Common_Mistakes_In_Doctor_s_Prescriptions-1.pdf

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1. COMMON MISTAKES
In
DOCTOR'S PRESCRIPTIONS
By
Dr / Abdullah Rabie3 Ezz
BENHA Medical School – EGYPT

ﻉﺎﺴﺗﻻ ﺍﺮﻈﻧ ﺔﻔﻠﺘﺨﳌﺍ ﺐﻄﻟﺍ ﺮﺋﺍﻭﺩﻭ ﺓﲑﺜﻜﻟﺍ ﻪﺒﻌﺷ ﻞﺧﺍﺪﺗ
،،
ﻂﻘﺴﺗ ﺕﺎﻣﻮﻠﻌﻣ ، ﺎﻤﺋﺍﺩ ﻙﺎﻨﻬﻓ ﺐﻴﺒﻄﻟﺍ ﺓﺪﻨﺟﺃ ﻦﻣ ﺱﺭﺎﻤﳌﺍ
،،
ﺔﻄﻴﺴﺑ ﺕﺎﻣﻮﻠﻌﻣ ﻲﻫ ﺎﲟﺭ ﻡﻮﻠﻋ ﻦﻣ ﺐﻴﺒﻄﻟﺍ ﺱﺃﺭ ﻪﻳﻮﲢ ﺎﻣ ﻡﺎﻣﺃ
ﻭ ﺺﻴﺨﺸﺘﻟﺍ ﺓﲑﺒﻛ ﺔﻴﻤﻫﺃ ﺕﺍﺫ ﻞﺻﻷﺍ ـﻓ ﺎﻬﻨﻜﻟ ، ﺔﻴﺳﺎﺳﻷﺍ ﺕﺎﺟﻼﻌﻟﺍ
،،
، ﺔﺨﺴﻨﻟﺍ ﻩﺬﻫ ﰲ
ﻦﻣ ﻢﻛ ﱪﻛﺃ ﺽﺮﻌﻧ ﻑﻮﺳءﺎﻄﺧﻷﺍ ـﻓ ﺔﻴﺒﻄﻟﺍﻲ :
، ﺐﻄﻟﺍ ﺔﻨﻬﳌ ﺔﻴﻠﻌﻔﻟﺍ ﺕﺎﺳﺭﺎﻤﳌﺍ
ﻭ ﰲ ، ﺕﺎﺘﺷﻭﺮﻟﺍ ﺔﺑﺎﺘﻛ
ﺔﻣﺎﳍﺍ ﺔﻴﺋﺍﻭﺪﻟﺍ ﺕﻼﺧﺍﺪﺘﻟﺍ ﺎﻤﻴﺳﻻﻭ.

2. Index

ﻻﻭﺃ :ﺔﻔﻠﺘﺨﳌﺍ ﺎﻬﺘﻔﺻﺍﻮﻣﻭ ﺔﺘﺷﻭﺮﻟﺍ ﻥﺎﻴﻛ
ﻢﻠﻘﺑ : ﺭﻮﺘﻛﺩ / ﺪﻣﺎﺣ ﺢﻣﺎﺳ "، ﻱﺮﺼﳌﺍ ﺏﺎﺼﻋﻷﺍﻭ ﺦﳌﺍ ﺡﺍﺮﺟ
ﺔﻴﻧﻭﱰﻜﻟﻹﺍ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ ﻮﻀﻌﻟﺍﻭ. "

ﺎﻴﻧﺎﺛ :ﺔﻔﻠﺘﺨﳌﺍ ﺔﻴﺒﻄﻟﺍ ﺕﺎﺳﺭﺎﻤﳌﺍ ﰲ ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﺃ
ﻢﻠﻘﺑ :ﺰﻋ ﻊﻴﺑﺭ ﷲﺍ ﺪﺒﻋ
" ﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ ﻡﺎﻌﻟﺍ ﺐﻗﺍﺮﳌﺍ ﺮ. "

ﺎﺜﻟﺎﺛ :ﺔﻣﺎﻫ ﺕﺎﻛﺭﺎﺸﻣ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ ﻦﻳﺰﻴﳑ ءﺎﺒﻃﺃ ﻦﻋ ﻼﻘﻧ :
١ /ﺩﺎﳊﺍ ﻱﻮﻠﻜﻟﺍ ﺺﻐﳌﺍ ﺹﻮﺼﲞ ﺔﻣﺎﻫ ﺔﻛﺭﺎﺸﻣ
ﻢﻠﻘﺑ :ﺩ/ ءﻼﻋ " ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ ﻡﺎﻌﻟﺍ ﺐﻗﺍﺮﳌﺍ. "
٢ /ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﻷ ﺔﻌﻳﺮﺳ ﺕﺎﻛﺭﺎﺸﻣ
ﻢﻠﻘﺑ :ﺩ/ءﻼﻋ .
٣/ ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﻷ ﺔﻌﻳﺮﺳ ﺕﺎﻛﺭﺎﺸﻣ
ﻢﻠﻘﺑ : ﺔﻤﻠﺴﻣ ﺓﺭﻮﺘﻛﺩ "ﺔﺒﻴﺒﻃ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ" .

3. ٤ /ﻝﺎﻔﻃﻷﺍ ﺕﺎﺘﺷﻭﺭ ﰲ ءﺎﻄﺧﺃ ﺹﻮﺼﲞ ﺔﻛﺭﺎﺸﻣ
ﻢﻠﻘﺑ :ﺩ/ ﻡﺎﺴﺣ "ﺐﻴﺒﻃ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ. "
٥ /ﻝﺎﻔﻃﻷﺍ ﺕﺎﺘﺷﻭﺭ ﰲ ءﺎﻄﺧﺃ ﺹﻮﺼﲞ ﺔﻛﺭﺎﺸﻣ
ﻢﻠﻘﺑ : ﻞﻜﻴﻫ ﺭﻮﺘﻛﺩ٧٧ " ﻲﺋﺎﺼﺧﺃ ﻝﺎﻔﻃﻷﺍ ﺐﻃ. "

ﺎﻌﺑﺍﺭ :
Hypertension Management
ﻢﻠﻘﺑ :ﺰﻋ ﻊﻴﺑﺭ ﷲﺍ ﺪﺒﻋ
ﺎﺴﻣﺎﺧ:
Hypertension Emergency
ﻢﻠﻘﺑ : ﺭﻮﺘﻛﺩ ﺎﻳﺮﻛﺯ ﺢﻣﺎﺳ "ﻄﻟﺍ ، ﺔﺟﺮﳊﺍ ﺕﻻﺎﳊﺍ ﻢﺴﻘﺑ ﻢﻴﻘﳌﺍ ﺐﻴﺒ
ﻲﻤﻴﻠﻌﺘﻟﺍ ﺎﻬﻨﺑ ﻰﻔﺸﺘﺴﲟ. "
ﺎﺳﺩﺎﺳ :
Hypertension Urgency
ﻢﻠﻘﺑ : ءﻼﻋ ﺭﻮﺘﻛﺩ

Nice Times

4. ﻻﻭﺃ:
، ﺔﺘﺷﻭﺮﻟﺍ ﻥﺎﻴﻛ ﺔﻔﻠﺘﺨﳌﺍ ﺎﻬﺘﻔﺻﺍﻮﻣﻭ:
ﻢﻠﻘﺑ :ﺩ / ﺪﻣﺎﺣ ﺢﻣﺎﺳ "ﺡﺍﺮﺟ ﺏﺎﺼﻋﻷﺍﻭ ﺦﳌﺍ ﻱﺮﺼﳌﺍ "
١ / ﺎﻘﺒﻃ ﺎﲥﻻﻮﻟﺪﻣ ﻭ ﻥﺍﻮﻟﻷﺍ ﺪﻋﺍﻮﻘﻟ ..ﻷﺍ ﺐﺴﻧﺃ ﻥﺃ ﺪﻘﺘﻋﺃ ﺾﻴﺑﻷﺍ ﻥﻮﻠﻟﺍ ﻲﻫ ﺕﺎﺘﺷﻭﺮﻠﻟ ﻥﺍﻮﻟ
ﲏﺒﻠﻟﺍ ﻥﻮﻠﻟﺍ ﻭﺃ .. ﺔﻓﺎﻈﻨﻟﺍ ﻭ ﺀﺎﻘﻨﻟﺍ ﻭ ﺀﺎﻔﺼﻟﺎﺑ ﺱﺎﺴﺣﺇ ﻲﻔﻀﺗ ﻥﺍﻮﻟﺃ ﺎﳖﻷ .. ﻢﺠﳊﺍ ﻦﻋ ﺎﻣﺃ
ﻮﻫ ﻑﻭﺮﻌﳌﺍ ﻭ ﻝﻭﺍﺪﺘﳌﺎﻓB5 ﻦﻣ ﺡﻭﺍﱰﻳ ﻕﺭﻮﻟﺍ ﻚﲰ ﻥﺃ ﺎﻤﻛ٦٠ ﱃﺇ٧٠ ﱃﺇ ٨٠ ﺪﻘﺘﻋﺃ ﻭ
ﻢﻫﺮﻓﻭﺃ ﻭ ﻢﻬﺒﺴﻧﺍ٧٠ .
٢ / ﺪﺑﻻ ﻥﺃ ﻰﻠﻋ ﺩﻮﺟﻮﻣ ﺐﻴﺒﻄﻟﺍ ﻢﺳﺍ ﻥﻮﻜﻳ ﺀﺍﻮﺳ ﺢﺿﺍﻭ ﻂﲞ ﻭ ﺢﺿﺍﻭ ﻥﺎﻜﻣ ﰲ ﺔﺘﺷﻭﺮﻟﺍ
ﺘﺧ ﻖﻳﺮﻃ ﻦﻋ ﻭﺃ ﺔﻋﺎﺒﻄﻟﺎﺑ ﺪﻴﻟﺍ ﻂﺧ ﻰﺘﺣ ﻭﺃ ﻪﻴﺷﻼﻛﺃ ﻭﺃ ﻢ ..ﺍﺬﻫ ﻭ ﺾﻳﺮﳌﺍ ﻕﻮﻘﺣ ﻦﻣ .
٣ / ﺔﻄﻴﺴﺑ ﻥﻮﻜﺗ ﻥﺃ ﺕﺎﺘﺷﻭﺮﻟﺍ ﺔﻋﺎﺒﻃ ﺪﻨﻋ ﻰﻋﺍﺮﻳ .. ﺔﺟﺭﺪﻟﺍ ﻪﺘﲢ ﻭ ﻢﺳﻻﺍ ﻼﺜﻣ ﻰﻨﻌﻳ
) ﻡﺎﻋ ﺱﺭﺎﳑ- ﺡﺍﺮﺟ ﻭ ﺐﻴﺒﻃ-ﻲﺋﺎﺼﺧﺃ- ﻯﺭﺎﺸﺘﺳﺇ (ﺭﺪﻟﺍ ﻦﻋ ﻒﻴﻔﺧ ﻪﻳﻮﻨﺗ ﻦﻜﳑ ﻭ ﺔﺟ
ﺔﻴﻤﻠﻌﻟﺍ)ﺱﻮﻳﺭﻮﻟﺎﻜﺑ -ﻡﻮﻠﺑﺩ -ﲑﺘﺴﺟﺎﻣ-ﻩﺍﺭﻮﺘﻛﺩ ( ﻞﻤﻌﻟﺍ ﻥﺎﻜﻣ ﻭﺃ .. ﻯﺪﻌﺘﻳ ﻻ ﺍﺬﻫ ﻞﻛ٣
ﺮﻄﺳﺃ .. ﻼﺜﻣ ﻥﻮﺒﺘﻜﻳ ﻭ ﻰﺿﺮﳌﺍ ﻥﻮﻋﺪﳜ ﻦﻳﺬﻟﺍ ﺀﺎﺒﻃﻷﺍ ﻰﻠﻋ ﻖﺒﻄﻨﻳ ﺮﻳﺬﺤﺘﻟﺍ ﺲﻔﻧ ﻭ
ﺐﺋﺎﻧ ﻝﺍﺯ ﺎﻣ ﻮﻫ ﻭ ﻲﺋﺎﺼﺧﺃ .

5. ٤ / ﺐﻫﺍﺬﻣ ﻥﻮﻘﺸﻌﻳ ﺎﻤﻴﻓ ﺱﺎﻨﻟﺍ ﻭ ﻚﻧﺍﻮﻨﻋ ﺎﳖﺇ ﻆﺣﻼﻓ ﺔﻋﻮﺒﻄﻣ ﺔﺘﺷﻭﺮﻟﺍ ﻮﻟ ..ﺬﻟﺍ ﻦﻜﻟ ﻱ
ﺔﺑﻮﻠﻄﻣ ﺔﻛﺎﻴﺸﻟﺍ ﻭ ﺔﻃﺎﺴﺒﻟﺍ ﻥﺇ ﻪﻴﻠﻋ ﻑﻼﺧ ﻻ، ﻪﻴﻓ ﻰﻘﺒﻳ ﻡﺯﻻ ﻚﺘﺘﺷﻭﺭ ﻢﻤﺼﺗ ﺖﻧﺃ ﻭ ﻰﻨﻌﻳ
ﺾﻳﺮﳌﺍ ﻢﺳﻻ ﺮﺧﺃ ﻭ ﺦﻳﺭﺎﺘﻠﻟ ﻕﻮﻓ ﺮﻄﺳ ﻥﺎﻜﻣ ﻯﺮﺧﻷﺍ ﺔﻬﳉﺍ ﻞﺑﺎﻘﳌﺍ ﰲ ﻭ ﻪﻨﺳ ﻭ ﻪﺴﻨﺟ ﻭ
ﺡﻮﺿﻮﺑ ﺺﻴﺨﺸﺘﻟﺍ ﺔﺑﺎﺘﻜﻟ .. ﻂﻠﻏ ﻮﻟ ﻰﺘﺣ ﻪﻴﺑ ﻊﻨﺘﻘﻣ ﺖﻧﺃ ﺺﻴﺨﺸﺗ ﺐﺘﻛﺍ .. ﺎﻬﻠﻛ ﻩﺬﻫ
ﰲ ﻭ ﻚﺋﺍﺩﺃ ﰲ ﻯﻮﻗ ﺭﻮﺘﻛﺩ ﻚﻧﺇ ﺔﻣﻼﻋ ﻪﻧﺇ ﻰﻠﻋ ﺓﻭﻼﻋ ﺀﻲﻄﲣ ﺪﻗ ﻭ ﺐﻴﺼﺗ ﺪﻗ ﺕﺍﺩﺎﻬﺘﺟﺍ
ﺭﺍﺮﻗ ﺫﺎﲣﺍ ﻰﻠﻋ ﺭﺩﺎﻗ ﻭ ﻚﺘﻴﺼﺨﺷ .. ﻪﻧﺇ ﻰﻠﻋ ﺓﻭﻼﻋ ﺎﻀﻳﺃﺍ ﺾﻌﺑ ﰲ ﻦﻜﳑ ﺪﻋﺎﺴﻳ ﻥﺎﻴﺣﻷ
ﺢﺿﺍﻭ ﺶﻣ ﻂﳋﺍ ﻥﺎﻛ ﺍﺫﺇ ﺔﻳﻭﺩﻷﺍ ﺔﻓﺮﻌﻣ ﻰﻠﻋ ﱄﺪﻴﺼﻟﺍ ) ﻥﻮﺒﻜﺗﺮﻳ ﺔﻟﺩﺎﻴﺼﻟﺍ ﺾﻌﺑ ﻥﺇ ﻊﻣ
ﻭ ﺪﻌﺗ ﻻ ﺔﻠﺜﻣﻷﺍ ﻭ ﺄﻄﺧ ﺓﺀﺍﺮﻗ ﻭﺃ ﺐﻴﺒﻄﻟﺍ ﻥﺍﺬﺌﺘﺳﺍ ﻥﻭﺪﺑ ﻞﻳﺪﺑ ﻑﺮﺻ ﻦﻣ ﺀﺍﻮﺳ ﺓﲑﺜﻛ ﺀﺎﻄﺧﺃ
ﻉﻮﺿﻮﳌﺍ ﺍﺬﻫ ﰲ ﻰﺼﲢ ﻻ ) ﻝﺎﺜﻣ :ﻩﺪﻨﻋ ﺾﻳﺮﳌ ﺐﺗﺎﻛ ﺖﻨﻛ ﻡﻮﻴﻟﺍ ﺏﺎﻬﺘﻟﺍ ﺏﺎﺼﻋﻷﺍ ﰲ
ﺔﻴﻓﺮﻄﻟﺍ :Lipoic 600 Tab ﱄﺪﻴﺼﺑ ﺖﺌﺟﻮﻔﻓﻪﻟ ﻑﺭﺎﺻ lopid 300
ﺔﻴﺛﻼﺜﻟﺍ ﻥﻮﻫﺪﻟﺍ ﺓﺩﺎﻳﺯ ﺝﻼﻌﻟ .
٥ / ﺢﺿﺍﻭ ﻥﻮﻜﻳ ﻡﺯﻻ ﺔﺘﺷﻭﺮﻟﺍ ﻂﺧ .. ﻭ ﲔﻓﺮﺣ ﺶﻣ ﻞﻣﺎﻜﻟﺎﺑ ﺔﺑﻮﺘﻜﻣ ﻥﻮﻜﺗ ﻡﺯﻻ ﺔﻳﻭﺩﻷﺍ
ﻂﺧ ﺩﺩﺎﺷ ﺡﻭﺮﺗ .. ﱄﺪﻴﺼﻟﺍ ﺀﺎﻄﺧﺃ ﻦﻣ ﻞﻠﻘﻳ ﻮﻬﻓ ﺔﻤﻴﻈﻋ ﺔﻤﻴﻗ ﻪﻟ ﻞﻴﻤﳉﺍ ﻭﺃ ﺢﺿﺍﻮﻟﺍ ﻂﳋﺍ
ﺔﻳﺎﻋﺩ ﻮﻬﻓ ﻯﺮﺧﺃ ﺔﻬﺟ ﻦﻣﻭ ﻞﺑﺎﻘﻣ ﻼﺑ ..  ﺪﻤﳊﺍ ﻭ ﻝﻮﻘﻨﻣ ﺶﻣ ﻲﻌﻗﺍﻭ ﻡﻼﻛ ﻝﻮﻘﺑ ﺪﲜ ﺎﻧﺃ
ﻑﺭﺎﻋ ﺎﻧﺎﻓ ﺢﺿﺍﻭ ﻰﻄﺧ ﺎﻧﺃ ﻥﺎﺸﻋﻪﻟ ﻪﻳﺇ ﺩﺃ ﲑﺛﺄﺗ ﻚﻌﻣ ﻞﻣﺎﻌﺘﻳ ﻦﻣ ﻞﻛ ﻰﻠﻋ .

6. ٦ /ﻷﺍ ﺾﻌﺑ ﺀﺎﺒﻃﳝ ﺪﲡ ﻻﻭ ﺾﻳﺮﳌﺎﺑ ﺔﺻﺎﳋﺍ ﺔﻴﻋﺩﻷﺍ ﻭ ﺭﺎﻛﺫﻷﺍ ﻦﻣ ﺍﺪﺟ ﲑﺒﻛ ﻢﻜﺑ ﺔﺘﺷﻭﺮﻟﺍ ﻸ
ﺔﺑﺎﺘﻜﻠﻟ ﱀﺎﺻ ﻂﻘﻓ ﺔﻗﺭﻮﻟﺍ ﺚﻠﺛ ﱄﺍﻮﺣ ﻻﺇ ..ﻲﻳﺃﺭ ﻼﻴﺼﻔﺗ ﻭ ﺔﻠﲨ ﺽﻮﻓﺮﻣ ﻩﺩ ﻡﻼﻜﻟﺍ ﻥﺇ ..
ﺶﻣ ﺎﻌﺒﻃ ﻭ ﻞﺼﻔﻨﻣ ﻞﻜﺸﺑ ﻥﻮﻜﻳ ﻦﻜﳑ ﻩﺩ ، ﺔﻴﻋﺩﺃ ﻭ ﺭﺎﻛﺫﺃ ﻰﺿﺮﳌﺍ ﻰﻠﻋ ﻉﺯﻮﺗ ﺰﻳﺎﻋ ﺖﻧﺍ ﻮﻟ
ﻰﺿﺮﳌﺍ ﻞﻜﻟ .. ﻼﺜﻣ ، ﻂﻴﺴﺑ ﺀﺎﻋﺩ ﻯﻮﻗ ﺔﻳﺎﻔﻛ ﺎﳕﺇ : ﻭ ﺱﺄﺒﻟﺍ ﺐﻫﺫﺃ ﺱﺎﻨﻟﺍ ﺏﺭ ﻢﻬﻠﻟﺍ
ﻥﺇ ﺎﻬﻠﻣﺎﻌﺗ ﻭ ﻱﺩ ﺔﺘﺷﻭﺮﻟﺍ ﻡﱰﺤﺘﻫ ﺱﺎﻨﻟﺍ ﻞﻛ ﺶﻣ ﻥﻷ ، ﰲﺎﺸﻟﺍ ﺖﻧﺃ ﻲﻔﺷﺍ ﺚﻳﺪﺣ ﻭﺃ ﺔﻳﺃ ﺎﻬﻴﻓ
..ﺍ ﺮﻬﺿ ﲑﻏ ﺵﺎﻘﻠﻳﺎﻣ ﻦﻜﳑ ﻒﻳﺮﻟﺍ ﰲ ﺔﺻﺎﺧ ﻭ ﺾﻌﺒﻟﺎﻓ ﺕﺎﺒﻠﻃ ﻪﻴﻓ ﺐﺘﻜﻳ ﻥﺎﺸﻋ ﺔﺘﺷﻭﺮﻟ
ﳌﺍﻝﺰﻨ ﻝﺎﻘﺒﻟﺍ ﺏﺎﺴﺣ ﻭﺃ ..ﻨﻟﺍ ﻞﻛ ﻥﺇ ﻩﺎﻨﻌﻣ ﺶﻣ ﻩﺩ ﺎﻌﺒﻃ ﻭ ﻩﺪﻛ ﺱﺎ .. ﺔﻣﱰﳏ ﺱﺎﻧ ﻪﻴﻓ
ﺑﻭ ﺍﺪﺟﺘ ﻦﻋ ﻝﺰﻌﲟ ﺔﻴﻋﺩﻷﺍ ﻭ ﺭﺎﻛﺫﻷﺍ ﻥﻮﻜﺗ ﻥﺃ ﻁﻮﺣﻷﺍ ﻦﻜﻟ ﻭ ﺎﲠ ﺎﻣﻭ ﺔﻔﺻﻮﻟﺍ ﻰﻠﻋ ﻆﻓﺎﺤ
ﻚﺘﺘﺷﻭﺭ .
٧ / ﺏﺎﻘﻟﺃ ﻥﻭﺪﺑ ﻭ ﺩﺮﳎ ﻢﺳﻻﺍ ﺐﺘﻜﻳ ﺎﻨﻣ ﺾﻌﺑ ﻥﺈﻓ ﺾﻳﺮﳌﺍ ﻢﺳﺍ ﺔﺑﺎﺘﻛ ﺪﻨﻋ ) .. ﻝﻮﻘﻳ
ﻢﻠﺳ ﻭ ﻪﻴﻠﻋ ﺍ ﻰﻠﺻ ﺍ ﻝﻮﺳﺭ : ﻢﳍﺯﺎﻨﻣ ﺱﺎﻨﻟﺍ ﺍﻮﻟﺰﻧﺍ ( ﻢﻬﻣﺍﱰﺣﺍ ﻢﻬﻄﻋﺃ ﻰﻨﻌﻳ .. ﺎﻣ
ﻲﻧﻼﻔﻟﺍ ﻥﻼﻓ ﻪﲰﺍ ﺐﺘﻜﺗﻭ ﻙﺪﻟﺍﻭ ﻦﺳ ﰲ ﺪﺣﺍﻭ ﻼﺜﻣ ﺶﺤﺼﻳ .. ﺝﺎﳊﺍ ﺔﻤﻠﻜﺑ ﺎﻬﻘﺒﺳﺃ ﻰﻨﻌﻳ
ﺪﻟﺍﻮﻟﺍ ﻭﺃ .. ﻯﺩ ﻭﺎﺟﺎﺣ ﻦﻜﻟ ﺔﻄﻴﺴﺑ ﺕﺍ ﺍﺪﺟ ﺓﲑﻄﺧ ﺎﻬﺘﻋﺎﺒﻄﻧ .. ﻦﻜﳑ ﺐﻘﻠﻟﺍ ﺍﺬﻫ ﻚﻟﺬﻛ
ﺔﻨﻴﻌﻣ ﺕﺎﺟﺎﲝ ﻚﻏﺎﻣﺩ ﰲ ﻪﳎﱪﻣ ﺖﻧﺍ ﻥﻮﻜﺗ .

