Hesperian Health Guides

Hesperian Health Guides

Alphabetical list of medicines

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HealthWiki > A Book for Midwives > Medicines: uses, dosage, and precautions for the medicines referred to in this book > Alphabetical list of medicines



Contents

activated charcoal

Activated charcoal is a specially prepared charcoal used to treat poisonings by drugs like aspirin, paracetamol, chloroquine, or other medicines or chemicals, by absorbing them in the stomach.

Often comes in:
Liquid: 25 g per 120 ml
Powder: 15 g
How to use:
For treating poisoning, give 30 to 100 g by mouth
all at one time.
Important
Do not give activated charcoal if the person has swallowed fuel, kerosene, lighter fluid or other
petroleum products.
Side effects
Black stool, vomiting, diarrhea.
Warning
After giving activated charcoal, get medical help immediately. People who take too much of a drug
or chemical can get very sick and need much more
help than activated charcoal.


Pregnant women need to take special care

WARNING!
acyclovir

Acyclovir is a medicine that fights viruses including herpes.

Often comes in:
Tablets: 200 mg
Powder: for mixing injections.
How to use:
For the first outbreak of herpes, give 400 mg by mouth 3 times a day for 7 to 10 days.

For continuing herpes outbreaks, give 400 mg acyclovir by mouth, 3 times a day for 5 days.

For a woman with more than 6 herpes outbreaks
a year,
give 400 mg acyclovir by mouth, 2 times every day for 1 year. Then stop and see if the medicine is
still needed.

For a pregnant woman who has had herpes outbreaks in the past, give 400 mg acyclovir by mouth, 2 times every day during the last month of pregnancy.
Important
Acyclovir can reduce the symptoms of herpes infection — but it will not cure it or prevent it from coming back.
Side effects
headache, dizziness, nausea, vomiting.
Warning
This medicine may have some harmful effects in pregnancy. For pregnant women, it is best only to give this medicine for an initial herpes outbreak, or during the last month to prevent an outbreak during labor.


adrenaline (epinephrine)

Adrenaline is used for allergic reactions or shock, for example, allergic shock caused by penicillin. It is also used for severe asthma attacks.

Often comes in:
Ampules for injection: 1 mg in 1 ml
How to use:
For allergic reaction or shock, inject 1:1000, 0.5 ml just under the skin (subcutaneous injection). If signs do not improve, repeat in 20 minutes. You will also need to give other medicines.
Important
Take the person’s pulse before injecting. Inject just
under the skin (subcutaneous injection) on the back
of the upper arm, not into the buttocks. If the pulse increases by more than 30 beats a minute after the
first injection, do not give another dose. Do not give
more than 3 doses.
Side effects
Fear, restlessness, nervousness, tension, headaches, dizziness, increased heart rate.


amoxicillin

Amoxicillin is an antibiotic of the penicillin family used to treat womb infections, urine system infections, pneumonia, and other infections. It is now used instead of ampicillin in many places.

Often comes in:
Tablets: 250 and 500mg
Liquid for injection: 125 or 250 mg per 5 ml
Syrup of various strengths.
How to use:
For kidney infection, give 500 mg by mouth 3 times a day for 7 days.
For chlamydia, give 500 mg by mouth 3 times a day for 7 days.

For pelvic infection,give 500 mg by mouth 3 times a day for 14 days.

For infection after genital cutting, give 500 mg by mouth 3 times a day for 10 days.

For preventing infection after an invasive procedure, give 1 g by mouth, 1 time only. Also give metronidazole.
Important
Take with food. If you do not start to get better in 3 days, get medical help. You may need a different medicine.
Side effects
Diarrhea, rash, nausea, vomiting. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
Ampicillin can almost always be used instead of amoxicillin. A person who is allergic to penicillins can try erythromycin.
Warning

Do not give amoxicillin to someone who is allergic to drugs in the penicillin family.


ampicillin

Ampicillin is an antibiotic of the penicillin family used to treat many kinds of infections.

Often comes in:
Tablets and Capsules: 250 and 500 mg
Liquid for injection: 125 or 250 mg per 5 ml
Powder for mixing injections
How to use:
For infection during labor, give 2 g by mouth 4 times a day for 7 to 10 days. Also give metronidazole.

For infection after birth, give 2 g by mouth or injected into muscle for the first dose, then give 1 g 4 times a day until fever has been gone for 48 hours. Give other antibiotics too.

