Standard Treatment Guidelines - Ministry Of Health

1 I Republic of GhanaMinistry of Health Ghana National Drugs Programme (GNDP) Standard Treatment GuidelinesMinistry of HealthSeventh Edition (7th), 2017 Standard Treatment Guidelines , 7th Edition, 2017ii 2017 Ministry of Health (GNDP) GhanaAll rights reserved. No part of this publication may be reproduced, stored in any retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording and/or otherwise, without prior written permission of the Ministry of Drugs List & National Formulary with Therapeutic Guidelines , 1st Edition, 1988 Essential Drugs List & National Formulary with Therapeutic Guidelines , 2nd Edition, 1993 Essential Drugs List & National Formulary with Therapeutic Guidelines , 3rd Edition, 1996 Standard Treatment Guidelines , 4th Edition, 2000 Standard Treatment Guidelines , 5th Edition, 2004 Standard Treatment Guidelines , 6th Edition, 2010 Standard Treatment Guidelines , 7th Edition, 2017 ISBN 978-9988-2-5787-3 For all enquiries write to the publishers.

2 Ghana National Drugs Programme (GNDP) Ministry of HealthP. O. Box MB-582, Accra, Ghana, West Africa Tel: +233 (0) 30 2661 670/1 Fax: +233 (0) 30 2664 309 E-mail: DisclaimerCare has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors and publishers are not responsible for errors and omissions or any consequences from application of the information in this booklet and make no warranty, expressed or implied, with respect to the content of the by:Yamens Press Limited, P. O. Box AF 274, Accra Tel: 0302-223 222E-mail: Design:Q-elements Limited, AccraTel: 0302-719432, 0268-080618E-mail: of Contents Preface ..xiiAcknowledgement ..xiiiIntroduction 1 How to use this book.

3 2 Prescribing for NHIS reimbursement ..3 Notes on cost-effectiveness ..3 Referral ..4 Abbreviations ..4 Prescription writing ..5 Dosing and medication based on Age and body weight in children ..7 Pharmacovigilance and Adverse Drug Event Reporting ..7 Important contacts ..8 Chapter 1. Disorders of the Gastrointestinal Tract 111. Diarrhoea ..112. Rotavirus Disease and Diarrhoea ..183. Constipation ..194. Peptic Ulcer Disease ..225. Gastro-oesophageal Reflux Disease ..256. Pain Originating from the Oesophagus ..287. Haemorrhoids ..29 Chapter 2. Disorders of the Liver 338. Amoebic Liver Access ..339. Jaundice ..3510. Acute Hepatitis ..3711. Chronic Hepatitis ..3812. Hepatic Encephalopathy.

4 4213. Ascites ..4614. Vomiting ..4815. Hepatocellular Carcinoma ..5316. Drugs and the Liver ..55 Chapter 3. Nutritional Disorders 5817. Malnutrition ..58 Chapter 4. Haematological Disorders 6217. Anaemia ..6218. Bleeding Disorders ..6519. Sickle Cell Disease ..6920. Plasma Cell Myeloma ..7321. Leukaemia ..7522. Malignant Lymphoma ..77 Chapter 5. Immunisable Diseases 80 Standard Treatment Guidelines , 7th Edition, 2017iv23. Immunisation ..8024. Measles ..8225. Pertussis ..8426. Tetanus ..8627. Poliomyelitis ..8928. Diphtheria ..9029. Yellow Fever ..9230. Haemophilus Influenzae type b Disease.

5 9431. Pneumococcal Disease ..9532. Hepatitis ..9633. Rotavirus Disease ..96 Chapter 6. Problems of the Newborn (Neonate) 9734. Sick newborn ..9735. Neonatal Hypoglycaemia ..10036. Neonatal Jaundice ..10137. Birth Injuries ..10438. Neonatal conjunctivitis ..10639. Retinoblastoma ..10840. Wilms Tumour ..110 Chapter 7. Disorders of the Cardiovascular System 11341. Chest Ischaemic Heart Disease ..11543. Dyspnoea ..12144. Deep Vein Thrombosis (DVT) ..12345. Pulmonary Embolism ..12746. Stroke ..12947. Heart Congenital Heart Disease ..14049. Hypercyanotic attack ..14350. Pericarditis ..14551. Hypertension ..14652. Hypertension in children and adolescents ..15153.

6 Hypertension in Pregnancy ..15454. Hypertensive Emergencies ..15455. Arrhythmias ..15656. Acute Rheumatic Fever ..16157. Dizziness and 8. Disorders of the Respiratory System 16758. Common Cold ..16759. Pneumonia ..16960. Bronchial Asthma ..17561. Acute Bronchitis ..18062. Chronic Bronchitis ..18363. Bronchiectasis ..18764. Lung Abscess ..189 Chapter 9. Disorders of the Central Nervous System 19365. Headache ..19366. Seizures ..19667. Epilepsy ..20068. The Unconscious Patient ..203 Chapter 10. Psychiatric Disorders 20769. Attention Deficit Hyperactivity Disorder (ADHD) ..20770. The Acutely Disturbed Patient ..20971. Psychogenic Seizures.

7 213 Table of Contentsv72. Insomnia ..21473. Depression ..21674. Schizophrenia ..22075. Bipolar Disorder ..22676. Alcohol Withdrawal Syndromes ..22977. Alcoholic Delirium Tremens ..23178. Anxiety Disorders ..23379. Substance Use Disorders ..23980. Autistic Spectrum Disorder ..242 Chapter 11. Disorders of the Skin 245 Bacterial Skin Infections 24581. Boils ..24582. Impetigo ..24683. Cellulitis and Erysipelas ..24984. Buruli Ulcer ..24985. Yaws ..250 Fungal Skin Infections 25286. Superficial Fungal Skin Infections ..25287. Pityriasis Versicolor ..255 Viral Skin Infections 25788.

8 Herpes Simplex Infections ..25789. Herpes Zoster Infections ..25990. Chicken pox ..261 Non-Specific Skin Infections 26591. Large Chronic Urticaria ..27294. Reactive Erythema and Bullous Reaction ..27495. Acne Vulgaris ..27696. Eczema ..27997. Intertrigo ..283 Chapter 12. Endocrine and Metabolic Disorders 28798. Diabetes Mellitus ..28799. Diabetic Ketoacidosis ..293100. Diabetes in Pregnancy ..297101. Treatment -Induced Hypoglycaemia ..298102. Dyslipidaemia ..300103. Goitre ..302104. Hypothyroidism ..303105. Hyperthyroidism ..305106. Adrenal Insufficiency ..307107. Cushing s Syndrome ..310108. Overweight and Obesity ..311 Chapter 13. Obstetric Care and Obstetric Disorders 314109.

9 Antenatal Care ..314110. Hyperemesis Gravidarum ..322111. Hypertension in Pregnancy ..323112. Pre-eclampsia ..325113. Severe Pre-Eclampsia and Imminent Eclampsia ..326114. Eclampsia ..328115. Malaria in Pregnancy ..331116. Anaemia in Pregnancy ..331117. Sickle Cell Disease in Pregnancy ..334118. Diabetes Mellitus in Pregnancy ..338 Standard Treatment Guidelines , 7th Edition, 2017vi119. Cardiac Disease in Pregnancy ..341120. Jaundice in Pregnancy ..343121. Post-Partum Haemorrhage ..344122. Post-Partum Pyrexia ..349123. Analgesia in Labour ..352124. Preterm Labour in Premature Delivery ..354125. Premature Rupture of the Membranes ..356 Chapter 14. Gynaecological Disorders 358126. Dysmenorrhoea.

10 358127. Abortion ..359128. Abnormal Vaginal Bleeding ..371129. Abnormal Vaginal Discharge ..373130. Acute Lower Abdominal Pain ..379131. Female Infertility ..382132. Menopause ..384133. Carcinoma of the Cervix ..386 Chapter 15. Disorders of the Kidney and Genitourinary System 388134. Acute Glomerulonephritis ..388135. Nephrotic Syndrome ..390136. Acute Kidney Injury ..392137. Chronic Kidney Disease ..396138. Anaemia in Chronic Kidney Disease ..399139. Urinary Tract Infection ..401140. Medicines and the Kidney ..403141. Acute Cystitis ..406142. Benign Prostatic Hyperplasia ..408143. Bacterial Prostatitis ..410144. Scrotal Masses ..413145. The Empty Scrotum ..414146. Priapism ..416147. Posterior Urethral Valves ..417148. Urinary Tract Calculi.