Ministry of Health Kenya National Formulary for Primary Care Level KNF-PCL 2008 A pilot edition for limited distribution June 2008 Ministry of Medical Services Kenya National Formulary for Primary Care Level KNF-PCL 2008 A pilot edition for limited distribution June 2008 Disclaimer The information in this Formulary is provided in good faith. While every effort has been made to ensure that the information and guidance in the Formulary is accurate, complete and correct, the author and publisher cannot be held responsible for errors, individual responses to medicines or any other consequences of utilisation of any of the medicines and medical supplies in the Formulary KNF-PCL 2008 iii Contents Contents ............................................................................................ iii Abbreviations & Acronyms............................................................ix Units of Measurement ....................................................................xi Foreword .......................................................................................... xii Cautionary Note on Conditions to be Managed at each Level of Primary Care .................................................................. xiv Preface .............................................................................................. xv Acknowledgements ..................................................................... xviii How to Use the Formulary ............................................................ 1 Presentation of Information ......................................................... 3 in the Monographs .......................................................................... 3 Monograph Name ............................................................................ 3 General advice to prescribers .................................................... 12 1. Rational approach to therapeutics ....................................... 12 2. Variation in dose response .................................................... 14 3. Adherence (compliance) with drug treatment .................. 18 4. Adverse effects and interactions .......................................... 23 5. Prescription writing .................................................................. 26 Example of MoH Prescription Form .......................................... 29 6 Drug treatment in children ..................................................... 31 EMMS Monographs ....................................................................... 34 1. ANAESTHETICS ........................................................... 35 1.2 Local Anaesthetics ...................................................... 35 Lidocaine ......................................................................................... 35 2. ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY MEDICINES (NSAIMS) ........................ 38 2.1 Non-opioids and NSAIMS..................................................... 39 Aspirin .............................................................................................. 39 Ibuprofen ........................................................................................ 45 Paracetamol .................................................................................... 50 3. ANTIALLERGICS AND MEDICINES USED IN ANAPHYLAXIS ................................................................................ 54 iv KNF-PCL 2008 Adrenaline ....................................................................................... 56 Chlorphenamine maleate ............................................................ 60 Hydrocortisone............................................................................... 67 5. ANTICONVULSANTS/ANTIEPILEPTICS ................................ 69 Diazepam ........................................................................................ 71 Phenobarbitone ............................................................................. 77 6. ANTI-INFECTIVE MEDICINES ................................................ 83 6.1 Anthelminthics ........................................................................ 83 6.1.1 Intestinal anthelminthics .................................................. 83 6.1.1.2 Intestinal nematode infections.................................... 83 Albendazole .................................................................................... 84 6.2 Antibacterials .......................................................................... 88 6.2.1 Beta Lactams ...................................................................... 89 Amoxicillin ....................................................................................... 92 Benzathine benylpenicillin ........................................................ 102 Benzylpenicillin injection ........................................................... 106 Ceftriaxone ................................................................................... 113 6.2.2 Other antibacterials ......................................................... 119 Chloramphenicol .......................................................................... 119 Ciprofloxacin................................................................................. 122 Cotrimoxazole .............................................................................. 131 Doxycycline .................................................................................. 140 Erythromycin ................................................................................ 149 Gentamicin.................................................................................... 160 Metronidazole ............................................................................... 163 Tinidazole ...................................................................................... 171 6.3 Antifungal medicines .......................................................... 173 Clotrimazole.................................................................................. 174 Ketoconazole ................................................................................ 176 Nystatin ......................................................................................... 181 6.5 Antiprotozoal medicines ..................................................... 184 6.5.1 Antiamoebic & antigiardiasis medicines ..................... 184 Metronidazole See p160 ............................................................ 185 6.5.3 Antimalarial medicines.................................................... 185 6.5.3.1 For curative treatment ................................................ 185 KNF-PCL 2008 v Artemether/Lumefantrine (AL) ................................................ 186 Quinine .......................................................................................... 191 6.5.3.2 For prophylaxis ............................................................. 198 Doxycycline see p138 ................................................................ 198 Sulfadoxine/pyrimethamine tabs ............................................ 198 7. ANTIMIGRAINE MEDICINES ................................................. 202 7.1 For treatment of acute attack .......................................... 202 Aspirin See p38 ........................................................................... 202 Paracetamol See p49 ................................................................. 202 10. MEDICINES AFFECTING THE BLOOD .............................. 202 10.1 Antianaemia medicines .................................................... 202 Ferrous sulphate ......................................................................... 204 Folic acid ....................................................................................... 209 10.2 Medicines affecting coagulation ..................................... 212 Phytomenadione.......................................................................... 212 13. DERMATOLOGICAL (topical) MEDICINES ....................... 214 13.1 Antifungal medicines ........................................................ 216 Clotrimazole.................................................................................. 217 13.3 Anti-inflammatories & antipruritics ............................... 219 Calamine ....................................................................................... 220 Hydrocortisone............................................................................. 221 13.6 Scabicides & pediculicides ............................................... 224 Benzyl benzoate .......................................................................... 224 15. DISINFECTANTS AND ANTISEPTICS ............................... 228 Chlorhexidine gluconate ............................................................ 228 Ethanol denatured 70% ............................................................ 232 Povidone iodine ........................................................................... 234 15.2 Disinfectants ....................................................................... 236 Sodium hypochlorite .................................................................. 236 17. GASTROINTESTINAL MEDICINES .................................... 240 17.1 Antacids ............................................................................... 240 Magnesium trisilicate compound ............................................. 242 17.2 Antiemetics ........................................................................