For infection in a newborn baby, inject in the thigh muscle 2 times a day for a baby less than 1 week old, 3 times a day for a baby 1 week old or more. For a baby that weighs 2 kg or less, use 80 mg; 3 kg, use 150 mg; 4 kg or more, use 200 mg.

For infection after abortion, inject 2 g in the muscle, then reduce dose to 1 g, 4 times a day until fever has been gone for 48 hours. Give other antibiotics too.

or give 3.5 g by mouth 1 time only.
Important
Take ampicillin before eating.
Side effects
May cause stomach upset, diarrhea, and rash. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
Amoxicillin can almost always be used instead of ampicillin. A person who is allergic to penicillins can try erythromycin.
Warning
Do not give ampicillin to someone who is allergic to drugs in the penicillin family.


Pregnant women need to take special care

WARNING!
Artemisinin-based combination therapy (ACT) (artesunate, artemether, wormwood)

To treat malaria, medicines in the artemisinin family, such as artemether or artesunate, must be taken in combination with a second medicine. This is called Artemisinin-based Combination Therapy, or ACT. The medicine combinations, sometimes in a combined pill, are necessary because there is so much resistance to anti-malaria drugs.

How to use:
For malaria, give 4 tablets (560 mg) of artemether
+ lufemantrine (a combined pill) by mouth, 2 times
a day for 3 days.
Important
Always take artemisinins combined with another medicine. Artemisinin seems to become stronger
if you also drink grapefruit juice. Prevent malaria
by sleeping under treated bednets.
Other medicines
that may work
There are many different types of ACT that treat
malaria, including artesunate + amodiaquine,
artesunate + mefloquine, and artesunate + pyrimethamine + sulfadoxine. Contact your local
health authority to find out what works best where
you live. For women in the first 3 months of
pregnancy, give quinine + clindamycin instead.
Warning
Women in the first 3 months of pregnancy should
avoid all kinds of ACT.


BCG vaccine

The BCG vaccine helps to protect against getting tuberculosis (TB).

Often comes in:
Liquid for injection.
How to use:
Inject 0.1 ml in the skin (intradermal injection), usually on the upper arm.
Important
The BCG vaccine is a live vaccine so it must be kept cold at all times or it will not work.
Side effects
The vaccination usually makes a sore and leaves a scar.




benzathine benzylpenicillin (penicillin G benzathine)

Benzathine benzylpenicillin is a long-acting antibiotic of the penicillin family used to treat syphilis, genital ulcers, and other infections. It is always given as an injection into muscle.

Often comes in:
Powder for mixing injections of 1.2 or 2.4 million Units in a 5 ml vial.
How to use:
For syphilis inject 2.4 million Units into muscle 1 time only. If the sores have disappeared but syphilis shows in a blood test, then repeat the injection once a week for 2 more weeks.

If a baby needs to be treated, inject about 150,000 Units into muscle 1 time only (or 50,000 Units per kilogram of the baby’s weight).
Important
May cause yeast infection in women or diaper rash in children. Be ready to treat an allergic reaction.
Other medicines
that may work
erythromycin.
Warning
Do not give benzathine benzylpenicillin to someone who is allergic to medicines in the penicillin family.

benzylpenicillin (penicillin G)

Benzylpenicillin is an antibiotic of the penicillin family used to treat serious infections.

Often comes in:
Powder for mixing injections:1 or 5 million Units.
How to use:
For tetanus in a newborn, inject 100,000 Units into the muscle in the front of the thigh, 1 time only.
Important
Be ready to treat an allergic reaction.
Side effects
May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
ampicillin, procaine penicillin.
Warning
Do not give benzylpenicillin to someone who is allergic to drugs in the penicillin family.



cefixime

Cefixime is an antibiotic of the cephalosporin family that is used to treat many infections including gonorrhea, pelvic infection, and others.

Often comes in:
Tablets: tablets of 200 or 400 mg
Liquid: 100 mg in 5 ml
How to use:
For gonorrhea or PID: give 400 mg by mouth one time only.
Important
Be ready to treat an allergic reaction. People who have liver problems should be careful when taking cefixime.
Side effects
Nausea, diarrhea, headache. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
ceftriaxone, erythromycin.
Warning
Do not give cefixime to someone who is allergic to medicines in the cephalosporin family.



ceftriaxone

Ceftriaxone is a very strong antibiotic of the cephalosporin family that is injected into muscle. It is used for many infections including gonorrhea, pelvic infection, kidney infections, and serious infections after abortion, childbirth, or miscarriage.