7. ٨ / ﺔﻳﻭﺩﻷﺍ ﺔﺑﺎﺘﻛ .. ﻩﺪﻓ ﺪﺣﺍﻭ ﻒﻨﺼﺑ ﰿﺎﻌﺗ ﺕﺭﺪﻗ ﺍﺫﺇ ﻰﻨﻌﻳ ﺮﺼﺘﲣ ﻚﻧﺇ ﺔﻣﺎﻌﻟﺍ ﺓﺪﻋﺎﻘﻟﺍ
ﻦﻣ ﻦﺴﺣﺃ٢ ﻦﻣ ﻦﺴﺣﺃ ﻩﺩ ﻭ٣ ﺶﻧﻮﻜﻴﺑ ﺎﻣ ﺔﻳﻭﺩﻷﺍ ﻉﺎﺘﺑ ﻦﺸﻛﺃﱰﻧﻹﺍ ﻉﻮﺿﻮﻣ ﺎﻨﻠﻛ ﺎﻨﻧﻷ ﰲ
ﻰﻨﻌﻳ ﻉﻮﻨﻧ ﻭ ﻦﻓ ﺔﻳﻮﺷ ﻪﻴﻓ ﻰﻘﺒﻳ ﻡﺯﻼﻓ ﻒﻨﺻ ﻦﻣ ﱰﻛﺃ ﺐﺘﻜﻧ ﺎﻧﺭﺮﻄﺿﺍ ﻥﺇ ﻦﻜﻟ ﻭ ﻯﻮﻗ ﺎﻨﻏﺎﻣﺩ
ﻚﺻ ﺎﻬﻠﻛ ﺔﺘﺷﻭﺮﻟﺍ ﺵﺎﻘﺒﺗ ﺎﻣ ﻭ ﻥﺎﻫﺩ ﻭﺃ ﺹﺍﺮﻗﺃ ﻒﻨﺻ ﻭ ﺱﻮﺒﻟ ﻒﻨﺻ ﻭ ﻦﻘﺣ ﻒﻨﺻ
)ﻡﺎﺷﺮﺑ .. ( ﻚﺻ ﺶﻣ ﻪﳉﺎﻌﺘﺑ ﻚﻧﺇ ﺎﳍﻼﺧ ﻦﻣ ﻦﻘﻴﺘﻳ ﺾﻳﺮﳌﺍ ﻭ ﺔﻴﳘﻷﺍ ﺔﻐﻟﺎﺑ ﻱﺩ ﺔﻇﻮﺤﻠﳌﺍ
ﺲﺑ ﻭ ﲏﻴﺗﻭﺭ ..ﻘﻔﺗﺍ ﺎﻣ ﻯﺯ ﻭﺍﻭﺩﺃ ﻙﺎﻌﻣ ﻥﻮﻜﺗ ﻡﺯﻻ ﺎﻌﺒﻃ ﺎﻨﲏﻌﻳ ﻚﺗ ﺔﻳﻭﺩﻷﺍ ﻑﺭﺎﻋ ﻥﻮﻜﺗ
ﻯﻭﺃ ﺲﻳﻮﻛﺎﻣ ﻼﺜﻣ ﻥﺎﻴﻋ ﻮﻟ ﺚﻴﲝ ﻪﻠﻳﺪﺗ ﺭﺪﻘﺘﻓ ﻦﻘﳊﺍ ﺶﺒﺤﻴﺑﺏﺍﺮﺷ ﻭﺍ ﺹﺍﺮﻗﺃ .. ﺎﻣ ﻭﺃ
ﻞﻳﺪﺒﻟﺍ ﻰﻄﻌﺘﻓ ﺱﻮﺒﻠﻟﺍ ﺶﺒﺤﻴﺑﺹﺍﺮﻗﺃ ﻭﺃ ،ﺍﺬﻜﻫ ﻭ ﻦﻘﺣ .. ﻝﺎﺜﻣ : ، ﲔﺴﺑﺮﺗﻮﻤﻴﻜﻟﺍ ﺓﺩﺎﻣ
ﻞﻀﻋ ﺪﺧﺎﺘﺘﺑ ﲔﺴﺑﺮﺗﻮﻤﻴﻛﺎﻔﻟﺃ ﻦﻘﺣ ﺎﻬﻨﻣ ﻞﻛ١٢ ﺔﻋﺎﺳ ﻭﻣﺎﻬﻨ ﻞﺒﻗ ﺪﺧﺎﺘﺘﺑ ﻢﻳﺰﻴﺒﻣﺃ ﺹﺍﺮﻗﺃ
ﺔﻋﺎﺳ ﺺﻨﺑ ﻞﻛﻷﺍ٣ ﺕﺍﺮﻣ ﺎﻬﻨﻣ ﻭ ﻥﱰﻨﻴﻔﻟﺃ ﺹﺍﺮﻗﺃ ﺯﻼﻴﺴﻛﺎﻣ ﺏﺍﺮﺷ ﺎﻬﻨﻣﻭ ﻞﻛﻷﺍ ﻞﺒﻗ ﺔﻘﻌﻠﻣ
ﺔﻋﺎﺳ ﻒﺼﻨﺑ .. ﻪﺒﺳﺎﻨﻳ ﺎﻣ ﻚﻀﻳﺮﳌ ﱰﺧﺍ ﻥﺫﺇ.
٩ /ﺔﻴﺋﺍﻭﺪﻟﺍ ﺔﻋﻮﻤﺍ ﺲﻔﻧ ﻦﻣ ﻒﻨﺻ ﻦﻣ ﱰﻛﺃ ﺐﺘﻜﺗ ﺮﻄﻀﻣ ﺖﻨﻛ ﺍﺫﺇ .. ﻥﻮﻜﻳ ﻡﺯﻼﻓ
ﻉﻮﻨﺗ ﻡﺯﻻ ﻭ ﺭﱪﻣ ﻙﺪﻨﻋ .. ﺕﺎﻨﻜﺴﻣ ﺐﺘﻜﺘﻫ ﻼﺜﻣ ﻰﻨﻌﻳ- ﺕﺍﺩﺎﻀﻣ ﺏﺎﻬﺘﻟﺍ- ﺶﻴﺠﺘﻣ
ﻰﻘﺑﰲ ﻭ ﻦﻳﺪﻠﻓ ﺐﺘﻜﺗ ﺓﺪﺣﺍﻭ ﺔﺘﺷﻭﺭ، ﻦﻳﺭﺎﺘﻟﻮﻓ ﻷﲔﻨﺛﻻﺍ ﺔﻋﻮﻤﺍ ﺲﻔﻧ ﻦﻣ ، ﻝﻮﺒﻘﳌﺍ ﻦﻜﻟ
ﺪﺣﺍﻭ ﺐﺘﻜﺗﺀﻲﻄﺑ ﲔﻓﻭﺮﺑﻮﻴﺒﻳﻹﺍ ﻭﺃ ﲔﻓﻭﺮﺑﻮﺘﻴﻜﻟﺍ ﻯﺯ ﻊﻳﺮﺳ ﺪﺣﺍﻭ ﻭ ﻝﻭﺩ ﻯﺯ .

8. ١٠ /ﰲ ﻷﺍ ﻰﻠﻔﺴﻟﺍ ﻦﻛﺮﻟﺍ ﰲ ﺔﻋﻮﺒﻄﻣ ﺎﺒﻟﺎﻏ ﻥﻮﻜﺗ ﺓﲑﻐﺻ ﺔﻧﺎﺧﺪﻋﻮﻣ ﺪﻳﺪﺤﺘﻟ ﻦﳝ ﻭﺃ ﺔﻌﺑﺎﺘﳌﺍ
ﻒﺸﻜﻟﺍ ﺓﺩﺎﻋﺇ .. ﻭﻩﺬﻫ ﺖﻧﺃ ﻦﻣ ﺡﻭﺍﱰﺗ ﻭ ﺔﻟﺎﳊﺍ ﺽﺮﻣ ﺔﻌﻴﺒﻃ ﻰﻠﻋ ﺀﺎﻨﺑ ﻚﺴﻔﻨﺑ ﺎﻫﺩﺪﲢ
ﻭﺃ ﻱﻮﻠﳋﺍ ﺏﺎﻬﺘﻟﻻﺍ ﺕﻻﺎﺣ ﰲ ﺎﻤﻛ ﺔﻠﻴﻠﻗ ﻡﺎﻳﺃ٥ ﰲ ﻉﻮﺒﺳﺃ ﻭﺃ ﻯﻭﺪﻌﻟﺍ ﺕﻻﺎﺣ ﰲ ﻂﺳﻮﺘﻤﻛ ﻡﺎﻳﺃ
ﻲﻈﻔﲢ ﺝﻼﻋ ﺓﱰﻔﻛ ﰲﻭﺮﻀﻐﻟﺍ ﻕﻻﺰﻧﻻﺍ ﺕﻻﺎﺣ .. ﻥﺈﻓ ﻡﺎﻋ ﻪﺟﻮﺑ ﺎﻌﺒﻃ ﻭ ﺾﻳﺮﳌﺍ ﺔﺑﺎﺠﺘﺳﺍ
ﺓﺮﳌﺎﺑ ﺓﺪﻋﺎﻗ ﻭﺃ ﺖﺑﺎﺛ ﻞﻜﺷ ﻪﻟ ﺲﻴﻟ ﺔﻌﺑﺎﺘﻤﻠﻟ ﺩﺪﶈﺍ ﺪﻋﻮﳌﺍ ﰲ ﻩﺭﻮﻀﺣ ﻭ ﺐﻴﺒﻄﻛ ﻚﻟ .. ﻭ
ﻚﻴﺑ ﺾﻳﺮﳌﺍ ﻉﺎﻨﻗﺇ ﰲ ﻚﺣﺎﳒ ﻰﻠﻋ ﺪﻛﺆﳌﺍ ﻲﺑﺎﳚﻹﺍ ﻝﻮﻟﺪﳌﺍ ﻦﻜﻟ ﻭ ﺐﻴﺒﻄﻛ ﻚﺗﺍﻮﻄﺧ ﺡﺎﳒ ﻰﻠﻋ
ﻲﻫ ﺔﻴﺟﻼﻌﻟﺍ :ﺘﳌﺍ ﺩﺎﻌﻴﻣ ﰲ ﻚﻠﻴﳚ ﺾﻳﺮﳌﺍ ﻥﺇ ﻰﻓﺎﻌﻣ ﻮﻫﻭ ﻪﺗﺩﺪﺣ ﺖﻧﺃ ﻲﻠﻟﺍ ﺔﻌﺑﺎ- ﻴﻠﺳ ﻢ
ﻰﻨﻌﻳ - ﺲﻜﻌﻟﺍ ﻦﻜﻟ ، ﺢﺻ ﻲﺷﺎﻣ ﺖﻧﺍ ﻰﻘﺒﺗ ، ﻞﺼﺣ ﻮﻟ ﺍﺩﻭ– ﻭﺃ ﺶﻔﳐ ﺾﻳﺮﳌﺍ ﻥﺇ ﻱﺃ
ﳎ ﺓﺩﺎﻋﺇ ﺵﺎ– ﺖﻠﺸﻓ ﻚﻧﺇ ﻩﺎﻨﻌﻣ ﺲﻴﻟ ﻴﺋﺎﺼﺣﺇ ﻞﻤﻌﺗ ﻝﻭﺎﺣ ﺲﺑ ،ﺔ ﻚﺗﺎﻓﻮﺸﻜﻟ ﺔﻳﺮﻳﺪﻘﺗ.
١١/ ﻙﺎﻳﺇ ﻢﺛ ﻙﺎﻳﺇﻝﺎﳘﺇ ﺽﺮﳌﺍ ﻰﻋﺪﻣ ﻪﻧﺇ ﻖﻳﺮﻄﻟﺍ ﻝﻭﺃ ﻦﻣ ﻝﻮﻘﺗ ﻻﻭ ﺾﻳﺮﳌﺍ ﻯﻮﻜﺷ .. ﻊﻘﺘﻫ
ﺮﻤﻌﻟﺍ ﻝﻮﻃ ﻪﻴﻠﻋ ﻚﺴﻔﻧ ﺢﻣﺎﺴﺘﻫ ﺶﻣ ﺐﻄﻣ ﰲ .. ﺖﺒﺜﻳ ﻥﺃ ﱃﺇ ﺔﻣﱰﳏ ﺾﻳﺮﳌﺍ ﻯﻮﻜﺷ
ﻥﺎﻫﱪﻟﺍ ﻭ ﻞﻴﻟﺪﻟﺎﺑ ﻚﻟﺫ ﺲﻜﻋ ﰿﺎﻌﺘﺗ ﺖﻠﻀﻓ ﺕﺎﺠﻨﺸﺗ ﺔﻟﺎﺣ ﻱﺮﻤﻋ ﻰﺴﻨﻫ ﺶﻣ ،٨ ﲔﻨﺳ
ﺓﻮﺧﻹﺍ ﺾﻌﺑ ﺔﻄﺳﺍﻮﺑ-ﺔﻴﺴﻔﻨﻟﺍ ﺀﺎﺒﻃﺃ- ﺗﺃ ﻢﺛ ﻉﺮﺻ ﺎﳖﺇ ﻰﻠﻋ ﺔﻟﺎﺣ ﰲ ﺉﺭﺍﻮﻄﻟﺍ ﰲ ﱄ ﺖ
ﺦﳌﺎﺑ ﲑﺒﻛ ﻡﺭﻭ ﺩﻮﺟﻭ ﲔﺒﺗ ﺎﻫﺮﻳﻮﺼﺗ ﺪﻌﺑ ﻭ ﺔﺑﻮﺒﻴﻏ ) ﺎﻣﻮﻴﺠﻨﻴﻨﻴﻣ.(

9. ﻴﻧﺎﺛ ﺎ:
ﺔﻔﻠﺘﺨﳌﺍ ﺔﻴﺒﻄﻟﺍ ﺕﺎﺳﺭﺎﻤﳌﺍ ﰲ ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﺃ :
ﻢﻠﻘﺑ : ﺰﻋ ﻊﻴﺑﺭ ﷲﺍ ﺪﺒﻋ
١/
Nasal drops contain decongestants
ﻱﺯ ﻼﺜﻣ
Afrin-Balkis-Nasostop-Nasotal-Rhinex
ﺓﱰﻓ ﻥﻮﻜﺗ ﻥﺃ ﺪﺑﻻﻡﺍﺪﺨﺘﺳﻻﺍ ﻦﻣ ﻯﺪﻌﺘﺗ ﻻ ﺓﺪﺣﺍﻮﻟﺍ ﺓﺮﻤﻠﻟ ﻯﻮﺼﻘﻟﺍ 4 ﱃﺇ ﻡﺎﻳﺃ٧ ﻡﺎﻳﺃ
ﰲ ﻥﺎﻴﻌﻟﺍ ﻞﺧﺪﺘﻫ ﺍﺪﻛ ﻚﻧﻷ Rebound Congestion
" ﻥﺎﻘﺘﺣﺍ ﻲﺴﻜﻋ "
ﺐﺒﺴﻟﺍ :
ﻝﺎﺑ ﻞﻤﻌﺘﺑ ﻚﻧﺇ Local decongestant
Low bl. supply to nasal epithelium
، ﻰﻠﻋ ﺓﻭﻼﻋ
Chemical Rhinitis
ﻟ ﺐﻴﻃ ـﺑ ﻡﻮﻳ ﻡﺎﻛ ﻞﻤﻜﺗ ﺝﺎﺘﳏ ﻪﺴﻟ ﺖﻨﻛ ﻮDecongestants
ﻞﻤﻛ .. ﺲﺑ :
Oral decongestant

10. ٢/
ﻞﻣﺍﻮﺤﻠﻟ ﻪﺒﺘﻜﺗ ﺔﺻﺎﺧ ـﻟﺍ ﺓﺩﺎﻣ ﻪﻴﻓ ﻲﻠﻟﺍ ﻞﻣﺍﻮﳊﺍ ﰲ ﺕﻼﻬﺴﳌﺍ :ﺶﻣ ﻞﻬﺴﻣ ﻱﺃ
anthraquinon
ﺽﺎﻬﺟﺇ ـﻟ ﻞﺻﻮﺗ ﺭﻮﻣﻷﺍ ﻦﻜﳑﻭ ﺾﺒﻘﻨﺗ ﻢﺣﺮﻟﺍ ﺕﻼﻀﻋ ﻲﻠﺨﻴﻫ ..، ﺎﻌﺒﻃ ﻉﻮﻨﳑ ﻚﻟﺬﻟﻭ
ﻭ ﻮﻟﻭ ، ﲑﺘﻛ ﱭﻟ ﺏﺮﺸﺗ ﺎﳍﻮﻗ ﻱﻮﻗ ﻱﺭﻭﺮﺿ ﺔﻳﺎﻜﳊﺍ ﻮﻟﻪﺴﻟ ﻲﻘﺒﻳ ﻲﻧﺎﺗﻱﺃ ـﻟﺍ ﺓﺩﺎﻣ ﻰﻠﻋ ﻱﻮﺘﲢ ﺔﺟﺎﺣ
bisadocodyl
ﺲﻛﻻﺎﻨﻴﻣ ﻭﺃ ﻞﻳﺩﺎﺴﻴﺑ ﻱﺯ
ﻞﻀﻓﺃ ﺎﻣﻮﻤﻋﻭ ـﻟﺍ ﻮﻫ ﻞﻣﺎﺤﻠﻟ ﻞﻬﺴﻣ
Lactulose

٣/
ﻉﻭﺍ ﻯﺪﺗﻱﺃ ﻩﺪﻨﻋ ﺾﻳﺮﳌ ﻚﻧﺯ ﻪﺑ ﺐﻛﺮﻣpsychosis /
ﻉﻭﺍ ﻯﺪﺗﻱﺃ ﺪﺒﻛ ﺾﻳﺮﳌ ﺪﻳﺪﺣ ﻪﺑ ﺀﺍﻭﺩ/
ﻉﻭﺍ ﻊﻣ ﺪﻳﺪﺣ ﻯﺪﺗ vit e /
ﻉﻭﺍ ﻯﺪﺗﻱﺃ ﻝﻮﻣﺎﺘﻴﺳﺍﺭﺎﺒﻟﺍ ﺀﺎﻨﺜﺘﺳﺎﺑ ﺪﺒﻛ ﺾﻳﺮﳌ ﻦﻜﺴﻣ ﻼﺜﻣ ،: ﻝﻮﻣﺎﺒﻴﳍﺍ /
ﻉﻭﺍ ﻱﺃ ﻱﺪﺗ ﳌ ﻦﻜﺴﻣ ﺾﻳﺮﻟﺍﻮﺑﺮ
" ﻮﺑﺮﻟﺍ ﺕﻻﺎﺣ ﺾﻌﺑ ﰲ ﻝﻮﻣﺎﺘﻴﺳﺭﺎﺒﻟﺍ ﺡﻮﻤﺴﻣ" /
ﻉﻭﺍ ﻯﺪﺗﻱﺃ ﺺﻐﻣ ﻩﺪﻨﻋ ﺾﻳﺮﳌ ﻦﻜﺴﻣ" ﻩﺭﺪﺼﻣ ﺺﺨﺸﻳ ﱂ " ﻂﺒﻀﻟﺎﺑ ﺺﻐﳌﺍ ﻥﺎﻜﻣ ﻑﺮﻌﺗ ﺎﳌ ﻻﺇ
ﺄﺘﺗﻭ ﺪﻛﺙﺪﳛ ﻻ ﻰﺘﺣ ﺓﺪﻳﺍﺯ ﺶﻣ ﻪﻧﺇ masking ﺓﺪﻳﺍﺰﻟﺍ ﺽﺍﺮﻋﻷ ﻥﺎﻴﻌﻟﺍﻭ ﻦﻜﳑ ﰲ ﻼﺜﻣ ﻞﺧﺪﻳ
Peritonitis

11. ٤/
ﻞﻤﳊﺍ ﰲ ﺕﺎﻳﺮﻄﻔﻟﺍ ﺕﺍﺩﺎﻀﻣ: ﻣﻷﺍ ﻊﺸﺑﺃﻭ ﺮﻄﺧﺃ ﻦﺔﻳﻭﺩ ، ﲔﻨﳉﺍ ﺪﻨﻋ ﺕﺎﻫﻮﺸﺗ ﺐﺒﺴﺗ ﻦﻜﳑ ﻲﻠﻟﺍ
ﺎﺧﻭﺔﺻ
Griseofulvin
ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ ﺍﻮﻫ ﻲﻠﻟﺍ
Griseovin syrup
ﻲﺳﺎﺳﺃ ﺎﻴﻨﻴﺘﻟﺍ ﺔﺘﺷﻭﺭ ﰲ ﺎﳝﺍﺩ ﺐﺘﻜﺘﻴﺑ ..
ﺕﺎﻳﺮﻄﻔﻟﺍ ﰿﺎﻌﻴﺑ ﺍﻭﺩ ﻞﻣﺎﺣ ﻱﺪﺗ ﻉﻭﺍ ..
٥/
ﻆﻔﲢ ﺎﻳﻢﺳﺍ ﻞﺻﻷﺍ ﻦﻣ ﺵﻮﺒﺘﻜﺘﻣ ﺎﻳ ﻚﺘﺘﺷﻭﺭ ـﻓ ﺲﻳﻮﻛ ﻪﺒﺘﻜﺗﻭ ﺲﻳﻮﻛ ﻱﺭﺎﺠﺘﻟﺍ ﺀﺍﻭﺪﻟﺍ:
ﻙﺪﻨﻋ٤ ﻝﺎﺜﻣ ـﻛ ﺎﻬﻴﻓ ﻂﻠﻐﻨﺘﺑ ﻲﻠﻟﺍ ﺕﺎﺟﺎﳊﺍ ﺮﻬﺷﺃ ﻦﻣ :
ﺐﺘﻜﺗ furamipeﺎﻬﻓﺮﺼﻳ ﱄﺪﻴﺼﻟﺍﻭ furamebe
ﺐﺘﻜﺗgenuphil ﺪﺼﻘﺗ ﺖﻧﺍﻭ genuofil
ﺐﺘﻜﺗduphaston ﺎﻬﻓﺮﺼﻳ ﱄﺪﻴﺼﻟﺍﻭ duspataline
ﺐﺘﻜﺗpiascledine ﺪﺼﻘﺗ ﺖﻧﺍﻭ
Paxeladine
ﺍﺬﻜﻫﻭ...

12. ٦/
ﻰﻠﻋ ﻱﻮﺘﲢ ﱵﻟﺍ ﺕﺎﻨﻜﺴﳌﺍDiclofenac Na
ﻞﺜﻣ ﻝﺍ :
Olfen-Declophen-Dolphen-Rheumafen-
Rhumaren-Voltaren
ﻢﻬﻔﺻﻭ ﻉﻮﻨﳑ ﺀﻻﺆﳍ:
1/
Patients Hypertensive
ﻞﻤﻌﺘﺑ ﺓﺭﻮﻛﺬﳌﺍ ﺕﺎﻨﻜﺴﳌﺍ ﻥﻷ Fluid Retention
" ﻝﺍ ﻙﺪﻨﻋ ، ﻢﻴﻠﺴﻟﺍ ـﻓ ﻚﻴﻠﺧ Paracetamol ﺔﺟﺎﺣ ﻞﻀﻓﺃ"
2/
ﻩﺪﻨﻋ ﺪﺣﺍﻭ Peptic Ulcer ﻱﺃ ﻭﺃGastric Impairment
؟؟ ﻞﳊﺍﻭ ﻙﺪﻨﻋ ﻚﻟﻮﻘﻫ:
Declophenac K
ﻱﺯ
Dolphin-K –Oflam-Cataflam-Rapiflam
ﺐﻠﻐﺘﺗ ﻥﺎﺸﻋ ﻰﻠﻋ Gastric Side Effect Of Declo.Na
3/
History of asthma with aspirin intake -
Lactating Women – Hepatic Impair – Acute
Rhinitis .

13. ٧/
ﺏ ﲔﻣﺎﺘﻴﻓ ﻂﻠﺧ١٢ ﻡﻮﻳﺩﻮﺼﻟﺍ ﺕﺎﻨﻴﻓﻮﻠﻜﻳﺩ ﻊﻣ:
ﻝﻮﺒﻣﺃ ﻱﺃ
Hydroxycobalamine
B12 ﲏﻌﻳ ﲔﻣﺎﺘﻴﻓ
ﺕﻻﻮﺒﻣﺃ ﻱﺯ ـﻟﺍ
Neurovit-Neuroton-Neurobion-Tri-B
ﻰﻠﻋ ﻱﻮﺘﳛ ﻝﻮﺒﻣﺃ ﻢﻫﺎﻌﻣ ﻂﻠﲣ ﻉﻮﻨﳑ
Declophenac Na
ﺐﻴﺳﺮﺗ ﺙﻭﺪﺣ ﻦﻣ ﺎﻌﻨﻣ
ﻮﻫ ﺓﺪﻋﺎﻘﻟﺍ ﻦﻣ ﺪﻴﺣﻮﻟﺍ ﻲﻔﻌﳌﺍﻭ ،
Depovit-B12
ﻱﺩﺎﻋ ﲔﻔﻟﻭﻷﺍ ﻝﻮﺒﻣﺃ ﻱﺯ ﻡﻮﻳﺩﻮﺻ ﺕﺎﻨﻴﻓﻮﻠﻜﻳﺩ ﻩﺎﻌﻣ ﻱﺩﺇ.

8/
ﻒﺻﻭﺎﻔﻠﺴﻟﺍ ﻊﻣ ﲔﻣﺎﺴﻜﻴﳍﺍ :
ﺐﻴﻫﺭ ﺄﻄﺧ ﻰﻨﻌﲟ ،:
ﺎﻴﺋﺪﺒﻣ ﱄﻮﺒﻟﺍ ﺯﺎﻬﳉﺍ ـﻠﻟ ﺍﺪﺟ ﺯﺎﺘﳑ ﺮﻬﻄﻣ ﺍﺩﻭ ، ﺕﺍﱰﺳ ﻦﻳﺯﺍﱪﺑ ﺍﺩ ، ؟ ﲔﻣﺎﺴﻜﻴﳍﺍ ﺍﻮﻫ ﻪﻳﺍ - ﻰﻠﻜﻟﺍ
ﺕﺍﻮﺼﳊﺍ ﺕﻻﺎﺣ ﰲ ﺔﻴﻟﻮﺒﻟﺍ ﻚﻟﺎﺴﳌﺍﻭ ﺔﻧﺎﺜﳌﺍﻭ .
ﺾﲪ ﱃﺇ ﻢﺛ ﺪﻴﻫﺪﻟﺃ ﱃﺇ ﺪﺴﻛﺄﺘﻴﺑ ، ﲔﻣﺎﺴﻜﻴﳍﺍ.. ﺔﻴﻀﻣﺎﺣ ، ﺎﻔﻠﺴﻟﺍ ﺔﻌﻴﺒﻃ ﻥﻷ ﺍﺮﻈﻧﻭ .. ﺎﳖﺈﻓ
ﺔﻄﻴﺴﺑ ﺕﺍﻮﺼﺣ ﻥﻮﻜﺗﻭ ﺐﺳﱰﺗ ..

14. ﻥﺫﺇﻝﺍ ﻉﻮﻧ ﲑﻴﻐﺗ ﺐﺟﻮﺘﻳ ﺎﻨﻫ anti-microbial
ـﻟﺍ ﰲ ﻼﺜﻣ ﻚﻴﻠﺧ ، ﺕﺍﻮﺼﺤﻠﻟ ﺐﻳﺬﳌﺍ ﺭﺍﻮﻔﻟﺍ ﲑﻴﻐﺗ ﻭﺃ Mag Citrate
، ﺎﻔﻠﺳ ﺪﺧﺎﻴﻫ ﺾﻳﺮﻣ ﻱﺃ ﺔﺤﻴﺼﻧ ﺐﳚ ،، ﺎﻣﻮﻤﻋﻭ ﺏﺮﺷﻭ ﺕﺍﻭﺮﻀﳋﺍ ﻦﻣ ﺮﺜﻜﻳ ﻪﻧﺇ ﻦﻣ٢ ﻝ٣ ﻩﺎﻴﻣ ﱰﻟ
ﺎﻴﻣﻮﻳ.. ﺐﻴﺳﺮﺗ ﻊﻨﳌ ﺎﻔﻠﺴﻟﺍ ﻞﻴﻬﺴﺗﻭﺇﺎﻬﺟﺍﺮﺧ ..
9/
ـﻟﺍAllopurinol ﺓﺩﺎﳊﺍ ﺱﺮﻘﻨﻟﺍ ﺔﻟﺎﺣ ﰲ:
ﺎﻫﺪﻨﻋ ﺱﺎﻧ ﰲ ..ﺔﺛﺭﺍﻮﺘﻣﻭ ﺔﺘﺑﺎﺛ ﺓﺪﻋﺎﻗ " ﺎﻌﺒﻃ ﻂﻠﻏ ﺓﺪﻋﺎﻗ " ﺱﺮﻘﻧ ﺔﻟﺎﺣ ﻱﺃ ﻚﻟﻮﻘﻳ Gout
ﺎﻬﻳﺩﺃ Allopurinol
ﺍﻮﻫ ﻲﻠﻟﺍ Zyloric 100 or 300
ﺢﻴﺤﺻ ﻡﻼﻛ ﺍﺬﻫ ﻦﻜﻟ ، .. ﺍﺩﻝﺍ ﺔﻟﺎﺣ ﰲ Stable gout patient
ﺲﻴﻟﻭ Acute Gout Case
ﻉﻭﺇ ﻢﺛ ﻉﻭﺇ .. ﻱﺪﺗ Zyloric ﰲ Acute ﺍﺍﺍﺍﺍﺍﺍﺍﺍﺍﺪﺑﺃ
ﺯﺍﺍﺍﺍﺍﺍﺍﺍﺍﺍﺍﺍﺍﻻﺍ ﻦﻣ ﱰﻛﺃ ﺔﻟﺎﳊﺍ ﺩﻭﺰﻴﻫﻡ
ـﻟﺍ ﰲ ﻞﳊﺍﻭ ﺐﻴﻃ Acute ؟؟ ﻪﻳﺇ
COLCHICINE
ﱪﻛﺃ ﻪﻨﻣ ﻱﺪﺗ dose ﺔﻨﻜﳑ .. ـﻟ ﺹﺮﻗ ﻦﻣ3 ﺎﻴﻣﻮﻳ .. ـﻟﺍ ﺹﺍﺮﻗﺃ ﱃﺇ ﺔﻓﺎﺿﻹﺎﺑ
Indomethacin

15. ﻝﺍ ﻚﻟ ﺮﻬﻈﺗ ﺎﻣ ﺔﻳﺎﻐﻟ
Toxic Signs Of Colchicines' Toxicity
ﺔﺌﻴﻫ ﻰﻠﻋ
Emesis and Abdominal Pain
ﺔﻋﺮﺴﺑ ﻒﻗﻮﺗ ﺎﻨﻫ ..
؟؟ ﻪﻳﺇ ﻪﻟ ﻱﺭﺎﺠﺘﻟﺍ ﻢﺳﻻﺍ ﺍﻮﻫ
Colmediten tab.
ﻭﺃ
Colchicine tab.
ﺪﻴﻛﺃﻭﺖﻧﺍ ﻑﺭﺎﻋ ﻰﻠﻜﻟﺍﻭ ﺪﺒﻜﻟﺍ ﻰﺿﺮﻣﻭ ﻞﻣﺍﻮﺤﻠﻟ ﻉﻮﻨﳑ ﲔﺴﻴﺸﻟﻮﻜﻟﺍ.
10/
ﻝﺍQuinolones :
ﻝﺍ ﺾﻌﺑ ﺽﺮﻌﺑ ﻡﻮﻗﺃ ـﺳPoints ﻝﺎﻜﻨﻴﻠﻜﻛ ﻚﻤﲥ ﻲﻠﻟﺍﺪﻨﻋ ﺲﺘﻛﺍﺮﺑ ﻡﺍﺪﺨﺘﺳﺍ ﺰﻧﻮﻟﻮﻨﻴﻜﻟﺍ.. ﺎﻌﻨﻣ
ﺎﻬﻌﻣ ﻞﻣﺎﻌﺘﻟﺍ ﺪﻨﻋ ﺓﺪﻳﺪﻋ ﺀﺎﻄﺧﺃ ﰲ ﻉﻮﻗﻮﻟﺍ ﻦﻣ:
، ﺎﻴﺋﺪﺒﻣﺔﻳﺭﺎﺠﺘﻟﺍ ﺎﻬﺋﺎﲰﺃ ..ﱄﺎﺘﻟﺎﻛ :
Bactiflox-Ciprocin-Ciprofar-Ciprofloxacin-
Rancif-Levanic-Unibiotic-Ofloxin-Peflox

16. ﻚﻤﲥ ﱵﻟﺍ ﺕﺎﻣﻮﻠﻌﳌﺍ:
١/
ﰲ ﻥﺎﻣﻷﺍ ﻦﻣ ﺪﺣ ﻰﻧﺩﺃ ﺪﺟﻮﻳ ﻻﺎﻬﻣﺍﺪﺨﺘﺳﺍ ﻝﺍ ﻦﺳ ﺖﲢ ﻢﻫ ﻦﻣ ﻊﻣ١٨ ﺔﻨﺳ ..
) ﺪﻌﺑﺍ ﺎﻘﻠﻄﻣ ﻢﻬﻨﻋ (
٢/
ﺍﺪﺣﺍﻭ ﻊﻣ ، ﺰﻧﻮﻟﻮﻨﻴﻜﻟﺍ ﻡﺪﺨﺘﺴﺗ ﻉﻭ Subjected ﺕﺎﺠﻨﺸﺗ ـﻟ ..ﺔﻠﻜﺸﻣ ﻩﺪﻨﻋ ﻭﺃ CNS
ﺪﻌﺑﺍ ﻪﻟ ﲏﻏﻭ ﺮﺸﻟﺍ ﻦﻋ ..
٣/
ﺕﺎﻌﺿﺮﻣ ، ﻞﻣﺍﻮﺣ ، ﻰﻠﻛ ، ﺪﺒﻛ ﻰﺿﺮﻣ ..ﺵﺍﺍﺍﺍﻼﺑ
٤/
ﺎﻳﻮﺷ ﺓﺪﻳﺪﺟ ﺔﻣﻮﻠﻌﻣ .. ﲑﺘﻛ ﺲﻤﺸﻠﻟ ﺽﺮﻌﺘﻳ ، ﺰﻧﻮﻟﻮﻨﻴﻛ ﻪﻟ ﻱﺪﺘﻫ ﺪﺣ ﻱﺃ ﺶﻴﻠﺨﺘﻣ .. ﺙﺎﲝﻷﺍ ﻥﻷ
ﻥﺇ ﻝﻮﻘﺘﺑ ، ﺎﻬﻠﻛ ﺓﺪﻳﺪﳉﺍﺍﻮﻔﺸﺘﻛﺍ ﺎﳍ ﺰﻧﻮﻟﻮﻨﻴﻜﻟﺍ ﻥﺇ Photo-Sensitivity ﺔﺒﻴﻫﺭ
٥/
ﺰﻧﻮﻟﻮﻨﻴﻜﻠﻟ ﺔﻴﺳﺎﺴﺣ ﻩﺪﻨﻋ ﻰﻘﺒﻴﻫ ﺪﻛﺆﻣ ﻲﻠﻟﺍ ﺱﺎﻨﻟﺍ ﺮﻬﺷﺃ ﲔﻣ؟؟ ﻩﺎﻌﻣ ﺎﻬﺘﻠﻤﻌﺘﺳﺍ ﻮﻟ
ﺪﺧﺎﻴﺑﻭ ﻉﺮﺻ ﺾﻳﺮﻣNSAIDS ﻰﻘﺒﻴﻫ ﺔﻴﳌﺍ ﻥﻮﻴﻠﻣ Hypersensitive
ﺰﻧﻮﻟﻮﻨﻴﻜﻠﻟ

17. ٦/
ﻝﺍ ﻩﺪﻨﻋ ﺺﺨﺷ ﻱﺃ
Creatinine Clearance
ﻦﻣ ﻞﻗﺃ 29 ﺔﻴﻧﺎﺜﻟﺍ ﰲ ﻲﻠﻣ ..
ﺓﺩﺪﻌﺘﻣ ﺔﻳﻮﻠﻛ ﻞﻛﺎﺸﻣﻭ ﺰﻧﻮﻟﻮﻨﻴﻜﻟﺎﺑ ﻢﻤﺴﺘﻟ ﺽﺮﻌﻣ ..
٧/
ﺰﻧﻮﻟﻮﻨﻴﻜﻟﺍ ﻮﻫ ﺎﻣﻞﻤﳊﺍ ﰲ ﻦﻣﺁ ﻲﻠﻟﺍ ؟
Nalidram 500 tab.
ﺐﻴﻃ ﻞﻤﳊﺍ ﰲ ﻪﻴﻟ ﻪﻣﺪﺨﺘﺴﻫ ﺎﻧﺍﻭ؟؟
ﻮﻟ ، ﻚﻟﻮﻗﺃﺎﻫﺪﻨﻋ ﻩﺪﺣﺍﻭ Urinary tract infection.. ﺔﻋﺭﺰﳌﺍ ﺔﺠﻴﺘﻧ ﻼﺜﻣﻭ
ﺰﻧﻮﻟﻮﻨﻴﻛ ﲑﺧﻷﺍﻭ ﻝﻭﻷﺍ ﻪﺟﻼﻋ ﺏﻭﺮﻜﻴﳌﺍ ﻥﺇ ﺎﻬﻴﻓ ﺏﺮﲡﻭ ﺕﺍﺩﺎﻀﳌﺍ ﻉ ﻒﻠﺗ ﺯﻭﺎﻋ ﺶﻣ ﺖﻧﺍﻭ .. ﻰﻘﺒﻳ
ﻡﺍﺭﺪﻴﻟﺎﻨﻟﺍ ﻻﺇ ﻚﻣﺍﺪﻗ ﺶﻣ .
٨/
ـﻟﺍQuinlones ﲢﻬﻠﻤﻌﻟ ﺝﺎﺘﺎ ﺔﺑﺎﺘﻛ ﺐﳚ ﻻ ﻚﻟﺬﻟ ﺓﺪﻌﳌﺍ ﰲ ﻲﻀﲪ ﻂﺳﻭ ﱃﺇ antacid
ﻬﻌﻣﺎ ﻝﺍ ﻒﺻﻭ ﺐﺠﻴﻓ ﻚﻟﺫ ﱃﺇ ﺎﻧﺭﺮﻄﺿﺍ ﺍﺫﺇﻭ Quinlones ﻭﺃ ﺔﻋﺎﺴﺑ ﺔﺿﻮﻤﳊﺍ ﺩﺎﻀﻣ ﻞﺒﻗ
ﻞﻗﻷﺍ ﻰﻠﻋ ﺕﺎﻋﺎﺳ ﻊﺑﺭﺄﺑ ﻩﺪﻌﺑ ﻭﺃ ﲔﺘﻋﺎﺳ.
ﺖﻬﺘﻧﺍ ـﻟﺍQuinolones

18. 11/
" ﻱﻮﻴﳊﺍ ﺩﺎﻀﳌﺍ ..ﻞﻛﻷﺍ ﻊﻣ ﻪﻠﻋﺎﻔﺗﻭ " :
ﻞﻜﺑﺭﺎﺼﺘﺧﺍ ..ﻝﻮﻘﺗ ﺔﻣﺎﻋ ﺓﺪﻋﺎﻗ ﻙﺎﻨﻫ " ﺪﻌﺑ ﻭﺃ ﺔﻋﺎﺴﺑ ﻞﻛﻷﺍ ﻞﺒﻗ ﺬﺧﺆﺗ ﺔﻳﻮﻴﳊﺍ ﺕﺍﺩﺎﻀﳌﺍ ﻊﻴﲨ
ﻩﺮﻛﺫﺄﺳ ، ﺪﻴﺣﻭ ﺀﺎﻨﺜﺘﺳﺍ ﻙﺎﻨﻫﻭ ، ﲔﺘﻋﺎﺴﺑ ﻞﻛﻷﺍ " .. .
ﺎﻴﺼﺨﺷ ﻞﻀﻓﺃ ﺎﻧﺃﻭ .. ﻞﻛﻷﺍ ﺪﻌﺑ ﻦﻜﻳ .. ﺓﺪﻌﳌﺍ ﺀﺎﺸﻏ ﻞﻛﺎﺸﻣﻭ ﻉﺎﲡﺭﻻﺍﻭ ﺔﺿﻮﻤﺤﻠﻟ ﺎﺒﻨﲡ ..
ﲔﺘﻋﺎﺴﺑ ﻩﺪﻌﺑ ﻭﺃ ﺔﻋﺎﺴﺑ ﻞﻛﻷﺍ ﻞﺒﻗ ﺬﺧﺆﺗ ﱵﻟﺍ ﺕﺍﺩﺎﻀﳌﺍ ﺮﻬﺷﺃ ﻦﻣ - ﻦﻣ ﺭﺪﻗ ﱪﻛﺃ ﻖﻴﻘﺤﺘﻟﺹﺎﺼﺘﻣﻻﺍ
ﺔﻤﻌﻃﻷﺍ ﺕﺎﻧﻮﻜﻣ ﻊﻣ ﺩﺎﻀﳌﺍ ﺕﻼﺧﺍﺪﺗ ﻦﻣ ﺭﺪﻗ ﱪﻛﺃ ﺐﻨﲡﻭ - ـﻟﺍ ﺔﻋﻮﻤﳎ Quinolones ﻞﺜﻣ
ـﻟﺍCiprofloxacin ،
ـﻟﺍ ﺔﻋﻮﻤﳎ ﺎﻀﻳﺃﻭMacrolides ـﻟﺍ ﻞﺜﻣAzithromycin ـﻟﺍﻭ
Erythromycin ـﻟﺍ ﺔﻋﻮﻤﳎﻭPenicillin ـﻟﺍﻭ Rifampicin
ﺎﻀﻳﺃ.
ـﻟﺍ ﺹﻮﺼﲞﻭQuinolones ـﻟﺍﻭ Macrolides ﻡﺎﻌﻄﻟﺍ ﻊﻣ ﺕﻼﺧﺍﺪﺘﻟﺍﻭ:
ﺎﳍ ﻥﺃ ﺔﻣﺎﻫ ﺔﻣﻮﻠﻌﻣ ﻙﺎﻨﻬﻓInteraction ﺪﻳﺪﳊﺍﻭ ﻡﻮﻴﺴﻟﺎﻜﻟﺍ ﻊﻣ،
ﻚﻴﻗﻼﺗﺐﺗﺎﻛ ﺐﻴﺒﻃ Ciprofloxacin ﻡﺎﻈﻌﻟﺍ ﺔﺷﺎﺸﳍ ﻼﺜﻣ ﺝﻼﻋ ، ﺔﺘﺷﻭﺮﻟﺍ ﺲﻔﻧ ـﻓﻭ ،
ﻪﻴﻓCa ﻪﻴﻓ ﺎﻴﻤﻴﻧﻸﻟ ﺝﻼﻋ ﻭﺃ ،Fe ﺐﺗﺎﻛ ﻭﺃ ،Vitamins ﺎﻬﻴﻓﲔﻨﺛﻻﺍ ..
ﻞﺼﳛﻭInteraction ﺩﻮﺼﻘﻣ ﲑﻏ..

19. ، ﻚﻟﺬﻟﻭ ﻚﻀﻳﺮﻣ ﺭﺬﲢ ﺎﻣﺰﻟ:
ﺎﻬﻴﻓ ﺔﺟﺎﺣ ﻱﺃ ﻻﻭ ﱭﻟ ﻻﻭ ﻢﻳﺮﻛ ﺲﻳﺁ ﻻﻭ ﻱﺩﺎﺑﺯ ﻻﻭ ﻪﻨﺒﺟ ﻻCa ﺔﺟﺎﺣ ﻱﺃ ﻻﻭ ﺩﺎﻀﳌﺍ ﺔﻋﺮﺟ ﻞﺒﻗ
ﺎﻬﻴﻓFe ﻭﺩﺮﺑ ..
ﻞﻛﻷﺍ ﺖﻗﻮﺑ ﺮﺛﺄﺘﺗ ﻻ ﱵﻟﺍ ﺕﺍﺩﺎﻀﳌﺍ ﺾﻌﺑ ،، ﻙﺎﻨﻫ ﺍﲑﺧﺃﻭ .. ﺔﻋﻮﻤﳎ ﻦﻣ ﻝﻭﻷﺍ ﻞﻴﳉﺍ ﻢﻫﻭ
ﺕﺎﻧﺭﻮﺒﺳﻮﻟﺎﻔﻴﺴﻟﺍ .. ـﻟﺍ ﻞﺜﻣCephalexine
12/
ـﻟﺍDigoxin ﺱﻮﺴﻗﺮﻌﻟﺍﻭ " ـﻟﺍ ﺓﺩﺎﻣLicorice : "
ﺔﻄﻴﺴﺑ ﻢﻤﺴﺗ ﺕﻻﺎﺣ ﺓﺪﻋ ﻞﻴﺠﺴﺗ ﰎ " mild toxicity "
ـﻟﺍ ﺎﲠ ﺕﺍﺭﺎﻘﻋ ﻥﻮﻟﻭﺎﻨﺘﻳ ﻦﻳﺬﻟﺍ ﺐﻠﻘﻟﺍ ﻰﺿﺮﳌDigoxin ﻥﺎﻀﻣﺭ ﺮﻬﺷ ﰲ !!
ﺔﻟﻮﻬﳎ ﺔﻴﻀﻘﻟﺍ ﺖﻠﻇﻭ .. ﺍﺪﻳﺪﲢ ﻥﺎﻀﻣﺭ ﰲ ﺎﳌ؟!
ﺕﻻﺎﳊﺍ ﻩﺬﳍ ﻲﻣﻮﻴﻟﺍ ﻁﺎﺸﻨﻟﺍ ﺔﻌﺑﺎﺘﻣ ﺪﻌﺑﻭ ..ﺏﺍﺮﺷ ﻥﻮﻟﻭﺎﻨﺘﻳ ﻢﻬﻌﻴﲨ ﻥﺃ ﺪﺟﻭ " ﺱﻮﺴﻗﺮﻌﻟﺍ" ﻰﻠﻋ
ﺭﺎﻄﻓﻹﺍ .. ﺍﺮﺳﺈﺑﻭ ﻑ!!
ﻭﺚﺣﺎﺒﻟﺍ ﺐﻴﺒﻄﻟﺍ .. ـﻟﺍ ﺓﺩﺎﻣ ﻮﻫ ، ﺱﻮﺴﻗﺮﻌﻟﺍ ﻥﺃ ﻢﻠﻌﻳ Licorice ، ﻥﺃﻭ ﻞﻟ ﻪﺑﺎﺸﻣ ﲑﺛﺄﺗ ﺎﳍ
Aldosterone ﺎﻀﻳﺃ ﻰﻠﻋﺃ ﺔﺟﺭﺪﺑﻭ ..ﺙﻭﺪﺣ ﰲ ﺐﺒﺴﺘﺗﻭ Hypokalemia
ﻭﻚﻟﺬﺑ ﺍﺩﻮﻘﻔﻣ ﻡﻮﻴﺳﺎﺗﻮﺒﻟﺍ ﺢﺒﺻﺃ ، ..، ﻚﻟﺫ ﻰﻠﻋ ﺐﺗﱰﻳﻭ
ﻉﺎﻔﺗﺭﺍ ﻦﺴﻛﻮﳚﺪﻟﺍ ﺔﻴﻟﺎﻌﻓﻭ ﺰﻴﻛﺮﺗ .. ـﻠﻟ ﻪﺑﺭﺎﻘﻣ ﺔﻟﺎﳊ ﺾﻳﺮﳌﺍ ﺾﻳﺮﻌﺗﻭToxicity

20. 13/
Hypotensives In Pregnancy :
ﺣ ﻩﺪﺣﺍﻭﻚﻟﻮﻘﺘﺑﻭ ﻙﻼﻳﺎﺟ ﻞﻣﺎ ﻂﻐﻀﻟﺍ ﺎﻬﻠﺴﻳﺎﻗ ﺖﻤﻘﻓ ﻪﳜﺍﺩ ﻰﻧﺍ ﻪﺳﺎﺣ ﺎﻧﺍ ﺭﻮﺘﻛﺩ ﺎﻳ - ﻉﻭﺍﻭ ﻰﻫﻭ ﻪﺴﻴﻘﺗ
ﺓﺪﻗﺍﺭ ﻝﺍ ﻥﺎﺸﻋ supine hypotensive syndrome -
ﻪﺘﺴﻘﻓﻊﻠﻄﻓ ﺾﻔﺨﻨﻣ ﺍﺩﻭ ﺎﻌﺒﻃﺣﳌﺍ ﻥﺎﺸﻋ ﻪﻌﻗﻮﺘﻣ ﻪﺟﺎ ﺕﺎﺘﺒﺜﻲﻠﻟﺍ ﻞﻣﺍﻮﳊﺍ ﺎﻫﻭﺪﺧﺎﻴﺑ ،
ﺎﳍﺪﺗ ﻉﻭﺍ ﻢﺛ ﻉﻭﺍﻱﺃ ﻪﻳﻭﺩﺃ ﻯﺯ ﻂﻐﻀﻟﺍ ﻊﻓﱰﺑ effortil ﻭﺍ ﻂﻘﻧ cortilon ﺹﺍﺮﻗﺃ ،
ﻱﺃ ﻭﺃ ﺩ ﺕﺎﺟﺎﳊﺍ ﻦﻣ ﻪﺟﺎﺣﻱ ﻮﻟ ﻰﺘﺣﺔﻋﺮﲜ ﺔﻄﻴﺴﺑ ﻑ ﺎﺻﻮﺼﺧﻭﻝﻭﺃ ﺭﻮﻬﺷ ﺖﻠﺗ ﻥﻷ ﺔﻳﻭﺩﻷﺍ ﻯﺩ
ﻤﻌﺘﺑﻞ maternal hypoperfusin ﳑﻭﻜ ﻯﺩﺆﺗ ﻦﱃﺇ abortion ﺔﻟﺎﺤﻠﻟ ،
ﺏﺮﺸﺗ ﺎﳍﻮﻗ ﻥﺎﺠﻨﻓ ﺓﻮﻬﻗ ﺎﻴﻣﻮﻳ ﻒﻴﻀﺗ ﻭﺃﻞﻴﻠﻗ ﳌﺍ ﻦﻣ ﺎﻬﻣﺎﻌﻄﻟ ﺢﻠ ﻞﻤﻌﺘﺴﻧ ﺓﲑﺧﻷﺍ ﻞﻤﳊﺍ ﺮﻬﺷﺃ ﰲ ﻦﻜﳑﻭ ،
ﻮﻟ ﻞﻴﺗﺭﻮﻔﻳﻹﺍﺎﺘﳏ ﻱﻭﺃ ﻪﺟ.
14/
Lipid Regulating agent , Cholestyramine :
ﲑﺘﻛ ﺀﺎﺒﻃﺃ ..، ﲔﻣﺍﺮﻳﺎﺘﺴﻴﻟﻮﻜﻟﺍ ﻞﻤﻌﺘﺴﺗ ﻥﻮﻫﺪﻟﺍ ﺔﺒﺴﻧ ﻂﺒﻈﺘﻫ ﻮﻟ ﺐﲢ
ﰲ ﺩﻮﺟﻮﻣ ﺍﻮﻫ ﻲﻠﻟﺍ ﺔﺌﻴﻫ ﻰﻠﻋ ﻕﻮﺴﻟﺍ :
Questran sachets
or
Cholestran packets

21. ﱃﻭﻷﺍ ﺔﻠﻜﺸﳌﺍ :
ﺔﻴﺒﻠﻗ ﺕﺎﻣﺯﺃ ﻭﺃ ﲔﻳﺍﺮﺷ ﺐﻠﺼﺗ ﻭﺃ ﺐﻠﻗ ﻰﺿﺮﻣ ﺍﻮﻘﺒﻴﺑ ، ﻥﻮﻫﺪﻟﺍ ﻉﻮﺿﻮﻣ ﻢﳍ ﻂﺒﻈﻨﺑ ﻲﻠﻟﺍ ﺱﺎﻨﻟﺍ ﻢﻈﻌﻣ ﻥﺇ
ﻚﻟﺫ ﱃﺇ ﺎﻣ ﻭﺃ ..
ﺍﺪﺟ ﺔﻤﻬﻣ ﺔﺟﺎﺣ ﻰﺴﻨﻨﺒﻓ
ـﻟﺎﺑ ﺍﻮﳉﺎﻌﺘﻴﺑ ﺍﻮﻧﻮﻜﻴﺑDigoxin
ﺔﻴﻟﺎﻌﻓ ﻦﻣ ﻞﻠﻘﻳ ﲔﻣﺍﺮﻳﺎﺘﺴﻴﻟﻮﻜﻟﺍ ﻥﺇ ، ﻝﻮﻘﺘﺑ ﺓﲑﻄﺧ ﺓﺪﻋﺎﻗ ﰲﻭ ﺴﻛﻮﳚﺪﻟﺍﻭ ، ﻦ ﻦﻣﻪﺻﺎﺼﺘﻣﺍ ..
ﻦﻣ ﺭﺎﻴﺧ ﻚﻣﺍﺪﻗ ﻚﺗﺩﺎﻌﺳ ﻥﺫﺇﲔﻨﺗﺍ ﺎﻨﻫ ، :
ﺍﺩ ﻊﻣ ﺍﺩ ﺶﺒﺘﻜﺗ ﺎﻣ ﺎﻳ ..
ﻚﻋﺎﺘﺑ ﺾﻳﺮﻤﻠﻟ ﻝﻮﻘﺗ ﺎﻣﺇ ﺎﻳ ..ﺍﺩﻭ ﺍﺩ ﲔﺑ ﲔﺘﻋﺎﺳ ﻞﺼﻔﻳ ..
ﺎﻨﺘﻠﻜﺸﻣﺔﻴﻧﺎﺜﻟﺍ ﲔﻣﺮﻳﺎﺘﺴﻴﻟﻮﻜﻟﺍ ﻊﻣ :
ﻪﻟ ﻥﺇ
Mild blood thinning effect
ﻥﻮﻫﺪﻟﺍ ﻢﳍ ﻂﺒﻈﻨﺑ ﻲﻠﻟﺍ ﻢﻈﻌﻣ ﻭﺩﺮﺑﻭ .. ﺍﻭﺪﺧﺎﻴﺑ ﺍﻮﻧﻮﻜﻴﺑWarfarin or heparin
ﻦﻳﺭﺎﺒﻴﳍﺍﻭ ﻦﻳﺭﺎﻓﺭﺍﻮﻟﺍ ﻥﺇ ﻑﻭﺮﻌﻣ ﺎﻌﺒﻃﻭ
Powerful Blood Thinners
ﺍﺪﻛ ﻲﻬﻳﺪﺑ ﻰﻘﺒﻳ ..ﺶﻌﻔﻨﻴﻣ ﺔﺟﺎﺣ ﻪﻟ ﻱﺩﺍﻭ ﻉﻮﺿﻮﳌﺍ ﺩﻭﺯﺍ - ﲔﻣﺮﻳﺎﺘﺴﻴﻟﻮﻜﻟﺍ - ﻪﻟ ﻞﻤﻌﺗ
Thinning ﻥﺎﻤﻛ !!
ﺘﺴﻴﻟﻮﻜﻟﺍ ﻒﺻﻮﻳ ﻻﺃ ﻞﻀﻔﻳ ﻥﺫﺇ ﻦﻳﺭﺎﻓﺭﺍﻮﻟﺍﻭ ﻦﻳﺭﺎﺒﻴﳍﺍ ﻊﻣ ﲔﻣﺮﻳﺎ.

22. 15/
Sine up & no flu & congestal " Under 1 Y "
ﺽﻭﺮﻔﳌﺍ ﻯﺩ ﺔﻋﻮﻤﺍ ﺖﻴﻘﺑﻭﺎﳖﺃ ﺺﻧﻭ ﺔﻨﺳ ﻞﺒﻗ ﺔﻋﻮﻨﳑ ﻰﻠﻋﻞﻗﻷﺍ ﺎﳖﻷ ﻰﻠﻋ ﻯﻮﺘﲢ
chlorphenramine maleate
ﻭﺭﺎﺼﺘﺧﺎﺑ ، ﻉﻮﻨﳑ ،ﻝﺎﻤﻌﺘﺳﺍ ـﻟﺍ ﰲ ﺔﻔﻠﺘﺨﳌﺍ ﺎﻬﻐﻴﺼﺑ ﲔﻣﺎﺘﺴﻴﳍﺍ ﺕﺍﺩﺎﻀﻣ Neonates ـﻟﺍﻭ
premature
ﻭ ﻮﻟﺎﻬﺘﻣﺪﺨﺘﺳﺍ ﲏﻌﻳ ﻪﻳﺇ ﻞﺼﺤﻴﻫ ،؟
Severe CNS Excitation and high risk of Seizures
16/
ﻡﺍﺪﺨﺘﺳﺍ ﺪﺒﻜﻟﺍ ﻰﺿﺮﻣ ﻊﻣ ﺔﻴﺳﺎﺴﳊﺍ ﺕﺍﺩﺎﻀﻣ:
ﺇ ﺪﻘﻌﻣ ﻉﻮﺿﻮﻣ ﻮﻫﻴﻓ ﻊﻃﺎﻗ ﻱﺃﺭ ﺪﺟﻮﻳ ﻻﻭ ، ﺎﻣ ﺪﺣ ﱃ ﻪ ..
ـﻟﺍ ، ﻝﺎﺜﳌﺍ ﻞﻴﺒﺳ ﻰﻠﻋ ﺎﻨﺑﺮﺿ ﻮﻟSystemic Corticosteroids
ﻙﺎﻨﻫﺀﺎﺒﻃﺃ ـﻟﺍ ﻥﻮﻠﻤﻌﺘﺴﻳ Short-acting ـﻟﺍ ﻱﺯ ، ﺎﻬﻨﻣpredinsone or
predinsolone
ﻯﻮﺳ ، ﻚﻟﺫ ﰲ ﺭﺮﺿ ﻥﻭﺪﳚ ﻻﻭﻉﺎﻔﺗﺭﺍ ﺕﺎﳝﺰﻧﻹﺍ ﰲ ﺖﻗﺆﻣ ..

