("ABBREVIATIONS", style("abh", fontSize=7, fontName="Helvetica-Bold",
                                       textColor=WHITE, alignment=TA_CENTER, leading=9)),
     Paragraph("", style("empty2", fontSize=7, leading=9))]
]
abbrs = [
    ("IV = Intravenous", "IM = Intramuscular"),
    ("SC = Subcutaneous", "OD = Once daily"),
    ("BD = Twice daily", "TDS = Three times daily"),
    ("QDS = Four times daily", "q = every (e.g. q8h = every 8 hours)"),
    ("NS = Normal Saline 0.9%", "D5W = 5% Dextrose in Water"),
    ("UO = Urine output", "RR = Respiratory rate"),
    ("ECG = Electrocardiogram", "APTT = Activated Partial Thromboplastin Time"),
    ("TI = Therapeutic index", "EPS = Extrapyramidal side effects"),
    ("OD = Overdose (context)", "Rx = Treatment"),
]
for a, b in abbrs:
    abbr_data.append([
        Paragraph(a, style(f"aa{a}", fontSize=6, fontName="Helvetica", leading=8)),
        Paragraph(b, style(f"ab{b}", fontSize=6, fontName="Helvetica", leading=8)),
    ])
abbr_tbl = Table(abbr_data, colWidths=[W/2, W/2])
abbr_tbl.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),(-1,0), NAVY),
    ("SPAN",          (0,0),(-1,0)),
    ("ROWBACKGROUNDS",(0,1),(-1,-1), [LIGHT_GRY, WHITE]),
    ("GRID",          (0,1),(-1,-1), 0.3, MED_GRY),
    ("TOPPADDING",    (0,0),(-1,-1), 2),
    ("BOTTOMPADDING", (0,0),(-1,-1), 2),
    ("LEFTPADDING",   (0,0),(-1,-1), 4),
]))
story.append(abbr_tbl)
story.append(Spacer(1, 3*mm))
story.append(Paragraph(
    "For educational purposes only. Not a substitute for standard treatment protocols.\n"
    "Refer to current AIIMS/ICMR/WHO guidelines and local hospital policy for updates.",
    foot_style))

# BUILD
doc.build(story)
print(f"PDF created: {OUTPUT}")

from reportlab.lib.pagesizes import A5
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph, Spacer, PageBreak
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT

OUTPUT = "/tmp/workspace/pocket-guide/Complete_98_Injections_Pocket_Guide.pdf"

# ── Colour palette ──────────────────────────────────────────
RED       = colors.HexColor("#C0392B")
DARK_RED  = colors.HexColor("#922B21")
ORANGE    = colors.HexColor("#E67E22")
YELLOW    = colors.HexColor("#F9E79F")
GREEN     = colors.HexColor("#1A5276")
LIGHT_BLU = colors.HexColor("#D6EAF8")
TEAL      = colors.HexColor("#117A65")
TEAL_LITE = colors.HexColor("#D1F2EB")
PURPLE    = colors.HexColor("#6C3483")
PURP_LITE = colors.HexColor("#E8DAEF")
NAVY      = colors.HexColor("#1B2631")
WHITE     = colors.white
LIGHT_GRY = colors.HexColor("#F2F3F4")
MED_GRY   = colors.HexColor("#BFC9CA")
AMBER     = colors.HexColor("#F0B27A")
BROWN     = colors.HexColor("#784212")
BROWN_LT  = colors.HexColor("#FDEBD0")
OLIVE     = colors.HexColor("#0E6655")
OLIVE_LT  = colors.HexColor("#D5F5E3")
INDIGO    = colors.HexColor("#154360")

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A5,
    leftMargin=7*mm, rightMargin=7*mm,
    topMargin=9*mm,  bottomMargin=7*mm,
)
W = A5[0] - 14*mm   # usable page width

styles = getSampleStyleSheet()

def PS(name, **kw):
    return ParagraphStyle(name, parent=styles["Normal"], **kw)

title_st  = PS("T",  fontSize=12, textColor=WHITE, alignment=TA_CENTER,
               fontName="Helvetica-Bold", leading=15)
sub_st    = PS("S",  fontSize=7,  textColor=WHITE, alignment=TA_CENTER,
               fontName="Helvetica", leading=9)
sec_st    = PS("Sc", fontSize=8,  textColor=WHITE,
               fontName="Helvetica-Bold", leading=10, leftIndent=2)
warn_st   = PS("W",  fontSize=6.2,textColor=DARK_RED,
               fontName="Helvetica-BoldOblique", leading=8)
foot_st   = PS("F",  fontSize=5.8,textColor=colors.HexColor("#555555"),
               alignment=TA_CENTER, fontName="Helvetica-Oblique", leading=7.5)
hdr_st    = PS("H",  fontSize=6.5,fontName="Helvetica-Bold",
               textColor=WHITE, leading=8.5)
cell_st   = PS("C",  fontSize=6.2,fontName="Helvetica", leading=8)
sno_st    = PS("N",  fontSize=6.2,fontName="Helvetica-Bold",
               textColor=NAVY, leading=8)
note_st   = PS("Nt", fontSize=5.8,fontName="Helvetica-Oblique",
               textColor=colors.HexColor("#555555"), leading=7.5)

# column widths: S.No | Drug | Dose+Route | Form | Notes
CW = [7*mm, 30*mm, 43*mm, 20*mm, 32*mm]   # total 132mm ≈ W

def sec_header(text, bg=GREEN):
    t = Table([[Paragraph(text, sec_st)]], colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), bg),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LEFTPADDING",   (0,0),(-1,-1), 5),
    ]))
    return t

def drug_tbl(rows, hdr_bg=GREEN, alt=LIGHT_BLU):
    headers = ["#", "Drug", "Dose / Route", "Form", "Key Notes"]
    data = [[Paragraph(h, hdr_st) for h in headers]]
    for row in rows:
        data.append([
            Paragraph(str(row[0]), sno_st),
            Paragraph(str(row[1]), cell_st),
            Paragraph(str(row[2]), cell_st),
            Paragraph(str(row[3]), cell_st),
            Paragraph(str(row[4]), note_st),
        ])
    t = Table(data, colWidths=CW)
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,0),  hdr_bg),
        ("ROWBACKGROUNDS",(0,1),(-1,-1), [WHITE, alt]),
        ("GRID",          (0,0),(-1,-1), 0.35, MED_GRY),
        ("TOPPADDING",    (0,0),(-1,-1), 1.8),
        ("BOTTOMPADDING", (0,0),(-1,-1), 1.8),
        ("LEFTPADDING",   (0,0),(-1,-1), 2.5),
        ("RIGHTPADDING",  (0,0),(-1,-1), 2.5),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ]))
    return t

# ════════════════════════════════════════════════════════════
#  ALL 98 INJECTIONS  (grouped by category)
# ════════════════════════════════════════════════════════════

# ── 1. ANALGESICS & ANTI-INFLAMMATORY (5) ──
analg = [
    [1,  "Diclofenac",           "75 mg IM deep (gluteal); max 150 mg/day\n(IM only – not IV)",
     "Amp\n25 mg/ml\n3 ml",      "Avoid renal impairment, GI bleed, asthma"],
    [2,  "Paracetamol",          "1 g IV over 15 min q6h (max 4 g/day;\n2 g/day in liver disease)",
     "Infusion\n10 mg/ml\n100 ml","Hepatotoxic in OD – antidote is NAC"],
    [3,  "Tramadol",             "50–100 mg in 100 ml NS IV over 20 min;\nIM 50–100 mg q4–6h; max 400 mg/day",
     "Amp\n50 mg/ml\n2 ml",      "Lowers seizure threshold. Avoid with MAOIs"],
    [4,  "Morphine",             "IV: 2–5 mg slowly q4h\nAMI: 2–4 mg IV, titrate\nIM: 5–10 mg q4h",
     "Amp\n10 mg/ml\n1 ml",      "Keep naloxone ready. Avoid in head injury"],
    [5,  "Pentazocine",          "IM/SC 30–60 mg q3–4h; IV 30 mg q3–4h\nMax 360 mg/day",
     "Amp\n30 mg/ml",            "Mixed agonist-antagonist; avoid with pure opioids"],
]

# ── 2. ANTIBIOTICS (20) ──
abx = [
    [6,  "Benzylpenicillin\n(Crystalline Pen)",
     "Meningitis/sepsis: 20–24 lakh U/day IV in 4–6 divided doses",
     "Vial\n10 lakh U\n(dry pwd)",  "Dilute in NS/D5W. Give over 30 min. Check allergy"],
    [7,  "Benzathine\nBenzylpenicillin",
     "Rheumatic fever prophylaxis: 12 lakh U IM q3–4 wk\n(Single IM injection only)",
     "Vial\n12 lakh U\n(dry pwd)",  "Deep IM gluteal only. NEVER IV. Warm to RT first"],
    [8,  "Ampicillin",
     "500 mg–2 g IV/IM q4–6h\nMeningitis: 2 g IV q4h",
     "Vial\n250 mg/500 mg\n1 g",    "Dilute & give over 30 min. Common rash with EBV"],
    [9,  "Amoxicillin\n+Clavulanic Acid",
     "1.2 g (1 g+200 mg) IV q8h\nSevere: 1.2 g IV q6h",
     "Vial\n1 g+200 mg",            "Infuse over 30 min. Check penicillin allergy"],
    [10, "Cloxacillin",
     "500 mg–1 g IV/IM q4–6h",
     "Vial\n500 mg\n(dry pwd)",      "Anti-staphylococcal. Give on empty stomach (oral)"],
    [11, "Cefazolin",
     "1–2 g IV/IM q8h\nSurgical prophylaxis: 1–2 g IV 30–60 min pre-op",
     "Vial\n500 mg / 1 g\n(dry pwd)","1st-gen cephalosporin. Good for skin/soft tissue"],
    [12, "Cefotaxime",
     "1–2 g IV/IM q6–8h\nMeningitis: 2 g IV q4h",
     "Vial\n250 mg / 1 g\n(dry pwd)","3rd-gen. Broad Gram-neg cover"],
    [13, "Ceftriaxone",
     "1–2 g IV OD (or BD for meningitis)\nGonorrhoea: 500 mg IM single dose",
     "Vial\n250 mg/500 mg\n1 g",     "IM: reconstitute in 1% lignocaine. Avoid Ca-containing fluids"],
    [14, "Ceftazidime",
     "1–2 g IV/IM q8h\nPseudomonas: 2 g IV q8h",
     "Vial\n250 mg / 1 g\n(dry pwd)","Anti-pseudomonal 3rd-gen cephalosporin"],
    [15, "Piperacillin\n+Tazobactam",
     "4.5 g IV over 30 min q6–8h\nExtended: 4.5 g over 4 hr q8h",
     "Vial\n4.5 g (4 g+0.5 g)",     "Broadest beta-lactam. Good Pseudomonas cover"],
    [16, "Gentamicin",
     "ODD: 5–7 mg/kg IV/IM OD\nEndocarditis: 1 mg/kg IV q8h",
     "Amp\n40 mg/2 ml\n80 mg/2 ml",  "Monitor trough. Ototoxic/nephrotoxic"],
    [17, "Amikacin",
     "15 mg/kg/day IV/IM OD or in 2–3 divided doses",
     "Amp\n250 mg/ml\n2 ml (500 mg)","Reserve for resistant Gram-neg. Monitor levels & renal fn"],
    [18, "Ciprofloxacin\n(IV)",
     "400 mg IV q8–12h\nAnthrax/severe: 400 mg IV q8h",
     "IV Bottle\n200 mg/100 ml",     "Infuse over 60 min. Prolongs QTc. Avoid with theophylline"],
    [19, "Metronidazole\n(IV)",
     "500 mg IV q8h\nGive over 30–60 min",
     "IV Bottle\n500 mg/100 ml",     "Anaerobic cover. Avoid alcohol. Metallic taste (oral)"],
    [20, "Vancomycin",
     "Load: 25–30 mg/kg IV; Maint: 15–20 mg/kg q8–12h\n(Target trough 15–20 mcg/ml)",
     "Vial\n500 mg / 1 g\n(dry pwd)","Infuse >60 min (Red Man syndrome if fast). MRSA drug"],
    [21, "Meropenem",
     "1–2 g IV q8h\nMeningitis: 2 g IV q8h\nFN: 1 g IV q8h",
     "Vial\n500 mg / 1 g\n(dry pwd)","Carbapenem – last resort. Stable 8 hr at RT after reconstitution"],
    [22, "Imipenem\n+Cilastatin",
     "500 mg IV q6h\nSevere: 1 g IV q6–8h",
     "Vial\n500 mg+500 mg",          "Lowers seizure threshold. Avoid in CNS infections if possible"],
    [23, "Chloramphenicol",
     "50–100 mg/kg/day IV in 4 divided doses\nMax 4 g/day",
     "Vial\n1 g",                    "Aplastic anaemia risk. Monitor CBC. Use only when necessary"],
    [24, "Doxycycline\n(IV)",
     "100 mg IV q12h (infuse over 1–4 hr)",
     "Vial\n100 mg",                 "Not for children <8 yr. Avoid Ca/Mg/Fe co-administration"],
    [25, "Co-trimoxazole\n(IV)",
     "Pneumocystis: 15–20 mg/kg/day (TMP component) IV in 3–4 divided doses",
     "Amp\n80 mg TMP +\n400 mg SMX\n5 ml",  "Dilute in 250 ml NS. Monitor renal function. Hyperkalaemia risk"],
]

# ── 3. ANTIFUNGAL (2) ──
antifung = [
    [26, "Amphotericin B\n(Conventional)",
     "Test dose 1 mg in 100 ml D5W over 30 min;\nthen 0.25–1 mg/kg/day IV over 4–6 hr",
     "Vial\n50 mg\n(dry pwd)",       "Light-sensitive (wrap). Fever/rigors common. Nephrotoxic"],
    [27, "Fluconazole\n(IV)",
     "Candida/Crypto: 400 mg IV OD Day 1;\nthen 200–400 mg IV OD",
     "IV Bottle\n2 mg/ml\n100 ml",   "Infuse over 60 min. Prolongs QTc. CYP3A4 inhibitor"],
]

# ── 4. ANTIVIRAL / ANTIPARASITIC (2) ──
antip = [
    [28, "Artesunate",
     "Severe malaria: 2.4 mg/kg IV/IM at 0, 12, 24 hr;\nthen OD for 7 days",
     "Vial\n60 mg\n(dry pwd)",       "Reconstitute with 5% NaHCO3 first; then dilute in D5W/NS"],
    [29, "Quinine",
     "Severe malaria: 20 mg/kg IV load over 4 hr;\nthen 10 mg/kg IV q8h (maintain until oral possible)",
     "Amp\n300 mg/ml\n2 ml",         "Cardiac monitor. Hypoglycaemia risk. Slow infusion only"],
]

# ── 5. ANTITUBERCULAR (1) ──
antitb = [
    [30, "Streptomycin",
     "TB: 0.75–1 g IM OD (15 mg/kg/day)\nMax 1 g/day",
     "Vial\n0.75 g / 1 g\n(dry pwd)","IM only. Ototoxic/nephrotoxic. Monitor renal function & hearing"],
]

# ── 6. CARDIOVASCULAR (17) ──
cardio = [
    [31, "Adrenaline\n(Epinephrine)",
     "Cardiac arrest: 1 mg IV q3–5 min\nAnaphylaxis: 0.5 mg IM (lateral thigh)\nShock infusion: 0.1–1 mcg/kg/min IV",
     "Amp\n1 mg/ml\n1 ml",           "Never give undiluted IV push outside arrest. Central line for infusion"],
    [32, "Noradrenaline",
     "Septic shock: 0.01–3 mcg/kg/min IV infusion\nTitrate to MAP ≥65 mmHg",
     "Amp\n2 mg/ml",                 "Central line only. Extravasation causes necrosis"],
    [33, "Dopamine",
     "Shock: 5–20 mcg/kg/min IV infusion\nRenal dose: 1–3 mcg/kg/min",
     "Amp\n40 mg/ml\n5 ml",          "Dilute in 250 ml NS/D5W. Prefer central line"],
    [34, "Dobutamine",
     "Cardiogenic shock: 2.5–20 mcg/kg/min IV infusion\nTitrate to HR & BP",
     "Vial\n250 mg/20 ml",           "Increases HR and contractility. Monitor ECG"],
    [35, "Digoxin",
     "AF rate control: Load 0.5 mg IV over 30 min;\nthen 0.25 mg q6h x2\nMaint: 0.125–0.25 mg IV/IM OD",
     "Amp\n0.25 mg/ml\n2 ml",        "Narrow TI. Toxicity: N/V, bradycardia, visual changes. Avoid hypokalaemia"],
    [36, "Lignocaine\n(Lidocaine)",
     "VT: 1–1.5 mg/kg IV bolus;\nInfusion: 1–4 mg/min\nMax bolus: 3 mg/kg",
     "Amp\n20 mg/ml\n5 ml",          "ECG monitor. Toxicity: seizures, arrhythmia"],
    [37, "Atropine",
     "Bradycardia: 0.5–1 mg IV q3–5 min (max 3 mg)\nOP poisoning: 2–4 mg IV q5–10 min (titrate secretions)",
     "Amp\n0.6 mg/ml\n1 mg/ml",      "Min dose 0.5 mg IV (paradox bradycardia <0.5 mg)"],
    [38, "Adenosine",
     "SVT: 6 mg rapid IV bolus; if no conversion\n12 mg after 1–2 min; max 18 mg total",
     "Amp\n3 mg/ml\n2 ml",           "Flush immediately with 20 ml NS. Warn: flushing, chest pain, brief asystole"],
    [39, "Amiodarone",
     "AF/VF/VT: 300 mg IV over 20–60 min;\nthen 900 mg over 24 hr\nCardiac arrest: 300 mg rapid IV",
     "Amp\n50 mg/ml\n3 ml",          "Dilute in 5% Dextrose ONLY. Phlebitis via peripheral line"],
    [40, "Esmolol",
     "SVT/HTN: 500 mcg/kg IV load over 1 min;\nthen 50–200 mcg/kg/min infusion\nTitrate q4 min",
     "Vial\n10 mg/ml",               "Ultra-short acting (9 min half-life). Avoid in asthma/decompensated HF"],
    [41, "Labetalol",
     "HTN crisis: 20 mg IV over 2 min;\nRepeat 40–80 mg q10 min (max 300 mg)\nInfusion: 2 mg/min",
     "Amp\n5 mg/ml",                 "Alpha + beta blocker. Avoid in asthma, acute HF, bradycardia"],
    [42, "Hydralazine",
     "Hypertensive emergency: 5–10 mg IV slowly q20 min\n(Max 40 mg)",
     "Amp\n20 mg/ml",                "Rapid BP drop; monitor closely. Avoid in dissection"],
    [43, "Sodium\nNitroprusside",
     "0.3–10 mcg/kg/min IV infusion\n(Start low; titrate every 5 min)",
     "Vial\n50 mg",                  "Wrap in foil (light-sensitive). ICU use. Cyanide toxicity if prolonged"],
    [44, "Streptokinase",
     "STEMI: 15 lakh U IV over 60 min\nPE/DVT: 2.5 lakh U IV load over 30 min;\nthen 1 lakh U/hr x12–24 hr",
     "Vial\n7.5 lakh U\n15 lakh U",  "Check contraindications. Allergic reactions common. 1 year repeat restriction"],
    [45, "Enoxaparin\n(LMWH)",
     "ACS: 1 mg/kg SC BD\nDVT Rx: 1 mg/kg SC BD\nProphylaxis: 40 mg SC OD",
     "Pre-filled\n40/60/80 mg",      "Avoid CrCl <30. No routine APTT. IV in STEMI: age/weight-based"],
    [46, "Heparin (UFH)",
     "ACS: 60–70 U/kg IV bolus (max 5000 U);\nthen 12–15 U/kg/hr infusion\nProphylaxis: 5000 U SC BD/TDS",
     "Vial\n5000 IU/ml\n25000 IU/ml","Monitor APTT (target 60–100 sec). Antidote: Protamine sulphate"],
    [47, "Furosemide\n(Frusemide)",
     "Pulm oedema: 40–80 mg IV bolus\nRefractory: up to 200 mg IV infusion\nMax rate: 4 mg/min IV",
     "Amp\n10 mg/ml\n2 ml",          "Monitor K+, creatinine. Ototoxic in high doses"],
]

# ── 7. CNS / NEUROLOGICAL (8) ──
cns = [
    [48, "Diazepam",
     "Status epilepticus: 5–10 mg IV at 2 mg/min\nMax 30 mg; may repeat after 15 min\nIM: 10 mg",
     "Amp\n5 mg/ml\n2 ml",           "Respiratory depression – bag-valve-mask ready. Short duration"],
    [49, "Lorazepam",
     "Status epilepticus: 4 mg IV over 2–5 min;\nRepeat 4 mg after 10 min if needed",
     "Amp\n2 mg/ml\n1–2 ml",         "Preferred 1st-line IV benzodiazepine for status epilepticus"],
    [50, "Midazolam",
     "Seizure (no IV): 10 mg IM\nSedation/procedure: 0.05–0.1 mg/kg IV",
     "Amp\n5 mg/ml\n5 ml",           "IM as effective as IV diazepam in field. Water-soluble"],
    [51, "Phenytoin",
     "Load: 15–20 mg/kg IV at max 50 mg/min\nMaint: 5–7 mg/kg/day IV/IM",
     "Amp\n50 mg/ml\n5 ml",          "NS only – precipitates in glucose. ECG monitor. Extravasation = necrosis"],
    [52, "Phenobarbitone",
     "Status: 15–20 mg/kg IV at max 60 mg/min\nMaint: 60–180 mg IV/IM OD",
     "Amp\n200 mg/ml\n1 ml",         "Hypotension + respiratory depression. ICU monitoring"],
    [53, "Haloperidol",
     "Acute psychosis: 5–10 mg IM q1h PRN\nIV (unlabelled): 2.5–5 mg slowly",
     "Amp\n5 mg/ml\n1 ml",           "Monitor QTc. Extrapyramidal effects. Avoid in Parkinson's"],
    [54, "Promethazine",
     "Sedation/allergy: 25–50 mg IM deep\nSlow IV: 25 mg diluted in 10 ml NS",
     "Amp\n25 mg/ml\n50 mg/ml",      "NEVER SC (tissue necrosis). IV must be diluted and slow"],
    [55, "Neostigmine",
     "Myasthenic crisis: 0.5–2.5 mg IV slowly\nReversal of NMB: 0.04–0.08 mg/kg IV",
     "Amp\n0.5 mg/ml",               "Give with atropine 0.6 mg IV to prevent bradycardia"],
]

# ── 8. CORTICOSTEROIDS (3) ──
ster = [
    [56, "Hydrocortisone",
     "Adrenal crisis: 100 mg IV stat, then 100 mg IV q8h\nAsthma/COPD: 100–200 mg IV q6h\nAnaphylaxis: 200 mg IV",
     "Vial\n100 mg / 200 mg\n(dry pwd)","Reconstitute with WFI. Short-acting. Has mineralocorticoid activity"],
    [57, "Dexamethasone",
     "Cerebral oedema: 8–16 mg IV stat; then 4 mg IV q6h\nCroup: 0.6 mg/kg IM single dose\nAnti-emetic: 8 mg IV",
     "Amp\n4 mg/ml\n2 ml",           "Long-acting. Least mineralocorticoid. Protect from light"],
    [58, "Methylprednisolone",
     "Asthma: 125 mg IV OD\nAutoimmune flare: 500 mg–1 g IV daily x3\nSpinal injury: 30 mg/kg IV over 15 min",
     "Vial\n40/125/500 mg\n1 g",     "High dose: monitor glucose, BP, infection. Give with PPI cover"],
]

# ── 9. DIABETES / ENDOCRINE (4) ──
dm = [
    [59, "Regular Insulin\n(Soluble)",
     "DKA: 0.1 U/kg/hr IV infusion\nHyperkalaemia: 10 U IV + 50 ml 50% Dex over 15–30 min\nSS: per hospital protocol SC",
     "Vial\n40 IU/ml (10 ml)\n100 IU/ml","Dedicated IV line. Monitor glucose hourly. Do NOT mix in same bag as other drugs"],
    [60, "Glucagon",
     "Severe hypoglycaemia: 1 mg IM/SC/IV\nRepeat in 15 min if no response",
     "Vial\n1 mg",                   "Turn patient lateral (vomiting risk). Check glucose in 15 min"],
    [61, "Octreotide",
     "Variceal bleed: 50 mcg IV bolus; then 25–50 mcg/hr infusion\nInsulinnoma: 50–100 mcg SC/IV q8h",
     "Amp\n50 mcg/ml\n100 mcg/ml",   "Gallstone risk with prolonged use. Refrigerate vial"],
    [62, "Vasopressin",
     "Variceal bleed: 0.2–0.4 U/min IV infusion\nDI: 5–10 U IM/SC q3–4h",
     "Amp\n20 IU/ml\n1 ml",          "Coronary vasoconstriction – concurrent nitrates recommended"],
]

# ── 10. ELECTROLYTES & IV METABOLIC (5) ──
elec = [
    [63, "50% Dextrose",
     "Hypoglycaemia: 25–50 ml IV bolus\nProlonged hypoglycaemia: then 10% Dex infusion",
     "Amp\n500 mg/ml\n50 ml",         "Flush vein with NS before & after. Tissue necrosis if extravasated"],
    [64, "Calcium Gluconate",
     "Hypocalcaemia/Ca-channel OD: 1–3 g (10–30 ml 10%) IV over 10–20 min\nHyperkalaemia/HF fluoride: 1 g IV",
     "Amp\n10%: 1 g/10 ml",          "Cardiac monitor. Extravasation causes necrosis. Precipitates with bicarb"],
    [65, "Magnesium Sulphate",
     "Eclampsia: 4–6 g IV over 15–20 min; then 1–2 g/hr\nSevere asthma: 2 g IV over 20 min\nTorsades/HypoMg: 1–2 g IV over 1 hr",
     "Amp\n50%: 5 g/10 ml\n2 g/4 ml","Antidote = Ca gluconate 1 g IV. Monitor RR, knee jerk, UO"],
    [66, "Potassium Chloride\n(KCl)",
     "Severe hypokalaemia: add to 1 L NS/D5W\nMax peripheral rate: 10 mEq/hr\nMax peripheral conc: 40 mEq/L",
     "Amp\n15%: 20 mEq/10 ml",       "NEVER undiluted IV – fatal arrhythmias. ECG monitoring mandatory"],
    [67, "Sodium Bicarbonate",
     "Severe metabolic acidosis (pH <7.1): 1–2 mEq/kg IV slowly\nHyperkalaemia (membrane stabilization): 50 mEq IV\nTCA OD: 1–2 mEq/kg IV bolus",
     "Amp\n7.5%: ~9 mEq/10 ml",      "Do not mix with Ca (precipitates). Use only if clearly indicated"],
]

# ── 11. ANTIDOTES & POISONING (10) ──
antidotes = [
    [68, "Naloxone",
     "Opioid OD: 0.4–2 mg IV/IM q2–3 min (max 10 mg)\nInfusion: 2/3 of effective bolus dose/hr",
     "Amp\n0.4 mg/ml\n1 ml",         "Short acting (30–90 min) – watch for re-narcotization"],
    [69, "N-Acetylcysteine\n(NAC)",
     "Paracetamol OD:\n• 150 mg/kg in 200 ml D5W over 1 hr\n• then 50 mg/kg over 4 hr\n• then 100 mg/kg over 16 hr",
     "Amp\n200 mg/ml\n10 ml",         "Anaphylactoid reactions in 1st bag – slow if reaction occurs"],
    [70, "Calcium Gluconate\n(Antidote)",
     "Fluoride/Ca-channel blocker OD:\n1–3 g IV over 10–20 min; repeat PRN",
     "Amp\n10% (10 ml)\n= 1 g",      "Also for hypermagnesaemia. See #64"],
    [71, "Desferrioxamine",
     "Iron OD: 15 mg/kg/hr IV infusion (max 80 mg/kg/day)\nIM: 2 g IM if no IV access",
     "Vial\n500 mg",                  "Urine turns orange-red (ferrioxamine). Refrigerate unopened"],
    [72, "Atropine\n(OP Poisoning)",
     "Mild: 1–2 mg IV q5–10 min\nModerate-severe: 2–4 mg IV q5–10 min\nEndpoint: drying of secretions (not HR)",
     "Amp\n0.6 mg/ml\n1 mg/ml",      "No ceiling dose. Titrate to secretions. Give with Pralidoxime"],
    [73, "Pralidoxime\n(PAM 2-Cl)",
     "OP: 1–2 g IV over 15–30 min; repeat 1 g q1–2h\nInfusion: 500 mg/hr",
     "Vial\n1 g",                    "Effective within 24–48 hr of exposure. Always combine with atropine"],
    [74, "Snake Antivenom\n(Polyvalent)",
     "10 vials IV infusion in 100–200 ml NS over 30–60 min\nRepeat 10 vials if signs persist at 6 hr",
     "Vial\n(lyophilized\nor liquid)", "Pre-medicate: Adrenaline 0.25 mg SC + Promethazine 25 mg IM"],
    [75, "Sodium Bicarbonate\n(TCA OD)",
     "TCA OD with wide QRS: 1–2 mEq/kg IV bolus;\nRepeat to target pH 7.50–7.55",
     "Amp\n7.5%: ~9 mEq/10 ml",      "Alkalinization narrows QRS and treats arrhythmia in TCA poisoning"],
    [76, "Phytomenadione\n(Vitamin K)",
     "Warfarin reversal: 5–10 mg IV over 20 min\nCoagulopathy (hepatic): 10 mg IV/IM OD",
     "Amp\n10 mg/ml\n1 ml",           "Anaphylaxis risk with IV – infuse slowly. Use IM if less urgent"],
    [77, "Anti-Tetanus Serum\n(ATS)",
     "Prophylaxis: 1500 IU IM\nTreatment: 10000–20000 IU IM or slow IV",
     "Vial\n1500 IU\n10000 IU",       "Sensitivity test first. Adrenaline and antihistamine at bedside"],
]

# ── 12. RESPIRATORY (3) ──
resp = [
    [78, "Aminophylline",
     "Acute asthma/COPD: Load 5 mg/kg IV over 20–30 min\nMaint infusion: 0.5–0.9 mg/kg/hr\n(Omit load if on theophylline)",
     "Amp\n25 mg/ml\n10 ml (250 mg)","Narrow TI – cardiac arrhythmias, seizures. Monitor blood levels"],
    [79, "Salbutamol\n(IV)",
     "Life-threatening asthma: 5 mcg/min IV infusion;\ntitrate up (max 20 mcg/min)\n(Prefer nebulization)",
     "Amp\n0.5 mg/ml\n1 ml",         "IV reserved for ICU/life-threatening bronchospasm only"],
    [80, "Dexamethasone\n(Resp)",
     "Acute severe asthma: 8 mg IV/IM BD\nCroup: 0.6 mg/kg IM single dose\n(See #57 for full entry)",
     "Amp\n4 mg/ml\n2 ml",           "Reduces airway inflammation. Effect in 4–6 hr"],
]

# ── 13. GASTROENTEROLOGY / ANTIEMETICS (7) ──
gi = [
    [81, "Ondansetron",
     "Nausea/vomiting: 4–8 mg IV over 15 min q8h\nChemo-induced: 8 mg IV BD\nMax single IV dose: 16 mg",
     "Amp\n2 mg/ml\n2 ml (4 mg)",    "Prolongs QTc – slow IV. 5-HT3 antagonist"],
    [82, "Metoclopramide",
     "Nausea/gastroparesis: 10 mg IV/IM q8h\nMax 3 doses/day",
     "Amp\n5 mg/ml\n2 ml",           "EPS side effects. Avoid in epilepsy, bowel obstruction"],
    [83, "Pantoprazole",
     "Active GI bleed: 80 mg IV bolus; then 8 mg/hr x72 hr\nMaintenance: 40 mg IV OD",
     "Vial\n40 mg\n(dry pwd)",       "Reconstitute in NS. Higher dose for acute bleed protocol"],
    [84, "Ranitidine",
     "PUD/stress ulcer: 50 mg IV q8h or 6.25 mg/hr infusion\n(Give over 5–15 min slowly)",
     "Amp\n25 mg/ml\n2 ml (50 mg)",  "Less commonly used now (pantoprazole preferred). Avoid rapid IV"],
    [85, "Phytomenadione\n(Vit K)",
     "See #76 above",
     "Amp\n10 mg/ml\n1 ml",          "GI bleed coagulopathy & warfarin reversal"],
    [86, "Octreotide\n(Variceal)",
     "See #61 above",
     "Amp\n50/100 mcg",              "Used for oesophageal variceal haemorrhage"],
    [87, "Vasopressin\n(Variceal)",
     "See #62 above",
     "Amp\n20 IU/ml",                "Give with nitrates to reduce cardiac side effects"],
]

# ── 14. VITAMINS & HAEMATINICS (5) ──
vit = [
    [88, "Thiamine\n(Vitamin B1)",
     "Wernicke's/Alcohol: 200–500 mg IV TDS for 3 days\nProphylaxis: 100 mg IV/IM OD",
     "Amp\n100 mg/ml\n2 ml",         "ALWAYS give before glucose in alcoholics. Anaphylaxis risk IV"],
    [89, "Hydroxocobalamin\n(Vit B12)",
     "Deficiency: 1 mg IM OD for 7 days; then weekly/monthly",
     "Amp\n1 mg/ml\n1 ml",           "IM only (not IV). Rotate injection sites"],
    [90, "Folic Acid\n(IV/IM)",
     "Deficiency/megaloblastic: 5 mg IV/IM OD\n(Oral usually preferred)",
     "Amp\n5 mg/ml\n1 ml",           "Rule out B12 deficiency before treating with folic acid alone"],
    [91, "Iron Sucrose\n(IV Iron)",
     "Iron deficiency: 100–200 mg IV (diluted in 100 ml NS) over 30 min;\nMax 200 mg/session",
     "Amp\n20 mg/ml\n5 ml (100 mg)", "Test dose first. Anaphylaxis equipment at bedside. Avoid IM"],
    [92, "Ferric\nCarboxymaltose",
     "Iron deficiency: 500–1000 mg IV over 15 min\n(Max 1000 mg/week)",
     "Vial\n50 mg/ml\n(10–20 ml)",   "No test dose required. Higher single dose than iron sucrose"],
]

# ── 15. ANTIHISTAMINES & ALLERGY (2) ──
antihist = [
    [93, "Chlorpheniramine\nMaleate",
     "Allergic reaction/anaphylaxis: 10–20 mg IV/IM (slow IV)\nMax 40 mg/day",
     "Amp\n10 mg/ml\n1 ml",          "Sedating. Adjunct in anaphylaxis (not primary treatment)"],
    [94, "Pheniramine\nMaleate",
     "Allergic reaction: 22.75 mg (1 ml) IV/IM\nMay repeat q4–6h",
     "Amp\n22.75 mg/ml\n1 ml",       "Similar to chlorpheniramine. Sedation. Dilute before slow IV"],
]

# ── 16. MISCELLANEOUS (4) ──
misc = [
    [95, "Mannitol",
     "Raised ICP/cerebral oedema: 0.25–2 g/kg IV over 30–60 min\nRepeat q4–6h PRN",
     "IV Bottle\n20%: 100/250\n500 ml", "Use in-line filter. Monitor serum osmolality & renal function"],
    [96, "Albumin\n(Human)",
     "Hypoalbuminaemia/ascites: 50–100 ml of 20–25% IV over 2–4 hr\nSBP: 1.5 g/kg on Day 1; 1 g/kg on Day 3",
     "Vial\n20%/25%\n50/100 ml",     "Expensive – use as per protocol. Monitor fluid balance"],
    [97, "Anti-Rabies\nImmunoglobulin",
     "Post-exposure prophylaxis: 20 IU/kg\n(Infiltrate max around wound; remainder IM elsewhere)",
     "Vial\n150 IU/ml",              "Give with rabies vaccine. Do NOT give in same syringe/site as vaccine"],
    [98, "Tetanus\nImmunoglobulin\n(TIG)",
     "Treatment: 500–3000 IU IM\nProphylaxis (unimmunized): 250–500 IU IM",
     "Vial\n500 IU",                 "Human TIG preferred over equine ATS. Give at different site from toxoid"],
]

# ════════════════════════════════════════════════════════════
#  BUILD PDF
# ════════════════════════════════════════════════════════════
story = []

# ── COVER ──
story.append(Spacer(1, 6*mm))
cover = Table([[Paragraph(
    "COMPLETE INJECTION REFERENCE\nIV / IM QUICK GUIDE\n98 INJECTIONS", title_st)]],
    colWidths=[W])
cover.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),(-1,-1), DARK_RED),
    ("TOPPADDING",    (0,0),(-1,-1), 10),
    ("BOTTOMPADDING", (0,0),(-1,-1), 10),
    ("BOX",           (0,0),(-1,-1), 1.5, DARK_RED),
]))
story.append(cover)
story.append(Spacer(1, 2.5*mm))

sub = Table([[Paragraph(
    "Medicine Department  |  Govt Hospital, Odisha\nDosages, Forms & Key Notes for IV & IM Use", sub_st)]],
    colWidths=[W])
sub.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),(-1,-1), PURPLE),
    ("TOPPADDING",    (0,0),(-1,-1), 5),
    ("BOTTOMPADDING", (0,0),(-1,-1), 5),
    ("BOX",           (0,0),(-1,-1), 0.8, PURPLE),
]))
story.append(sub)
story.append(Spacer(1, 2.5*mm))

warn = Table([[Paragraph(
    "⚠  FOR TRAINED HEALTHCARE PROFESSIONALS ONLY  ⚠\n"
    "Verify all dosages before administration. Adjust for weight, renal/hepatic function & age.\n"
    "This guide does not replace clinical judgment or hospital protocols.", warn_st)]],
    colWidths=[W])
warn.setStyle(TableStyle([
    ("BACKGROUND",    (0,0),(-1,-1), YELLOW),
    ("BOX",           (0,0),(-1,-1), 1, ORANGE),
    ("TOPPADDING",    (0,0),(-1,-1), 5),
    ("BOTTOMPADDING", (0,0),(-1,-1), 5),
    ("LEFTPADDING",   (0,0),(-1,-1), 5),
]))
story.append(warn)
story.append(Spacer(1, 2.5*mm))

# TOC
sections = [
    ("1–5",   "Analgesics & Anti-inflammatory",  5),
    ("6–25",  "Antibiotics",                     20),
    ("26–27", "Antifungals",                      2),
    ("28–29", "Antiviral / Antiparasitic",         2),
    ("30",    "Antitubercular",                    1),
    ("31–47", "Cardiovascular",                   17),
    ("48–55", "CNS / Neurological",                8),
    ("56–58", "Corticosteroids",                   3),
    ("59–62", "Diabetes / Endocrine",              4),
    ("63–67", "Electrolytes & Metabolic",          5),
    ("68–77", "Antidotes & Poisoning",            10),
    ("78–80", "Respiratory",                       3),
    ("81–87", "Gastroenterology / Antiemetics",    7),
    ("88–92", "Vitamins & Haematinics",            5),
    ("93–94", "Antihistamines",                    2),
    ("95–98", "Miscellaneous",                     4),
]
toc_hdr = Table([[
    Paragraph("DRUG", PS("th1", fontSize=6.5, fontName="Helvetica-Bold", textColor=WHITE, leading=8)),
    Paragraph("SECTION", PS("th2", fontSize=6.5, fontName="Helvetica-Bold", textColor=WHITE, leading=8, alignment=TA_LEFT)),
    Paragraph("COUNT", PS("th3", fontSize=6.5, fontName="Helvetica-Bold", textColor=WHITE, leading=8, alignment=TA_CENTER)),
]], colWidths=[16*mm, 95*mm, 21*mm])
toc_hdr.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),NAVY),
    ("TOPPADDING",(0,0),(-1,-1),2),("BOTTOMPADDING",(0,0),(-1,-1),2),
    ("LEFTPADDING",(0,0),(-1,-1),4)]))
story.append(toc_hdr)
for i, (nos, name, cnt) in enumerate(sections):
    row_data = [[
        Paragraph(nos, PS(f"tn{i}a", fontSize=6, fontName="Helvetica-Bold", textColor=NAVY, leading=7.5)),
        Paragraph(name, PS(f"tn{i}b", fontSize=6, fontName="Helvetica", leading=7.5)),
        Paragraph(str(cnt), PS(f"tn{i}c", fontSize=6, fontName="Helvetica-Bold",
                               textColor=DARK_RED, alignment=TA_CENTER, leading=7.5)),
    ]]
    bg = LIGHT_BLU if i % 2 == 0 else WHITE
    rt = Table(row_data, colWidths=[16*mm, 95*mm, 21*mm])
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),1.5),("BOTTOMPADDING",(0,0),(-1,-1),1.5),
        ("LEFTPADDING",(0,0),(-1,-1),4)]))
    story.append(rt)

story.append(Spacer(1, 2*mm))
story.append(Paragraph(
    "Based on District Hospital EML (India, Jan 2024) & OSMCL Odisha  |  Compiled July 2026",
    foot_st))

# ── helper ──
def add_sec(label, rows, bg, alt):
    story.append(Spacer(1, 2*mm))
    story.append(sec_header(label, bg=bg))
    story.append(drug_tbl(rows, hdr_bg=bg, alt=alt))

# ── PAGES ──
story.append(PageBreak())
add_sec("1–5   ANALGESICS & ANTI-INFLAMMATORY",   analg,    BROWN,  BROWN_LT)
add_sec("6–25  ANTIBIOTICS",                       abx[:10], colors.HexColor("#4A235A"), PURP_LITE)
story.append(PageBreak())
add_sec("6–25  ANTIBIOTICS (contd.)",              abx[10:], colors.HexColor("#4A235A"), PURP_LITE)
add_sec("26–27 ANTIFUNGALS",                       antifung, TEAL,   TEAL_LITE)
add_sec("28–29 ANTIVIRAL / ANTIPARASITIC",         antip,    TEAL,   TEAL_LITE)
add_sec("30    ANTITUBERCULAR",                    antitb,   TEAL,   TEAL_LITE)

story.append(PageBreak())
add_sec("31–47 CARDIOVASCULAR",                    cardio[:9],  GREEN, LIGHT_BLU)
story.append(PageBreak())
add_sec("31–47 CARDIOVASCULAR (contd.)",           cardio[9:],  GREEN, LIGHT_BLU)

story.append(PageBreak())
add_sec("48–55 CNS / NEUROLOGICAL",                cns,      PURPLE, PURP_LITE)
add_sec("56–58 CORTICOSTEROIDS",                   ster,     OLIVE,  OLIVE_LT)

story.append(PageBreak())
add_sec("59–62 DIABETES / ENDOCRINE",              dm,       DARK_RED, colors.HexColor("#FADBD8"))
add_sec("63–67 ELECTROLYTES & METABOLIC",          elec,     INDIGO, LIGHT_BLU)

story.append(PageBreak())
add_sec("68–77 ANTIDOTES & POISONING",             antidotes[:6], colors.HexColor("#7D6608"), colors.HexColor("#FDFDE7"))
story.append(PageBreak())
add_sec("68–77 ANTIDOTES & POISONING (contd.)",    antidotes[6:], colors.HexColor("#7D6608"), colors.HexColor("#FDFDE7"))
add_sec("78–80 RESPIRATORY EMERGENCIES",           resp,     TEAL,   TEAL_LITE)

story.append(PageBreak())
add_sec("81–87 GASTROENTEROLOGY / ANTIEMETICS",    gi,       colors.HexColor("#117864"), TEAL_LITE)
add_sec("88–92 VITAMINS & HAEMATINICS",            vit,      colors.HexColor("#1A5276"), LIGHT_BLU)
add_sec("93–94 ANTIHISTAMINES",                    antihist, colors.HexColor("#6C3483"), PURP_LITE)
add_sec("95–98 MISCELLANEOUS",                     misc,     NAVY,   LIGHT_BLU)

# ── BACK PAGE: Critical Reminders ──
story.append(PageBreak())
story.append(sec_header("CRITICAL SAFETY REMINDERS  –  Always Verify Before Use", bg=DARK_RED))
story.append(Spacer(1, 2*mm))
reminders = [
    ("NEVER give KCl undiluted IV (fatal)", "Vancomycin: infuse >60 min (Red Man Syndrome if fast)"),
    ("Sodium Nitroprusside: wrap drip in foil", "Streptokinase: check contraindications strictly"),
    ("MgSO4 antidote = Ca gluconate 1 g IV", "Phenytoin: NS only – DO NOT use in Dextrose"),
    ("Opioids: keep Naloxone at bedside", "Promethazine: NEVER SC – tissue necrosis"),
    ("OP poisoning: no ceiling dose for atropine", "Artesunate: NaHCO3 reconstitution first"),
    ("Snake antivenom: pre-medicate with adrenaline SC", "Noradrenaline: central line only (extravasation risk)"),
    ("Insulin: dedicated IV line; hourly glucose check", "Aminophylline: narrow TI – ECG monitor"),
    ("Thiamine BEFORE glucose in alcoholics", "Amphotericin B: test dose first; protect from light"),
    ("NAC 1st bag: slow rate if anaphylactoid reaction", "Benzathine penicillin: NEVER IV – IM only"),
    ("Atropine min IV dose = 0.5 mg (paradox bradycardia)", "Diazepam/Lorazepam: keep airway equipment ready"),
]
for i, (a, b) in enumerate(reminders):
    bg = YELLOW if i % 2 == 0 else WHITE
    rt = Table([[
        Paragraph("⚠ " + a, PS(f"ra{i}", fontSize=6.2, fontName="Helvetica-Bold",
                               textColor=DARK_RED, leading=8)),
        Paragraph("→ " + b, PS(f"rb{i}", fontSize=6.2, fontName="Helvetica-Bold",
                               textColor=colors.HexColor("#1A5276"), leading=8)),
    ]], colWidths=[W/2, W/2])
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),2.5),("BOTTOMPADDING",(0,0),(-1,-1),2.5),
        ("LEFTPADDING",(0,0),(-1,-1),3),("VALIGN",(0,0),(-1,-1),"TOP")]))
    story.append(rt)

story.append(Spacer(1, 3*mm))
# Abbreviations
abbrs = [
    ("IV = Intravenous","IM = Intramuscular","SC = Subcutaneous","OD = Once daily"),
    ("BD = Twice daily","TDS = Three times daily","QDS = Four times daily","q = every (e.g. q8h)"),
    ("NS = Normal Saline 0.9%","D5W = 5% Dextrose","WFI = Water for Injection","RT = Room Temperature"),
    ("TI = Therapeutic Index","EPS = Extrapyramidal S/E","UO = Urine output","RR = Respiratory Rate"),
    ("OD = Overdose (context)","HTN = Hypertension","Rx = Treatment","APTT = Activated PTT"),
]
abh = Table([[Paragraph("ABBREVIATIONS", PS("abh", fontSize=7, fontName="Helvetica-Bold",
    textColor=WHITE, alignment=TA_CENTER, leading=9)),
    Paragraph("",""), Paragraph("",""), Paragraph("","")]], colWidths=[W/4]*4)
abh.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),NAVY),("SPAN",(0,0),(-1,-1)),
    ("TOPPADDING",(0,0),(-1,-1),2),("BOTTOMPADDING",(0,0),(-1,-1),2)]))
story.append(abh)
for i, row in enumerate(abbrs):
    bg = LIGHT_GRY if i%2==0 else WHITE
    rt = Table([[Paragraph(c, PS(f"ab{i}{j}", fontSize=5.8, fontName="Helvetica", leading=7.5))
                 for j, c in enumerate(row)]], colWidths=[W/4]*4)
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),1.5),("BOTTOMPADDING",(0,0),(-1,-1),1.5),
        ("LEFTPADDING",(0,0),(-1,-1),3)]))
    story.append(rt)

story.append(Spacer(1, 2*mm))
story.append(Paragraph(
    "For educational & reference purposes only. Not a substitute for standard treatment protocols.\n"
    "Refer to current AIIMS/ICMR/WHO guidelines and local hospital policy for updates.\n"
    "Based on District Hospital EML (India, Revised Jan 2024) & OSMCL Odisha Essential Drug List 2020.",
    foot_st))

doc.build(story)
print(f"PDF created: {OUTPUT}")

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/pocket-guide/generate_full98.py'

from reportlab.lib.pagesizes import A5
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
    SimpleDocTemplate, Table, TableStyle, Paragraph, Spacer, PageBreak
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT

OUTPUT = "/tmp/workspace/pocket-guide/Complete_Hospital_Injection_Guide.pdf"

# ── Colours ──────────────────────────────────────────────────
RED       = colors.HexColor("#C0392B")
DARK_RED  = colors.HexColor("#922B21")
ORANGE    = colors.HexColor("#E67E22")
YELLOW    = colors.HexColor("#F9E79F")
GREEN     = colors.HexColor("#1A5276")
LIGHT_BLU = colors.HexColor("#D6EAF8")
TEAL      = colors.HexColor("#117A65")
TEAL_LITE = colors.HexColor("#D1F2EB")
PURPLE    = colors.HexColor("#6C3483")
PURP_LITE = colors.HexColor("#E8DAEF")
NAVY      = colors.HexColor("#1B2631")
WHITE     = colors.white
LIGHT_GRY = colors.HexColor("#F2F3F4")
MED_GRY   = colors.HexColor("#BFC9CA")
BROWN     = colors.HexColor("#784212")
BROWN_LT  = colors.HexColor("#FDEBD0")
OLIVE     = colors.HexColor("#0E6655")
OLIVE_LT  = colors.HexColor("#D5F5E3")
INDIGO    = colors.HexColor("#154360")
MAROON    = colors.HexColor("#641E16")
MAROON_LT = colors.HexColor("#FADBD8")
SLATE     = colors.HexColor("#2E4053")
SLATE_LT  = colors.HexColor("#D5D8DC")
GOLD      = colors.HexColor("#7D6608")
GOLD_LT   = colors.HexColor("#FDFDE7")

doc = SimpleDocTemplate(
    OUTPUT, pagesize=A5,
    leftMargin=7*mm, rightMargin=7*mm,
    topMargin=9*mm, bottomMargin=7*mm,
)
W = A5[0] - 14*mm

styles = getSampleStyleSheet()

def PS(name, **kw):
    return ParagraphStyle(name, parent=styles["Normal"], **kw)

title_st = PS("T",  fontSize=11, textColor=WHITE, alignment=TA_CENTER,
              fontName="Helvetica-Bold", leading=14)
sub_st   = PS("S",  fontSize=6.8, textColor=WHITE, alignment=TA_CENTER,
              fontName="Helvetica", leading=9)
sec_st   = PS("Sc", fontSize=7.8, textColor=WHITE, fontName="Helvetica-Bold",
              leading=10, leftIndent=2)
warn_st  = PS("W",  fontSize=6,   textColor=DARK_RED,
              fontName="Helvetica-BoldOblique", leading=7.8)
foot_st  = PS("F",  fontSize=5.5, textColor=colors.HexColor("#555555"),
              alignment=TA_CENTER, fontName="Helvetica-Oblique", leading=7)
hdr_st   = PS("H",  fontSize=6.2, fontName="Helvetica-Bold",
              textColor=WHITE, leading=8)
cell_st  = PS("C",  fontSize=5.9, fontName="Helvetica", leading=7.5)
sno_st   = PS("N",  fontSize=6,   fontName="Helvetica-Bold",
              textColor=NAVY, leading=7.5)
note_st  = PS("Nt", fontSize=5.5, fontName="Helvetica-Oblique",
              textColor=colors.HexColor("#4D4D4D"), leading=7)
new_st   = PS("Nw", fontSize=5.5, fontName="Helvetica-Bold",
              textColor=colors.HexColor("#117A65"), leading=7)

# col widths: #(7) | Drug(29) | Dose+Route(43) | Form(20) | Notes(33)
CW = [7*mm, 29*mm, 43*mm, 20*mm, 33*mm]  # 132mm total

def sec_header(text, bg=GREEN):
    t = Table([[Paragraph(text, sec_st)]], colWidths=[W])
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,-1), bg),
        ("TOPPADDING",    (0,0),(-1,-1), 3),
        ("BOTTOMPADDING", (0,0),(-1,-1), 3),
        ("LEFTPADDING",   (0,0),(-1,-1), 5),
    ]))
    return t

def drug_tbl(rows, hdr_bg=GREEN, alt=LIGHT_BLU):
    headers = ["#", "Drug", "Dose / Route", "Form", "Key Notes"]
    data = [[Paragraph(h, hdr_st) for h in headers]]
    for row in rows:
        # last col: if row has 6 elements, element[5]="NEW" tag
        note_text = str(row[4])
        is_new = len(row) > 5 and row[5] == "NEW"
        ns = new_st if is_new else note_st
        prefix = "[NEW] " if is_new else ""
        data.append([
            Paragraph(str(row[0]), sno_st),
            Paragraph(str(row[1]), cell_st),
            Paragraph(str(row[2]), cell_st),
            Paragraph(str(row[3]), cell_st),
            Paragraph(prefix + note_text, ns),
        ])
    t = Table(data, colWidths=CW)
    t.setStyle(TableStyle([
        ("BACKGROUND",    (0,0),(-1,0),  hdr_bg),
        ("ROWBACKGROUNDS",(0,1),(-1,-1), [WHITE, alt]),
        ("GRID",          (0,0),(-1,-1), 0.35, MED_GRY),
        ("TOPPADDING",    (0,0),(-1,-1), 1.8),
        ("BOTTOMPADDING", (0,0),(-1,-1), 1.8),
        ("LEFTPADDING",   (0,0),(-1,-1), 2.5),
        ("RIGHTPADDING",  (0,0),(-1,-1), 2.5),
        ("VALIGN",        (0,0),(-1,-1), "TOP"),
    ]))
    return t

def add_sec(label, rows, bg, alt):
    story.append(Spacer(1, 2*mm))
    story.append(sec_header(label, bg=bg))
    story.append(drug_tbl(rows, hdr_bg=bg, alt=alt))

# ════════════════════════════════════════════════════════════════
#  COMPLETE DRUG DATA  (130 injections)
#  [#, "Drug", "Dose/Route", "Form", "Notes"]
#  [#, "Drug", "Dose/Route", "Form", "Notes", "NEW"]  ← added drugs
# ════════════════════════════════════════════════════════════════

# ─── 1. ANALGESICS & PAIN MANAGEMENT ────────────────────────
analg = [
    [1,  "Diclofenac",
     "75 mg IM deep (gluteal) q8–12h; max 150 mg/day\n(IM only)",
     "Amp\n25 mg/ml\n3 ml",
     "Avoid renal impairment, GI bleed, asthma. Rotate sites"],
    [2,  "Paracetamol",
     "1 g IV over 15 min q6h (max 4 g/day;\n2 g/day if liver disease)",
     "Infusion\n10 mg/ml\n100 ml",
     "Hepatotoxic in OD. Antidote = NAC"],
    [3,  "Tramadol",
     "50–100 mg diluted in 100 ml NS IV over 20 min; IM 50–100 mg q4–6h; max 400 mg/day",
     "Amp\n50 mg/ml\n2 ml",
     "Lowers seizure threshold. Avoid MAOIs"],
    [4,  "Morphine",
     "IV: 2–5 mg slowly q4h\nAMI: 2–4 mg IV, titrate\nIM: 5–10 mg q4h",
     "Amp\n10 mg/ml\n1 ml",
     "Keep naloxone ready. Avoid in head injury, respiratory depression"],
    [5,  "Pentazocine",
     "IM/SC 30–60 mg q3–4h; IV 30 mg q3–4h\nMax 360 mg/day",
     "Amp\n30 mg/ml",
     "Mixed agonist-antagonist. Avoid with pure opioids"],
    [6,  "Fentanyl",
     "Procedural sedation/ICU: 25–50 mcg IV slowly q5–10 min\nInfusion: 25–200 mcg/hr",
     "Amp\n50 mcg/ml\n2 ml (100 mcg)",
     "100x more potent than morphine. Rigid chest with rapid IV. Naloxone reverses", "NEW"],
    [7,  "Ketamine",
     "Procedural sedation: 1–2 mg/kg IV over 1–2 min; IM 4–5 mg/kg\nAnalgesia: 0.1–0.5 mg/kg IV",
     "Vial\n10 mg/ml / 50 mg/ml",
     "Dissociative. Preserves airway reflexes & BP. Avoid in HTN, psychosis, head injury", "NEW"],
]

# ─── 2. ANTIBIOTICS ──────────────────────────────────────────
abx = [
    [8,  "Benzylpenicillin\n(Crystalline)",
     "Meningitis/sepsis: 20–24 lakh U/day IV in 4–6 divided doses",
     "Vial\n10 lakh U\n(dry pwd)",
     "Dilute in NS/D5W. Give over 30 min. Check penicillin allergy"],
    [9,  "Benzathine\nBenzylpenicillin",
     "Rheumatic fever prophylaxis: 12 lakh U IM q3–4 weeks",
     "Vial\n12 lakh U\n(dry pwd)",
     "Deep IM gluteal ONLY. NEVER IV. Warm to room temp first"],
    [10, "Ampicillin",
     "500 mg–2 g IV/IM q4–6h\nMeningitis: 2 g IV q4h",
     "Vial\n250 mg/500 mg\n1 g",
     "Dilute & infuse over 30 min. Rash common in EBV"],
    [11, "Amoxicillin\n+Clavulanic Acid",
     "1.2 g (1 g+200 mg) IV q8h\nSevere: 1.2 g IV q6h",
     "Vial\n1.2 g",
     "Infuse over 30 min. Check penicillin allergy"],
    [12, "Cloxacillin",
     "500 mg–1 g IV/IM q4–6h",
     "Vial\n500 mg\n(dry pwd)",
     "Anti-staphylococcal beta-lactamase stable"],
    [13, "Cefazolin",
     "1–2 g IV/IM q8h\nSurgical prophylaxis: 1–2 g IV 30 min pre-op",
     "Vial\n500 mg / 1 g",
     "1st-gen cephalosporin. Good for skin/soft tissue/surgical prophylaxis"],
    [14, "Cefotaxime",
     "1–2 g IV/IM q6–8h\nMeningitis: 2 g IV q4h",
     "Vial\n250 mg / 1 g",
     "3rd-gen. Broad Gram-neg cover including meningitis"],
    [15, "Ceftriaxone",
     "1–2 g IV OD (BD for meningitis)\nGonorrhoea: 500 mg IM single dose",
     "Vial\n250 mg/500 mg\n1 g",
     "IM: reconstitute in 1% lignocaine. AVOID calcium-containing IV fluids"],
    [16, "Ceftazidime",
     "1–2 g IV/IM q8h\nPseudomonas: 2 g IV q8h",
     "Vial\n250 mg / 1 g",
     "Anti-pseudomonal 3rd-gen cephalosporin"],
    [17, "Piperacillin\n+Tazobactam",
     "4.5 g IV over 30 min q6–8h\nExtended: 4.5 g over 4 hr q8h",
     "Vial\n4.5 g",
     "Broadest beta-lactam. Covers Pseudomonas + anaerobes"],
    [18, "Gentamicin",
     "ODD: 5–7 mg/kg IV/IM OD\nEndocarditis: 1 mg/kg IV q8h",
     "Amp\n40 mg/2 ml\n80 mg/2 ml",
     "Monitor trough (<2 mcg/ml). Ototoxic & nephrotoxic"],
    [19, "Amikacin",
     "15 mg/kg/day IV/IM OD or in 2–3 divided doses",
     "Amp\n250 mg/ml\n2 ml (500 mg)",
     "Reserve for resistant Gram-neg. Monitor levels & renal function"],
    [20, "Ciprofloxacin\n(IV)",
     "400 mg IV q8–12h; Infuse over 60 min",
     "IV Bottle\n200 mg/100 ml",
     "Prolongs QTc. Avoid with theophylline. Not 1st-line for pneumonia"],
    [21, "Levofloxacin\n(IV)",
     "500 mg IV OD or 750 mg IV OD (severe)\nInfuse over 60–90 min",
     "IV Bottle\n500 mg/100 ml",
     "CAP/HAP, UTI, skin. Prolongs QTc. Avoid in epilepsy", "NEW"],
    [22, "Metronidazole\n(IV)",
     "500 mg IV q8h; Infuse over 30–60 min",
     "IV Bottle\n500 mg/100 ml",
     "Anaerobic cover. Avoid alcohol. Darkens urine"],
    [23, "Azithromycin\n(IV)",
     "CAP/Legionella: 500 mg IV OD x2–5 days;\nthen switch to oral",
     "Vial\n500 mg\n(dry pwd)",
     "Infuse over 60 min (not faster). QTc prolongation", "NEW"],
    [24, "Vancomycin",
     "Load: 25–30 mg/kg IV; Maint: 15–20 mg/kg q8–12h\n(Target trough 15–20 mcg/ml)",
     "Vial\n500 mg / 1 g",
     "Infuse >60 min (Red Man if faster). For MRSA & Gram+ infections"],
    [25, "Linezolid\n(IV)",
     "600 mg IV q12h; Infuse over 30–120 min",
     "IV Bottle\n600 mg/300 ml",
     "MRSA/VRE. Serotonin syndrome with SSRIs. Monitor CBC (thrombocytopenia)", "NEW"],
    [26, "Teicoplanin",
     "Load: 400 mg IV/IM q12h x3 doses;\nMaint: 400 mg IV/IM OD",
     "Vial\n400 mg\n(dry pwd)",
     "Glycopeptide like vancomycin. Once-daily dosing. Monitor LFT/renal", "NEW"],
    [27, "Meropenem",
     "1–2 g IV q8h\nMeningitis/MDR: 2 g IV q8h",
     "Vial\n500 mg / 1 g",
     "Broad-spectrum carbapenem. Stable 8 hr at RT after reconstitution"],
    [28, "Imipenem\n+Cilastatin",
     "500 mg IV q6h\nSevere: 1 g IV q6–8h",
     "Vial\n500 mg+500 mg",
     "Lowers seizure threshold. Avoid in CNS infections if meropenem available"],
    [29, "Ertapenem",
     "1 g IV/IM OD; Infuse over 30 min",
     "Vial\n1 g",
     "Once-daily carbapenem. No Pseudomonas cover. Community MDR infections", "NEW"],
    [30, "Colistin\n(Polymyxin E)",
     "Loading: 9 million IU IV over 30 min;\nMaint: 4.5 million IU IV q12h",
     "Vial\n1 million IU\n2 million IU",
     "Last resort for XDR Gram-neg. Nephrotoxic. Monitor creatinine daily", "NEW"],
    [31, "Chloramphenicol",
     "50–100 mg/kg/day IV in 4 divided doses (max 4 g/day)",
     "Vial\n1 g",
     "Aplastic anaemia risk. Use only when no alternatives. Monitor CBC"],
    [32, "Doxycycline\n(IV)",
     "100 mg IV q12h; Infuse over 1–4 hr",
     "Vial\n100 mg",
     "Not for <8 yr. Avoid Ca/Mg/Fe co-administration. Phototoxicity"],
    [33, "Co-trimoxazole\n(IV)",
     "PCP pneumonia: 15–20 mg/kg/day (TMP) IV in 3–4 divided doses",
     "Amp\n80 mg TMP +\n400 mg SMX\n/5 ml",
     "Dilute in 250 ml NS. Monitor renal fn & K+"],
    [34, "Acyclovir\n(IV)",
     "Herpes encephalitis: 10 mg/kg IV q8h over 1 hr (x14–21 days)\nVZV: 10 mg/kg IV q8h\nImmunocompromised HSV: 5 mg/kg IV q8h",
     "Vial\n250 mg\n(dry pwd)",
     "Hydrate well (nephrotoxic if under-hydrated). Adjust for renal impairment", "NEW"],
]

# ─── 3. ANTIFUNGAL ──────────────────────────────────────────
antifung = [
    [35, "Amphotericin B\n(Conventional)",
     "Test dose 1 mg in 100 ml D5W over 30 min;\nthen 0.25–1 mg/kg/day IV over 4–6 hr",
     "Vial\n50 mg\n(dry pwd)",
     "Wrap in foil (light-sensitive). Nephrotoxic. Pre-hydrate. Fever/rigors common"],
    [36, "Fluconazole\n(IV)",
     "Candida: 400 mg IV OD loading; then 200–400 mg IV OD\nCryptococcal: 800 mg IV OD (with AmB)",
     "IV Bottle\n2 mg/ml\n100 ml",
     "Infuse over 60 min. QTc prolongation. CYP3A4 inhibitor"],
]

# ─── 4. ANTIVIRAL / ANTIPARASITIC ───────────────────────────
antip = [
    [37, "Artesunate",
     "Severe malaria: 2.4 mg/kg IV/IM at 0, 12, 24 hr; then OD x7 days",
     "Vial\n60 mg\n(dry pwd)",
     "Reconstitute with 5% NaHCO3 first; then dilute in D5W/NS"],
    [38, "Quinine",
     "Severe malaria: 20 mg/kg IV over 4 hr (load); then 10 mg/kg IV q8h",
     "Amp\n300 mg/ml\n2 ml",
     "Cardiac monitor. Hypoglycaemia risk. Use only if artesunate unavailable"],
]

# ─── 5. ANTITUBERCULAR ──────────────────────────────────────
antitb = [
    [39, "Streptomycin",
     "TB: 15 mg/kg IM OD (max 1 g/day)\nUsually in Category II regimen",
     "Vial\n0.75 g / 1 g",
     "IM only. Ototoxic & nephrotoxic. Monitor hearing & renal function"],
]

# ─── 6. CARDIOVASCULAR ──────────────────────────────────────
cardio = [
    [40, "Adrenaline\n(Epinephrine)",
     "Cardiac arrest: 1 mg IV q3–5 min\nAnaphylaxis: 0.5 mg IM (lateral thigh)\nShock: 0.1–1 mcg/kg/min IV infusion",
     "Amp\n1 mg/ml\n1 ml",
     "Never undiluted IV push outside arrest. Central line for infusion"],
    [41, "Noradrenaline",
     "Septic shock: 0.01–3 mcg/kg/min IV infusion\nTitrate to MAP ≥65 mmHg",
     "Amp\n2 mg/ml",
     "Central line preferred. Extravasation = necrosis. Antidote: phentolamine local"],
    [42, "Dopamine",
     "Shock: 5–20 mcg/kg/min IV infusion\n(Low dose 1–3 mcg/kg/min for renal)",
     "Amp\n40 mg/ml\n5 ml",
     "Dilute in 250 ml NS/D5W. Central line preferred"],
    [43, "Dobutamine",
     "Cardiogenic shock: 2.5–20 mcg/kg/min IV infusion",
     "Vial\n250 mg/20 ml",
     "Increases HR and contractility. Monitor ECG. Tachyarrhythmia risk"],
    [44, "Digoxin",
     "AF rate control load: 0.5 mg IV over 30 min; then 0.25 mg q6h x2\nMaint: 0.125–0.25 mg IV/IM OD",
     "Amp\n0.25 mg/ml\n2 ml",
     "Narrow TI. Toxicity: N/V, bradycardia, visual changes. Avoid hypokalaemia"],
    [45, "Lignocaine\n(Lidocaine)",
     "VT: 1–1.5 mg/kg IV bolus; Infusion: 1–4 mg/min\nMax bolus: 3 mg/kg",
     "Amp\n20 mg/ml\n5 ml",
     "ECG monitor. Toxicity: seizures, arrhythmia"],
    [46, "Atropine",
     "Bradycardia: 0.5–1 mg IV q3–5 min (max 3 mg)\nOP poisoning: 2–4 mg IV q5–10 min (titrate to secretions)",
     "Amp\n0.6 mg/ml\n1 mg/ml",
     "Min IV dose 0.5 mg (paradox bradycardia if <0.5 mg)"],
    [47, "Adenosine",
     "SVT: 6 mg rapid IV bolus (central/antecubital);\n12 mg if no conversion after 1–2 min; max 18 mg",
     "Amp\n3 mg/ml\n2 ml",
     "Flush immediately with 20 ml NS. Brief asystole, flushing, chest pain expected"],
    [48, "Amiodarone",
     "AF/VF/VT: 300 mg IV over 20–60 min; then 900 mg over 24 hr\nCardiac arrest: 300 mg rapid IV",
     "Amp\n50 mg/ml\n3 ml",
     "5% Dextrose ONLY. Phlebitis via peripheral. Multiple drug interactions"],
    [49, "Verapamil\n(IV)",
     "SVT (narrow complex): 5–10 mg IV over 2–3 min;\nRepeat 5–10 mg after 30 min if needed",
     "Amp\n2.5 mg/ml\n2 ml (5 mg)",
     "NEVER with beta-blocker IV – fatal bradycardia. Avoid in WPW/HF", "NEW"],
    [50, "Esmolol",
     "SVT/HTN: 500 mcg/kg IV load over 1 min;\nthen 50–200 mcg/kg/min infusion; titrate q4 min",
     "Vial\n10 mg/ml",
     "Ultra-short acting (9 min half-life). Avoid in asthma, decompensated HF"],
    [51, "Labetalol",
     "HTN crisis: 20 mg IV over 2 min; repeat 40–80 mg q10 min (max 300 mg)\nInfusion: 2 mg/min",
     "Amp\n5 mg/ml",
     "Alpha + beta blocker. Avoid in asthma, acute HF, bradycardia"],
    [52, "Hydralazine",
     "Hypertensive emergency (esp. pregnancy): 5–10 mg IV slowly q20 min\n(Max 40 mg)",
     "Amp\n20 mg/ml",
     "Rapid BP drop – monitor closely. Preferred in eclampsia with labetalol"],
    [53, "Nicardipine\n(IV)",
     "Hypertensive emergency: 5 mg/hr IV infusion;\ntitrate by 2.5 mg/hr q5–15 min (max 15 mg/hr)",
     "Amp\n1 mg/ml\n10 ml (10 mg)",
     "Dihydropyridine CCB. Smooth & titratable BP control. Preferred in neurological HTN emergencies", "NEW"],
    [54, "Sodium\nNitroprusside",
     "0.3–10 mcg/kg/min IV infusion (start low; titrate every 5 min)",
     "Vial\n50 mg",
     "Wrap infusion in foil (light-sensitive). ICU use only. Cyanide toxicity if prolonged"],
    [55, "Streptokinase",
     "STEMI: 15 lakh U IV over 60 min\nPE: 2.5 lakh U load over 30 min; then 1 lakh U/hr x12–24 hr",
     "Vial\n7.5 lakh U\n15 lakh U",
     "Check contraindications strictly. Allergic reactions common"],
    [56, "Enoxaparin\n(LMWH)",
     "ACS: 1 mg/kg SC BD\nDVT Rx: 1 mg/kg SC BD\nProphylaxis: 40 mg SC OD",
     "Pre-filled\n40/60/80 mg",
     "Avoid CrCl <30. No routine APTT. IV bolus 30 mg in STEMI (age/weight-based)"],
    [57, "Heparin (UFH)",
     "ACS: 60–70 U/kg IV bolus (max 5000 U); then 12–15 U/kg/hr infusion\nProphylaxis: 5000 U SC BD/TDS",
     "Vial\n5000 IU/ml\n25000 IU/ml",
     "Monitor APTT (target 60–100 sec). Antidote: Protamine sulphate"],
    [58, "Protamine\nSulphate",
     "Heparin reversal: 1 mg IV per 100 IU heparin given in last 2–3 hr\nMax 50 mg; slow IV over 10 min",
     "Amp\n10 mg/ml\n5 ml (50 mg)",
     "Anaphylaxis risk (fish allergy, diabetics on NPH insulin). Give slowly", "NEW"],
    [59, "Tranexamic\nAcid",
     "Trauma haemorrhage: 1 g IV over 10 min within 3 hr of injury; then 1 g over 8 hr\nSurgical: 15 mg/kg IV pre-op\nGI bleed: 1 g IV TDS",
     "Amp\n100 mg/ml\n5 ml (500 mg)\n10 ml (1 g)",
     "Antifibrinolytic. Give within 3 hr of trauma (less effective after). Thrombosis risk", "NEW"],
    [60, "Furosemide\n(Frusemide)",
     "Pulm oedema: 40–80 mg IV bolus\nRefractory: up to 200 mg IV infusion\nMax rate: 4 mg/min",
     "Amp\n10 mg/ml\n2 ml",
     "Monitor K+, creatinine. Ototoxic in high doses/rapid infusion"],
    [61, "Phentolamine",
     "Noradrenaline extravasation: 5–10 mg in 10 ml NS infiltrate locally\nHTN crisis (phaeochromocytoma): 2–5 mg IV",
     "Amp\n10 mg/ml",
     "Alpha blocker. Local infiltration for extravasation necrosis prevention", "NEW"],
]

# ─── 7. CNS / NEUROLOGICAL ──────────────────────────────────
cns = [
    [62, "Diazepam",
     "Status epilepticus: 5–10 mg IV at 2 mg/min; max 30 mg\nIM: 10 mg if no IV access",
     "Amp\n5 mg/ml\n2 ml",
     "Respiratory depression – keep airway equipment ready. Short duration"],
    [63, "Lorazepam",
     "Status epilepticus: 4 mg IV over 2–5 min;\nRepeat 4 mg after 10 min",
     "Amp\n2 mg/ml\n1–2 ml",
     "Preferred 1st-line IV benzodiazepine for status epilepticus. Longer duration than diazepam"],
    [64, "Midazolam",
     "Seizure (no IV access): 10 mg IM\nSedation: 0.05–0.1 mg/kg IV",
     "Amp\n5 mg/ml\n5 ml",
     "IM midazolam = as effective as IV diazepam. Water-soluble"],
    [65, "Phenytoin",
     "Load: 15–20 mg/kg IV at max 50 mg/min\nMaint: 5–7 mg/kg/day IV/IM",
     "Amp\n50 mg/ml\n5 ml",
     "NS only – precipitates in glucose. ECG monitor. Extravasation = necrosis"],
    [66, "Phenobarbitone",
     "Status: 15–20 mg/kg IV at max 60 mg/min\nMaint: 60–180 mg IV/IM OD",
     "Amp\n200 mg/ml\n1 ml",
     "Hypotension + respiratory depression. ICU monitoring"],
    [67, "Sodium\nValproate (IV)",
     "Seizure: 400–800 mg (15–20 mg/kg) IV over 3–5 min\nMaint infusion: 1–2 mg/kg/hr\nAcute mania: 20 mg/kg IV load",
     "Vial\n400 mg/4 ml",
     "Avoid in liver disease, pregnancy. Thrombocytopaenia. Monitor LFT", "NEW"],
    [68, "Levetiracetam\n(IV)",
     "Status epilepticus: 60 mg/kg IV over 15 min (max 4500 mg)\nMaint: 500–1500 mg IV BD",
     "IV Bottle\n500 mg/100 ml",
     "Minimal drug interactions. Renal dose adjustment needed. Well tolerated", "NEW"],
    [69, "Haloperidol",
     "Acute psychosis/agitation: 5–10 mg IM q1h PRN\nIV (unlabelled): 2.5–5 mg slowly",
     "Amp\n5 mg/ml\n1 ml",
     "Monitor QTc. Extrapyramidal side effects. Avoid in Parkinson's"],
    [70, "Promethazine",
     "Sedation/allergy: 25–50 mg IM deep\nSlow IV: 25 mg diluted in 10 ml NS",
     "Amp\n25 mg/ml\n50 mg/ml",
     "NEVER SC (tissue necrosis). IV must be diluted and very slow"],
    [71, "Neostigmine",
     "Myasthenic crisis: 0.5–2.5 mg IV slowly\nNMB reversal: 0.04–0.08 mg/kg IV",
     "Amp\n0.5 mg/ml",
     "Always give with atropine 0.6 mg IV to prevent bradycardia/bronchospasm"],
    [72, "Desmopressin\n(DDAVP)",
     "Haemophilia A/vWD: 0.3 mcg/kg IV over 30 min\nDiabetes insipidus: 1–4 mcg IV/SC OD–BD",
     "Amp\n4 mcg/ml\n1 ml",
     "Hyponatraemia risk. Restrict fluids after dose. Monitor serum Na+", "NEW"],
]

# ─── 8. CORTICOSTEROIDS ─────────────────────────────────────
ster = [
    [73, "Hydrocortisone",
     "Adrenal crisis: 100 mg IV stat; then 100 mg IV q8h\nAsthma/COPD: 100–200 mg IV q6h\nAnaphylaxis: 200 mg IV",
     "Vial\n100 mg / 200 mg\n(dry pwd)",
     "Reconstitute with WFI. Short-acting. Has mineralocorticoid activity"],
    [74, "Dexamethasone",
     "Cerebral oedema: 8–16 mg IV stat; then 4 mg IV q6h\nCroup: 0.6 mg/kg IM single dose\nAnti-emetic: 8 mg IV\nSeptic shock: 6 mg IV OD x10 days (COVID-19 data)",
     "Amp\n4 mg/ml\n2 ml",
     "Long-acting. Least mineralocorticoid activity. Protect from light"],
    [75, "Methylprednisolone",
     "Severe asthma: 125 mg IV OD\nAutoimmune: 500 mg–1 g IV daily x3 (pulse)\nSpinal injury: 30 mg/kg IV over 15 min",
     "Vial\n40/125/500 mg\n1 g",
     "High dose: monitor glucose, BP, infection. Give with PPI"],
]

# ─── 9. DIABETES / ENDOCRINE ────────────────────────────────
dm = [
    [76, "Regular Insulin\n(Soluble)",
     "DKA: 0.1 U/kg/hr IV infusion\nHyperkalaemia: 10 U IV + 50 ml 50% Dex\nHHS: 0.05 U/kg/hr",
     "Vial\n40 IU/ml (10 ml)\n100 IU/ml",
     "Dedicated IV line. Hourly glucose. NEVER mix with other drugs in same line"],
    [77, "Glucagon",
     "Severe hypoglycaemia: 1 mg IM/SC/IV\nRepeat in 15 min if no response",
     "Vial\n1 mg",
     "Turn patient lateral (vomiting risk). Check glucose at 15 min"],
    [78, "Octreotide",
     "Variceal bleed: 50 mcg IV bolus; then 25–50 mcg/hr infusion\nInsulinnoma: 50–100 mcg SC/IV q8h",
     "Amp\n50 mcg/ml\n100 mcg/ml",
     "Gallstone risk with prolonged use. Refrigerate unopened vials"],
    [79, "Vasopressin\n(ADH)",
     "Variceal bleed: 0.2–0.4 U/min IV infusion\nDI: 5–10 U IM/SC q3–4h\nSeptic shock (2nd vasopressor): 0.03–0.04 U/min IV",
     "Amp\n20 IU/ml\n1 ml",
     "Give with nitrates to reduce cardiac side effects in variceal bleed"],
    [80, "Terlipressin",
     "Variceal haemorrhage: 2 mg IV bolus q4h; reduce to 1 mg IV q4h after haemostasis\nHepato-renal syndrome: 0.5–1 mg IV q4–6h",
     "Amp\n1 mg/5 ml",
     "Vasopressin analogue with longer half-life. Monitor for ischaemia (fingers, skin)", "NEW"],
]

# ─── 10. ELECTROLYTES & METABOLIC ───────────────────────────
elec = [
    [81, "50% Dextrose",
     "Hypoglycaemia: 25–50 ml IV bolus\nThen maintain with 10% Dextrose infusion",
     "Amp\n500 mg/ml\n50 ml",
     "Flush line with NS before & after. Tissue necrosis if extravasated"],
    [82, "Calcium Gluconate",
     "Hypocalcaemia/Ca-channel OD: 1–3 g (10–30 ml 10%) IV over 10–20 min\nHyperkalaemia/HF: 1 g (10 ml 10%) IV",
     "Amp\n10%: 1 g/10 ml",
     "Cardiac monitor. Extravasation causes necrosis. Precipitates with bicarb/phosphate"],
    [83, "Magnesium\nSulphate",
     "Eclampsia: 4–6 g IV over 15–20 min; then 1–2 g/hr\nSevere asthma: 2 g IV over 20 min\nTorsades/HypoMg: 1–2 g IV over 1 hr",
     "Amp\n50%: 5 g/10 ml\n2 g/4 ml",
     "Antidote = Ca gluconate 1 g IV. Monitor RR (>12/min), knee jerk, UO (>25 ml/hr)"],
    [84, "Potassium\nChloride (KCl)",
     "Severe hypokalaemia: dilute in 1 L NS/D5W\nMax peripheral rate: 10 mEq/hr\nMax peripheral conc: 40 mEq/L",
     "Amp\n15%: 20 mEq\n/10 ml",
     "NEVER undiluted IV – fatal arrhythmias. ECG monitoring mandatory"],
    [85, "Sodium\nBicarbonate",
     "Severe metabolic acidosis (pH <7.1): 1–2 mEq/kg IV slowly\nHyperkalaemia membrane stabilization: 50 mEq IV\nTCA OD: 1–2 mEq/kg IV bolus",
     "Amp\n7.5%:\n~9 mEq/10 ml",
     "Do NOT mix with Ca (precipitates). Use only if clearly indicated"],
    [86, "3% Hypertonic\nSaline",
     "Severe symptomatic hyponatraemia: 100–150 ml IV over 20 min;\nRepeat x2 if seizure persists\nRaise Na+ by max 5–10 mEq/L in first 1–2 hr",
     "IV Bottle\n3% NaCl\n100/250 ml",
     "Max correction 10 mEq/L/day (avoid osmotic demyelination). Neuro unit use", "NEW"],
    [87, "Mannitol\n(20%)",
     "Raised ICP/cerebral oedema: 0.25–2 g/kg IV over 30–60 min\nRepeat q4–6h PRN",
     "IV Bottle\n20%: 100/250\n500 ml",
     "Use in-line filter. Monitor serum osmolality (target <320 mosm/kg). Monitor renal fn"],
]

# ─── 11. ANTIDOTES & POISONING ──────────────────────────────
antidotes = [
    [88, "Naloxone",
     "Opioid OD: 0.4–2 mg IV/IM q2–3 min (max 10 mg)\nInfusion: 2/3 of effective bolus dose/hr",
     "Amp\n0.4 mg/ml\n1 ml",
     "Short acting (30–90 min) – watch for re-narcotization"],
    [89, "N-Acetylcysteine\n(NAC)",
     "Paracetamol OD (Prescott):\n• 150 mg/kg in 200 ml D5W over 1 hr\n• 50 mg/kg over 4 hr\n• 100 mg/kg over 16 hr",
     "Amp\n200 mg/ml\n10 ml",
     "Anaphylactoid reaction in 1st bag – slow/stop; restart at lower rate after premedication"],
    [90, "Calcium Gluconate\n(Antidote)",
     "Ca-channel blocker OD/fluoride: 1–3 g IV over 10–20 min; repeat PRN\nHypermagnesaemia: 1 g IV",
     "Amp\n10% (10 ml)\n= 1 g",
     "Cardiac monitor. Also antidote for hypermagnesaemia. See #82"],
    [91, "Desferrioxamine",
     "Iron OD: 15 mg/kg/hr IV infusion (max 80 mg/kg/day)\nIM: 2 g IM if no IV",
     "Vial\n500 mg",
     "Urine turns orange-red (ferrioxamine). Refrigerate unopened vial"],
    [92, "Atropine\n(OP Poisoning)",
     "Mild: 1–2 mg IV q5–10 min\nModerate-severe: 2–4 mg IV q5–10 min\nEndpoint: drying of secretions (NOT heart rate)",
     "Amp\n0.6 mg/ml\n1 mg/ml",
     "No ceiling dose in OP poisoning. Always combine with pralidoxime"],
    [93, "Pralidoxime\n(PAM 2-Cl)",
     "OP poisoning: 1–2 g IV over 15–30 min;\nRepeat 1 g q1–2h; Infusion: 500 mg/hr",
     "Vial\n1 g",
     "Effective within 24–48 hr of exposure only. Always with atropine"],
    [94, "Flumazenil",
     "Benzodiazepine reversal: 0.2 mg IV over 15 sec;\nRepeat 0.1 mg q60 sec (max 1 mg)",
     "Amp\n0.1 mg/ml\n5 ml (0.5 mg)",
     "Short acting (45–90 min) – re-sedation occurs. AVOID in BZD-dependent patients (seizures)", "NEW"],
    [95, "Snake Antivenom\n(Polyvalent)",
     "10 vials IV infusion in 100–200 ml NS over 30–60 min;\nRepeat 10 vials if signs persist at 6 hr",
     "Vial\n(lyophilized\nor liquid)",
     "Pre-medicate: Adrenaline 0.25 mg SC + Promethazine 25 mg IM. Keep adrenaline ready"],
    [96, "Anti-Tetanus\nSerum (ATS)",
     "Prophylaxis: 1500 IU IM (after sensitivity test)\nTreatment: 10000–20000 IU IM or slow IV",
     "Vial\n1500 IU\n10000 IU",
     "Sensitivity test mandatory. Adrenaline & antihistamine at bedside"],
    [97, "Phytomenadione\n(Vit K)",
     "Warfarin reversal: 5–10 mg IV over 20 min\nCoagulopathy (hepatic): 10 mg IV/IM OD",
     "Amp\n10 mg/ml\n1 ml",
     "Anaphylaxis risk – infuse slowly. IM if less urgent. Reversal takes 6–12 hr"],
    [98, "Physostigmine",
     "Anticholinergic toxidrome (TCA/atropine OD): 1–2 mg IV slowly over 5 min\nRepeat 1–2 mg after 20 min if needed",
     "Amp\n1 mg/ml\n2 ml",
     "Short-acting cholinesterase inhibitor. Contraindicated in TCA overdose (seizures). ICU only", "NEW"],
]

# ─── 12. RESPIRATORY EMERGENCIES ────────────────────────────
resp = [
    [99, "Aminophylline",
     "Acute asthma/COPD: Load 5 mg/kg IV over 20–30 min\nMaint infusion: 0.5–0.9 mg/kg/hr\n(Omit load if on theophylline)",
     "Amp\n25 mg/ml\n10 ml\n(250 mg)",
     "Narrow TI – cardiac arrhythmias, seizures at high levels. Monitor drug levels"],
    [100,"Salbutamol\n(IV)",
     "Life-threatening asthma: 5 mcg/min IV infusion; titrate (max 20 mcg/min)\n(Prefer nebulization in ward)",
     "Amp\n0.5 mg/ml\n1 ml",
     "IV reserved for ICU/life-threatening bronchospasm. Tachycardia & hypokalaemia"],
    [101,"Dexamethasone\n(Resp)",
     "Acute severe asthma: 8 mg IV/IM BD\nCroup: 0.6 mg/kg IM single dose",
     "Amp\n4 mg/ml\n2 ml",
     "Reduces airway inflammation. Effect in 4–6 hr. See #74 for full entry"],
    [102,"Ipratropium\n(IV – rare)",
     "Nebulization preferred; IV rarely: 0.25 mg in 50 ml NS over 20 min in ICU",
     "Vial\n0.25 mg/ml",
     "Anticholinergic bronchodilator. IV route only if nebulization impossible. Usually nebulized", "NEW"],
]

# ─── 13. OBSTETRICS & GYNAECOLOGY ───────────────────────────
obs = [
    [103,"Oxytocin",
     "PPH (active management): 10 IU IM after delivery of anterior shoulder\nTreatment of PPH: 5–10 IU slow IV or 20–40 IU in 500 ml NS at 125 ml/hr\nInduction: 2–8 mIU/min infusion (titrate)",
     "Amp\n5 IU/ml\n1 ml",
     "Rapid IV bolus causes hypotension & tachycardia. Always dilute for infusion", "NEW"],
    [104,"Ergometrine\n(Ergometrine\nMaleate)",
     "PPH: 0.5 mg IM or slow IV (over 1 min)\nRepeat 0.5 mg after 5 min if needed",
     "Amp\n0.5 mg/ml\n1 ml",
     "Avoid in HTN, pre-eclampsia, cardiovascular disease. IV use only in severe PPH", "NEW"],
    [105,"MgSO4\n(Eclampsia)",
     "See #83 Electrolytes section above",
     "Amp\n50%: 5 g/10 ml",
     "First-line for seizure prevention & treatment in eclampsia/pre-eclampsia"],
    [106,"Labetalol\n(Obstetric HTN)",
     "See #51 Cardiovascular section\nPre-eclampsia: 20 mg IV; repeat 20–80 mg q20 min (max 220 mg)",
     "Amp\n5 mg/ml",
     "Safe in pregnancy. Avoid in asthma. Target BP <160/110 mmHg"],
]

# ─── 14. HAEMATOLOGY / COAGULATION ──────────────────────────
haem = [
    [107,"Tranexamic Acid\n(TXA)",
     "Trauma: 1 g IV over 10 min within 3 hr; then 1 g over 8 hr\nGI bleed: 1 g IV TDS x5 days\nSurgery: 15 mg/kg IV pre-op",
     "Amp\n100 mg/ml\n5 ml (500 mg)\n10 ml (1 g)",
     "Give within 3 hr of trauma onset. Antifibrinolytic. Thrombosis risk. See #59"],
    [108,"Protamine\nSulphate",
     "Heparin reversal: 1 mg IV per 100 IU recent heparin\nMax 50 mg; slow IV over 10 min",
     "Amp\n10 mg/ml\n5 ml (50 mg)",
     "Anaphylaxis risk (fish allergy / NPH insulin users). Have adrenaline ready. See #58"],
    [109,"Desmopressin\n(DDAVP)",
     "vWD/Haemophilia A: 0.3 mcg/kg IV over 30 min\nCentral DI: 1–4 mcg IV/SC OD–BD",
     "Amp\n4 mcg/ml\n1 ml",
     "Hyponatraemia risk. Restrict fluids post-dose. Monitor serum Na+. See #72"],
    [110,"Phytomenadione\n(Vit K)",
     "See #97 Antidotes section",
     "Amp\n10 mg/ml\n1 ml",
     "Warfarin reversal & coagulopathy management"],
]

# ─── 15. GASTROENTEROLOGY / ANTIEMETICS ─────────────────────
gi = [
    [111,"Ondansetron",
     "Nausea/vomiting: 4–8 mg IV over 15 min q8h\nChemo-induced CINV: 8 mg IV BD\nMax single IV dose: 16 mg",
     "Amp\n2 mg/ml\n2 ml (4 mg)",
     "Prolongs QTc – give as slow IV infusion. 5-HT3 antagonist"],
    [112,"Metoclopramide",
     "Nausea/gastroparesis: 10 mg IV/IM q8h\nMax 3 doses/day; 5 mg in elderly",
     "Amp\n5 mg/ml\n2 ml",
     "EPS side effects (akathisia, dystonia). Avoid in epilepsy, bowel obstruction"],
    [113,"Pantoprazole",
     "Active GI bleed: 80 mg IV bolus; then 8 mg/hr x72 hr\nMaintenance: 40 mg IV OD",
     "Vial\n40 mg\n(dry pwd)",
     "Reconstitute in NS. High-dose infusion for high-risk peptic ulcer bleed"],
    [114,"Ranitidine\n(IV)",
     "PUD/stress ulcer prophylaxis: 50 mg IV q8h or 6.25 mg/hr infusion\n(Give slowly over 5–15 min)",
     "Amp\n25 mg/ml\n2 ml (50 mg)",
     "H2 blocker. Less commonly used now (pantoprazole preferred). Avoid rapid IV"],
    [115,"Terlipressin",
     "Variceal haemorrhage: 2 mg IV q4h initially;\nReduce to 1 mg IV q4h after haemostasis\nHRS type 1: 0.5–1 mg IV q6h",
     "Amp\n1 mg/5 ml",
     "Vasopressin analogue. Monitor for peripheral ischaemia, chest pain, arrhythmia. See #80"],
]

# ─── 16. VITAMINS & HAEMATINICS ─────────────────────────────
vit = [
    [116,"Thiamine\n(Vitamin B1)",
     "Wernicke's/Alcoholic: 200–500 mg IV TDS x3 days (Pabrinex)\nProphylaxis: 100 mg IV/IM OD",
     "Amp\n100 mg/ml\n2 ml",
     "ALWAYS give BEFORE glucose in alcoholics to prevent Wernicke's. Anaphylaxis risk IV"],
    [117,"Hydroxocobalamin\n(Vit B12)",
     "Deficiency: 1 mg IM OD x7 days; then 1 mg weekly x4; then monthly\nCyanide poisoning: 5 g IV over 15 min",
     "Amp\n1 mg/ml\n1 ml\n(5 g vial for CN)",
     "IM only for deficiency. High-dose IV for cyanide poisoning (turns urine/skin red)"],
    [118,"Folic Acid\n(IV/IM)",
     "Deficiency/megaloblastic: 5 mg IV/IM OD\n(Oral usually preferred)",
     "Amp\n5 mg/ml\n1 ml",
     "Rule out B12 deficiency before treating with folic acid alone (masks subacute combined degeneration)"],
    [119,"Iron Sucrose\n(IV Iron)",
     "IDA: 100–200 mg IV in 100 ml NS over 30 min per session\nMax 200 mg per dose",
     "Amp\n20 mg/ml\n5 ml (100 mg)",
     "Test dose not required. Anaphylaxis equipment at bedside. Avoid IM"],
    [120,"Ferric\nCarboxymaltose",
     "IDA: 500–1000 mg IV over 15 min (max 1000 mg/week)",
     "Vial\n50 mg/ml\n(10–20 ml)",
     "Higher single dose than iron sucrose. No test dose. Hypophosphataemia risk"],
]

# ─── 17. ANTIHISTAMINES & ALLERGY ───────────────────────────
antihist = [
    [121,"Chlorpheniramine\nMaleate",
     "Allergic reaction/anaphylaxis: 10–20 mg IV/IM (slow IV over 1 min)\nMax 40 mg/day",
     "Amp\n10 mg/ml\n1 ml",
     "Sedating antihistamine. Adjunct in anaphylaxis (not primary Rx)"],
    [122,"Pheniramine\nMaleate",
     "Allergic reaction: 22.75 mg (1 ml) IV/IM; repeat q4–6h",
     "Amp\n22.75 mg/ml\n1 ml",
     "Similar to chlorpheniramine. Sedation. Dilute before slow IV"],
]

# ─── 18. IMMUNOGLOBULINS & BIOLOGICALS ──────────────────────
immuno = [
    [123,"Anti-Rabies\nImmunoglobulin\n(RIG)",
     "Post-exposure: 20 IU/kg\nInfiltrate max around wound; remainder IM at distant site",
     "Vial\n150 IU/ml",
     "Give with rabies vaccine but NOT in same syringe/site. Human RIG preferred over equine"],
    [124,"Tetanus\nImmunoglobulin\n(TIG – Human)",
     "Treatment (tetanus): 500–3000 IU IM\nProphylaxis (unimmunized): 250–500 IU IM",
     "Vial\n500 IU",
     "Human TIG preferred over equine ATS. Different site from tetanus toxoid"],
    [125,"Normal Human\nImmunoglobulin\n(IVIG)",
     "ITP/AIDP (GBS): 0.4 g/kg/day IV over 4–8 hr x5 days\nKawasaki: 2 g/kg IV over 10–12 hr single dose",
     "Vial\n5%/10%\n50/100 ml",
     "Pre-medicate with paracetamol/antihistamine. Anaphylaxis risk (IgA deficiency)", "NEW"],
]

# ─── 19. MISCELLANEOUS / CRITICAL CARE ──────────────────────
misc = [
    [126,"Mannitol (20%)",
     "Raised ICP: 0.25–2 g/kg IV over 30–60 min; repeat q4–6h\nOliguric renal failure: 0.5 g/kg IV test dose",
     "IV Bottle\n20%: 100/250\n500 ml",
     "Use in-line filter. Monitor serum osmolality <320 mosm/kg. Monitor renal function"],
    [127,"Albumin\n(Human 20/25%)",
     "Hypoalbuminaemia/cirrhosis/SBP:\n1.5 g/kg on Day 1; 1 g/kg on Day 3 (SBP protocol)\nSpontaneous: 50–100 ml 20–25% over 2–4 hr",
     "Vial\n20%/25%\n50/100 ml",
     "Expensive – use per protocol. Monitor fluid balance & albumin levels"],
    [128,"Hyaluronidase",
     "Extravasation of IV vesicants (vincristine, TPN, KCl):\n150–1500 IU injected into or around extravasation site",
     "Vial\n1500 IU",
     "Facilitates absorption of extravasated fluid. Give within 1 hr of extravasation", "NEW"],
    [129,"Methylergometrine\n(Methylergonovine)",
     "PPH (uterotonic): 0.2 mg IM after delivery;\nRepeat q2–4h if needed (max 5 doses)\nIV ONLY in life-threatening PPH: 0.2 mg slow IV",
     "Amp\n0.2 mg/ml\n1 ml",
     "Avoid IV if BP unstable. Avoid in HTN, Raynaud's, cardiac disease. Store in fridge", "NEW"],
    [130,"Adenosine\n(Diagnostic)",
     "Pharmacological stress test (cardiac imaging): 140 mcg/kg/min IV infusion over 6 min",
     "Amp\n3 mg/ml\n2 ml",
     "See #47 for SVT dose. Diagnostic use needs monitoring. Bronchospasm in asthma"],
]

# ════════════════════════════════════════════════════════════════
#  BUILD PDF
# ════════════════════════════════════════════════════════════════
story = []

# ── COVER ──
story.append(Spacer(1, 5*mm))
cover = Table([[Paragraph(
    "COMPLETE HOSPITAL INJECTION\nQUICK REFERENCE GUIDE\n130 INJECTIONS  |  IV / IM", title_st)]],
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cover.setStyle(TableStyle([
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story.append(Spacer(1, 2*mm))

sub = Table([[Paragraph(
    "Medicine Department  |  Govt Hospital, Odisha\n"
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    "[NEW] = Additional drugs added beyond original 98", sub_st)]],
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story.append(Spacer(1, 2*mm))

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    "⚠  FOR TRAINED HEALTHCARE PROFESSIONALS ONLY  ⚠\n"
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    ("LEFTPADDING",   (0,0),(-1,-1), 5),
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story.append(warn)
story.append(Spacer(1, 2*mm))

# ── TOC ──
sections_toc = [
    ("1–7",    "Analgesics & Pain Management",       7),
    ("8–34",   "Antibiotics (incl. Antifungal/Antiviral)", 27),
    ("35–38",  "Antifungal & Antiparasitic",           4),
    ("39",     "Antitubercular",                       1),
    ("40–61",  "Cardiovascular (22 drugs)",            22),
    ("62–72",  "CNS / Neurological (11 drugs)",        11),
    ("73–75",  "Corticosteroids",                      3),
    ("76–80",  "Diabetes / Endocrine",                 5),
    ("81–87",  "Electrolytes & Metabolic",             7),
    ("88–98",  "Antidotes & Poisoning (11 drugs)",     11),
    ("99–102", "Respiratory Emergencies",              4),
    ("103–106","Obstetrics & Gynaecology",             4),
    ("107–110","Haematology / Coagulation",            4),
    ("111–115","Gastroenterology / Antiemetics",       5),
    ("116–120","Vitamins & Haematinics",               5),
    ("121–122","Antihistamines",                       2),
    ("123–125","Immunoglobulins / Biologicals",        3),
    ("126–130","Miscellaneous / Critical Care",        5),
]

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        Paragraph(str(cnt), PS(f"tc{i}", fontSize=5.8, fontName="Helvetica-Bold",
                               textColor=DARK_RED, alignment=TA_CENTER, leading=7.5)),
    ]], colWidths=[18*mm, 95*mm, 19*mm])
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),1.5),("BOTTOMPADDING",(0,0),(-1,-1),1.5),
        ("LEFTPADDING",(0,0),(-1,-1),3)]))
    story.append(rt)

story.append(Spacer(1, 2*mm))
story.append(Paragraph(
    "Based on District Hospital EML (India, Jan 2024) & OSMCL Odisha  |  Compiled July 2026\n"
    "[NEW] = 32 additional drugs added for complete hospital coverage",
    foot_st))

# ── DRUG PAGES ──
story.append(PageBreak())
add_sec("1–7   ANALGESICS & PAIN MANAGEMENT",         analg,      BROWN,   BROWN_LT)
add_sec("8–20  ANTIBIOTICS (Part 1 – Beta-lactams & Aminoglycosides)", abx[:13], colors.HexColor("#4A235A"), PURP_LITE)

story.append(PageBreak())
add_sec("21–34 ANTIBIOTICS (Part 2 – Fluoroquinolones, Macrolides, Carbapenems, Others)", abx[13:], colors.HexColor("#4A235A"), PURP_LITE)
add_sec("35–36 ANTIFUNGALS",                           antifung,   TEAL,    TEAL_LITE)
add_sec("37–38 ANTIVIRAL / ANTIPARASITIC",             antip,      TEAL,    TEAL_LITE)
add_sec("39    ANTITUBERCULAR",                        antitb,     TEAL,    TEAL_LITE)

story.append(PageBreak())
add_sec("40–50 CARDIOVASCULAR (Part 1 – Vasoactives, Antiarrhythmics)", cardio[:11], GREEN, LIGHT_BLU)

story.append(PageBreak())
add_sec("51–61 CARDIOVASCULAR (Part 2 – Antihypertensives, Thrombolytics, Anticoagulants)", cardio[11:], GREEN, LIGHT_BLU)

story.append(PageBreak())
add_sec("62–72 CNS / NEUROLOGICAL",                    cns,        PURPLE,  PURP_LITE)
add_sec("73–75 CORTICOSTEROIDS",                       ster,       OLIVE,   OLIVE_LT)

story.append(PageBreak())
add_sec("76–80 DIABETES / ENDOCRINE",                  dm,         MAROON,  MAROON_LT)
add_sec("81–87 ELECTROLYTES & METABOLIC",              elec,       INDIGO,  LIGHT_BLU)

story.append(PageBreak())
add_sec("88–98 ANTIDOTES & POISONING",                 antidotes[:6], GOLD, GOLD_LT)
story.append(PageBreak())
add_sec("88–98 ANTIDOTES & POISONING (contd.)",        antidotes[6:], GOLD, GOLD_LT)
add_sec("99–102 RESPIRATORY EMERGENCIES",              resp,        TEAL,   TEAL_LITE)

story.append(PageBreak())
add_sec("103–106 OBSTETRICS & GYNAECOLOGY",            obs,         colors.HexColor("#7D3C98"), PURP_LITE)
add_sec("107–110 HAEMATOLOGY / COAGULATION",           haem,        colors.HexColor("#1A5276"), LIGHT_BLU)
add_sec("111–115 GASTROENTEROLOGY / ANTIEMETICS",      gi,          colors.HexColor("#117864"), TEAL_LITE)

story.append(PageBreak())
add_sec("116–120 VITAMINS & HAEMATINICS",              vit,         colors.HexColor("#1A5276"), LIGHT_BLU)
add_sec("121–122 ANTIHISTAMINES",                      antihist,    colors.HexColor("#6C3483"), PURP_LITE)
add_sec("123–125 IMMUNOGLOBULINS / BIOLOGICALS",       immuno,      SLATE,   SLATE_LT)
add_sec("126–130 MISCELLANEOUS / CRITICAL CARE",       misc,        NAVY,    LIGHT_BLU)

# ── BACK PAGE – Safety Reminders ──
story.append(PageBreak())
story.append(sec_header("CRITICAL SAFETY REMINDERS  –  Must Know Before Use", bg=DARK_RED))
story.append(Spacer(1, 1.5*mm))

reminders = [
    ("NEVER give KCl undiluted IV – fatal arrhythmias", "Vancomycin: infuse >60 min (Red Man Syndrome if fast)"),
    ("NaHCO3 + Ca = precipitate – NEVER mix in same line", "Sodium Nitroprusside: wrap infusion in foil (light breaks it down)"),
    ("MgSO4 toxicity antidote = Calcium Gluconate 1 g IV", "Phenytoin: NS only – DO NOT dilute in dextrose"),
    ("Opioids: keep Naloxone at bedside always", "Promethazine: NEVER SC – causes tissue necrosis"),
    ("Atropine in OP poisoning: titrate to secretions (no ceiling dose)", "Artesunate: reconstitute in NaHCO3 first, then dilute in D5W"),
    ("Snake antivenom: pre-medicate with adrenaline SC + promethazine IM", "Noradrenaline/KCl infusions: central line preferred"),
    ("Insulin: dedicated IV line; hourly glucose monitoring", "Aminophylline: narrow TI – ECG monitor; omit load if on oral theophylline"),
    ("Thiamine BEFORE glucose in ALL alcoholics (prevents Wernicke's)", "Amphotericin B: test dose 1 mg first; protect from light throughout"),
    ("Benzathine penicillin: NEVER IV – IM only (cardiac arrest risk)", "Verapamil IV: NEVER with IV beta-blocker – fatal bradycardia"),
    ("Tranexamic acid: most effective within 3 hr of trauma", "Flumazenil: AVOID in benzo-dependent patients (precipitates seizures)"),
    ("NAC 1st bag: slow/stop if anaphylactoid reaction; restart after premedication", "High-dose NaHCO3 for TCA OD: target pH 7.50–7.55 to narrow QRS"),
    ("Oxytocin: NEVER rapid IV bolus – dilute always (causes severe hypotension)", "KCl max peripheral rate: 10 mEq/hr; max conc: 40 mEq/L"),
    ("3% Hypertonic saline: max correct Na+ by 10 mEq/L/day (osmotic demyelination risk)", "Colistin: last resort only – monitor renal function daily"),
    ("Fentanyl: 100x more potent than morphine; titrate cautiously", "Linezolid + SSRIs/MAOIs = serotonin syndrome"),
]
for i, (a, b) in enumerate(reminders):
    bg = colors.HexColor("#F9E79F") if i % 2 == 0 else WHITE
    rt = Table([[
        Paragraph("⚠ " + a, PS(f"ra{i}", fontSize=5.8, fontName="Helvetica-Bold",
                               textColor=DARK_RED, leading=7.5)),
        Paragraph("→ " + b, PS(f"rb{i}", fontSize=5.8, fontName="Helvetica-Bold",
                               textColor=colors.HexColor("#1A5276"), leading=7.5)),
    ]], colWidths=[W/2, W/2])
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),2),("BOTTOMPADDING",(0,0),(-1,-1),2),
        ("LEFTPADDING",(0,0),(-1,-1),3),("VALIGN",(0,0),(-1,-1),"TOP")]))
    story.append(rt)

story.append(Spacer(1, 2*mm))

# Abbreviations (4-column)
_es = PS("_es", fontSize=6, fontName="Helvetica", leading=8)
abh = Table([[
    Paragraph("ABBREVIATIONS", PS("abh", fontSize=7, fontName="Helvetica-Bold",
                                  textColor=WHITE, alignment=TA_CENTER, leading=9)),
    Paragraph(" ", _es), Paragraph(" ", _es), Paragraph(" ", _es)
]], colWidths=[W/4]*4)
abh.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),NAVY),("SPAN",(0,0),(-1,-1)),
    ("TOPPADDING",(0,0),(-1,-1),2),("BOTTOMPADDING",(0,0),(-1,-1),2)]))
story.append(abh)
abbrs = [
    ("IV = Intravenous","IM = Intramuscular","SC = Subcutaneous","OD = Once daily"),
    ("BD = Twice daily","TDS = Three times daily","QDS = Four times daily","q = every (e.g. q8h)"),
    ("NS = Normal Saline","D5W = 5% Dextrose","WFI = Water for Injection","RT = Room Temperature"),
    ("TI = Therapeutic Index","EPS = Extrapyramidal S/E","UO = Urine output","RR = Respiratory Rate"),
    ("OD = Overdose (context)","HTN = Hypertension","Rx = Treatment","APTT = Activated PTT"),
    ("XDR = Extremely Drug Resistant","MDR = Multi-Drug Resistant","IDA = Iron Def Anaemia","PPH = Postpartum Haemorrhage"),
    ("GBS = Guillain-Barre Syndrome","ITP = Immune Thrombocytopaenia","SBP = Spontaneous Bacterial Peritonitis","HRS = Hepatorenal Syndrome"),
]
for i, row in enumerate(abbrs):
    bg = LIGHT_GRY if i % 2 == 0 else WHITE
    rt = Table([[Paragraph(c, PS(f"ab{i}{j}", fontSize=5.5, fontName="Helvetica", leading=7))
                 for j, c in enumerate(row)]], colWidths=[W/4]*4)
    rt.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,-1),bg),
        ("GRID",(0,0),(-1,-1),0.3,MED_GRY),
        ("TOPPADDING",(0,0),(-1,-1),1.5),("BOTTOMPADDING",(0,0),(-1,-1),1.5),
        ("LEFTPADDING",(0,0),(-1,-1),3)]))
    story.append(rt)

story.append(Spacer(1, 2*mm))
story.append(Paragraph(
    "For educational & reference purposes only. Not a substitute for standard treatment protocols or clinical judgment.\n"
    "Refer to current AIIMS/ICMR/WHO guidelines and local hospital formulary for updates.\n"
    "Based on District Hospital EML (India, Revised Jan 2024) & OSMCL Odisha Essential Drug List 2020.",
    foot_st))

doc.build(story)
print(f"PDF created: {OUTPUT}")