Often comes in:
Vials for injection: 250 and 500 mg, and 1 gram,
2 grams, and 10 grams.
How to use:
For gonorrhea or chancroid , inject 250 mg into muscle 1 time only.
For gonorrhea in a newborn, inject 125 mg ceftriaxone into the thigh muscle 1 time only.
Important
Be ready to treat an allergic reaction.
Side effects
May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
cefixime, erythromycin.
Warning
Do not give ceftriaxone to someone who is allergic to medicines in the cephalosporin family.


Breastfeeding women need to take special care

WARNING!
clindamycin

Clindamycin is a strong antibiotic. In this book, we only describe how to use it to treat malaria in women in the first 3 months of pregnanacy.

Often comes in:
Capsules: 150 mg
Liquid for injection: 150 mg per ml
How to use:
For malaria in women in the first 3 months of pregnancy, give 600 mg by mouth 4 times a day for 7 days. You must also give quinine.
Side effects
Diarrhea, vomiting, rash, metallic taste in the mouth. May cause yeast infection in women or diaper rash in children.
Warning
Clindamycin can cause serious problems with the colon.

It also passes through a breastfeeding mother’s milk to her baby.

Only use this drug when it is truly needed.


Pregnant women need to take special care

WARNING!
cotrimoxazole(trimethoprim + sulfamethoxazole)

Cotrimoxazole is a combination of 2 antibiotics (one from the sulfa family) that is used to treat bladder, kidney, and other infections. It also helps prevent infections for people with HIV and AIDS.

Often comes in:
Tablets: 120, 480, and 960 mg
Liquid: 240 mg per 5 ml
How to use:
For kidney infections, give 960 mg (160 mg trimethoprim and 800 mg sulfamethoxazole) by mouth 2 times a day for 7 days.

To prevent infections for adults with HIV, take 960 mg by mouth every day.

For children of mothers with HIV:

For babies less than 6 months old, give 120 mg of liquid every day.

For children 6 months to 6 years old, give 240 mg of liquid every day.
Important
Take with lots of water.
Side effects
Stop taking cotrimoxazole if it causes allergic reactions like itching or rashes. It may also cause nausea or vomiting.
Warning
Women in the last 3 months of pregnancy should not use this drug.

Do not give cotrimoxazole to someone who is allergic to medicines in the sulfa family.

Do not give cotrimoxazole to someone already taking sulfadoxine-pyrimethamine for malaria.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
diazepam

Diazepam is a tranquilizer used to treat and prevent convulsions and seizures.

Often comes in:
Tablets of 5 to 10 mg
Liquid for injections of 5 mg per 1 ml.
How to use:
For convulsions, give 20 mg of injectable diazepam in the rectum using a syringe without a needle. Repeat if needed using 10 mg, 20 minutes after the first dose. Do not give more than 30 mg in 8 hours. Crush diazapam tablets into water if you do not have injectable diazapam.
Important
Diazepam is a habit-forming (addictive) medicine. Avoid taking with other drugs that will make you sleepy, especially alcohol.
Side effects
Sleepiness, loss of balance, confusion.
Other medicines
that may work
magnesium sulfate.
Warning
Diazepam is an addictive (habit-forming) drug.

Do not use diazepam with alcohol or other drugs that can make you sleepy.

Frequent or large doses of diazepam during pregnancy can cause birth defects.

This medicine also passes through breastmilk, so breastfeeding mothers should avoid it except in emergencies.


dicloxacillin

Dicloxacillin is an antibiotic of the penicillin family used to treat breast and skin infections.

Often comes in:
Capsules of 125, 250, or 500 mg
Liquid of 62.5 mg per 5 ml
How to use:
For breast infection, give 500 mg by mouth 4 times a day for 7 days.
Important
Be ready to treat an allergic reaction.
Side effects
Nausea, vomiting, diarrhea. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
erythromycin.
Warning
Do not give dicloxacillin to someone who is allergic to medicines in the penicillin family.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
diphenhydramine hydrochloride

Diphenhydramine is an antihistamine that treats allergic reactions and allergic shock. It is also used for treating chronic itching and sleep problems for people with AIDS.

Often comes in:
Tablets or capsules: 25 or 50 mg
Syrup: 12.5 mg per 5 ml
Ampules for injection: 10, 30, or 50 mg in 1 ml
How to use:
For mild to moderate allergic reaction, give 25 mg by mouth every 6 hours until signs go away.
For allergic shock, inject 50 mg into muscle. Repeat in 4 hours if signs do not improve.
Side effects
Sleepiness and dryness in the mouth and nose. May cause nausea and vomiting. Very rarely causes excitement rather than sleepiness.
Other medicines
that may work
promethazine.
Warning
Diphenhydramine is best taken by mouth. Only inject it for severe allergic reactions and shock.

Do not use diphenhydramine with alcohol or tranquilizers. It makes the effects dangerously strong.

This medicines is OK to use in emergencies, but should not be used regularly in pregnancy or while breastfeeding.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
doxycycline

Doxycycline is an antibiotic of the tetracycline family used to treat many different infections.

Often comes in:
Tablets: 50 and 100 mg.
How to use:
For infection after abortion, give 100 mg by mouth 2 times a day for 10 days.
Important
Take pills while sitting up and with lots of water. Stay out of the sun or you may get a rash.
Side effects
Diarrhea, upset stomach. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
amoxicillin, metronidazole.
Warning
Women who are pregnant should not take this medicine. Doxycycline can damage a baby's teeth and bones.

Women who are breastfeeding can take doxycycline for a short time to treat infections, but should avoid taking it long term.

Doxycycline may not be safe to use after it has passed its expiration date.



ergometrine (ergonovine, methylergonovine)

Ergometrine causes contractions of the womb and its blood vessels and is used to control heavy bleeding after childbirth or an abortion.

Often comes in:
Tablets: Tablets: 0.2 mg
For injection: 0.2, 0.25, and 0.5 mg in 1 ml vial.
How to use:
For heavy bleeding after childbirth, give 0.2 mg by mouth every 6 to 12 hours,
or inject 0.2 mg in muscle every 6 to 12 hours.

For heavy bleeding after an abortion, inject 0.2 mg in the muscle,
or give 0.2 mg by mouth.
Side effects
Nausea, vomiting, dizziness, sweating.
Other medicines
that may work
misoprostol, oxytocin.
Warning
Do not use ergometrine to start or speed up labor or to cause an abortion.

Do not give this drug before the baby and the placenta have come out.



erythromycin

Erythromycin is an antibiotic of the macrolide family used to treat many infections. It can be used safely during pregnancy and is often a good choice when a woman is allergic to penicillin family antibiotics.

Often comes in:
Tablets or capsules: 250 mg
Ointment: 1%
Powder for solution: 125 mg per 5 ml
How to use:
For newborn eye care, use 0.5% or 1% ointment 1 time only, within 2 hours of the birth.
For breast infection, chlamydia, or chancroid, give 500 mg by mouth 4 times a day for 7 days.
For a baby with chlamydia, give 30 mg syrup by mouth 4 times a day for 14 days.
For syphilis or pelvic infection, give 500 mg by mouth 4 times a day for 14 days.
For infection after genital cutting, give 500 mg by mouth 4 times a day for 10 days.
Important
Erythromycin works best when taken 1 hour before or 2 hours after a meal. If this makes a person nauseated, take with a little food.

Do not break up tablets. Tablets are often coated to prevent strong stomach juices from breaking down the drug before it can begin to work.
Side effects
Upset stomach, nausea, diarrhea. May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
amoxicillin, benzathine benzylpenicillin, ceftriaxone, dicloxicillin, iodine, procaine penicillin, tetracycline eye ointment.
Warning
Do not give erythromycin to someone who is allergic to drugs in the macrolide family.



ferrous sulfate (iron)

Iron is a mineral that everyone, especially a pregnant woman, needs to have healthy blood and enough energy. It is possible but difficult to get enough iron by eating meat or lots of green leafy vegetables.

Often comes in:
Tablets: of many different strengths.
How to use:
To prevent anemia in pregnancy, give 300 to 325 mg by mouth once a day with meals, throughout pregnancy.
To treat anemia, give 300 to 325 mg by mouth 2 or 3 times a day until the woman no longer has signs of anemia, or throughout pregnancy.
Important
Eating fruits and vegetables high in vitamin C can help the body use iron better.
Side effects
Nausea, diarrhea, constipation. Iron is best taken with food.
Warning
High doses of iron can be poisonous. Keep iron away from children.


folic acid (folate, folacin)

Folic acid is an important vitamin that helps prevent birth defects when the mother takes it early in pregnancy.

Often comes in:
Tablets: 0.1 mg, 0.5 mg, 0.8 mg (100, 500, and 800 micrograms).
How to use:
To prevent birth defects, give 0.5 to 0.8 mg by mouth every day.



Pregnant women need to take special care

WARNING!
gentamicin

Gentamicin is a very strong antibiotic of the aminoglycoside family that is used to treat serious infections.

Often comes in:
Vials for injection: 10 or 40 mg per ml.
How to use:
For womb infection after birth, inject 80 mg gentamicin in the muscle, 3 times a day until fever has been gone for 48 hours.

For infection after abortion, inject 300 mg in the muscle 1 time a day until fever has been gone for 48 hours. You must give other antibiotics too.
(Or use 5 mg for each kg the mother weighs, injected in the muscle 1 time a day.)

For infection in a newborn, inject 4 mg per kg the baby weighs, in the muscle, once a day for 7 days. So for a 3 kg baby, inject 12 mg a day.

Important
Use gentamicin only if the woman cannot take other drugs without vomiting, or if no other antibiotic is available. Give with plenty of fluids.
Side effects
May cause yeast infection in women or diaper rash in children.
Other medicines
that may work
ampicillin, benzylpenicillin, doxycycline, metronidazole, others.
Warning
Gentamicin can damage the kidneys and cause deafness. When it is given in pregnancy, it may cause birth defects in a baby. Do not give gentamicin to someone who is allergic to drugs in the aminoglycoside family.


gentian violet (crystal violet, methylrosanilinium chloride)

Gentian violet is a disinfectant used to fight fungus infections of the skin, mouth, and vagina.

Often comes in:
Liquid: 0.5%, 1%, and 2%
Tincture: 0.5%; dark blue crystals to mix in water where 1 teaspoon in ½ liter of water makes a 2% liquid.
How to use:
For yeast infections in a baby’s mouth (thrush), wipe the baby’s mouth and the mother’s nipples with a 0.25% liquid once a day for up to 5 days.

For yeast infections of the vagina, make a vaginal insert by soaking clean cotton in 1% liquid and place high in the vagina every night for 3 nights (remember to remove the insert in the morning).

Important
Stop using gentian violet if it irritates the skin. A person with a yeast infection should not have sex until she is cured, to avoid passing the infection to her partner. Gentian violet will stain skin and clothes purple.
Other medicines
that may work
miconazole, nystatin.



Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
hydrocortisone(cortisol)

Hydrocortisone fights swelling and itching and can be used to treat rashes. It also helps treat allergic shock.

Often comes in:
Creams or ointment: 1%
Tablets: 5, 10, and 20 mg
Liquid for injection
Powder for mixing for injections of various strengths.
How to use:
For allergic shock, inject 500 mg into muscle. Repeat in 4 hours if needed. Also give other drugs.
Warning
Pregnant and breastfeeding women should not use this medicine regularly — only in emergencies to treat allergic shock.




lidocaine(lignocaine)

Lidocaine is an anesthetic. It blocks pain in the part of the body where it is injected. It can be used to prevent pain while sewing tears or episiotomies, or during a manual vacuum aspiration.

Often comes in:
Liquid for injection in strengths of 0.5%, 1%, or 2%.
How to use:
For a local anesthetic, inject 5 to 30 ml 1% solution in the skin.




magnesium sulfate

Magnesium sulfate is used to stop convulsions in pregnant women with eclampsia.

Often comes in:
Liquid for injection: 10%, 12.5%, 25%, or 50%.
How to use:
To stop a convulsion in a woman with eclampsia, inject 10 grams of 50% solution into muscle. If necessary, give another dose after 4 hours.

Important
Injecting magnesium sulfate requires a big needle and may be uncomfortable. You can split the dose in half and give 2 smaller doses, 1 in each buttock. If you have it, you could also use a little lidocaine to lessen the pain.
Other medicines
that may work
diazepam.
Warning
Only use this drug if a woman’s blood pressure is over 160/110 or if she is having a convulsion. Stop using this drug and get medical help immediately if her breathing slows to less than 12 breaths a minute or if she has not urinated for 4 hours.

Women with kidney problems should not use magnesium sulfate.



Pregnant women need to take special care

WARNING!
metronidazole

Metronidazole is used against some bacteria, amoebic dysentery, trichomonas, and vaginal infections.

Often comes in:
Tablets: 200, 250, 400, and 500 mg
Inserts of 500 mg
Injection of 500 mg in 100 ml vial
Suspension of 200 mg in 5 ml.
How to use:
For womb infection in pregnancy, give 400 to 500 mg by mouth 3 times a day for 7 to 10 days.

For infection after birth, give 400 to 500 mg by mouth 3 times a day until fever has been gone for 48 hours.

To prevent infection in the womb after an invasive procedure, give 1 g by mouth 1 time only. Also give amoxicillin.

For bacterial vaginosis or trichomonas, give 400 to 500 mg by mouth 2 times a day for 7 days, or put a 500 mg insert high in the vagina every night for 7 nights.

For pelvic infection, give 400 to 500 mg by mouth 3 times a day for 14 days. You must give other antibiotics too.

For infection after abortion, give 400 to 500 mg by mouth 3 times a day until fever has been gone for 48 hours. You must give other antibiotics too.
Important
Drinking alcohol while taking metronidazole will cause nausea.
Side effects
Metallic taste in mouth, dark urine, nausea, vomiting, headache.
Other medicines
that may work
amoxicillin, ampicillin, benzylpenicillin, gentamicin, doxycycline.
Warning
This medicine may have some harmful effects in pregnancy. For pregnant women, it is best only to give this medicine for an initial herpes outbreak, or during the last month to prevent an outbreak during labor.



Pregnant women need to take special care

WARNING!
miconazole

Miconazole fights yeast and other fungus infections in the mouth (thrush), the vagina, or the skin.

Often comes in:
Cream: 2%
Inserts: 100 and 200 mg.
How to use:
For yeast infections of the vagina, put a 200 mg insert high in the vagina every night for 3 nights.

Important
Stop using miconazole if it irritates the skin. A person with a yeast infection should not have sex while using miconazole to avoid passing the infection to her partner.

Other medicines
that may work
gentian violet, nystatin.
Warning
Do not use miconazole during the first 3 months of pregnancy.



mifepristone

Mifepristone can be used with misoprostol or other medicines to end a pregnancy in the first 9 weeks.

Often comes in:
Tablets: 200 mg.
How to use:
See directions for using with misoprostol below.

Important
It is best to be close to medical help when taking this medicine in case it does not empty the womb completely.

Other medicines
that may work
misoprostol.
Warning
If this medicine does not end the pregnancy completely, the womb must be emptied by MVA or D&C abortion.



misoprostol

Misoprostol helps empty the womb or stop heavy bleeding after a birth.

Often comes in:
Tablets: 100 or 200 micrograms.
How to use:
For delivering the placenta, give 600 micrograms by mouth, give 600 micrograms by mouth, 1 time only.

To slow heavy bleeding after a birth, give 800 micrograms 1 time only by putting tablets against each cheek or under the tongue for about 30 minutes until they dissolve. Then swallow what is left. If the woman cannot swallow, insert pills in her rectum where they will dissolve and be absorbed. Wear a glove.

For incomplete abortion, give 400 micrograms 1 time only by putting tablets against each cheek or under the tongue for about 30 minutes until they dissolve. Then swallow what is left. Or give 600 micrograms by mouth, 1 time only.

To end a pregnancy with misoprostol and mifepristone, give 200 mg mifepristone by mouth. 2 days (48 hours) later, insert 800 micrograms misoprostol in the vagina. Or, give 800 micrograms misoprostol by putting tablets against each cheek or under the tongue for about 30 minutes until they dissolve. Then swallow what is left. Then give 400 micrograms misoprostol under the tongue or in the vagina every 3 hours up to 5 doses.

If you do not have mifepristone, insert 800 micrograms misoprostol in the vagina, or give 800 micrograms misoprostol under the tongue, 1 to 3 times, 3 to12 hours apart. Do not give more than 3 doses (2400 mcg total). Be ready to get medical help if the womb does not empty completely.
Important
Misoprostol is usually used with another medicine called mifepristone to end a pregnancy. Used by itself, misoprostol may not completely empty the womb. An abortion caused by misoprostol may take several hours to several days to finish.

After an incomplete abortion, misoprostol can empty the womb and help save a woman’s life.

Wetting misoprostol tablets before giving them may make them more effective.
Side effects
Nausea, vomiting, diarrhea, headache. If the woman is breastfeeding, misoprostol will cause diarrhea in infants.
Warning
Do not use misoprostol to empty the womb (end a pregnancy) after the 3rd month. Never use misoprostol to speed up or start a labor. It could cause the womb to tear open.



nystatin

Nystatin fights yeast and other fungus infections in the mouth (thrush), the vagina, or the skin.

Often comes in:
Inserts, lozenges for the mouth
Cream: 100,000 Units
Liquid with 100,000 Units per ml.
How to use:
For mouth or throat infections, put 1 ml of liquid in mouth, swish around both sides of mouth for 1 minute, and swallow. Do this 3 or 4 times a day for 5 days.

For vaginal infections, put one 100,000 Unit insert high in the vagina every night for 14 nights.
Important
Stop using nystatin if it irritates the skin.

A person with a yeast infection should not have sex while using nystatin to avoid passing the infection to her partner.

Nystatin works only against candida yeast infections, while miconazole works against other fungal infections as well.
Side effects
Diarrhea and stomach upset.
Other medicines
that may work
gentian violet, miconazole.



oxytocin

Oxytocin is used to cause contractions of the womb and its blood vessels to control heavy bleeding after abortion or childbirth.

Often comes in:
10 Units in 1 ml for injection.
How to use:
For delivery of the placenta or to stop bleeding after the baby is born, inject 10 Units in the muscle. Repeat after 10 minutes if needed.

Other medicines
that may work
ergometrine, misoprostol.
Warning
Do not use oxytocin to start or speed up labor. Oxytocin can make the womb contract so strongly that it will tear open.

Do not use this drug to cause an abortion because it could kill the woman before ending the pregnancy.



paracetamol(acetaminophen)

Paracetamol is used to ease pain and lower fever.

Often comes in:
Tablets: 100, 325, and 500 mg.
Liquid: 120 and 160 ml per 5 ml.
How to use:
Take 500 to 1000 mg by mouth every 4 to 6 hours. Do not take more than 4000 mg of paracetamol in 24 hours.

Important
Paracetamol does not cure sickness, it only eases pain or fever. It is important to find the cause of the pain and fever and treat that.
Other medicines
that may work
Aspirin or ibuprofen may work, but do not use either during pregnancy.
Warning
Paracetamol should not be used by women with liver or kidney problems. It can cause liver damage if taken regularly every day, or if it is used after drinking alcohol. Do not take more than 4000 mg a day and do not combine with other medicines that contain paracetamol.


procaine penicillin(benzylpenicillin procaine, PAM)

Procaine penicillin is a medium- to long-lasting antibiotic of the penicillin family used to treat womb and other infections.

Often comes in:
Vials for injection: 300,000 and 400,000 and 600,000 Units
Powder for mixing injections where 1 gram = 1 million Units.
How to use:
For serious infection during labor, inject 1.2 million Units in the muscle. Repeat after 12 hours if needed.

Important
When taken with probenecid, the amount of penicillin in the blood increases and lasts longer, making the treatment more effective. Be ready to treat for allergic reaction.
Other medicines
that may work
ampicillin, benzylpenicillin.
Warning
Procaine penicillin can cause asthma attacks in people who have asthma.

Never use this drug with tetracycline.

Do not give procaine penicillin to someone who is allergic to antibiotics in the penicillin family.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
promethazine

Promethazine is an antihistamine used to treat allergic reactions and allergic shock.

Often comes in:
Tablets: 10, 12.5, and 25 mg
Syrup: 5 mg per 5 ml
Ampules for injection: 25 mg in 1ml.
How to use:
For moderate allergic reaction, give 25 mg by mouth. Repeat in 6 hours if needed.
For allergic shock, inject 50 mg in muscle. Repeat in 6 hours if needed.
Side effects
Dry mouth and nose, blurry vision. Rarely, twitching of the body, face, or eyes.
Other medicines
that may work
diphenhydramine.
Warning
Promethazine is best taken by mouth. Only inject it for severe allergic reactions and shock.

This medicine is OK to use in emergencies, but should not be used regularly in pregnancy or while breastfeeding.




quinine(quinine sulfate or quinine bisulfate)

Quinine is a medicine used to treat malaria. In this book we recommend it only for women in the first 3 months of pregnancy.

Often comes in:
Tablets: 300 or 650 mg.
How to use:
For malaria in women in the first 3 months of pregnancy, give 600 mg by mouth, 3 times a day for 7 days.
Side effects
May cause sweaty skin, ringing of the ears or impaired hearing, blurred vision, dizziness, nausea, vomiting, and diarrhea.



tetanus antitoxin(tetanus immunoglobulin)

Tetanus antitoxin and tetanus immunoglobulin are similar medicines which can be given to people who have been exposed to tetanus but have not received tetanus toxoid vaccinations.

Often comes in:
Tetanus antitoxin comes in:
Vials: 1,500, 20,000, 40,000, and 50,000 Units.

Tetanus immunoglobulin comes in:
Vials: 250 Units.
How to use:
For someone who has a wound that could cause tetanus (like from an unsafe abortion) and has not been vaccinated against tetanus, inject 1,500 Units tetanus antitoxin in the muscle,
or inject 250 Units tetanus immunoglobulin in the muscle.

If a person develops signs of tetanus inject 50,000 Units of tetanus antitoxin in the muscle,
or inject 5000 Units tetanus immunoglobulin in the muscle.
Important
Many people are allergic to tetanus antitoxin. Give an antihistamine like diphenhydramine 15 minutes before giving tetanus antitoxin.

4 weeks after giving antitoxin or immunoglobulin, start giving tetanus toxoid vaccinations (see below). If you will not be able to see the woman again in 4 weeks, it is OK to give the vaccine on the same day as the antitoxin or immunoglobulin. But do not inject tetanus antitoxin or tetanus immunoglobulin into the same spot where you inject tetanus toxoid vaccination — it will stop the vaccination from working.
Side effects
Allergy.
Other medicines
that may work
benzylpenicillin, tetanus toxoid vaccine.
Warning
Tetanus can easily kill a person. Get medical help even after giving antitoxin or immunoglobulin.


tetanus toxoid vaccine

Tetanus toxoid is an immunization given to prevent a tetanus infection. It can be given during or after preganancy, or after abortion or female genital cutting. If a woman gets 2 injections (or better still, 3 injections — see schedule) when pregnant, it will also prevent this deadly infection in her newborn baby.

Often comes in:
Single dose (0.5 ml) ampules for injection

Liquid for injection.
How to use:
To give lifetime protection from tetanus, inject 5 immunizations of 0.5 ml into the muscle of the upper arm and then 1 booster injection every 10 years.
Injection 1..........As soon as possible
Injection 2..........4 weeks after injection 1
Injection 3..........6 months after injection 2
Injection 4..........1 year after injection 3
Injection 5..........1 year after injection 4
Booster.............10 years after injection 5

To prevent tetanus infection if a woman may already have been exposed, inject 0.5 ml in the muscle. You must also give 1500 Units tetanus antitoxin.
Important
Tetanus immunizations should be given to everyone starting in childhood. Tetanus immunization is often given to children as part of a combined immunization called DPT, and the 3 DPT immunizations are equal to the first 2 tetanus toxoid immunizations.
Side effects
Pain, redness, warmth, slight swelling.


Pregnant women need to take special care

Breastfeeding women need to take special care

WARNING!
tetracycline

Tetracycline is an antibiotic of the tetracycline family used to treat many infections. In this book we recommend it only for blindness prevention for newborns.

Often comes in:
Ointment: 1%.
How to use:
For newborn eye care, use 1% ointment in each eye at birth, 1 time only, within 2 hours of the birth.
Other medicines
that may work
erythromycin, iodine.
Warning
Tetracycline by mouth can be dangerous during pregnancy and breastfeeding.


tricloroacetic acid(bichloroacetic acid)

Either tricloroacetic acid or bichloroacetic acid can be used to treat genital warts.

Often comes in:
Liquids of varying strengths from 10% to 90%.
How to use:
To treat genital warts first protect the area around the wart with petroleum jelly. Then put on the trichloroacetic acid. It will hurt for 15 to 30 minutes. Then clean off. Repeat after a week if necessary, but do not use this more than 1 time each week.
Important
Use very carefully. It can burn normal skin badly enough to cause a scar. If it spills onto healthy skin, wash off with soap and water.

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