23. ﺔﻔﻠﺘﺨﳌﺍ ﲔﻣﺎﺘﺴﻴﳍﺍ ﺕﺍﺩﺎﻀﻣ ﺹﻮﺼﲞ ﺎﻣﺃ:
ﻲﻗﻼﺘﻫﻠﻗﺃﻢﻬ ﻮﻫ ﺪﺒﻜﻟﺍ ﻉ ﲑﺛﺄﺗ Acrivastine ﺩﻮﺟﻮﻣ ﻲﻠﻟﺍﻟﺍ ﰲﺕﺎﻴﻟﺪﻴﺼ
Semprex capsules
ـﻟﺍ ﺎﻣﺃ Astemizole ـﻟﺍﻭ Loratidine ﲑﺛﺄﺗ ﻥﻮﻜﻠﺘﳝ ،ﺀﻲﺳ ﺪﺒﻜﻟﺍ ﻰﻠﻋ ..
ﺎﺗﺎﺑ ﺎﻌﻨﻣ ﲔﻋﻮﻨﳑﻭ ..
17/
ﻝﺎﻤﻌﺘﺳﺍ ﺭﺍﻮﻓUrosolvin ﻞﻣﺎﳊﺍ ﻊﻣ :
ﻉﻭﻭﻭﻭﻮﻨﳑ
؟؟ ﻪﻴﻟ
has Teratogenic effect on fetus
18/
، ﺀﺎﻄﺧﻷﺍ ﺮﻬﺷﺃ ﻦﻣ ﻂﻠﺧ ﺔﻟﻮﺒﻣﺃﻟﺍ ﻥﺎﺑﻮﻜﺴﺒﻊﻣ ﺔﻟﻮﺒﻣﺃﻟﺍﻦﻳﺭﺎﺘﻟﻮﻔ :
ﻪﻧﺎﻜﻣ ﻦﻣ ﻙﺮﺤﺘﻴﻫ ﺶﻣﻭ ، ﺔﻟﻮﺒﻣﻷﺍ ﺎﻬﻴﻓ ﻥﻮﻘﶈﺍ ، ﺔﻠﻀﻌﻟﺍ ﺎﻳﻼﺧ ﰲ ﺐﺳﱰﻴﻫ ، ﻪﻧﻷ ..
ﻭ ﻼﺻﺃ ﺍﺪﻛ ﻞﻤﻌﺗ ﻪﻴﻟ ﺖﻧﺍ !!
ﻋ ﺎﳌﻙﺪﻨ ﻝﺍ ﻝﻮﺒﻣﺃSpasmofen
ﻪﻴﻓ ﲔﺳﻮﻴﻫ + ﲔﻓﻭﺮﺑﻮﺘﻴﻛ ، ﻡﻮﻘﻳ ﺏﻮﻠﻄﳌﺎﺑ .

24. 19/
ﺔﻟﻭﺎﶈ ﺔﺼﺧﺭ ﻚﻌﻣ ﺖﻧﺃ ، ﺎﻤﻬﻴﻓ ، ﲔﺘﻟﺎﺣﻡﺍﺪﺨﺘﺳﺍ ـﻟﺍCiprofloxacin ـﻟﺍ ﺖﲢ ﻢﻫ ﻦﻣ ﻊﻣ
١٨ ﻡﺎﻋ:
ﻻ ﻥﺃ ﺎﻳﱰﻜﺒﻟﺍ ﺔﻋﺭﺰﻣ ﺔﺠﻴﺘﻧ ﺕﺮﻬﻇﺃ ﻭﺃ ﺔﻳﻮﻴﳊﺍ ﺕﺍﺩﺎﻀﳌﺍ ﻦﻣ ﻱﻷ ﺐﻴﺠﺘﺴﺗ ﻻ ، ﻞﻔﻄﻟﺍ ﻯﻭﺪﻋ ﻦﻜﺗ ﻥﺃ
ﻦﻳﺎﺴﻛﻮﻠﻓﻭﱪﻴﺴﻟﺍ ﻻﺇ ﻪﻟ ﺝﻼﻋ.. ﺭﺩﺎﻧ ﺍﺬﻫﻭ ﺙﺪﳛ ﺎﻣ ﺍ
ـﻟﺍ ﻯﻭﺪﻋ ، ﺔﻴﻧﺎﺜﻟﺍ ﺔﻟﺎﳊﺍﻭ Anthrax
ﺎﻨﻫ ..ﺍﺖﻧ ﳏ ﺔﺼﺧﺭ ﻙﺎﻌﻣ ﺔﻟﻭﺎ ..ﻣ ﺖﻧﺍﻭ ﻝﻭﺎﺤﺘﺑ ، ﻦﻜﻟ ﻊﻗﻮﺘﺙﻭﺪﺣ ﺔﻠﻜﺸﻣ،
ﻑﺭﺎﻋﻪﻳﺇ ؟؟ ﺔﻠﻜﺸﳌﺍ
Joint Damage and ,
Severe musculo-skeletal disorders
ﰲ ﰲ ﺍﻮﻠﺧﺩ ، ﲔﺳﺎﺴﻛﻮﻠﻓﻭﱪﻴﺴﻟﺍ ، ﺍﺩ ﻦﺴﻟﺍ ﺖﲢ ﻝﺎﻔﻃﺃ ﻱﺪﺗ ﺖﻟﻭﺎﺣ ﺱﺎﻧ
Arthritis ﻭArthralgia
ﻥﻵﺍ ﺕﻻﻭﺎﶈﺍﻭ ﺙﺎﲝﻷﺍ ﺖﻧﺎﻛ ﺎﻤﻬﻣﻭ .. ﺔﺼﺧﺭ ﺩﺎﳚﺇ ﰲﻪﻟﺎﻤﻌﺘﺳﻻ ﻦﺴﻟﺍ ﺍﺬﻫ ﰲ " ﻝﺍ ﺖﲢ١٨
ﻪﻧﺃ ﻻﺇ ﻦﺴﻟﺍ ﺍﺬﻫ ﺖﲢ ﲔﺳﺎﺴﻛﻮﻠﻓﻭﱪﻴﺴﻟﺍ ﻡﺪﺨﺘﺴﻧ ﻦﻟ.

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" ﺪﺒﻜﻟﺍ ﺾﻳﺮﻣﻭ ﺔﻳﻮﻴﳊﺍ ﺕﺍﺩﺎﻀﳌﺍ: "
ﻚﻨﻴﻟﻮﻴﻓﻼﻜﻟﺍﻭ ﲔﻠﺴﺴﻛﻮﻣﻷﺍ ﻮﻫ ﺪﺒﻜﻟﺍ ﺾﻳﺮﳌ ﺕﺍﺩﺎﻀﳌﺍ ﻞﻀﻓﺃ ﻥﺃ ﻡﻮﻠﻌﳌﺍ ﻦﻣ ﻢﻬﻨﻣ ﲔﺸﻨﻴﺒﻣﻮﻜﻟﺍ ﻭﺃ:
ﻱﺎﳍﺍ ﲔﺘﻨﲨﻭﻷﺍ ﻭﺃ ﻚﺗﻮﻴﺑ ﻦﻜﻟ ، ﺔﻳﻮﻴﳊﺍ ﺕﺍﺩﺎﻀﳌﺍ ﻲﻫ ﺎﻣ؟؟ ﺪﺒﻜﻟﺍ ﺾﻳﺮﻣ ﻰﻠﻋ ﺔﻋﻮﻨﻤﳌﺍ
" ﻝﺍﻮﺣﻷﺍ ﻦﻣ ﻝﺎﺣ ﻱﺃ ﰲ ﺯﻮﳚ ﻻﻭﺎﻬﻣﺍﺪﺨﺘﺳﺍ " ؟؟
ﺎﻔﻠﺴﻟﺍ ﺕﺎﺒﻛﺮﻣ– ﻥﺎﺘﻛﺎﳝﺮﻟﺍ - ﲔﺴﻳﺎﻣﻭﺮﺛﺭﻹﺍ– ﻝﻮﻜﻴﻨﻔﻴﻣﺍﺭﻮﻠﻟﺍ– ﲔﻠﻜﻴﺳﺍﱰﺘﻟﺍ .
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Dospa Ampoule
ﻩﺪﻨﻋ ﻞﻔﻃ ﻚﻟﺎﺟ ﻮﻟ١٠ ﻭﺃ ﻯﻮﻠﻛ ﺺﻐﻣ ﻭﺃ ﻯﺩﺎﻋ ﺺﻐﻣ ﻩﺪﻨﻋ ﻭ ﻞﻗﺃ ﻭﺃ ﺕﺍﻮﻨﺳﻱﻷ ﻚﻧﺍ ﺖﺠﺘﺣﺍ ﺐﺒﺳ
ﻪﻠﻳﺪﺗ buscopan amp ﻚﻠﻀﻓﺃ ﺎﳖﺎﻜﻣ ﻡﺪﺨﺘﺴﺗ ﻚﻧﺍ dospa amp ﻥﻷ
ﻝﺍbuscopan ﻷﺍ ﺕﺎﻘﺘﺸﻣ ﻦﻣﲔﺑﻭﺮﺗ ﺡ ﻭ ﺩﻭﺰﻳﻭ ﺍﺪﺟ ﻪﺒﻠﻗ ﺕﺎﺑﺮﺿﺎﻀﻳﺃ ﰲ ﻻ ﺭﺎﺒﻜﻟﺍ ﻰﻄﻌﺗﺓﺮﺑﺇ
ﻥﺎﺑﻮﻜﺳﻮﺒﻟﺍﻱﺪﻳﺭﻭ ﻰﻄﻌﺗ ﻥﺃ ﻞﻀﻔﻳ ﺓﺮﺷﺎﺒﻣﰲ ﻞﻀﻋ ﻭﺃ ﻝﻮﳏ .
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ﻡﺍﺪﺨﺘﺳﺍ ـﻟﺍ Acyclovir ﻞﻣﺍﻮﳊﺍ ﻊﻣ ﻝﺍ ﺕﻻﺎﺣ ﰲ ﺔﺻﺎﺧChicken pox :
ﺢﻴﺒﺗ ﱵﻟﺍ ، ﺕﺎﺳﺍﺭﺪﻟﺍﻭ ﺙﺎﲝﻷﺍ ﻦﻣ ﰲﺎﻜﻟﺍ ﻢﻜﻟﺍ ﺮﻓﻮﺘﻳ ﱂﻡﺍﺪﺨﺘﺳﺍ ـﻟﺍ Acyclovir ﻞﻣﺍﻮﳊﺍ ﻊﻣ
ﺔﻘﻠْﻄﻣ ﺔﺣﺎﺑﺇ ، ..

26. ﰎ ، ﻲﺗﺍﻮﻠﻟﺍ ،، ﻚﻟﺫ ﻢﻏﺭﻭﻡﺍﺪﺨﺘﺳﺍ ـﻟﺍ Acyclovir ﻦﻬﻌﻣ ..ﺕﻼﻜﺸﻣ ﻱﻷ ﻦﺿﺮﻌﺘﻳ ﱂ ..
، ﺎﻣﻮﻤﻋ ـﻠﻟ ﺔﻄﻴﺴﺒﻟﺍ ﺽﺍﺮﻋﻷﺍ ﻦﻣ ﻲﻧﺎﻌﺗ ﺓﺃﺮﳌﺍ ﺖﻧﺎﻛ ﺍﺫﺇChicken pox ،
ـﻟﺍ ﺎﻬﻌﻣ ﻡﺪﺨﺘﺴﺗ
Oral Acyclovir " Zovirax "
ﻮﻟ ﻦﻜﻟ ﺔﻟﺎﳊﺍComplicated ـﺑ Pneumonia
ـﻟﺍ ﺎﻬﻌﻣ ﻡﺪﺨﺘﺴﺗ
I.V Acyclovir and Hospitalization
ـﻟﺍ ﰿﺎﻌﺗﻭPneumonia ﺍﺍﺍﺍﺍﺍﺍﺪﻴﺟ ﰲ ﺐﺒﺴﺘﺗ ﺪﻗ ﺎﳖﻷ
Maternal death
ﺔﺒﺳﺎﻨﳌﺎﺑ .. ـﻟﺍ ﻦﻣ ﻞﻣﺎﳊﺍ ﺓﺃﺮﳌﺍ ﻪﻟ ﺽﺮﻌﺘﺗ ﻥﺃ ﻦﻜﳝ ﺎﻣ ﻰﺼﻗﺃ Acyclovir ـﻟﺍ ﻲﻫ
Seizures
ﲔﻨﳉﺍ ﻰﻠﻋ ﺭﺮﻀﻟﺍﻭ.. ﻨﻣ ﺕﻻﺎﺣ ﻞﺠﺴﻳ ﱂﻭ ﻅﻮﺤﻠﻣ ﲑﻏ ﻪ..
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ﻞﻴﺗﻮﻣﻮﻠﻟﺍﻭ ﻡﻮﻳﺩﻮﳝﻹﺍ ﻮﻫ ﻪﻨﻣ ﻑﺎﺨﺘﻳ ﻲﻠﻟﺍ ﺎﳕﺇﻭ ﺀﺎﻌﻣﻷﺍ ﺔﻛﺮﺣ ﻰﻠﻋ ﻲﻄﻴﺒﺜﺗ ﲑﺛﺄﺗ ﻪﻟ ﺲﻴﻟ ﻝﺎﻨﻴﺘﻧﻷﺍ:
ـﻟﺍ antinalﺍﺩ Nifuroxazide
ﻮﻫﻭﺪﻤﺘﻌﻳ ﻻ ﻰﻠﻋ ﻪﻠﻤﻋ ﰲ Inhibitng ـﻟﺍ Peristalis
ـﻟﺍ ﺎﺌﺑ ﻑﻼﺧ ﻰﻠﻋLoperamide
ﻟﺍ ﰲ ﺍﻮﻫ ﻲﻠﻟﺍﺕﺎﻴﻟﺪﻴﺼ Lomotil ﻭﺃimmodium

27. ﺍ ﺎﺌﺑ ﺍﺩﻴﺑ ﻲﻠﻟﺱﺎﺳﺃ ﻰﻠﻋ ﻞﻐﺘﺸ ﺀﺎﻌﻣﻷﺍ ﺔﻛﺮﺣ ﻂﻴﺒﺜﺗ ..
ﰲ ﻥﺎﻴﻌﻟﺍ ﻞﺧﺪﺗ ﻦﻜﳑ ﻲﻠﻟﺍ ﺔﻴﻟﺎﻌﻟﺍ ﻪﺘﻋﺮﺟ ﻦﻣ ﻑﺎﺨﺘﻳ ﻲﻠﻟﺍ ﺍﺩﻭ
GIT Atony ـﻟﺍ ﱃﺇ ﻪﻨﻣﻭ Severe Constipation
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Salbutamol under 2 years :
ﻲﻋﺍﺩ ﻻ، ﺹﻼﺧﻭ ﺪﻠﻘﻣ ﺵﺎﻘﺒﺘﻣﻭ ، ﲔﺘﻨﺴﻟﺍ ﺖﲢ ﻢﻫ ﻦﻣ ﰲ ﻪﻣﺍﺪﺨﺘﺳﻻ
ﻪﻧﻷ
Less Effective
، ﰲﺎﻜﻟﺍ ﺭﺪﻘﻟﺎﺑ ﺖﻧﻮﻜﺗ ﻦﻜﺗ ﱂ ﺎﺘﻴﺒﻟﺍ ﺕﻼﺒﻘﺘﺴﻣ ﻥﻷ
، ﻪﻧﺃ ﻰﻠﻋ ﺓﻭﻼﻋ
ـﻟﺍ ﺮﻓﻮﻳ ﻻ Protection ﺔﻴﻓﺎﻜﻟﺍﺽﺍﺮﻋﻷﺍ ﺭﻮﻄﺗ ﺐﻨﲡ ﰲ ﻞﻔﻄﻟﺍ ﺍﺬﳍ .
25/
ـﻟﺍOrphenadrine ﻞﻤﳊﺍﻭ:
ﺍﺩ ﺎﻌﺒﻃMuscle relaxant ، ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ ﺲﻜﻴﻠﻓﺭﻮﻨﻟﺍﻭ ﻚﺴﻴﺟﺭﻮﻨﻟﺍ ﻱﺯ
ﻝﺍ ﺖﲢ ﻝﺎﻔﻃﻸﻟﻭ ﻞﻣﺍﻮﺤﻠﻟ ﻪﻔﺻﻭ ﻞﻀﻔﻳ ﻻ١٢ ، ﻡﺎﻋ
ﻪﻧﻷﻳ ﻦﻜﳑﺘﺐﺒﺴ ﰲ Fetal worm
ـﻟﺍ ﰲ ﻞﻛﺎﺸﻣﻭ Reproduction

28. ﺍﺪﻛ ﻦﻣ ﻢﻏﺮﻟﺍ ﻰﻠﻋﻭ .. ﰲﺀﺎﺴﻧ ﺓﺪﻋ ﻞﻣﺍﻮﺣ ﻟﻭﺎﻨﺗﻦ ـﻟﺍ ﺹﺍﺮﻗﺃ Norflex ﰲ٣ ﻞﲪ ﺕﺍﺮﻣ
ﳍﻦ ..ﺀﻮﺳ ﻱﻷ ﲔﻨﳉﺍ ﺽﺮﻌﺘﻳ ﱂﻭ ﺔﻴﻌﻴﺒﻃ ﺓﺩﻻﻮﻟﺍ ﺖﻧﺎﻛﻭ ..
ـﻟﺎﺑ ﻲﻧﺪﻴﻘﻳ ﻪﻳﺇ ﺎﻧﺃ ﺐﻴﻃ Orphenadrine ،
ﻞﻤﳊﺍ ﻑ ﻦﻣﺁ ﺕﻼﻀﻋ ﻂﺳﺎﺑ ﻭﺃ ﻦﻜﺴﻣ ﻱﺃ ﺭﺎﺘﺧﺃ ﺎﻣ ..
ﻮﻠﻌﻣ ﺪﺟﻮﺗ ﻻﻭ ﻪﻴﻓﺎﻛ ﺶﻣ ﻪﻴﻠﻋ ﺕﺎﺳﺍﺭﺪﻟﺍ ﻥﻷﺹﻮﺼﲞ ﺔﻌﻃﺎﻗ ﺔﻣ ﻪﻣﺪﻋ ﻦﻣ ﻪﻧﺎﻣﺃ!!
ﻥﺃ ﺖﺋﺮﻗ ﺪﻗﻭ ﻱﺃ ﺀﺎﻄﻋﺇ ﻡﺪﻋ ﺬﺒﲢ ﺙﺎﲝﻷﺍ ﺙﺪﺣﺃﻂﺳﺎﺑ ﻞﻣﺍﻮﺤﻠﻟ ﺕﻼﻀﻋ .. ﺓﺪﻳﺪﻋ ﻞﻛﺎﺸﳌ ﺎﻨﲡ.
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Severe Vomiting In Child :
ﻭ ﺶﻣ ﻭﺃ ﺐﺑﺎﺣ ﺶﻣ ﻭﺃ ﻥﺍﱪﻣﱪﻟﺍ ﻱﺪﺗ ﺯﻭﺎﻋ ﺶﻣ ﺖﻧﺍ ﻪﺘﻋﺮﺟ ﻂﺒﻈﺗ ﻑﺭﺎﻋ ﺐﻳﺎﺟ ﺶﻣ ﻭﺍ ، ﻞﻔﻄﻟ
ﻙﺎﻌﻣ، ﺔﺠﻴﺘﻧ
ﻻﺇ ﻚﻣﺍﺪﻗ ﺶﻣ ﺍﺪﻛ ﺹﻼﺧ
Zantac i.v or i.v.i
ﻪﺘﻋﺮﺟ ﻢﻫﻷﺍﻭ :
Slow intravenous 2 mg /kg over 2 minutes
ﻮﻠﳏ ﻑ ﺯﻭﺎﻋ ﻮﻟ ﺎﻳﻝ
slow i.v.i over 10 minutes on 20ml normal saline
ﺏ ﲔﲡﺭﻮﻜﻟﺍ ﻊﻣ ﻙﺎﺘﻧﺍﺯ ﻱﺪﺗ ﻚﻧﺇ ﻞﻀﻔﻳﻭ٦ ﻭﺩﺮﺑ ﺯﺎﺘﳑ ﻩﺪﺣﻮﻟ ﲔﲡﺭﻮﻜﻟﺍﻭ ،.

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ﺔﻋﺮﺟ ﻝﺍGentamycin ﺎﻣﻮﻤﻋ ﺕﺍﻮﻨﺳ ﺮﺸﻌﻟﺍ ﺖﲢ:
ﻲﻫ ﺪﺣﺍﻮﻟﺍ ﻡﻮﻴﻟﺍ ﰲ ﻚﺘﻋﺮﺟ
3 mg / kg
ﻰﻠﻋ ﻢﺴﻘﺘﺗﻭ 2- 3 ﻡﻮﻴﻟﺍ ﰲ ﺕﺍﺮﻣ
ﻭ ﻦﻜﳑSingle dose
ﰲ ﺎﻬﻄﺣ ﺲﺑ ٥٠ ـﻟ١٠٠ ﺯﻮﻛﻮﻠﺟ ﻭﺃ ﺢﻠﻣ ﻝﻮﻠﳏ ﻲﻠﻣ 5%
ﻭ ﻰﻠﻋ ﻝﻮﻠﶈﺍ ﺖﻗﻭ ﻂﺒﻇ٣٠ ﺔﻘﻴﻗﺩ
" ﲔﺴﻴﻣﺎﺘﻨﺟ ﺕﻻﻮﺒﻣﺃ ﻕﻮﺴﻟﺍ ﰲ ﻙﺪﻨﻋ ﺖﻧﺍ ﻮﻫﺃﻭ٢٠ ﻭ٤٠ ﻥﺎﻤﻛ ﻭ٨٠ .. ﺍ ﻝﺍ ﺐﻠﻃ٢٠ ﻑﻮﺷﻭ
ﻚﺘﻋﺮﺟ ﻪﺟﺎﺘﳏ ﺖﻧﺍ ﻲﻠﻟﺍﻭ ".
ﻞﻀﻋ ﲔﺴﻴﻣﺎﺘﻨﳉﺍ ﻱﺪﺘﻫ ﻮﻟ .. ﺓﺮﻣ ﻞﻛ ﻪﻴﻓ ﻱﺪﺘﻫ ﻲﻠﻟﺍ ﻥﺎﻜﳌﺍ ﲑﻏ
ﺪﻳﺭﻭ ﻱﺪﺘﻫ ﻮﻟ.. ﺍﺪﺟ ﺪﻳﺪﺷ ﺀﻂﺒﺑ ﻰﻘﺒﻳ
ﻝﻮﻠﳏ ﻱﺪﺘﻫ ﻮﻟﻭ .. ﺔﺟﺎﺣ ﻱﺃ ، ﲔﺴﻴﻣﺎﺘﻨﳉﺍ ﻊﻣ ﺶﻄﻠﲣ ﺎﻣﻼﺜﻣ ﺕﺎﻨﻴﻠﺴﻨﺒﻟﺍ ﻱﺯ ﺔﻴﻧﺎﺗ .. ﲔﺴﻴﻣﺎﺘﻨﳉﺍ
ﻝﻮﻠﶈﺍ ﰲ ﻪﻟ ﻚﻳﺮﺷ ﻻ ..
ﻼﻌﻟﺍ ﺓﺪﻣﻭﺝ :
ﻻﺇ ﲔﻣﻮﻳ ﻭﺃ ﻡﻮﻳ ﻪﻴﻠﻋ ﻱﺪﻌﻴﺑ ﺶﻣ ﻢﻈﻌﳌﺍﺎﻣﺇ ﺍﺪﺟ ﻦﺴﺤﺘﻳ .. ﻮﻟ ﺎﻣﺃ Severe infection
ﻦﻜﳑ ﻱﺩ ﺔﻟﺎﳊﺍ ﰲ ﲔﻣﻮﻳ ﻥﺎﻤﻛ ﺔﻋﺮﳉﺍ ﻒﻋﺎﻀﺗ .. ﰲ ﻚﻟ ﺶﲣ ﲏﻌﻳ ٤ - ٥ ﻡﺎﻳﺃ

30. ﻕﻮﻓ ﻲﻠﻟﺍ ﻡﻼﻜﻟﺍ ﻞﻛﻞﻔﻄﻟﺍ ﺍﺬﻫ ﻦﻜﻳ ﻥﺃ ﺔﻄﻳﺮﺷ Not renal impaired
ﻝﺎﻨﻳﺭ ﻝﺎﻣﺭﻮﻧ ﺶﻣ ﺍﻮﻫ ﻮﻟ ﻻﺇﻭ ..ﻡﻮﻳ ﻞﻛ ﻲﻠﻜﻟﺍ ﻒﻳﺎﻇﻭ ﻪﻟ ﻊﺑﺎﺘﺗ ﺮﻄﻀﺘﻫ
ﻝﺍ ﻥﺎﻤﻛ ﻪﻟ ﺐﻗﺍﺮﺗﻭ plasma gentamicin level
ﺔﻋﺮﺟ ﺖﻟﺎﺗ ﻭﺃ ﻲﻧﺎﺗ ﺪﻌﺑ ﺶﻳﺪﻌﻴﻣ ﺽﻭﺮﻔﳌﺍ ﻲﻠﻟﺍ ١٢ ﻞﻜﻟ ﻡﺍﺮﺟﻭﺮﻜﻴﻣ1 ﺎﻣﺯﻼﺑ ﻲﻠﻣ ..
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ـﻟﺍ ﺝﻼﻋ ﺕﺎﻴﺠﻴﺗﺍﱰﺳﺇ ﺹﻮﺼﲞpost-menopausal osteoporosis :
ﺔﻋﻮﻨﺘﻣﻭ ﺓﺩﺪﻌﺘﻣ ﻲﻫ ..
ﻼﺜﻣ ﺱﺎﻧ ﻙﺪﻨﻋ :
ـﻟﺎﺑ ﰿﺎﻌﺗOestrogen Replacement
ـﻟﺎﺑ ﰿﺎﻌﺗ ﺱﺎﻧﻭ Raloxifene ﻟﺍ ﰲ ﻲﻠﻟﺍﺕﺎﻴﻟﺪﻴﺼ Evista
ـﻟﺎﺑ ﰿﺎﻌﺗ ﺱﺎﻧﻭ Calcitonin
ﲔﻣﺎﺘﻴﻓ ﻭ ﻡﻮﻴﺳﺎﻜﻟﺎﺑ ﰿﺎﻌﺗ ﺱﺎﻧﻭD
ﻦﻣ ﺎﻧﺃﻭﻱﺬﺒﳏ ﻲﻠﻀﻔﻣﻭ ـﻟﺍ Alendronate ـﻟﺍ ﺍﻮﻫ ﻲﻠﻟﺍ Fosamax ـﻟﺍﻭﺃ
osteomax ﺔﻟﻮﺴﺒﻛ، ﺔﻋﺎﺴﺑ ﻩﺪﻌﺑ ﻭﺃ ﺔﻋﺎﺴﺑ ﻞﻛﻷﺍ ﻞﺒﻗ
ﺔﻓﺎﺿﻹﺎﺑ ﲔﻣﺎﺘﻴﻓﻭ ﻡﻮﻴﺴﻟﺎﻜﻠﻟD .
ﻒﺻﻮﻟﺍ ﻕﻮﻓ ﺔﻣﱰﳏ ﺲﺑ ﺔﻴﻟﺎﻏ ﺔﺟﺎﺣ ﺍﻮﻫ ..ﻞـﻟ ﺔﻀﻳﺮﳌﺍ ﺽﺮﻌﺗ ﺔﺒﺴﻧ ﻦﻣ ﻞﻠﻘﺘﺑﻭ
Fractures ـﻟﺍﻭother comp.

31. ـﻟﺍ ﺹﻮﺼﲞ ﺎﻣﺃ pain management ﻦﻣ ﲔﻧﺎﻌﻳ ﻲﺗﺍﻮﻠﻟﺍ ﰲPost-M.O.
ﺮﺜﻛﺃ ﺲﻴﻟ ﺕﺎﻨﻜﺴﻣ ﺝﻼﻌﻟﺍ ،
ـﻟﺎﺑ ﺔﻳﺍﺪﺑ NSAIDS ـﻟﺍﻭ narcotics ـﻟﺍ ﻰﺘﺣﻭNerve blockers
ﻰﻠﻋ ﺎﻬﻴﺸﲤ ﻦﻜﳑ ـﻟﺍ melocam ﺀﺍﻮﺳ ٧.٥ ﻭﺃ١٥ ﻭﲑﻐﺗ ﻦﻜﳑ ﻦﻜﺴﳌﺍ ﺔﻠﻴﺼﻓ ﺓﱰﻓ ﻞﻛ ..
ﻝﺎﻐﺷ ﻚﻴﻠﺧ ﺲﺑ ـﻟﺍ ﰲ COX2 inhibitors
ﻮﻟﲑﻐﺗ ﺯﻭﺎﻋ ﻡﺎﻛﻮﻠﻴﳌﺍ ..ﻰﻘﺒﻳ Celebrex
ـﻟﺍ ﺀﺍﻮﺳ١٠٠ ـﻟﺍ ﻭﺃ٢٠٠
ﻚﻴﻠﺧ ـﻟﺍ ﰲ ١٠٠
ﻊﻴﻈﻓ ﱂﻷﺍ ﻮﻟﻭ ﺔﻨﻴﻌﻣ ﺓﱰﻓ ﰲ ..ﲑﻐﺗ ﻦﻜﳑ ـﻠﻟ ٢٠٠ ﻊﺟﺮﺗﻭ ﻼﺜﻣ ﻉﻮﺒﺳﺃ ﺓﺪﳌ ﺎﺗﻲﻧ ١٠٠ ﺍﺪﻛ ﺪﻌﺑ ،
ﺔﻋﺮﳉﺍ :ﻞﻛﻷﺍ ﺪﻌﺑ ﺎﻴﻣﻮﻳ ﺓﺪﺣﺍﻭ ﺔﻟﻮﺴﺒﻛ ،
ﺓﺰﻴﻣ ﻞﻀﻓﺃﻭ ﻪﻟ ﻰﻠﻋ ﺔﻴﺒﻧﺎﳉﺍ ﺭﺎﺛﻵﺍ ﻞﻴﻠﻗ ﻪﻧﺇ ﺓﺪﻌﳌﺍ .. ﺲﺑ ﺍﻭﺩﺮﺑ ﻰﻠﻋ ﺶﺘﺒﺜﺗ ﺎﻣﻭ ﻩﱰﻓ ﻞﻛ ﻩﲑﻏ ﻲﻘﺑﺍ
ﺔﻨﻴﻌﻣ ﺔﺟﺎﺣ.
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ـﻟﺍSteven Jenson Syndrome :
Life Threatening and Emergency Condition
ﻭ ﺎﻔﻠﺴﻟﺍ ﺕﺎﺒﻛﺮﳌ ﺔﻴﺳﺎﺴﳊﺍ
ﺎﻔﻠﺴﻟﺍ ﺕﺎﺒﻛﺮﻣ ﻊﻣ ﺔﻴﺳﺎﺴﳊﺍ ﺙﻭﺪﺣ ﺍﺪﺟ ﺩﺭﺍﻮﻟﺍ ﻦﻣ:

32. ﺔﻳﺍﺪﺑﺔﻳﺭﺪﺼﻟﺍ ﺔﻣﺯﻷﺎﺑ ﺍﺭﻭﺮﻣ ﻱﺪﻠﳉﺍ ﺢﻔﻄﻟﺎﺑ ﻰﻠﻜﻟﺍ ﺡﺮﺟﻭ ﻱﺪﺒﻜﻟﺍ ﺡﺮﳉﺍﻭ.. ﺍﺬﻜﻫﻭ..
ﺮﺧﻵ ﺺﺨﺷ ﻦﻣ ﺕﻭﺎﻔﺘﺗ ﺎﻬﻨﻜﻟ "ﻪﺒﻴﺼﻧﻭ ﺍﻮﻫ "،
ﺐﻴﺼﺗ ﻱﺩ ﺔﻴﺳﺎﺴﳊﺍ ٣ ﻞﻛ ﻦﻣ ١٠٠ ﺺﺨﺷ ،
ﺎﻔﻠﺴﻠﻟ ﺔﻴﺳﺎﺴﳊﺍ ﻉﻮﻗﻭ ﺄﺒﻨﺘﻳ ﻥﺃ ﻢﻠﻌﻟﺍ ﻦﻣ ﻎﻠﺑ ﺎﻤﻬﻣ ﺐﻴﺒﻃ ﻊﻴﻄﺘﺴﻳ ﻻﻭ ..ﺙﺪﲢ ﻥﺃ ﺪﻌﺑ ﻻﺇ ..
، ﻦﻜﻟﻭ ﺮﺜﻛﺃ ﺓﺮﻈﻨﺑﺎﻛﺎﻜﺘﺣﺍ ﻙﺎﻨﻫ ، ﻰﺿﺮﳌﺎﺑ ٤ ،ﺪﻌﺑﺍ ﺔﺿﺮﻋ ﺮﺜﻛﻷﺍ ﻢﻬﻓ ، ﻢﻬﻨﻋ:
ﺪﺣﺍﻭHepatic Impaired
ﺪﺣﺍﻭImmune-compromised
ﺪﺣﺍﻭMalnourished
ﺪﺣﺍﻭ Penicillin allergic
ﻭﺪﺟ ﻲﻌﻴﺒﻃ ﺺﺨﺷ ﺎﲟﺭﺍ ..
ﻞﻜﺑ ﻥﺫﺇﺭﺎﺼﺘﺧﺍ :
، ﺎﻔﻠﺴﻟﺍ ﺕﺎﺒﻛﺮﲟ ﻱﺩﺎﻋ ﻞﻐﺘﺸﺘﻫ ﺖﻧﺍ
، ﻲﻧﻮﻓﺮﻌﺗ ﺔﻴﺳﺎﺴﺣ ﺽﺍﺮﻋﺃ ﻱﺃ ﻪﻴﻠﻋ ﺪﺟ ﻮﻟ ﺾﻳﺮﳌﺍ ﻞﻫﻷ ﻝﻮﻘﺘﻫﻭ
ﺖﻠﺼﺣ ﻮﻟﻭ، ﻼﻌﻓ ﺔﻴﺳﺎﺴﳊﺍ ، ﻪﻴﺑ ﻝﺎﻐﺷ ﺖﻧﺍ ﻲﻠﻟﺍ ﺎﻔﻠﺴﻟﺍ ﺐﻛﺮﻣ ﻒﻗﻭ
ﻱﺪﻳﺭﻮﻟﺍ ﻦﻘﳊﺍ ﻰﺘﺣ ﻭﺃ ﺔﻴﺳﺎﺴﺣ ﺩﺎﻀﻣ ﺏﺍﺮﺸﺑ ﻭﺃ ﺕﺎﳝﺮﻜﻟﺎﺑ ﺀﺍﻮﺳ ﺕﺪﺟ ﻲﻠﻟﺍ ﺔﻴﺳﺎﺴﳊﺍ ﰿﺎﻋﻭ
ﻭ ﺎﺴﻜﻳﺪﻠﻟ ﺕﺎﻧﻭﺰﻴﺗﺭﻮﻜﻟﺍ ﻦﻜﺗ ﱂ ﺎﻣ ﺔﻴﺳﺎﺴﳊﺍ ﺔﻟﺎﺣ ﺐﺴﺣ ﻰﻠﻋ ،SJ.Syndrome ﻞﻘﻨﻳﻭ
ﻰﻔﺸﺘﺴﳌﺍ ﱃﺇ ﺎﲠ.

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ﻚﻣﺰﻠﻳ ﺎﻣ ، ﻱﻮﻴﳊﺍ ﺩﺎﻀﳌﺍ ﺹﻮﺼﲞ ﲔﻠﻜﻴﺳﺍﱰﺘﻟﺍ :
ﺩﺪﻌﺘﻣ ﲔﻠﻜﻴﺳﺍﱰﺘﻟﺍ ﻥﺇ ﺎﲟﺔﻴﻟﺎﻌﻔﻟﺍ ﻥﺫﺇ ، ﻡﺍﺮﳉﺍ ﺔﺒﻟﺎﺳﻭ ﺔﺒﺟﻮﻣ ﺎﻳﱰﻜﺒﻟﺍ ﻦﻣ ﺎﳍ ﺮﺼﺣ ﻻ ﺔﻋﻮﻤﳎ ﺏﺭﺎﳛﻭ
ﻱﺃ ﰲ ﻪﻴﻣﺪﺨﺘﺴﺗ ﻦﻜﳑﺏﺎﻬﺘﻟﺍ ﻯﻭﺪﻋ ﻭﺃ ..
ﻱﺯ:
ﺎﺒﻴﻣﺃﻭ ﺎﻳﱰﻜﺑ ﻦﻋ ﺔﲡﺎﻧ ﺎﻳﺭﺎﺘﻨﺳﻭﺩ ﻭﺃ ﻝﺎﻬﺳﺇ
ﻭﺃ ﺏﺎﻬﺘﻟﺍ ﺏﻮﻴﳉﺍﺔﻴﻔﻧﻷﺍ ﻭﺃ ﺕﺎﺑﺎﻬﺘﻟﺍ ﻲﻠﻔﺴﻟﺍ ﻭﺃ ﻱﻮﻠﻌﻟﺍ ﻲﺴﻔﻨﺘﻟﺍ ﺯﺎﻬﳉﺍ ﻭﺃ ﺕﺎﺑﺎﻬﺘﻟﺍ ﱄﻮﺒﻟﺍ ﺯﺎﻬﳉﺍ
ﻭﺃ ﺕﺎﺑﺎﻬﺘﻟﺍ ﻲﻠﺳﺎﻨﺘﻟﺍ ﺯﺎﻬﳉﺍ ﻭﺃ ﺏﺎﻬﺘﻟﺍ ﺓﺭﺍﺮﳌﺍ .
ﺔﻇﻮﺤﻠﻣ : ﺩﱪﻟﺍ ﺕﻻﺎﺣ ﰲ ﺔﺠﻴﺘﻧ ﺐﻴﺠﻴﻫ ﺶﻣ .. ﻮﻟ ﺔﺠﻴﺘﻧ ﺐﻴﺠﻴﻫ ﻻﻭُﺘﺳﺍﻤﻌﻞ ﻩﲑﻏ ﺕﺍﺩﺎﻀﻣ ﻊﻣ
..ﺭﺎﺼﺘﺧﺎﺑ ﻪﻠﻤﻌﺑ ﻢﻘﻳ ﻲﻛ ﻚﻳﺮﺷ ﻞﺒﻘﻳ ﻻ ، ..
ﺀﺎﻄﺧﻷﺍﺕﺎﻃﺎﻴﺘﺣﻻﺍﻭ ﺳﺍﱰﺘﻟﺍ ﻊﻣ ﲔﻠﻜﻴ ..ﻫﲑﻏ ﺶﻴﻔﻣ ، ﺲﺑﻭ ﲔﺘﻤﻠﻛ ﻢ:
ﻉﻮﻨﳑ ﻦﻣ ﺮﻐﺻﺃ ﻝﺎﻔﻃﻷﺍﻭ ﺕﺎﻌﺿﺮﳌﺍﻭ ﻞﻣﺍﻮﳊﺍ ﻊﻣ ٨ ﺕﺍﻮﻨﺳ/
ﺩﺎﻀﳌﺍ ﺪﻌﺑﻭ ﻞﺒﻗ ﲔﺘﻋﺎﺳ ﺔﺿﻮﲪ ﺕﺍﺩﺎﻀﻣ ﻱﺃ ﻻﻭ ﺐﻴﻠﺣ ﻻﻭ ﱭﻟ ﻉﻮﻨﳑ .. ﻦﻣ ﻢﻛ ﱪﻛﺃ ﻖﻘﲢ ﻲﻛ
ﺓﺩﺎﻔﺘﺳﻻﺍ ..
ﱄﺎﺘﻟﺎﻛ ﺔﻋﺮﳉﺍ : " ﰲ ﻪﻠﺧﺪﻴﻫ ﺍﺪﻛ ﲏﻌﻳ ﺏﺎﻬﺘﻟﻻﺍ ﻝﺍﻭﺯ ﺪﻌﺑ ﲔﻣﻮﻳ ﻞﻤﻜﻳ ﻪﻧﺇ ﻲﺴﻨﺗ ﻉﻭﺍ ﻭ٧ ﻡﺎﻳﺃ"
ﻟ ﻝﺍ ﻕﻮﻓ ﻞﻔﻃ ﻮ٨ ﻨﺳ ﺕﺍﻮ: ﺔﻟﻮﺴﺒﻛ ﺺﻧ٢٥٠ ﺏﺍﺮﺷ ﻭﺃ ١٢٥ ﺔﻘﻌﻠﻣ ﻞﻛ ﺓﲑﻐﺻ ٦ ﺎﻋﺎﺳﺕ
ﻎﻟﺎﺑ ﻮﻟ : ﻛـــ ٢٥٠ ﻞﻛ٦ ﺕﺎﻋﺎﺳ ﻮﻟ ﻻﺇ ،Pneumonia ﺔﻟﻮﺴﺒﻛ ﻰﻘﺒﺗ٥٠٠ ﻞﻛ٦ ﺕﺎﻋﺎﺳ

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ﻝﺍ ﺔﻋﺮﺟdiazepam ﻝﺍ ﰲanxiety ﻦﻣ ﻝﺎﻔﻃﻷﺍ ﺪﻨﻋ٦ ﻝ ﺮﻬﺷﺃ١٢ ، ﺔﻨﺳ
ﱄﺎﺘﻟﺎﻛ:
0.12-0.8 mg/kg/day PO
ﺔﻤﺴﻘﻣ ﻰﻠﻋ٣ ﻭﺃ٤ ﺕﺎﻋﺮﺟ
ﻭﺃ
0.04-0.2 mg/kg IM/IV
ﻭﺃ ﲔﺘﻋﺎﺳ ﻞﻛ٤ ﺕﺎﻋﺎﺳ
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ﻟﺍ ﺔﺑﻮﻧ ﺝﻼﻌﻟﺍﻭ ﻲﺼﻌﺘﺴﳌﺍ ﻲﻔﺼﻨﻟﺍ ﻉﺍﺪﺼ ـﻟﺎﺑErgotamine :
ﻉﺍﺪﺼﻟﺍ ﺕﺎﺑﻮﻧ ﺝﻼﻋ ﰲ ﺔﻣﱰﳏ ﺔﺟﺎﺣ ﻮﻫ ﲔﻣﺎﺗﻮﺟﺭﻹﺍ ﻦﻣ ﻱﻷ ﺐﻴﺠﺘﺴﺗ ﻻ ﱵﻟﺍﻭ ﺓﺩﺎﳊﺍ ﻲﻔﺼﻨﻟﺍ
ﺕﺎﻨﻴﻓﻭﱪﻟﺍﻭ ﻝﻮﻣﺎﺘﻴﺳﺭﺎﺒﻟﺍﻭ ﺕﺎﻨﻳﱪﺳﻷﺍ ..
ﻊﻧﺍﻮﳌﺍ ﺏﺎﻴﻏﻭ ﺔﺒﺳﺎﻨﳌﺍ ﺔﻋﺮﳉﺍ ﺔﻄﻳﺮﺷ ..
ﻊﻧﺍﻮﲟﻝﺎﻤﻌﺘﺳﺍ ﲔﻣﺎﺗﻮﺟﺮﻳﻹﺍ:
١ / ﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻟﺍ
ﻪﻧﻷ Marked vasoconstrictor
٢ / ﻂﻐﻀﻟﺍﺾﻔﺨﻨﳌﺍ ﺾﻔﺨﻨﳌﺍ ﻂﻐﻀﻟﺍ ﺲﻴﻟﻭ ﺍﺪﺟ ﻂﻘﻓ

35. ٣ / ، ﺐﻠﻘﻟﺍ ﰲ ﺔﻠﻜﺸﻣ ﻱﺃﺭﺎﺼﺘﺧﺎﺑ any risk factor
٤ / ﺕﺎﻌﺿﺮﳌﺍﻭ ﻞﻣﺍﻮﳊﺍ" ﺎﻫﺪﻨﻋ ﻲﻠﻟﺍ ﻻﻭ ﻰﺘﺣﻱﺩ ﺓﱰﻔﻟﺍ ﰲ ﻞﲪ ﺔﺻﺮﻓ " ،
ﻞﻤﻌﻴﺑ ﻪﻧﻷ uterine contractions ﻥﺎﻤﻛﻭ
restrict by its v.c effect bl.supply to fetus
٥ / ﺍﲑﺧﺃﻭ ﻉﻮﻨﳑ ﺾﻳﺮﻣ ﻊﻣ ﻱﺩ ﺔﻳﻭﺩﻷﺍ ﺪﺧﺎﻴﺑ:
Macrolides ﻭﺃ antidepressant ﻭﺃ antifungal
ﺔﻋﺮﳉﺍ : ﲏﻌﻳ ، ﺔﺑﻮﻨﻟﺍ ﺖﻗﻭ ﲔﺻﺮﻗ 2 mg at attack
ﻲﺼﻗﺃ ﺪﲝ٣ ﺍﺩ ﻡﻮﻴﻟﺍ ﰲ ﺕﺍﺮﻣ .. ﻙﺎﺼﻗﺃ ﲏﻌﻳ٥ ﻭﺃ٦ ﻡﻮﻴﻟﺍ ﰲ ﻡﺍﺮﺟ .. ﺔﻋﺮﺟ ﻞﻛ ﲔﺑﺔﻴﻧﺎﺜﻟﺍﻭ ﺎﻣ
ﻦﻋ ﺪﻳﺰﻳ٣ ﺕﺎﻋﺎﺳ.. ﻭﺃ ﺎﻴﻋﻮﺒﺳﺃ ﲔﺗﺮﻣ ﻦﻣ ﺮﺜﻛﺃ ﺔﻋﺮﳉﺍ ﺭﺮﻜﺘﺗ ﻻﻭ٦ ﺎﻳﺮﻬﺷ.
ﺔﺒﺳﺎﻨﳌﺎﺑ : ﺮﻬﺷﺃ side effect ﻞﺼﺤﻴﺑ ﻞﻛ ﰲ٢ ﻦﻣ١٠ ﲔﻧﺎﻴﻋ .. ﻮﻫ
nausea and vomiting following 1st dose
ﺔﺟﺎﺣ ﰲﺓﺯﺎﺘﳑ ﻲﻔﺼﻨﻟﺍ ﻉﺍﺪﺼﻠﻟ :
ﻝﺍﻭ v.c effect ﻞﻴﻠﻗ ﺎﻬﻋﺎﺘﺑﻭ ﻱﻭﺃ ـﻟﺍ ﰲ ﻲﺸﲤ
prolonged therapy
ﻝﺍ ﺓﺩﺎﻣ ﻲﻫ Flunarizine ﻟﺍ ﰲ ﺓﺮﻓﻮﺘﳌﺍﻭﺕﺎﻴﻟﺪﻴﺼ ـﻟﺍ ﺕﻻﻮﺴﺒﻛ ﺔﺌﻴﻫ ﻰﻠﻋ Sibeliu
ﺎﻬﺘﻋﺮﺟﻭ: ١٠ ﲏﻌﻳ ﻡﺍﺮﺟﲔﺘﻟﻮﺴﺒﻛ ﻡﻮﻨﻟﺍ ﺪﻨﻋ " ﺔﻟﻮﺴﺒﻛ ﻞﻛ٥ ﻡﺍﺮﺟ "
ﺓﺪﳌ ٥ ﻡﺎﻳﺃ ﰲﻉﻮﺒﺳﻷﺍ ﺓﺪﳌ ٦ ﺷﺃﺮﻬ .

36. ﺎﺛﺜﻟﺎ :
ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﺃ ﺔﻣﺎﻫ ﺕﺎﻣﻮﻠﻌﻣﻭ:
١/
ﺩﺎﳊﺍ ﻱﻮﻠﻜﻟﺍ ﺺﻐﳌﺍ ﻊﻣ ﻞﻣﺎﻌﺘﻟﺍ ءﺎﻄﺧﺃ ﰲ ﺔﻣﺎﻫ ﺔﻛﺭﺎﺸﻣ:
ﻢﻠﻘﺑ / ءﻼﻋ ﺭﻮﺘﻛﺩ " ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ ﻡﺎﻌﻟﺍ ﻑﺮﺸﳌﺍ"
ﻯﺩ ﻕﺮﻄﻟﺍ ﻦﻣ ﺔﻘﻳﺮﻄﺑ ﻯﻮﻠﻜﻟﺍ ﺺﻐﳌﺍ ﺕﻻﺎﺣ ﻊﻣ ﻞﻣﺎﻌﺘﻴﺑ ﺎﻨﻤﻈﻌﻣ :
ﻯﺪﻨﺑ ﺎﻣﺍ NSAID injection ﻝﺍ ﻯﺯvoltaren , liometacine,
ketofan
ﻦﻋ ﺓﺭﺎﺒﻋ ، ﺐﺠﻋﺃ ﻞﻴﺘﻛﻮﻛ ﻪﻴﻠﻋ ﻰﻠﻟﺍ ﺐﻴﺠﻌﻟﺍ ﻝﻮﻠﶈﺍ ﻯﺪﻨﺑ ﻭﺃ ٧ ﺕﻻﻮﺒﻣﺃ :
Liometacin,visceralgine,dexamethasone,
atropine, avil , glucolynamine , lasix
ﺀﺎﻄﺧﻷﺍ ﺔﻌﺋﺎﺸﻟﺍ:
ًﻻﻭﺃ :ﻞﻟ ﺔﺒﺴﻨﻟﺎﺑ NSAID ﺲﺑ ﻯﺩ ﺕﻻﺎﳊﺍ ﻰﻓ ﺍﺪﺟ ﺓﺪﻴﻔﻣ ﻰﻬﻓﻒﺳﻸﻟ ﺶﻌﻔﻨﺗﺎﻣﰲ ﻞﻛ
ﺕﻻﺎﳊﺍ ﺎﺻﻮﺼﺧ ﺕﻻﺎﳊﺍﻲﻠﻟﺍ ﺎﻫﺪﻨﻋ
renal impairment
ﻷﺍ ﻦﻣ ﻯﺩ ﺔﻠﻴﻌﻟﺍ ﻥﻻ ﺔﻳﻭﺩ)ﻝﺍ ﻯﺪﺼﻗ NSAID ﺔﻳﺪﻳﻭﲑﺘﺳ ﲑﻐﻟﺍ ﺕﺎﺑﺎﻬﺘﻟﻻﺍ ﺕﺍﺩﺎﻀﻣ ﻭﺃ ( ﱰﻛﺃ ﻦﻣ
ﺔﻳﻭﺩﻷﺍ ﻲﻠﻟﺍ ﻞﻤﻌﺘﺑ Renal and hepatic impairment

37. ﻞﻤﻌﺗ ﻦﻜﳑﻭ acute renal failure ﺪﺧ ﻝﺎﻔﻃﺃ ﻊﻣ ﲑﺘﻛ ﻞﺼﺣ ﻩﺩﻭﺍﻭ ﻦﻣ ﺓﺩﺎﻳﺯ ﺔﻋﺮﺟ
ﺮﻬﺷﺃ ﰲ ﻝﺎﻔﻃﻸﻟ ﺓﺭﺍﺮﺣ ﺾﻓﺎﺧ ﺮﺼﻣ- dolphin - ﺍﻮﻠﺧﺩﻭﰲ acute renal
failure ﺴﺑﺐﺒ ﻪﺳﻮﺒﻟ ﲔﻔﻟﻭﺩ !! ﺓﺮﺗﺎﻛﺩﻭﻝﺎﻔﻃﻷﺍ ﺧ ﺍﻮﻓﺮﻌﻳ ﺪﻴﻛﺃ ﺔﻌﻣﺎﳉﺍ ﻉﻮﺘﺑ ﺎﺻﻮﺼ ﻡﻼﻜﻟﺍ
ﺍﺩ ﻭ ﲑﺘﻛ ﻩﻮﻓﺎﺷ.
ﺔﺟﺎﺣﺔﻴﻧﺎﺛ ﻯﺩ ﺔﺒﺒﻬﳌﺍ ﺔﻠﻴﻌﻠﻟ ﺔﺒﺴﻨﻟﺎﺑ -ﲑﺘﻜﻟﺍ ﺎﲥﺍﺰﻴﳑ ﻢﻏﺭ - ﻻﺇ ﺎﳖﺃ ﺎﻣ ﺶﻌﻔﻨﺘﺑﰲ ﺎﺻﻮﺼﺧ ﺕﻻﺎﳊﺍ ﻞﻛ
ﲔﻧﺎﻴﻌﻟﺍﻲﻠﻟﺍ ﺪﻨﻋﻢﻫ impacted stones ﻭ ﻢﳍﻼﻤﻋ
calcular anuria ﻱﺩﻭ ﺎﻌﺒﻃ ﺓﺯﻭﺎﻋ
emergency interference to relieve the
obstruction
ﻻﺇﻭ ﻥﺎﻴﻌﻟﺍ ﺶﳜﺎﻫﰲ ﻞﺸﻓﻱﻮﻠﻛ ﻭ ﻢﻬﻓﺮﻌﻨﺑ ﻝﻭﺩ ﲔﻧﺎﻴﻌﻟﺍﻭ ﺩﺎﺣﻧﻢﻫﺪﻨﻋ ﻰﻗﻼ
history of bilateral stone
ﻚﻟﻮﻘﻳ ﻰﺠﻴﻳ ﻥﺎﻴﻌﻟﺍﻭﻱﺪﻨﻋ ﺵﺎﺤﺘﻣ ﻝﻮﺒﻟﺍﻭ ﻊﻴﻈﻓ ﱂﺍﻱﺪﻨﻋ ﻪﻴﻗﻼﺗ ﻂﻐﻀﻟﺍ ﺲﻴﻘﺗ ﺎﳌﻭﱄﺎﻋ ﺎﻌﺒﻃ ﻩﺩﻭ
ﻰﻠﻋ ﺍﺭﻮﻓ ﻪﻟﻮﲢﻲﺋﺎﺼﺧﺃ ﻚﻟﺎﺴﻣ.
ًﺎﻴﻧﺎﺛ : ﺐﻴﺠﻌﻟﺍ ﻝﻮﻠﺤﻤﻠﻟ ﺔﺒﺴﻨﻟﺎﺑﻲﻠﻟﺍ ﺃ ﺐﺠﻋﺃ ﻞﻴﺘﻛﻮﻛ ﻪﻴﻠﻋﻴﺑ ﺍ ﻥﺎﺤﺒﺳﻭ ﻩﺎﻨﺑﺮﺟ ﺎﻨﻠﻛ ﺪﻴﻛﺐﻴﺠ ﺞﻳﺎﺘﻧ
ﺕﺎﻈﺣﻼﻣ ﻪﻴﻠﻋ ﺲﺑ ﺔﻠﻳﺎﻫﺓﲑﻨﻛ ﺎﻬﻨﻣ :
ﻻﻭﺃ :ﺎﻣ ﺶﺘﻔﺷﻱﺃ guide line ﻞﻛﻭ ﻩﺩ ﺐﻴﺠﻌﻟﺍ ﻞﻴﺘﻛﻮﻜﻟﺍ ﻦﻋﻲﻠﻟﺍ ﻪﺘﻳﺮﻗﻢﳖﺇ ﺍﻭﺪﻴﺑ iv
drip ﺔﺟﺎﺣ ﻪﻴﻠﻋ central pain killer ﻯﺯ pethidine

38. ﺎﻴﻧﺎﺛ :ﻥﺇ ﲔﻧﺎﻴﻌﻟﺍ ﻢﻈﻌﻣﻲﻠﻟﺍ ﻢﻫﺪﻨﻋ renal colic ﻢﻫﺪﻨﻋ gastritis ﻥﻻ ﺎﻌﺒﻃ ﻩﺩﻭ
ﻞﻛﻷﺍ ﻲﻠﻟﺍ ﺺﻐﳌﺍ ﻞﻤﻌﻴﺑﻱﻮﻠﻜﻟﺍ ﺎﺒﻳﺮﻘﺗ ﻮﻫﻞﻛﻷﺍ ﻲﻠﻟﺍ ﺓﺪﻌﳌﺍ ﺕﺎﺑﺎﻬﺘﻟﺍ ﻞﻤﻌﻴﺑ ،
ﻩﺩﺮﺑﰲ ﺎﻬﲰﺍ ﺔﺟﺎﺣ reflex gastritis ﻰﺠﻴﻳ ﻩﺪﻛ ﻥﺎﺸﻋ ﻝﻭﺩ ﲔﻧﺎﻴﻌﻟﺍ ﻊﻣ ﻞﺼﺤﺘﺑﺎﻣﺇ
ﺑﻊﺟﲑ ﻩﺪﻨﻋ ﻭﺃﺱﺎﺴﺣﺇ ﺀﻲﻘﻟﺎﺑ .. ﺍﺩﺔﻓﺎﺿﻹﺎﺑ ﻦﻋ ﲔﻓﺭﺎﻋ ﺎﻨﻠﻛ ﺪﻴﻛﺃ stress ulcer
ﻱﺩﻭ ﺔﺠﻴﺘﻧ ﻢﻫﺎﻌﻣ ﻞﺼﺤﺘﺑ ﻩﺩﺮﺑ ﺪﻴﻛﺃﱂﻷﺍ ﻊﻴﻈﻔﻟﺍ ،
ﻡﻮﻘﻧﺎﻨﺣﺇ ﻰﻬﺘﻨﲟﺀﺍﱪﻟﺍﺓ ﺓﺪﻌﳌﺍ ﺞﻴﻬﺘﺑ ﻰﻠﻟﺍ ﺕﺎﺟﺎﳊﺍ ﻊﻴﲨ ﻪﻴﻠﻋ ﻝﻮﻠﳏ ﻪﻠﻳﺪﻧ ﺔﻴﻨﻬﳌﺍ ﺔﺟﺍﺬﺴﻟﺍﻭ ﺔﻴﺒﻄﻟﺍ
ﻞﻤﻌﺗﻭ acute gastritisﻼﺗﻭ ﺪﻌﺑ ﻥﺎﻴﻌﻟﺍ ﻰﻗﻳﻮﺷﺎ ﺥﺮﺼﻳ ﻩﺁ ﺎﻳ ﻲﺗﺪﻌﻣ ﻳﻮﺷﺎ ﻭﻩﺁ ﺎﻳﱯﻨﺟ
ﻳﻮﺷﺎ ﺑﻳﻮﺷ ﺪﻌﺎ ﻗﻼﺗﻪﻴ ﻳﻮﺷ ﺪﻌﺑﻭ ﻊﻴﺟﺮﺗ ﻝﺎﺒﻘﺘﺳﻻﺍ ﻕﺮﻏﺎ ﺎﻨﻴﻠﻋ ﱰﺴﻳ ﺎﻨﺑﺭ ﺎﻌﻴﲨ .
ﺎﺜﻟﺎﺛ :ﻫ ﻥﺎﻛ ﻩﺩﻭ ﺓﺪﺣﺍﻭ ﻊﻣ ﺎﻴﺼﺨﺷ ﺎﻳﺎﻌﻣ ﻞﺼﺤﻴﱵﺒﻳﺮﻗ - ﺖﻨﻛ ﺎﳌﰲ ﺯﺎﻴﺘﻣﺍ ﺔﻳﺍﺪﺑ - ﻰﺑ ﺖﻠﺼﺗﺍ
ﺖﻜﺘﺷﺍﻭ ﻦﻣﺇﺎﳖ ﺺﻐﻣ ﺎﻫﺪﻨﻋﻱﻮﻠﻛ ﻫ ﺎﲥﻮﻤﻴ ، ﺎﳍ ﺢﻳﺍﺭ ﺖﺣﻭﺭ ﺍ ﻥﺎﺤﺒﺳﻭ ﻞﳊﺍ ﻮﻫ ﻝﻮﻠﶈﺍ ﺎﻬﻠﺘﻠﻗﻭ
ﺐﻳﺮﻏ ﺾﻓﺭ ﺖﻀﻓﺭ -  ﺪﻤﳊﺍﻭﺎﳖﺇ ﻫ ﺖﻀﻓﺭﻪﻴﻟ ﻦﻳﺪﻌﺑ ﻢﻜﻟ ﻝﻮﻘ - ﻡﻮﻳ ﻰﻧﺎﺗ ﺎﻫﺎﻌﻣ ﺖﺣﻭﺭ ﻢﻬﳌﺍ
ﳍ ﺲﻳﺎﻗ ﺡﺍﺭ ﻚﻟﺎﺴﻣ ﺭﻮﺘﻛﺪﻟﺎ ﻊﻠﻃ ﻂﻐﻀﻟﺍ٢٠٠\١١٠ ﺎﻫﺮﻤﻋ ﻰﻫﻭ ﺎﻣﺖﻜﺘﺷﺍ ﺭﺎﻧﻮﺳ ﺎﻬﻠﻤﻋﻭ ﻂﻐﻀﻟﺎﺑ
ﻰﻘﻟ ﰲ
severe back pressure on both kidneys
ﺖﻌﻠﻃ ﻰﻠﻛ ﻒﺋﺎﻇﻭ ﻞﻤﻋﻭﰲ ﺎﻬﺼﺨﺷ ﺭﻮﺘﻛﺪﻟﺍ ﻢﻬﳌﺍ ﺎﻤﺴﻟﺍﺎﳖﺃ calcular anuria ﻝﺎﻗﻭ
ﱄ ﺩ ﻱ ﺖﺗﺎﻣ ﻭ ﺖﻌﻗﺮﻓ ﺎﳖﺎﻣﺯ ﻥﺎﻛﰲ ﻝﺍ ﺐﺒﺴﺑ ﻝﻮﻠﶈﺍ ﺺﻧ pressure overload
، ﻥﺫﺇﺩ ﻡﻼﻜﻟﺍﺍ ﺎﻳ ﺍﺪﺟ ﻢﻬﻣ ﻝﺍ ﻑﻮﺸﺗ ﻡﺯﻻ ﻪﻋﺎﲨ vital signs ﻷﻱ ﺖﻧﺎﻛ ﺎﻤﻬﻣ ﻪﻟﺎﺣ .

39. ٢/
ﺕﺎﻛﺭﺎﺸﻣ ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﻷ ﺔﻌﻳﺮﺳ:
ﻢﻠﻘﺑ : ءﻼﻋ ﺭﻮﺘﻛﺩ
١ / ﺇﻥﺎﻴﻌﻟ ﻒﺻﻮﺗ ﺎﻣ antidematous drugs ﻝﺍ ﻯﺯ reparil ﻭﺃ
alphintern ﺹﺍﺮﻗﺃ .. ﺔﻳﻭﺩﻷﺎﻓ ﻞﺒﻗ ﺪﺧﺎﺘﺗ ﻡﺯﻻ ﻯﺩﻞﻛﻷﺍ ﻒﺼﻨﺑﺔﻋﺎﺳ ﻰﻠﻋﻞﻗﻷﺍ
ﻪﻴﻟ ﱃﻮﻘﺘﻫ ؟؟ ﻥﺎﺸﻋ َﻜﺘﺑﺮﺴ ﻝﺎﺑ digestive enzymes .
٢ / ﻭﺃ ﻩﺭﻮﻛ ﺐﻌﻠﻴﺑ ﻥﺎﻛ ﺪﺣﺍﻭ ﻚﻟﺎﺟ ﺔﺟﺎﺣ ﻝﺎﺷﻪﻠﻴﻘﺗ ﻪﻟ ﻞﺼﺣﻭmuscle spasm ،
ﻚﻟﻮﻘﻳ ﺾﻌﺒﻟﺍﻱﺩﺃ ﻪﻟMuscle relaxant i.v ﰲ ﻞﺧﺪﻳ ﻦﻜﳑ ﻪﻧﻷ ﺪﻳﺪﺷ ﺄﻄﺧ ﺍﺩﻭ
respiratory apnea ﻝﺍ ﻱﺯ ﺕﻻﻮﺴﺒﻛ ﻰﻠﻋ ﻲﺸﳝ ﻞﻀﻓﻷﺍ ، ﻚﻨﻣ ﺕﻮﳝﻭ
Myolax ﻞﻛ٨ ﻥﺎﻫﺩﻭ ﺕﺎﻋﺎﺳProfenid Gel ٣ ﺎﻴﻣ ﺕﺍﺩﺎﻤﻛ ﻰﻠﻋ ﺓﻭﻼﻋ ﺕﺍﺮﻣ
ﻪﻨﺨﺳ ﺍ ﻰﻠﻋ ﺔﻠﻀﻌﻟ.. ﻲﻠﻀﻋ ﺪﺷ ﻱﺃ ﰲ ﺍﺩ ﻡﻼﻜﻟﺍﻭ ﻷﺍ ﰲ ﺀﺍﻮﺳ ﻢﺴﳉﺍﺮﻫﺪﻟﺍ ﻭﺃ ﺔﺒﻗﺮﻟﺍ ﻭﺃ ﻑﺍﺮﻃ.
٣ /ﲔﻠﻠﻴﻓﻮﻨﻴﻣﻷﺍ ﺔﻋﺮﺟ ﻞﻠﻘﺗ ﺎﻨﻫ ﺎﻣﺰﻟ ، ﲔﻠﻠﻴﻓﻮﻨﻴﻣﺃ ﻩﺎﻌﻣﻭ ﻥﺎﺘﻛﺎﳝﺭ ﻭﺃ ﻦﺴﻴﻣﻭﺮﺛﺮﻳﺇ ﻥﺎﻴﻋ ﻱﺪﺘﺑ ﻮﻟ ﻥﻷ ،
ﻥﺎﻘﺑﺎﺴﻟﺍ ﻥﺍﺩﺎﻀﳌﺍ ﺍﻮﻠﻤﻌﻴﺑ Enzyme inhibition in the liver ﻚﻟﺬﺑﻭ
ﺪﻳﺰﻴﺳ ﻝﺍhalf life ﺪﺧﺎﻴﺑ ﻥﺎﻴﻋ ﻮﻟ ﺲﻜﻌﻟﺍﻭ ، ﲔﻠﻠﻴﻓﻮﻨﻴﻣﻷﺍ ﻉﺎﺘﺑTegretol ﺏﺮﺸﻴﺑ ﻭﺃ
ﻝﻭﺩ ﻥﻷ ، ﲔﻠﻠﻴﻓﻮﻨﻴﻣﻷﺍ ﺔﻋﺮﺟ ﺩﻭﺰﺗ ﺎﻨﻫ ، ﺮﻳﺎﺠﺳEnzyme inducers
ﻑﺭﺎﻋ ﺖﻧﺍ ﺐﻴﻃﻼﺻﺃ ؟ ﲔﻠﻠﻴﻓﻮﻨﻴﻣﻷﺍ ﺔﻋﺮﺟ

40. ﻰﻘﺒﺗ ﺔﻨﺳ ﻦﻣ ﻞﻗﺃ ﻞﻔﻃ ﻮﻟ10 mg/kg/day ﻰﻘﺒﻳ ﺔﻨﺳ ﻦﻣ ﱰﻛﺍ ﻮﻟ ﺐﻴﻃ
15-25 mg/kg/day ﺍ ﻦﻋ ﻝﺎﻔﻃﻷﺍ ﰲ ﺵﺩﻭﺰﺗ ﺎﻣﻭﺶﻠﺼﲢ ﺎﻣ ﻥﺎﺸﻋ ﺎﻫﺎﻧﺮﻛﺫ ﻲﻠﻟﺍ ﺔﻋﺮﳉ
ﻭﺃ ﺕﺎﺠﻨﺸﺗTremors .
٤ /ﺔﺒﺴﻨﻟﺎﺑ ﳌﺐﻠﻄﺗ ﺎ culture ﻦﻣﻣ ﺾﻳﺮ ﻰﻘﺒﻳ ، ﺃﺪﺒﺗ ﺎﻣ ﻞﺒﻗﰲ ﺩﺎﻀﳌﺍﻱﻮﻴﳊﺍ ،ﻭﺃ ﺍﻮﻫ ﻮﻟ
ﺩﺎﻀﳌﺍ ﺪﺧﺎﻴﺑﻱﻮﻴﳊﺍ ﻰﻘﺒﻳ ، ﺩﺎﻀﳌﺍ ﻡﺯﻻ ﻩﺪﳌ ﻒﻗﻮﺘﻳ٤٨ ﺔﻋﺎﺳ ﻰﻠﻋﻞﻗﻷﺍ ﺔﻋﺭﺰﳌﺍ ﻞﺒﻗ ﻭ ، ﻩﺪﻣ
ﺩﺎﻀﳌﺍ ﻝﺎﻤﻌﺘﺳﺍﻱﻮﻴﳊﺍ ﺎﺒﻟﺎﻏ ﻦﻣ٧ ﱃﺇ ١٠ ﻡﺎﻳﺃ ، ﻯﺍﺯﺍ ﺐﻴﻃﻢﻴﻗﺃ ﺔﻟﺎﳊﺍ ﻑﺮﻋﺍﻭ ﺾﻳﺮﳌﺍ ﻉﺎﺘﺑﻥﺇ ﺩﺎﻀﳌﺍ
ﻱﻮﻴﳊﺍ ﻰﻋﺎﺘﺑﻁﻮﺒﻀﻣ ، ﻞﻤﻋﺍﺔﻋﺭﺰﻣ ﺔﻴﻧﺎﺛ ﺪﻌﺑ ﺾﻳﺮﻤﻠﻟ٣ ﻡﺎﻳﺃ ﺃﺪﺑ ﻦﻣﻑﻮﺸﺗ ﺎﻣﺇﻭ ، ﺔﺠﻴﺘﻨﻟﺍ ﻣﻠ ﺶﻜ
ﻞﻤﻌﳌﺎﺑ ﻩﻮﻋﺩ ﺺﻟﺎﺧﺖﻧﺃ ﻝﺍ ﻰﻠﻋ ﺺﺒﺗ organism ﻲﻠﻟﺍ ﻝﺍ ﻦﻋ ﺶﺟﺮﺨﻴﺑ ﺎﻣ ﺎﺒﻟﺎﻏ ﺍﻮﻫ
e.coliﻭﺃ ﻝﺍ klebsiella
ﺭﺎﺘﲣﺖﻧﺃ ﺩﺎﻀﳌﺍﻱﻮﻴﳊﺍ ﻰﻠﻋﺱﺎﺳﻷﺍ ﻼﺜﻣ ﻪﺒﺗﺎﻛ ﺎﻬﻴﻗﻼﺗ ﻞﻣﺎﻌﳌﺍ ﺾﻌﺑ ﻥﺎﺸﻋ ﻩﺩ e.coli
ﻯﺩﺍ ﻚﻟﻮﻘﺗﻭ meronemﻭﺍ tienam
ﻰﻨﻌﻳ ﻪﻴﻟﺏﺮﺧﺃ ﻥﺎﻴﻌﻟﺍ ﺖﻴﺑ، ﻛﺮﻣ ﺎﻧﺪﻨﻋ ﺎﻣ ﺐﻴﻃﻝﻭﺯﺎﺘﺒﺴﻟﺍ ﻯﺯ ﺎﻔﻠﺴﻟﺍ ﺕﺎﺒ ..
ﺃﻭ ﻦﺴﻴﻣﺎﺘﻨﳉﺍﺃﻭ ﻻﺍﲔﻠﺴﻴﺴﻛﻮﻣ + ﻷﺍ ﻯﺯ ﻚﻴﻧﻮﻠﻴﻓﻼﻛﲔﺘﻨﲨﻭ ﻭﺃ ﻚﺗﻮﻴﺑ ﻯﺎﳍﺍ .

41. ٣/
ﺕﺎﻛﺭﺎﺸﻣ ﺓﺭﻮﻬﺸﻣ ءﺎﻄﺧﻷ ﺔﻌﻳﺮﺳ:
ﻢﻠﻘﺑ : ﺔﻤﻠﺴﻣ ﺓﺭﻮﺘﻛﺩdr_muslema ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ
ًﻻﻭﺃ :ﻞﻟ ﺔﺒﺴﻨﻟﺎﺑ streptococcal tonsillitis :
١ /ﻯﺪﻧ ﺔﻣﺯﻻ ﺵﻮﻠﻣ broad spectrum antibiotic
ﻝﺍ ﻥﻻ infection gram +ve ﻦﻜﳑﻥﺇ ﺎﻨﺣﺇ ﻝﺍ ﺩﺪﳓ spectrum ﻯﺪﻧﻭ
ﻯﺯ ﺔﺟﺎﺣ :
Erythromythin /
1st generation cephalosporins as ceporex /
Also , oral penicillin is very effective as ospen.
٢ / ﺪﻳﺭﻭ ﺯﺪﻳﺯﻮﻜﻴﻠﺟﻮﻨﻴﻣﺃ ﻱﺪﺗ ﻚﻧﺇ ﺔﻣﺰﻟ ﺵﻮﻠﻣﻭﺃ ﺵﺎﻬﻠﻣ ﺎﻴﻫ ﻥﺎﺸﻋ ﺍﺪﻛﲑﺛﺄﺗ ﻰﻠﻋ ﻼﺻﺃﺖﻴﺑﱰﺳﻹﺍ.
٣ /ﻱﺪﺗ ﻚﻧﺇ ﺔﻣﺰﻟ ﺵﻮﻠﻣ ﺎﻨﻫ 3
rd
G. Cephalosporins ﺍﺮﳉﺍ ﺪﺿ ﻪﻧﻷﺔﺒﻟﺎﺴﻟﺍ ﻡ.
٤ / ﻝﺍ ﻥﻷ ، ﺎﻨﻫ ﺪﻳﺭﻭ ﺕﺍﺩﺎﻀﻣ ﻱﺪﺗ ﻚﻧﺇ ﺔﻣﺰﻟ ﺵﻮﻠﻣoral ﺓﺯﺎﺘﳑ ﺔﺠﻴﺘﻧ ﺐﻴﺠﻴﻫ.
٥ / ﻝﺍ ﲔﺑ ﻕﺮﻔﺗ ﺎﻣﺰﻟstrept ﻳﲑﺘﻜﺒﻟﺍﺔ ﺔﻴﺳﻭﲑﻔﻟﺍﻭ ﰲ ﻥﻮﻜﻴﺑ ﺔﻴﺳﻭﲑﻔﻟﺍ ﰲ ،Nasal
discharge ﺎﻣﺃﺔﻳﲑﺘﻜﺒﻟﺍ ﻥﻮﻜﻴﺑ ،Watery ﻢﺛMucoid

42. ًﺎﻴﻧﺎﺛ : ـﻟﺍ ﺹﻮﺼﲞ ﺕﺎﻣﻮﻠﻌﻣUTI ﻝﺎﻔﻃﻷﺍ ﰲ:
١ / ﻥﻮﻜﻳ ﺎﻬﻋﺎﺘﺑ ﺺﻴﺨﺸﺘﻟﺍ ﺽﻭﺮﻔﳌﺍﰲ ﺭﺎﺒﺘﻋﻻﺍ ﺎﳖﻷ ﺕﺎﻗﻭﺃ ﻥﻮﻜﺘﺑ asymptomatic
ًﺎﻀﻳﺃﻭ ﰲ ﻮﻟﺍ ﺲﻔﻧ ﺖﻗﺮﻜﻓﺃ ﰲ ﺕﺎﺟﺎﳊﺍﺔﻴﻧﺎﺜﻟﺍ ﻲﻠﻟﺍ ﻞﻤﻌﺗ ﻦﻜﳑ Fever+ dysuria
ﻯﺯ :
sever napkin dermatitis /valvovaginitis
ﻭﺃ ﻰﺘﺣ irritation ﺐﺒﺴﺑﻥﺇ ﺍﻡﻷ ﻝﺍ ﲑﻐﺘﺑ ﺶﻣ wet diaper ﺭﺍﺮﻤﺘﺳﺎﺑ .
٢ /ﺍ ﺽﻭﺮﻔﳌﻥﺇ ﺎﻨﺣﺇ ﺃﺪﺒﻧ ﺏ ﺝﻼﻌﻟﺍ Broad spectrum antibiotic ﻯﺯ
Emox /ceporex ﻧ ﺎﻣ ﻰﺘﺣ ﻞﺒﻗﻑﻮﺸ ﻝﺍ ﺔﺠﻴﺘﻧculture ﻝﺍ ﻥﺎﻤﻛﻭ
sulpha / amino glycosids/nitrofurnatoin
ﻮﻧﻮﻜﻴﺑ ﺍVery Effective
٣ / ـﻟﺍ Recurrent UTI ﺔﻠﻣﺎﻌﻣ ﺎﻬﻴﻟ ﺧ ﻞﻤﻌﻧ ﻡﺯﻻ ﻰﻨﻌﻳ ﺎﻬﻴﺑ ﺶﻧﻮﻬﺘﺴﻧﺎﻣ ﻡﺯﻻ ﻰﻨﻌﲟ ﺔﺻﺎ
ﺎﻫﺎﻌﻣ renal function ﻥﺎﺸﻋ CRF ﻞﺼﳛ ﻦﻜﳑﺴﺑﺐﺒ ﻝﺍreflux ﻥﺎﻤﻛﻭ
ﺪﻛﺄﺘﻧ ﺩﻮﺟﻭ ﻦﻣ calculi ﻷ ﻻﻭ ؟ﻞﻤﻌﻧ ﻰﻨﻌﻳ US ﻭﺃ IVP ﻥﺎﻤﻛﻭﰲ ﻯﺪﻨﺑ ﻯﺩ ﺔﻟﺎﳊﺍ
long term prophylaxis
ﺏ ﻥﻮﻜﻴﺑ ﺶﻣ ﺲﺑbroad spectrum ﺎﳖﻷ ﺎﻬﻴﻟ ﻥﻮﻜﺘﺑ resistance ﻰﻨﻌﻳ
ﻥﻮﻜﻴﺑﻞﻀﻓﻷﺍ nitrfurnatoin

43. ٤ / ﺽﻭﺮﻔﳌﺍﻒﻴﻀﻧ alkalizing agent ﻝﺍ ﻯﺯepimag or
citromag ﻝﺍ ﻊﻣ ﺎﺻﻮﺼﺧﻭ aminoglycosids
٥ /ﰲ ﺕﺎﺟﺎﺣﺔﻴﻧﺎﺛ ﻭﺩﺮﺑ ﰲ ﻼﻋﺝ ﻝﺍ UTI ﻯﺪﻨﺑ ﻰﻨﻌﻳ antipyretic ﻭ
bladder analgesics ﺍﺪﺟ ﺔﻤﻬﻣ ﺔﺟﺎﺣ ﻰﻓﻭﺎﻀﻳﺃ ﻚﻧﺍ ﺏﺮﺸﻳ ﻥﺎﻴﻌﻠﻟ ﻝﻮﻘﻧﻴﻣﺎ ﺘﻛﲑ
ــﻳ ﻥﺎﺸﻋWash Urinary System ﻭ ﻥﺎﺸﻋﺪﺧﺎﻴﺑ ﻮﻟ ﻥﺎﻤﻛ sulpha
(septazol) ﺶﻧﻮﻜﻴﻣ calculi
٤/
ﺔﻛﺭﺎﺸﻣ " ﻝﺎﻔﻃﻷﺍ ﺕﺎﺘﺷﻭﺭ ﺹﻮﺼﲞ: "
ﻢﻠﻘﺑ :ﺩ / ﻡﺎﺴﺣ "ﺐﻴﺒﻃ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﲟ"

١/ ﻟﺍ ﻞﻴﳉﺍﺚﻟﺎﺜ ﻟﺍ ﻦﻣﺴﺰﻨﻳﺭﻮﺒﺳﻮﻟﺎﻔﻴ – ﻥﻭﺯﺎﻔﻴﺴﻟﺍﻭ ﺲﻛﺎﺗﻮﻔﻴﺴﻟﺍ ﻞﺜﻣ - ﻢﻬﻳﺪﻧ ﻩﺪﳌ٣ ﻡﺎﻳﺃ ، ﻂﻘﻓ
3 successive days only" "
٢ / ﲔﻠﺳﺎﺴﻛﻮﻣﻷﺍ + ، ﺏﺍﺮﺷ ﻚﻨﻟﻮﻴﻓﻼﻜﻟﺍ ﻞﺒﻗ ﻉﻮﻨﳑ٩ ﺭﻮﻬﺷ ﰲ ﺐﺒﺴﺘﻳ ﻻ ﻰﺘﺣ ،gastric
irritation and vomiting
٣ /ﻪﻋﻮﻤﳎ macrolides ﻯﺯ erythromycin ﺵﺎﳍﺎﻣﻱﺃ ﻦﻣ ﻉﻮﻧﺔﻴﺳﺎﺴﳊﺍ
ﺩ ﺎﻌﺒﻃﻭﻱ ﻊﻔﻨﺗ ﺎﻬﻴﻠﺨﺘﺑ ﻩﺰﻴﻣﰲ ﻱﺃ ﺎﻬﻴﻟ ﻪﻟﺎﺣﺔﻴﺳﺎﺴﺣ ﻧﺎﺗ ﺍﻭﺩ ﻦﻣ ﻲ .
٤/ ﺍﺪﺟ ﻰﻠﻜﻟﺍ ﺐﻌﺘﺘﺑ ﻚﻧﻷ ﺱﻮﺒﻟ ﲔﻔﻟﻭﻷﺍ ﻊﻣ ﲔﻓﻭﱪﻟﺍ ﻱﺪﺗ ﻉﻮﻨﳑ.

44. ٥ /ﰲ G6PDDﻝﺍ ﻉﻮﻨﳑ diclofenac , brufen ﻝﻮﻣﺎﺘﻴﺳﺍﺭﺎﺒﻟﺎﺑ ﺎﻌﺒﻃ ﺡﻮﻤﺴﻣﻭ
ﻦﻣ ﻥﺎﻣﺃ ﺍﻮﻫ ﻥﺎﻤﻛﻭ ،ﻝﻭﺃ ﻡﻮﻳ.
٦ / ﻞﺒﻗ ﻉﻮﻨﳑ ﲑﻬﺸﻟﺍ ﲔﻔﻟﻭﺪﻟﺍ ﺱﻮﺒﻟ٩ ﺭﻮﻬﺷ.
٧ / ﺍﻭﺩ ﲔﻋﻮﻧﻲﻠﻟﺍ ﺶﻔﺸﻣ side effects ﻪﻌﻟﻭ ﻢﻬﺒﺘﻜﻴﺑ ﻢﻬﺘﻋﺎﺘﺑﻲﻠﻟﺍﻭ ﺎﻣ ﻩﺮﻤﻋ ﻑﺎﺷ ﻢﻬﺒﺘﻜﻴﺑ
ﺎﺗﻲﻧ ، ﻷﺍ ﺱﻮﺒﻟ ﺎﳘﺏﻮﺘﺳﻮﻨﻳﺮﻟﺍ ﻂﻘﻧﻭ ﻦﻠﻠﻴﻓﻮﻨﻴﻣ ﻢﳖﻷﻳﺍﻮﺠﻴﻬ ﺯﺎﻬﳉﺍﱯﺼﻌﻟﺍ ، ﺔﻌﺸﺑ ﺓﺭﻮﺼﺑ ﺱﺎﻨﻟﺍ ﻰﻗﻼﺗ
ﲔﳝ ﻪﺒﻴﲡ ﻂﻴﻌﻳ ﻝﺎﻤﻋ ﲑﻐﺻ ﻞﻴﻋ ﻢﻫﺎﻌﻣﻭ ﻞﻴﻠﻟﺎﺑ ﻚﻴﻠﻋ ﲔﻠﺧﺍﺩ ﻁﺎﻴﻌﻟﺍ ﲑﻏ ﻪﺟﺎﺣ ﺵﻮﻬﻔﻣ ﻝﺎﴰ ﻲﻠﻟﺍ
ﻝﺎﺴﺗ ﺐﺒﺳ ﺵﻮﻠﻣﻪﻠﻫﺃ ﺪﺧﻪﻳﺇ ﻮﻟﻮﻘﻳﻚﻟ ﲔﻠﻠﻴﻓﻮﻨﻴﻣ ﻪﺳﻮﺒﻟ .
٥/
ﺔﻛﺭﺎﺸﻣ " ﻝﺎﻔﻃﻷﺍ ﺕﺎﺘﺷﻭﺭ ﺹﻮﺼﲞ: "
ﻢﻠﻘﺑ :ﺩ / ﻞﻜﻴﻫ٧٧ " ﻝﺎﻔﻃﻷﺍ ﺐﻃ ﻲﺋﺎﺼﺧﺃ"
١/ ﻚﻟﺎﺑ ﻰﻠﺧﺖﻧﺃﻭ ﺑﺐﺘﻜﺘ primpran amp ﺍﺪﺟ ﺲﻳﻮﻛ ﺔﻋﺮﳉﺍ ﻑﺭﺎﻋ ﻰﻘﺒﺗ ﻡﺯﻻ
ﻪﻧﻷ ﻞﻤﻌﻳ ﻦﻜﳑ extra pyramidal manifestations ﺎﻌﺒﻃ ﺞﻨﺸﺘﻳ ﺩﺍﻮﻟﺍﻭ
ﻭﻩﺩ reversible
ﺔﻋﺮﳉﺍ ﻫﻲ ﻞﻔﻃ ﻮﻟ ﻰﻨﻌﻳ ﻮﻠﻴﻛ ﻞﻜﻟ ﺔﻃﺮﺷ١٠ ﺪﺧﺎﻳ ﻰﻘﺒﻳ ﻢﺠﻛ١٠ ﻰﻨﻌﻳ ﻁﺮﺷ١ ﻢﺳ٣ .
٢ /ﻚﺤﺼﻧﺃ ﻠﺴﻴﻟﺎﺳ ﻞﻴﺘﻴﺳﻻﺍ ﻦﻋ ﺪﻌﺒﺗ ﻚﻧﺍ ﺺﻟﺎﺧ ﺪﻴﺳﺍ ﻚﰲ ﻝﺎﻔﻃﻷﺍ
ﲔﻨﺳ ﺲﲬ ﻦﻣ ﻞﻗﺍ ﻝﺍ ﻥﺎﺸﻋRey's Syndrome
ﲔﻜﺳﺎﺠﻴﻔﻟﺍ ﺱﻮﺒﻟ ﰲ ﻼﺜﻣ ﲔﻓﻭﱪﻟﺍ ﻞﺜﻣ ﻩﲑﻏ ﻊﻣ ﺪﻨﻴﺒﻣﻮﻛ ﻭﺃ ﻱﺮﻓ ﺀﺍﻮﺳ .

45. ﻞﺠﺳﺃﻭ ﺔﻣﻮﻠﻌﳌﺍ ﻩﺬﻫ ﺎﻨﻫﻥﺇ ﻞﻀﻓﺃ ﺓﺭﺍﺮﳊﺍ ﺝﻼﻌﻟ ﺀﻲﺷﻮﻫ ﺀﺎﳌﺍ :
ﺓﺪﳌ ﻯﺭﺎﺟ ﺀﺎﻣ ﺖﲢ ﻞﻔﻄﻟﺍ ﻰﻤﲢ١٥ ﺔﻘﻴﻗﺩ ﻭ ﻯﺍ ﺎﻫﺪﻌﺑ ﻯﺪﺗ anti pyretic ﻦﻣﺍ .
٣ /ﻱﺃ ﺔﻳﻮﻌﻣ ﺔﻟﺰﻧ ﻩﺪﻨﻋ ﺪﺣ
ﻢﻫﺃ ﺀﻲﺷ ﻪﺤﻠﺼﺗﻭﺃ ﻮﻫ ﻩﺍﺩﺎﻔﺘﺗdehydration
ﻖﻳﺮﻃ ﻦﻋ ﻩﺩﻭﺀﺎﻄﻋﺇ ﻝﻮﻠﶈﺍ
ﻮﻟ ﺎﻌﺒﻃﻭﰲ ﻮﻟﻭ ﺎﻬﳉﺎﻌﻧ ﺓﺭﺍﺮﺣﰲ ﻮﻟﻭ ﻪﳉﺎﻌﻧ ﻊﻴﺟﺮﺗﰲ ﻪﻴﻄﻌﻧ ﻰﻘﺒﻳ ﺔﻴﻟﺎﻋ ﺓﺭﺍﺮﺣanti biotic
ﻥﻮﻜﻳ ﻞﻀﻔﻳﻭ cefoperazon (cefozon)
50 mg/kg/day
ﻞﻛ١٢ ﺔﻋﺎﺳﻪﻧﻷ ﺶﺨﻴﺑ enterohepatic circulation ﻞﻐﺘﺸﻳﻭ ﰲ ﺀﺎﻌﻣﻷﺍ
ﺲﻳﻮﻛ
ﺎﻤﺋﺍﺩ ﺮﻛﺬﺗﻭﻥﺃ ﻢﻫﺃ ﺀﻲﺷ ﻦﻋ ﺪﻌﺒﻟﺍ ﻮﻫ dehydration ﺎﻣ ﻝﻮﻃﺖﻧﺃ ﺎﻣ ﻝﻮﻃ ﺪﻴﻌﺑﺖﻧﺃ ﰲ
ﻥﺎﻣﻷﺍ .

46. ﺎﻌﺑﺍﺭ :
HYPERTESION MANAGEMENT
ﻢﻠﻘﺑ :ﺪﺒﻋ ﺰﻋ ﻊﻴﺑﺭ ﷲﺍ
ﻻﻭﺃ / ﺔﺘﺷﻭﺮﻟﺍ ﰲ ﻙﺪﻴﺑ ءﺍﻭﺩ ﺐﺘﻜﺗ ﻥﺃ ﻞﺒﻗ:
ﻝﻭﻷﺍ ﺪﻬﺸﳌﺍ :
ﻲﻌﻴﺒﻄﻟﺍ ﻦﻣ ﻰﻠﻋﺃﻭ ﻚﳛﺮﻣ ﺶﻣ ﻂﻐﻀﻟﺍ ﺖﻴﻘﻟ ﻂﻐﻀﻟﺍ ﻪﻟ ﺖﺴﻴﻗﻭ ﺾﻳﺮﳌﺍ ﻚﻟﺎﺟ " ﺶﻣ ﺔﻳﺍﺮﻗ ﻱﺃ ﺪﺼﻗﺃ
ﻙﺎﺒﺟﺎﻋ .. " ﺎﻧﺭﻮﻨﺗﻭ ﺝﺎﺣ ﺎﻳ ﱵﻗﻮﻟﺩ ﻞﻀﻔﺘﺘﻫ ﻪﻟﻮﻘﺘﻫ٣ ، ﲔﻣﻮﻳ ﻞﻛ ﺓﺮﻣ ، ﻱﺎﳉﺍ ﻉﻮﺒﺳﻷﺍ ﻝﻼﺧ ﺕﺍﺮﻣ
ﻂﻐﻀﻟﺍ ﻚﻟ ﺲﻴﻘﺘﻫ ﻪﺿﺮﻤﳌﺍﻭ .. ﺢﻳﱰﺴﻣ ﻥﻮﻜﺗ ﺲﺑ ﻞﻛﺎﺸﻣ ﺶﻴﻔﻣ ﺖﻴﺒﻟﺍ ﰲ ﻙﺪﻨﻋ ﻪﺴﻴﻘﺗ ﺐﲢ ﻮﻟﻭ
ﻭ ﺏ ﻞﻛﻷﺍ ﺪﻌﺑ٤ ﺔﻳﺩﺎﻛﺭﺎﻛ ﻻﻭ ﺓﻮﻬﻗ ﻻﻭ ﻱﺎﺷ ﺏﺭﺎﺷ ﺶﻣﻭ ﺕﺎﻋﺎﺳ ..ﺴﺗﻭ ـﻟﺍ ﱄ ﻞﺠ٣ ﻭﺃ ﺕﺎﺳﺎﻴﻗ
ﺗ ﺎﻬﻴﻠﻋ ﻚﺘﻟﻮﻗ ﻲﻠﻟﺍ ﺕﺎﻃﺎﻴﺘﺣﻹﺎﺑ ﺔﺿﺮﻤﳌﺍ ﻊﻣ ﻱﺪﻨﻋ ﺎﻨﻫ ﻢﻬﻠﺠﺴ ..ﺔﻣﻼﺴﻟﺍ ﻊﻣ
ﻲﻧﺎﺜﻟﺍ ﺪﻬﺸﳌﺍ :
ـﻟﺍ ﺖﻓﻮﺷ ﻚﺗﺩﺎﻌﺳ3 ـﻟﺍ ﻦﻤﺿ ﻚﻋﺎﺘﺑ ﺾﻳﺮﳌﺍ ﻒﻨﺼﺗ ﺎﻣﺰﻟ ، ﺕﺎﺳﺎﻴﻗ 3 ﻝﻭﺩ ﲔﻣﺩﺎﻘﻟﺍ ﺕﻻﺎﻤﺘﺣﺇ :
ﻦﻣ ﻥﻮﻜﻳ ﺎﻳ١٢٥ ـﻟ١٤٠ /٨٥ ـﻟ٩٠ ﻲﻌﻴﺒﻄﻟﺍ ﻕﻮﻓ ﺍﺩ ﻞﺟﺍﺮﻟﺍ ﻰﻘﺒﻳ ﺍﺪﻛﻭﻳﻮﺸﺑﺎ
ﻥﻮﻜﻳ ﺎﻳ١٤٠ ـﻟ١٦٠ /٩٠ ـﻟ١٠٠ ﻰﻘﺒﻳ ﺍﺪﻛﻭ Stage 1
ـﻟﺍ ﻕﻮﻓ ﻥﻮﻜﻳ ﺎﻳ١٦٠ / ـﻟﺍ ﻕﻮﻓ١٠٠ ﻰﻘﺒﻳ ﺍﺪﻛﻭ Stage 2
ﺕﺎﺳﺎﻴﻘﻟﺍ ﻑﻮﺸﺗ ﺎﻣ ﺪﻌﺑﻭ .. ﺞﻴﺘﺳ ﺎﻳ ﻝﺎﻣﺭﻮﻧ ﻱﺎﻫ ﺎﻳ ﻪﻔﻨﺼﺗ١ ﺞﻴﺘﺳ ﺎﻳ٢ .. ﺔﺻﻼﳋﺍ ﻱﺩ ﻚﺒﻴﺳ
ﻲﻧﺎﺗ ﻡﻼﻛ ﻱﺃ ﻦﻣ ..

47. ﺖﻟﺎﺘﻟﺍ ﺪﻬﺸﳌﺍ :
ﻱﺃ ﻰﻠﻋ ﻚﻋﺎﺘﺑ ﻥﺎﻴﻌﻟﺍ ﻊﻠﻃ ﺀﺍﻮﺳ Stage .. ﺎﻳﻮﺷ ﱄﺎﻋ ﻂﻐﻀﻟﺍ ﻙﺪﻨﻋ ﺖﻧﺍ ﺝﺎﺣ ﺎﻳ ﻪﻟﻮﻘﺘﻫ ..
ﻦﻤﻄﻧ ﻥﺎﺸﻋ ﺍﺪﻛ ﺔﻄﻴﺴﺑ ﻞﻴﻟﺎﲢ ﺎﻳﻮﺷ ﻞﻤﻌﻨﻫ ﺲﺑ :
؟؟ ﻪﻴﻟﻭ ﻞﻴﻟﺎﺤﺘﻟﺍ ﺎﻴﻫ ﻪﻳﺇ
CBC
Creatinine
Fasting Glucose
total Cholesterol
HDL
+
Urine analysis
ECG
ـﻟﺍ ﻦﻣ ﺔﺠﻴﺘﻨﺑ ﻊﻠﻄﺗ ﻱﺩ ﻞﻴﻟﺎﺤﺘﻟﺍ ﻦﻣ ﻚﺗﺩﺎﻌﺳ ﺽﻭﺮﻔﳌﺍ٤ :
؟؟؟ ﻷ ﻻﻭ ﺐﻠﻘﻟﺍ ﰲ ﻞﻛﺎﺸﻣ ﻩﺪﻨﻋ ﺍﺩ ﻞﺟﺍﺮﻟﺍ
Cardiac problem
؟؟؟ ﻪﻳﺍ ﻻﻭ ﺔﻴﻟﺎﻋ ﻩﺪﻨﻋ ﻥﻮﻫﺪﻟﺍ ﻡﺎﻈﻧ
Risk factor
؟؟؟ ﻷ ﻻﻭ ﺮﻜﺳ ﻩﺪﻨﻋ
Diabetes
؟؟؟ ﻷ ﻻﻭ ﻰﻠﻜﻟﺍ ﰲ ﺔﻠﻜﺸﻣ ﻩﺪﻨﻋ
Renal Problem

48. ﺍ ﻞﺒﻗ ﺎﻣﻊﺑﺍﺮﻟﺍ ﺪﻬﺸﳌ :
" ﻰﻠﻋ ﻚﻋﺎﺘﺑ ﻥﺎﻴﻌﻟﺍ ﻲﺸﻤﺘﻫ ﻑﻮﺸﺗ ﻚﻧﺇ ، ﺍﺩ ﺪﻬﺸﳌﺍ ﰲ ﻚﻨﻣ ﺏﻮﻠﻄﻣLife-style
modifications ﻻﻭ ﺲﺑDrug-therapy ؟ ﻩﺎﻌﻣ
" ﻞﻴﻟﺎﺤﺘﻟﺍﻭ ﺕﺎﺳﺎﻴﻘﻟﺍ ، ﺍﻮﺗﺎﻓ ﻲﻠﻟﺍ ﻦﻳﺪﻬﺸﳌﺍ ﻰﻠﻋ ﺀﺎﻨﺑ " ..
ﻊﺑﺍﺮﻟﺍ ﺪﻬﺸﳌﺍ :
ﺪﻬﺸﳌﺍ ﻦﻣ ﻞﻛ ﻊﻤﲜﻲﻧﺎﺜﻟﺍ ﻟﺍﻭﺚﻟﺎﺜ ،
" ﻊﻠﻄﺘﺘﺑﺕﻻﺎﻤﺘﺣﻻﺍ ﻱﺩ ﺔﻣﺩﺎﻘﻟﺍ "
١ / ﻝﺎﻣﺭﻮﻧ ﻱﺎﻫ ﺪﺣﺍﻭ.. ﻩﲑﻏ ﻻﻭ ﺮﻜﺳ ﻻﻭ ﺺﻟﺎﺧ ﺔﻴﻧﺎﺗ ﺔﻠﻜﺸﻣ ﻱﺃ ﻩﺪﻨﻋ ﺶﻣﻭ .. ﻰﻠﻋ ﻲﺸﳝ ﺍﺩ
Life-style ﻱﻭﺃ ﺔﻳﺎﻔﻛ..
" ـﻟﺍ ﻝﻮﻘﻨﻫ Life-Style ﺎﻳﻮﺷ ﺪﻌﺑ "
٢ / ﻝﺎﻣﺭﻮﻧ ﻱﺎﻫ ﺪﺣﺍﻭ.. ﺮﻜﺳ ﺾﻳﺮﻣ ﺍﻮﻫﻭ..
ـﻟﺍ ﺎﻨﻫ Life-style ﺔﻳﺎﻔﻛ ﺶﻣ ..
ﻂﻐﻀﻠﻟ ﺀﺍﻭﺩ ﺪﺧﺎﻴﻫ ﺍﺪﻛ.. ﻦﻳﺪﻌﺑ ﻪﻟﻮﻘﻨﻫ ..
٣ / ﺪﺣﺍﻭ Stage 1" " ﻪﻣﺍﺪﻗ ﺍﺩ ، 3 ﺕﻻﺎﻤﺘﺣﺇ :
ﺃ / ﺔﻴﻧﺎﺗ ﺔﻠﻜﺸﻣ ﻱﺃ ﻩﺪﻨﻋ ﺶﻣ " ﺮﻜﺳ ﻪﻴﻓ ﻻﻭ ﺓﺯﺎﺘﳑ ﺎﻬﻠﻛ ﻪﻠﻴﻟﺎﲢ ﺪﺼﻗﺃ" .. ﺝﺎﺣ ﺎﻳ ﻪﻟﻮﻘﺗ ﺍﺩﻭ
ﻰﻠﻋ ﻲﺸﻤﺘﻫlife-style ﺪﻌﺑ ﺎﻧﺭﻮﻨﺗﻭ ﺲﺑ 3 ﻥﺇ ﺮﻬﺷﺃ ﺍ ﺀﺎﺷ .. ﻲﻧﺎﺗ ﻂﻐﻀﻟﺍ ﻉ ﻦﻤﻄﻧ،
ـﻟﺍ ﻢﻗﺭ ﻱﺪﻋ ﻮﻟﻭ stage ﺪﻌﺑﺍﺪﻛ ـﻟﺍ ﻦﻋ ﻲﻠﻋ ﲏﻌﻳ١٤٠/٩٠ ﺐﺳﺎﻨﳌﺍ ﺀﺍﻭﺪﻟﺍ ﻪﻟ ﺐﺘﻜﻧ ﻰﻘﺒﻧ ..

49. ﺏ / ﺪﺣﺍﻭﺎﻳﻮﺷ ﻩﺪﻨﻋ Risk factors ﺔﻔﻴﻔﺧ" ﺔﻴﻟﺎﻋ ﻥﻮﻫﺩ ﺎﻳﻮﺷ ﻱﺯ .. " ﺶﻣ ﺲﺑ
ﺮﻜﺳ ﰲ ﻻﻭ ﺐﻠﻘﻟﺍ ﰲ ﺔﻠﻜﺸﻣ ﻩﺪﻨﻋ.. ﻥﻮﻫﺪﻟﺍ ﻝﺰﻨﻳ ﺀﺍﻭﺩ ﺔﻠﻳﺪﺗ ﺍﺩ ..ﻰﻠﻋ ﺔﻴﺸﲤﻭ life-style
ﺝﻼﻋ ﻪﻟ ﺶﺒﺘﻜﺘﻣﻭ ﻂﻐﻀﻠﻟ .. ﺪﻌﺑ ﺎﻧﺭﻮﻨﻳﻭ٣ ﺮﻬﺷﺃ .. ﻝﺍ ﻦﻋ ﻲﻠﻋ ﻮﻟ ﻂﻐﻀﻟﺍ ﻪﻟ ﻑﻮﺸﻧ١٤٠/٩٠
ﻂﻐﻀﻠﻟ ﺝﻼﻋ ﺪﺧﺎﻳ ..
ﺝ / ﻭﺃ ﻂﺒﻈﺘﻣ ﺶﻣ ﲔﺗﺎﺘﻳﺮﻜﻟﺍ ﻱﺯ ﻰﻠﻜﻟﺍ ﰲ ﺔﻠﻜﺸﻣ ﻭﺃ ﺐﻠﻘﻟﺍ ﰲ ﺔﻠﻜﺸﻣ ﻩﺪﻨﻋﻭ ﺯﺭﻮﺘﻛﺎﻓ ﻚﺴﻳﺭ ﻩﺪﻨﻋ
ﺮﻜﺳ ﻭﺃ ﻝﻮﺒﻟﺍ ﰲ ﲔﺗﻭﺮﺑ ﰲ .. ﻂﻐﻀﻟﺍﻭ ﺐﻠﻘﻠﻟ ﻡﱰﳏ ﺝﻼﻋ ﻰﻠﻋ ﻲﺸﳝ ﺍﺩ ..ﻦﻳﺪﻌﺑ ﻪﻓﺮﻌﻨﻫ ..
ـﻟﺍﻭ ﻝﺎﻣﺭﻮﻧ ﻱﺎﳍﺍ ﺎﻨﺼﻠﺧ ﺍﺪﻛ stage 1
٤ / ـﻟﺍ ﺍﲑﺧﺃstage 2 ﻝﺎﺑ ﺪﻳﺪﺸﻟﺍ ﻡﺍﺰﺘﻟﻹﺍ ﻰﻠﻋ ﺓﻭﻼﻋﻭ ﻡﱰﳏ ﺝﻼﻋ ﻰﻠﻋ ﻲﺸﳝ ﺔﻴﻬﻳﺪﺑ ﻞﻜﺑ ﺍﺩﻭ
ﻪﻓﻼﺧﻭ ﲔﺧﺪﺘﻟﺍ ﻱﺯ ﻉﺎﻄﺘﺴﳌﺍ ﺭﺪﻗ ﻰﻠﻋ ﺯﺭﻮﺘﻛﺎﻓ ﻚﺴﻳﺭ ﻝﺍ ﻞﻴﻠﻘﺗﻭ ﻞﻴﺘﺳﺇ ﻒﻳﻻ ..
ﻥﺫﺇ ﺔﻳﺰﻴﻠﳒﻹﺎﺑ ،:
Hi-normal .. without D.M .. life-style only
Hi-normal .. with D.M .. Drug-Therapy

Stage 1 .. without risk.fs nor cardiac or renal
problem nor D.M .. Life-style only and recheck
after 3 months

Stage 1 .. with 1 risk factor " as hyperlipedimia "
but no other problems nor D.M .. life-style only
and recheck after 3 months

50. Stage 1 .. with more risk.fs and other problems
or D.M .. Drug Therapy

Stage 2 .. drug therapy

ﺎﻴﻧﺎﺛ / ﺐﺳﺎﻨﳌﺍ ءﺍﻭﺪﻟﺍ ﺭﺎﻴﺘﺧﺍ:

ﻼﺑ ﻡﺪﻟﺍ ﻂﻐﺿ ﻯﻮﺘﺴﻣ ﻞﻴﻠﻘﺗ ﰲ ﺔﻣﺪﺨﺘﺴﳌﺍ ، ﻲﺼﲢ ﻻﻭ ﺪﻌﺗ ﻻ ﱵﻟﺍ ﺔﻳﻭﺩﻷﺍ ﻦﻣ ﺕﺎﻋﻮﻤﳎ ﻙﺎﻨﻫ ، ﻚﺷ
ﻦﻜﻟ
Be a good picker for drug , to benefit ur patient
،، ﺀﻲﺷ ﻞﻛ ﻞﺒﻗ ﺮﻛﺫﺃ

Life style modifications :

ﺢﻠﳌﺍ ﻦﻣ ﻝﻼﻗﻹﺍ ، ﻝﻭﱰﺴﻴﻟﻮﻜﻟﺎﺑ ﺎﻫﺎﻨﻐﻟ ﺔﲰﺪﻟﺍ ﺔﻤﻌﻃﻷﺍ ﻞﻠﻘﻳ ، ﲔﺧﺪﺗ ﻞﻄﺒﻳ ، ﻪﻧﺯﻭ ﻞﻠﻘﻳ" ﺔﻘﻌﻠﻣ ﻩﺎﺼﻗﺃ
ﻪﻠﻛ ﻡﻮﻴﻟﺍ ﰲ ﺓﲑﻐﺻ " ﺔﻋﺎﺳ ﺺﻧ ﻡﻮﻳ ﻞﻛ ﻲﺸﳝ ، ﻡﻮﻴﺳﺎﺗﻮﺒﻟﺎﺑ ﺎﻫﺎﻨﻐﻟ ﻑﺎﻴﻟﻷﺍﻭ ﺭﺎﻀﳋﺍﻭ ﺔﻬﻛﺎﻔﻟﺎﺑ ﻢﺘﻬﻳ ،..
ﰲ ﺍﺍﺪﺟ ﺎﻧﺪﻴﻔﻳ ﺾﻳﺮﳌﺍ ﺓﺎﻴﺣ ﻞﻴﺘﺳﺇ ﲑﻴﻐﺗ ﻥﺃ ، ﺎﻘﺒﺴﻣ ﺎﻨﻘﻔﺗﺇ ﺎﻤﻛﻭ ﻱﺎﳍﺍ ﻭﺃ ﻂﻴﺴﺒﻟﺍ ﻡﺪﻟﺍ ﻂﻐﺿ ﺝﻼﻋ
ﻝﺎﻣﺭﻮﻧ .. ﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻟﺍ ﺕﺎﺟﺭﺩ ﺔﻓﺎﻛ ﺝﻼﻋ ﰲ ﺔﻳﻭﺩﻷﺍ ﻊﻣ ﺎﻀﻳﺃ ﻪﻨﻋ ﻰﻨﻏ ﻻﻭ..

51. ﻚﻀﻳﺮﻣ ﺐﺳﺎﻨﻳ ﺎﻣ ﺭﺎﺘﲣ ﻒﻴﻛ ﻢﻠﻌﺗ ، ﺔﻴﺴﻴﺋﺭ ﺕﺎﻋﻮﻤﳎ ﺲﲬ ﰲ ﻂﻐﻀﻟﺍ ﺕﺎﺟﻼﻋ ﺮﺼﺤﻨﺗ:
A/ Diuretics
ﻥﻮﻜﺗ ﻥﺃ ﻞﻀﻔﻳ - ﻲﻫ - ﰿﺎﻌﺗ ﻥﺃ ﻊﻴﻄﺘﺴﺗﻭ ﻂﻐﻀﻟﺍ ﺝﻼﻌﻟ ﻝﻭﻷﺍ ﻂﳋﺍ ﻱﻷ ﺎﻬﺘﻓﺎﺿﺇ ﻭﺃ ﺎﻫﺩﺮﻔﳌ ﺎﲠ
ﻂﻐﻀﻠﻟ ﺮﺧﺁ ﺾﻓﺎﺧ " ﺔﻴﻧﺎﺗ ﺔﻠﻜﺸﻣ ﻩﺪﻨﻋ ﺍﺩ ﺺﺨﺸﻟﺍ ﻭﺃ ، ﻲﻌﻴﺒﻄﻟﺍ ﻢﻗﺮﻟﺍ ﻰﻠﻋ ﺶﻄﺒﻈﺗﺍ ﺎﻣ ﻂﻐﻀﻟﺍ ﻮﻟ
ﻂﻐﻀﻟﺍ ﻊﻣ .. ﺕﺍﺭﺪﳌﺍ ﻊﻣ ﺔﻴﻧﺎﺗ ﺕﺎﺟﺎﺣ ﻒﻴﻀﻨﺑ ﺎﻨﻫ.. ﻝﺍ ﻼﺜﻣ ﻱﺯ ، ﻦﻳﺪﻌﺑ ﺎﻬﻓﺮﻌﻨﻫB
blockers ﺍﺬﻜﻫﻭ.. " ..
ﺕﺍﺭﺪﻣ ﻥﻮﻠﻤﻌﺘﺴﻳ ﺎﻤﻨﻴﺣ ﺱﺮﻘﻨﻟﺍ ﺔﻣﺯﺃ ﻦﻣ ﻥﻮﻧﺎﻌﻳ ﻦﻣ ﺔﺻﺎﺧ ﺱﺮﻘﻨﻟﺍ ﻰﺿﺮﻣ ﻊﻣ ﺔﻠﻀﻔﻣ ﲑﻏ ﺕﺍﺭﺪﳌﺍ
ﻝﻮﺒﻠﻟ ..
ﻞﻴﻠﻘﺗ ﰲ ﺐﺒﺴﺘﺗ ﺕﺍﺭﺪﳌﺍ ﺎﻌﺒﻃ ﻥﻷ ﻡﻮﻴﺳﺎﺗﻮﺒﻟﺍ ﻆﻔﲢ ﺔﺟﺎﺣ ﻱﺃ ﺭﺎﺘﺨﳌﺍ ﻝﻮﺒﻟﺍ ﺭﺪﻣ ﻊﻣ ﻒﻴﻀﺗ ﻚﻧﺇ ﻞﻀﻔﻳ
ﺎﻨﻫ ﻒﻴﻀﻨﺑﻭ ﻢﺴﳉﺍ ﰲ ﻡﻮﻴﺳﺎﺗﻮﺒﻟﺍ ﺔﺒﺴﻧk-sparing diuretic
ﻝﻮﺒﻟﺍ ﺕﺍﺭﺪﻣ" ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ " ﱄﺎﺘﻟﺎﻛ:
A/
Frank Diuretics
" ﺶﻣ ﺪﺼﻗﺃ Combined ﻯﺮﺧﺃ ﺔﻳﻭﺩﺃ ﻊﻣ : ".
ﻻﻭﺃ : ـﻟﺍindapamide
ﰲ ﻼﺜﻤﺘﻣ :
Diurex-Natrilix-Natrilix SR-Inamide
ﺔﻋﺮﳉﺍ : ﺐﺴﺣ ﻰﻠﻋ ﻞﻴﻠﻟﺎﺑ ﺪﺣﺍﻭﻭ ﺢﺒﺼﻟﺍ ﺪﺣﺍﻭ ﻦﻜﳑ ﻭﺃ ، ﺎﻴﻣﻮﻳ ﺪﺣﺍﻭ ﺹﺮﻗ Severity

52. ﺎﻴﻧﺎﺛ : ﻝﺍFuresemide
ﰲ ﻼﺜﻤﺘﻣ :
Lasix 40- Lafurex 20 , 40
ﺔﻋﺮﳉﺍ : ﺹﺮﻗ٢٠ ﺹﺮﻗ ﻭﺃ٤٠ .. ﲔﺻﺮﻗ ﺔﻳﺎﻐﻟ ﻙﺎﻌﻣﻭ 40 ﻡﻮﻴﻟﺍ ﰲ .. ﱪﻛﻭ ﺔﻟﺎﳊﺍ ﺐﺴﺣ ﻰﻠﻋ
ﻂﻐﻀﻟﺍ ﺔﻤﻴﻗ .. ﻱﻭﺍ ﱄﺎﻋ ﺶﻣ ﻂﻐﻀﻟﺍ ﻮﻟ ﻦﻜﳑﻭ .. ﻡﻮﻳﻭ ﻡﻮﻳ ﻰﻘﺒﻳ .. ﻚﻀﻳﺮﻣ ﻑﻮﺷﻭ ﺏﺮﺟﻭ
ﻪﻳﺇ ﻰﻠﻋ ﻂﺒﻈﺘﻴﻫ ..
ﺎﺜﻟﺎﺛ : ﻝﺍSpironolactone
ﰲ ﻼﺜﻤﺘﻣ :
Aldactone 25 , 100-Epilactone 25- Spectone 100
ﺔﻋﺮﳉﺍ : ﲔﺻﺮﻗ٢٥ ﻡﻮﻴﻟﺍ ﰲ ﺓﺪﺣﺍﻭ ﺓﺮﻣ .. ﻦﻣ ﻙﺎﻌﻣ٥٠ ﻝ١٠٠ ﻡﻮﻴﻟﺎﺑ ..
B/
Combined Diuretics :
1/
ﻝﺍ ﻊﻣ ﺪﻨﻴﺒﻣﻮﻜﻟﺍ k-sparing:
Hydro.C.Thiazide + Spironolactone
ﰲ
Aldactazide-Spirozide

53. Furesmide + Spironolactone
ﰲ
Lasilactone 50 ,100
2/
ﻝﺍ ﻊﻣ ﺪﻨﻴﺒﻣﻮﻜﻟﺍ B-Blockers :
ﻚﺘﻳﺭﻮﻳﺍﺪﻟﺍ ﻊﻣ ، ﻦﻳﺪﻌﺑ ﺎﻬﻓﺮﻌﻨﻫﻭ ، ﺎﻬﺟﺎﺘﳏ ﺖﻧﺍ ﻮﻟ ﺯﺮﻛﻮﻠﺑ ﺎﺘﻴﺒﻟﺍ ﻚﻟ ﺮﻓﻮﺘﺑ ﺎﳖﻷ ، ﺓﺯﺎﺘﳑ ﻱﺩ ﺔﻳﻭﺩﻷﺍ ﺎﻨﻫﻭ
ﻥﺎﻤﻛ ..ﻡﱰﳏ ﻲﺑﺍﲑﺛ ﺪﻨﻴﺒﻣﻮﻛ ﲏﻌﻳ ..
ﺪﻨﻴﺒﻣﻮﻜﻟﺍ ﺔﻳﻭﺩﺃ ﰲ : ﻼﺜﻣ ﺔﺒﻠﻌﻟﺍ ﻰﻠﻋ ﺏﻮﺘﻜﻣ ﻲﻗﻼﺗ10 ﻰﻠﻋ٦.٢٥ ﻑﺎﻀﳌﺍ ﺰﻴﻛﺮﺗ ﻮﻫ ﻝﻭﻷﺎﺑ ﺪﺼﻘﻳ
ﻚﺘﻳﺭﻮﻳﺍﺪﻟﺍ ﻮﻫ ﻲﻧﺎﺜﻟﺍﻭ :
Chlorthalidone + Atenolol
ﰲ
Blokium diu - Tenedone
ـﻟﺍ
Amiloride + Atenolol
ﰲ
Atenoretic – Teklo
ـﻟﺍ
H.C.Thiazide + Bisoprolol
ﰲ
Lodoz 2.5, 5, 10 - Concor plus

54. 3/
ﻊﻣ ﺪﻨﻴﺒﻣﻮﻜﻟﺍ ACE-Inhibitors :
ﻝﺍ ﻮﻫﻭ ﺖﺑﺎﺛ ﻚﺘﻳﺭﻮﻳﺍﺪﻟﺍ ﺎﻨﻫﻭ H.C.Thiaz.
ﻑﺎﻀﳌﺍ ﺭﻮﺘﺒﳖﻹﺍ ﻉﻮﻧ ﻮﻫ ﲑﻐﺘﳌﺍﻭ :
ـﻟﺍ
Benazapril
ﰲ
Cibadrex

ـﻟﺍ
Captopril
ﰲ
Capozide - Farcopril plus - Capojed-H

ـﻟﺍ
Enalapril
ﰲ
Ezapril-co - Co-renitac

55. B/ Beta Blockers
، ﻪﻴﻠﻋ ﺙﺭﺍﻮﺘﳌﺍ ﻦﻣ ﻥﺎﻛﻡﺍﺪﺨﺘﺳﺍ ، ﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻠﻟ ﻝﻭﺃ ﻲﺟﻼﻋ ﻂﺨﻛ ، ﺎﺘﻴﺒﻟﺍ ﺕﻼﺒﻘﺘﺴﻣ ﺩﺍﻮﺿ
ﺽﺍﱰﻓﺎﺑ ﻦﻣ ﻞﻠﻘﺗ ﺎﳖﺃ
Cardiac morbidity and mortality
ﻥﺎﻣﺰﻟﺍ ﻪﻴﻠﻋ ﻰﺘﻋ ﺍﺬﻫ ﻦﻜﻟ .. ﻥﺃ ﱃﺇ ﲑﺸﺗ ﺓﺪﻳﺪﳉﺍ ﺙﺎﲝﻷﺍﻭﻡﺍﺪﺨﺘﺳﺍ ﻱﺃ ﻦﻣ ﻞﻠﻘﻳ ﻻ ﺩﺍﻮﻀﻟﺍ ﻩﺬﻫ
ﻪﻟ ﺎﲟﺭ ﻒﺳﻸﻟﻭ ﺭﺎﻄﺧﺃ
Some Worse clinical outcome
ﻦﻣ ﻞﻠﻘﺗ ﺎﳖﺃ ﺎﻘﻠﻄﻣ ﻲﻔﻨﻧ ﻻ ﺎﻨﻨﻜﻟﺔﻴﻟﺎﻤﺘﺣﺍ ﺔﺒﺴﻨﺑ ﺔﻴﻏﺎﻣﺪﻟﺍ ﺔﺘﻜﺴﻟﺍ ﺙﻭﺪﺣ 20% ـﻟﺍ ﻦﻣ ﻲﻤﲢﻭ
coronary events ﺔﺒﺴﻨﺑ40% ﺎﻣﺃ ،،ﺎﳖﺃ ﺔﻣﺯﻷﺍ ﻦﻣ ﻭﺃ ﺔﺘﻜﺴﻟﺍ ﻦﻣ ﺎﻘﻠﻄﻣ ﻲﻤﲢ
ﺔﻴﺒﻠﻘﻟﺍMI ﺍﺬﻫ ،ﺓﺮﳌﺎﺑ ﺢﻴﺤﺻ ﲑﻏ ﻡﻼﻛ ..
، ﺎﻀﻳﺃ ﻖﳏ ﲑﻏ ﺖﻧﺃ ﰲ ﺎﺘﻴﺒﻟﺍ ﺩﺍﻮﺿ ﻡﺪﺨﺘﺴﺗ ﺎﻤﻨﻴﺣ:
Uncomplicated hypertension
ـﻛ ﺎﻬﺘﻣﺍﺪﺨﺘﺳﺇ ﺀﺍﻮﺳ
monotherapy ﻭﺃ1st line ttt

ﱪﺘﻌﺗ ، ﺎﺘﻴﺒﻟﺍ ﺩﺍﻮﺿ Of-Choice ﰲ٨ ﻰﻠﻋ ،٣ ﺔﻴﺴﻴﺋﺭ ﻦﻳﻭﺎﻨﻋ :
1/
Complicated HTN
ـﺑ ﺪﺘﻴﻜﻠﺒﻣﻮﻛ ﺀﺍﻮﺳ angina ﻭﺃ post-MI ﻭﺃArrhythmia ﻭﺃCHF

56. 2/
HTN + Frequent migraine attacks
HTN + Resting Tachycardia
HTN+ Palpitation
3/
Uncontrolled HTN by Other ttt. Lines
ـﻟﺍ ﻦﻣ ﻥﺎﻛ ﻚﻋﺎﺘﺑ ﺾﻳﺮﳌﺍ ﺹﻼﺧ8 ، ﻢﻫﺮﻛﺫ ﰎ ﻲﻠﻟﺍ ـﻟﺍ ﻦﻣ ﺪﺣﺍﻭ ﺶﻣ ﻥﻮﻜﻳ ﺎﻣﺰﻟ ﻥﺎﻤﻛﻭ٤ ﻻﺇﻭ ، ﻝﻭﺩ
ﺯﺮﻛﻮﻠﺑ ﺎﺘﻴﺒﻟﺍ ﻪﻨﻋ ﺔﻋﻮﻨﳑ:
Brady-cardiac
Broncho-Athmatic
has peripheral circulatory disturbances
has untreated Myocardial Insufficiency
ـﻟﺍ ﻦﻣ ﺀﻯﺮﺑ ﻥﺎﻛ٤ ـﻟﺍ ﺪﺣﺃ ﻥﺎﻛﻭ٨ .. ﺀﺪﺑﺍﻭ ﻞﻛﻮﺗ ﻥﺫﺇ..
ـﻟﺍ ﺯﺮﻛﻮﻠﺑ ﺎﺘﻴﺒﻟﺍ ﺔﻤﺋﺎﻗ ﺭﺪﺼﺘﺗ
BisoProlol and Metoprolol
" ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ: "
Metoprolol , in :
Betaloc-Betacor
ﺔﻋﺮﳉﺍ: ﻱﻭﺃ ﺔﻳﺎﻔﻛ ﺎﻴﻣﻮﻳ ﺪﺣﺍﻭ ﺹﺮﻗ .
Bisoprolol , in :
ﻮﻫ ﺎﻣ ﻪﻨﻣFree ﻮﻫ ﺎﻣ ﻪﻨﻣﻭCombined
ـﻟﺍ ﻝﻮﺒﻟﺍ ﺭﺪﻣ ﻊﻣ Hydrocholorthiazide

57. ـﻟﺍ free :
Concor 2.5 , 5 , 10
ﺔﻋﺮﳉﺍ :
Selected individually
ﺀﺪﺑﺍ ، ﺔﺘﻳﺍﺪﺑ ﰲ ﻪﺴﻟ ﻱﺩﺎﻋ ﻉﻮﺿﻮﳌﺍ ﻮﻟ 5 ﻰﻘﺒﻳ ﲑﺘﻛ ﻝﺰﻨﺘﻫﻭ ﻝﻭﺃ ﱄﺎﻋ ﻂﻐﻀﻟﺍ ﻮﻟﻭ10
ﺭﺎﻄﻔﻟﺍ ﻊﻣ ﻭﺃ ﻖﻳﺮﻟﺍ ﻉ ﺎﻴﻣﻮﻳ ﺪﺣﺍﻭ ﺹﺮﻗ ..
ﻝﺍcompined :
ﻢﻫﺎﻨﻟﻮﻗﰲ ﻩﻼﻋﺃ ﻫﻭ ﻝﻮﺒﻟﺍ ﺕﺍﺭﺪﻣﻢ ـﻟﺍ
Lodoz 2.5/5/10
Concor plus
ﺎﻀﻳﺃ ﺎﻴﻣﻮﻳ ﺪﺣﺍﻭ ﺹﺮﻗ .
C/ ACE-Inhibitors :
ﻥﺇ ﻚﻟﻮﻘﻳ ﺐﻧﺎﺟﻷﺍ ﺪﻨﻋ ﺓﺭﻮﻬﺸﻣ ﺔﻠﲨ ﰲ ACEI ـﻟﺍ ﻊﻨﲤ
Early carido-renal and multi-organ Death
ﺮﻜﺴﻟﺍﻭ ﻂﻐﻀﻟﺍ ﺾﻳﺮﻣ ﺪﻨﻋ .
ﻦﻣ ﻞﻠﻘﺗ ﻱﺩ ﺔﻳﻭﺩﻷﺍ ﻥﺇ ﺍﺪﻛ ﻦﻣ ﻢﻬﻔﻧﺔﻴﻟﺎﻤﺘﺣﺍ ﻊﻣ ﻡﺪﺨﺘﺴﺗ ﻥﺃ ﻞﻀﻔﻳ ﻭﺃ CHF ﻖﺑﺎﺳ ﻢﻫﺪﻨﻋ ﻦﻣ ﻭﺃ
ـﻠﻟ ﻲﺿﺮﻣ Heart Attacks ﻭﺃStroke
ﺮﻜﺴـﻟﺍ ﻰﺿﺮﻣ ﻢﻫﻷﺍﻭ ﺍﲑﺧﺃﻭ..
ﺎﻤﺋﺍﺩ ﻝﻮﻗﺃ ﺎﻧﺃ :
ACEI = HTN + CHF + or - D.M

58. ﻮﻫﻭ ﺮﻜﺴﻟﺍ ﺽﺮﳌ ﺮﻄﺧ ﱪﻛﺃ ﻦﻣ ﲔﺘﻴﻠﻜﻟﺍ ﻲﻤﲢﻭ ﻊﻨﲤ ﺎﳖﺃ ﺔﻳﻭﺩﻷﺍ ﻩﺬﻫ ﺰﻴﳝ ﺎﻣ ﻢﻫﺃﻭ
Diabetic Nephropathy
ﻦﻣ ﻉﻮﻨﳑ ﺪﺣ ﰲ ACEI ؟؟
ﺐﻳﺮﻐﻟﺍ ﻑﻮﺷ .. ﺔﺒﻄﻌﻟﺍ ﺔﻴﻠﻜﻟﺍ ﺔﻟﺎﺣ ﻦﻣ ﺀﻮﺴﺗ ﺎﻬﻨﻜﻟﻭ ﺔﻤﻴﻠﺴﻟﺍ ﺔﻴﻠﻜﻟﺍ ﻲﻤﲢ ﺔﻳﻭﺩﻷﺍ ﻩﺬﻫ ﻥﺇ..
i.e
ـﻴﻫ ﺍﺪﻛ ، ﱄﺎﻋ ﲔﻧﺎﺘﻳﺮﻜﻟﺍ ﻭﺃ ﺔﻟﺎﻐﺷ ﺶﻣ ﺔﻴﻠﻜﻟﺍ
decrease ACEI elimination
ﻭﻊﻧﺎﻣ ﻝﻭﺃ ﺍﺩ Impaired renal
ﻦﻋ ﻊﻔﺗﺭﺍ ﲔﻨﻴﺗﺎﻳﺮﻜﻟﺍ ﻢﻫﺪﻨﻋ ﻦﻣ ﻰﻨﻌﲟ٣ :٢
؟؟ ﺎﻴﻧﺎﺛﻭ
Renal artery stenosis
ﺎﻌﺒﻃ ﻞﻣﺎﺣ ﻮﻟﻭ ..ﻉﻮﻨﳑ
ﲔﺘﻤﻠﻛ ﺮﺧﺃ ﺎﻨﻫ:
1/
ﺮﻬﺷﺃ side effectﻮﻫ Cough
ﺶﻣ ﺍﺩﻭ ﻢﺘﲥ ﻚﻴﻠﳜ ﻻﻭ ﻚﻘﻠﻘﻳ ..ﺪﺟ ﻱﺩﺎﻋﺍ
2/
ـﻟﺍ ﻩﺎﻌﻣ ﺏﺮﲡ ﻲﻠﻟﺍ ﺍﻮﻫ ﲔﻣ ACEI ﻝﻭﺃﻭ ؟؟ ﻝﻮﻃ ﻰﻠﻋ ﺀﺍﻭﺪﻟﺍ ﻒﻗﻮﺗ ، ﺔﻨﻴﻌﻣ ﺔﺟﺎﺣ ﻚﻟ ﺮﻬﻈﺗ ﺎﻣ
ﻪﻟ ﻪﺟ ﺪﺣﺍﻭ Angionecrotic edema ﻞﻤﻌﺘﺳﺍ ﺎﻣ ﻝﻭﺃ ﻼﺻﺃ ﻩﺪﻨﻋ ﻭﺃ ﺝﻼﻌﻟﺍ.

59. " ـﻟﺍACEI ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ ":
" ﺭﺎﺘﺧﺍ ﺍﻴﺸﻣﻭ ﻚﳛﺮﺗ ﻲﻠﻟﺍ ﺔﻋﻮﻤ ﻝﻮﻃ ﻰﻠﻋ ﻚﺘﺘﺷﻭﺭ ﰲ ﺎﻬ "
ﱃﻭﻷﺍ ﺔﻋﻮﻤﺍ :
ـﻟﺍ ﺓﺩﺎﻣCaptopril
ﰲ:
Capoten 25,50 - Capotril 25,50
ﺔﻋﺮﳉﺍ :
ﺀﺪﺑﺍ٢٥ ﻭﺃ ﲔﺗﺮﻣ٣ ﺎﻴﻣﻮﻳ
" ﻝﺍ ﻦﻣ ﺍﺭﺬﺣ ﲔﻣﻮﻳ ﻝﻭﺃ ﺓﲑﻐﺻ ﺔﻋﺮﺟ ﺀﺪﺒﺗ ﻚﻧﺇ ﻞﻀﻔﻳﻭPostural
Hypotension "
ﱰﻛﺍ ﻝﺰﻨﺗ ﺯﻭﺎﻋ ﺐﻴﻃ - ﲔﻋﻮﺒﺳﺃ ﺪﻌﺑ-
ﻱﺩﺍ٥٠ ﻭﺍ ﲔﺗﺮﻣ٣ ﺎﻴﻣﻮﻳ
،
ﻝﻮﺑ ﺭﺪﻣ ﺔﻳﺍﺪﺒﻟﺍ ﻦﻣ ﻒﻴﻀﺗ ﻦﻜﳑﻭHY.Ch.Thiaz.
ﻞﻳﺮﺗﻮﺑﺎﻜﻟﺍ ﻊﻣ :
ﻱﺯ:
Capozide - Farcopril plus - Capojed-H -
Hypodress-D

60. ﺔﻴﻧﺎﺜﻟﺍ ﺔﻋﻮﻤﺍ :
ـﻟﺍ ﺓﺩﺎﻣ Enalapril
ﰲ :
Enalapril 5 ,20 - Ezapril 10,20 -
Renitac 5,20
ﺔﻋﺮﳉﺍ :
ﺹﺮﻗ١٠ ﺎﻴﻣﻮﻳ ﲔﺗﺮﻣ ﻭﺍ ﺓﺮﻣ
ﺔﻳﺎﻐﻟ ﻙﺎﻌﻣﻭ٢٠ ﻭﺩﺮﺑ ﲔﺗﺮﻣ ﻭﺍ ﺓﺮﻣ
ﻦﻣ ﰲ ﺐﻴﻃ ﻞﻳﺮﺑﻻﺎﻨﻳﻹﺍ Compined ﻊﻣ H.C.Thiazide
؟
ﻢﻌﻧ
ﺔﻤﻠﻛ ﺩﻭﺯ co ﻕﻮﻓ ﻲﻠﻟﺍ ﺔﻳﻭﺩﻷﺍ ﻰﻠﻋ :

Co-Renitac
Ezapril-Co
or
Thiazopril

61. ﺓﲑﺧﻷﺍﻭ ﺔﺜﻟﺎﺜﻟﺍ ﺔﻋﻮﻤﺍ :
ACEI ﱃﺇ ﺔﻓﺎﻀﻣ ﺔﻋﻮﻨﺘﻣ HY.C.Thiazide
" ﻚﺘﺘﺷﻭﺭ ﰲ ﻪﻴﻠﻋ ﻲﺸﻣﺍﻭ ﻚﳛﺮﻳ ﻲﻠﻟﺍ ﺭﺎﺘﺧﺍ "
" ﺕﺎﻴﻟﺪﻴﺼﻟﺍ ﰲ: "
Cibadrex 10/12.5 - Cibadrex 10/25
" ﺭﺪﳌﺍ ﺔﻋﺮﺟ ﺩﻭﺰﺗ ﺯﻭﺎﻋ ﻮﻟ ﺍﺩ"

MonoZide 10/12.5 - MonoZide 20/12.5
" ـﻟﺍ ﺔﻋﺮﺟ ﺩﻭﺰﺗ ﺯﻭﺎﻋ ﻮﻟ ﺍﺩ ACEI "

Tritace comp 5/25
Tritace Ls 2.5/12.5

ﻭﻞﻴﻠﻗ ﻦﻣ ﺎﻧﺮﻛﺫ ﺎﻤﻛ ﺀﻻﺆﻫ ﻞﻛ ﺔﻋﺮﺟ :
one or 2 tablets " 2.5 or 5 or 10 or 20 " daily

ﺍﺬﻜﻫﻰﻬﺘﻧﺍ ﻊﻔﺗﺮﳌﺍ ﻡﺪﻟﺍ ﻂﻐﺿ ﺝﻼﻌﻟ ﻁﻮﻄﺧ ﺙﻼﺛ ﻞﻀﻓﺃﻭ ﻢﻫﺃ ﺽﺮﻋ

62. ﺎﺴﻣﺎﺧ :
ﺉﺭﺍﻮﻃﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻟﺍ
HYPERTESION EMEREGENCY
ﻢﻠﻘﺑ :ﺎﻳﺮﻛﺯ ﺢﻣﺎﺳ ﺭﻮﺘﻛﺩ
" ﺕﻻﺎﳊﺍ ﻢﺴﻘﺑ ﻢﻴﻘﻣ ﺐﻴﺒﻃﳊﺍ ﻲﻤﻴﻠﻌﺘﻟﺍ ﺎﻬﻨﺑ ﻰﻔﺸﺘﺴﲟ ﺔﺟﺮ"
ﺉﺭﺍﻮﻃ ﻂﻐﻀﻟﺍ
ﺩﺎﺣ ﻉﺎﻔﺗﺭﺍ ﻮﻫﺊﺟﺎﻔﻣ ﻡﺪﻟﺍ ﻂﻐﻀﺑﻲﺿﺎﺒﻘﻧﻻﺍ ﻭ/ ﻭﺃﻲﻃﺎﺴﺒﻧﻻﺍ ﻯﺩﺃ ﱃﺇ ﺏ ﻑﺮﻌﻳ ﺎﻣ EOD
ﻰﻨﻌﺗﻭEnd organ damage
ﺾﻳﺮﳌﺍ ﺐﻴﻃﻲﺠﻴﻫ ﻮﻜﺸﻳ ﻦﻣﻪﻳﺇ :
The most common clinical presentations of
hypertensive emergencies include :

A/Acute left ventricular failure
ﻩﺩﻭﻫﻴﻲﺠ ﻳﺞﻬﻨ ﺍﺪﺟﺴﺗﻭﻊﻤ ﻪﻴﻠﻋ :
Fine bilateral and basal crepitations then
bubbling sound may be heard
ﺾﻳﺮﻣ ﻩﺩ ﻰﻨﻌﻳﻲﺠﻴﻫ ﺏPulmonary edema

63. ﻄﺧﺔ ﻢﻬﻴﻓ ﺝﻼﻌﻟﺍﻞﻤﺸﺗ :
Lowering preload by :
R/lasix
&
R/nitroglycerin I.V

Lowering after load by :
R/ACEIs
ﺪﺒﻨﺑ ﺶﻣ ﺎﻨﺣﺍ ﺢﻴﺤﺻ ﻥﺎﺴﻠﻟﺍ ﺖﲢ ﺹﺮﻗ ﻪﻳﺪﺗ ﻦﻜﳑ ﺲﺑ ﻦﺗﻮﺑﺎﻜﻟﺎﺑ ﺀﱃﺇ ﺲﻛﺯﻼﻟﺍ ﺐﻧﺎﺟﺉﺭﺍﻮﻄﻛ
ﻪﺘﻌﺑﺍﻭ ﳌﺍﻰﻔﺸﺘﺴ
B/Acute aortic dissection
ﻩﺩﻭﻲﺠﻴﻫ ﻰﻜﺘﺸﻳ ﻦﻣﺁﻡﻻ ﺓﺩﺎﺣ ﰲ ﺭﺪﺼﻟﺍﻭﺃ ﻝﺍ ﻊﻗﻮﻣ ﺐﺴﺣ ﻦﻄﺒﻟﺍ Aneurism
ﺎﻬﺼﺨﺸﺘﻫ ﺎﻣ ﻙﺮﻤﻋﻻﺇ ﺎﻬﻴﻓ ﺖﻴﻜﺷ ﻮﻟ
ﻧﺍ ﻑﻭﺮﻌﻣ ﺎﺒﻟﺎﻏ ﺾﻳﺮﻣ ﻰﻘﺒﻴﺑ ﻩﺩﻪ ﻦﻣﺰﻣ ﻂﻐﺿ ﺾﻳﺮﻣ
ﺮﻬﺷﺃﻭ ﻮﻫ ﻩﺩﻮﺟﻭ ﻰﻠﻋ ﺕﺎﻣﻼﻌﻟﺍ Unequal pulse
ﺾﺒﻨﻟﺍ ﺲﺣﰲ ﻂﻐﻀﻟﺍ ﺲﻴﻗﻭ ﲔﻋﺍﺭﺬﻟﺍ ﻼﻛﰲ ﻼﻛﲔﻋﺍﺭﺬﻟﺍ ﺙﺭﺍﻮﻛ ﻞﺼﺤﺘﺑﻭ ﻩﺩ ﻡﻼﻜﻟﺍ ﺍﺪﺟ ﻢﻬﻣﺍﺫﺇ
ﺎﻬﺼﻴﺨﺸﺗ ﺀﻰﺳﺍ
ﻰﻘﺒﻴﻫ ﻝﻭﺩ ﻰﺿﺮﳌﺍﻞﻀﻓﺃ ﻮﻫ ﻢﳍ ﺝﻼﻋ :
ﺎﺘﻴﺑ ﺕﺎﻄﺒﺜﻣ ﻦﻣ ﺝﻭﺩﺬﻣ ﺝﻼﻋ BB ﺐﻧﺎﺟ ﱃﺍV.Dilators

64. ﺃﻝﺍ ﻢﻬﳘ
Nifedipin and Na nitroprussiad
ﻂﻐﻀﻟﺍ ﺾﻔﲞ ﻉﺍﺮﺳﻻﺍ ﻚﻨﻣ ﺏﻮﻠﻄﻣ ﺎﻨﻫ ﻞﻴﲣﻲﺿﺎﺒﻘﻧﻻﺍ ﻑﺎﻘﻳﻹ ﻝﺍshearing force
ﻪﻟﺰﻨﺗ ﻯﻮﺘﺴﻣ ﱃﺍ١١٠ ﻭﺍ١٠٠
ﻝﺍﻭ ﺐﻴﻃ ﱃﻮﻘﺘﻫBrain auto regulation & stroke risk
ﺕﺮﺠﻔﻧﺍ ﻡﺯﺭﻮﻴﻧﻻﺍ ﻮﻟ ﺕﻮﻤﻴﻫ ﺾﻳﺮﻣ ