Elite House Officer Drug Atlas
A cinematic high-yield clinical handbook integrating pharmacology, internal medicine, surgery, ICU reasoning, and ward-based
survival pearls for Pakistani clinical rotations.
Clinical Architecture
• Mechanism → Indication → Contraindication → Interaction → Ward Pearl
• Optimized for MBBS, House Job, ER, ICU & Ward Rounds
• Pakistani brands and approximate local prices included
• Minimal wording • Maximum clinical meaning
Core Clinical Drug Matrix
Drug Dose Pakistani Brand + Approx Price
Indications Contraindications Interactions Clinical Pearl
Paracetamol 500 mg q6–8h Panadol (~PKR 120/strip) Fever, pain Severe liver disease ↑ Hepatotoxicity with alcoholMax 4 g/day
Ibuprofen 200–400 mg TDS Brufen (~PKR 180) Pain, inflammation Peptic ulcer disease ↑ Bleeding with warfarin NSAID nephrotoxicity
Diclofenac 50 mg BD Voren (~PKR 150) Musculoskeletal pain GI bleed, CKD ACEI + NSAID → AKI High CV risk
Tramadol 50–100 mg q6h Tramal (~PKR 300) Moderate pain Epilepsy SSRIs → serotonin syndrome
Seizure risk
Amoxicillin 500 mg q8h Amoxil (~PKR 220) ENT, RTI Penicillin allergy OCP failure possible Safe in pregnancy
Co-amoxiclav 625 mg TDS Augmentin (~PKR 650) Aspiration, bite wounds Liver disease Warfarin ↑ INR Diarrhea common
Ceftriaxone 1–2 g IV daily Rocephin (~PKR 450/vial) Sepsis, meningitis Neonatal jaundice Calcium precipitation Biliary sludging
Metronidazole 400–500 mg q8h Flagyl (~PKR 180) Anaerobes Alcohol intake Disulfiram reaction Metallic taste
Azithromycin 500 mg OD Azomax (~PKR 450) Atypical pneumonia QT prolongation QT drugs interaction Long half-life
Meropenem 1 g IV q8h Meronem (~PKR 2200) ICU sepsis Beta-lactam allergy Valproate level ↓ Broad-spectrum
Vancomycin 1 g IV q12h Vancomycin (~PKR 1800) MRSA Renal failure Nephrotoxins ↑ toxicity Monitor trough
Amlodipine 5 mg OD Amodip (~PKR 100) Hypertension Severe hypotension Additive with beta blockers Ankle edema
Losartan 50 mg OD Xavor (~PKR 250) HTN, diabetic nephropathy
Pregnancy K+ sparing drugs → hyperK Renoprotective
Frusemide 20–40 mg Lasix (~PKR 80) Pulmonary edema Hypovolemia Digoxin toxicity ↑ Loop diuretic
Spironolactone 25 mg OD Aldactone (~PKR 200) HF, ascites Hyperkalemia ACEI/ARB ↑ K+ Gynecomastia
Metformin 500 mg OD/BD Glucophage (~PKR 300) Type 2 DM eGFR <30 Contrast → lactic acidosis Weight neutral
Insulin Glargine 0.5–1 U/kg/day Basagine (~PKR 1900) Diabetes Hypoglycemia Steroids ↑ glucose Long acting
Prednisolone 1 mg/kg/day Deltacortil (~PKR 90) Asthma, autoimmune Systemic fungal infection NSAIDs ↑ ulcer risk Taper gradually
Omeprazole 20–40 mg OD Risek (~PKR 120) GERD, ulcer Hypersensitivity ↓ Clopidogrel activation Long-term ↓ Mg/B12
Lactulose 15–30 ml Duphalac (~PKR 450) Constipation, encephalopathy
Galactosemia Antacids reduce effect Traps ammonia
Cetirizine 10 mg OD Rigix (~PKR 100) Allergy Severe renal disease Sedatives ↑ drowsiness Less sedating
Aspirin 75–300 mg Ascard (~PKR 60) ACS, stroke prevention GI bleed Warfarin ↑ bleeding Irreversible platelet block
Clopidogrel 75 mg OD Lowplat (~PKR 350) Post-stent Active bleeding Omeprazole ↓ efficacy Dual antiplatelet therapy
Atorvastatin 10–80 mg OD Atorva (~PKR 450) Dyslipidemia Liver disease Macrolides ↑ myopathy Check LFTs
Salbutamol 2 puffs q4–6h Aerolin (~PKR 400) Asthma Tachyarrhythmia Beta blockers antagonize Causes tremor
A cinematic high-yield clinical handbook integrating pharmacology, internal medicine, surgery, ICU reasoning, and ward-based
survival pearls for Pakistani clinical rotations.
Clinical Architecture
• Mechanism → Indication → Contraindication → Interaction → Ward Pearl
• Optimized for MBBS, House Job, ER, ICU & Ward Rounds
• Pakistani brands and approximate local prices included
• Minimal wording • Maximum clinical meaning
Core Clinical Drug Matrix
Drug Dose Pakistani Brand + Approx Price
Indications Contraindications Interactions Clinical Pearl
Paracetamol 500 mg q6–8h Panadol (~PKR 120/strip) Fever, pain Severe liver disease ↑ Hepatotoxicity with alcoholMax 4 g/day
Ibuprofen 200–400 mg TDS Brufen (~PKR 180) Pain, inflammation Peptic ulcer disease ↑ Bleeding with warfarin NSAID nephrotoxicity
Diclofenac 50 mg BD Voren (~PKR 150) Musculoskeletal pain GI bleed, CKD ACEI + NSAID → AKI High CV risk
Tramadol 50–100 mg q6h Tramal (~PKR 300) Moderate pain Epilepsy SSRIs → serotonin syndrome
Seizure risk
Amoxicillin 500 mg q8h Amoxil (~PKR 220) ENT, RTI Penicillin allergy OCP failure possible Safe in pregnancy
Co-amoxiclav 625 mg TDS Augmentin (~PKR 650) Aspiration, bite wounds Liver disease Warfarin ↑ INR Diarrhea common
Ceftriaxone 1–2 g IV daily Rocephin (~PKR 450/vial) Sepsis, meningitis Neonatal jaundice Calcium precipitation Biliary sludging
Metronidazole 400–500 mg q8h Flagyl (~PKR 180) Anaerobes Alcohol intake Disulfiram reaction Metallic taste
Azithromycin 500 mg OD Azomax (~PKR 450) Atypical pneumonia QT prolongation QT drugs interaction Long half-life
Meropenem 1 g IV q8h Meronem (~PKR 2200) ICU sepsis Beta-lactam allergy Valproate level ↓ Broad-spectrum
Vancomycin 1 g IV q12h Vancomycin (~PKR 1800) MRSA Renal failure Nephrotoxins ↑ toxicity Monitor trough
Amlodipine 5 mg OD Amodip (~PKR 100) Hypertension Severe hypotension Additive with beta blockers Ankle edema
Losartan 50 mg OD Xavor (~PKR 250) HTN, diabetic nephropathy
Pregnancy K+ sparing drugs → hyperK Renoprotective
Frusemide 20–40 mg Lasix (~PKR 80) Pulmonary edema Hypovolemia Digoxin toxicity ↑ Loop diuretic
Spironolactone 25 mg OD Aldactone (~PKR 200) HF, ascites Hyperkalemia ACEI/ARB ↑ K+ Gynecomastia
Metformin 500 mg OD/BD Glucophage (~PKR 300) Type 2 DM eGFR <30 Contrast → lactic acidosis Weight neutral
Insulin Glargine 0.5–1 U/kg/day Basagine (~PKR 1900) Diabetes Hypoglycemia Steroids ↑ glucose Long acting
Prednisolone 1 mg/kg/day Deltacortil (~PKR 90) Asthma, autoimmune Systemic fungal infection NSAIDs ↑ ulcer risk Taper gradually
Omeprazole 20–40 mg OD Risek (~PKR 120) GERD, ulcer Hypersensitivity ↓ Clopidogrel activation Long-term ↓ Mg/B12
Lactulose 15–30 ml Duphalac (~PKR 450) Constipation, encephalopathy
Galactosemia Antacids reduce effect Traps ammonia
Cetirizine 10 mg OD Rigix (~PKR 100) Allergy Severe renal disease Sedatives ↑ drowsiness Less sedating
Aspirin 75–300 mg Ascard (~PKR 60) ACS, stroke prevention GI bleed Warfarin ↑ bleeding Irreversible platelet block
Clopidogrel 75 mg OD Lowplat (~PKR 350) Post-stent Active bleeding Omeprazole ↓ efficacy Dual antiplatelet therapy
Atorvastatin 10–80 mg OD Atorva (~PKR 450) Dyslipidemia Liver disease Macrolides ↑ myopathy Check LFTs
Salbutamol 2 puffs q4–6h Aerolin (~PKR 400) Asthma Tachyarrhythmia Beta blockers antagonize Causes tremor
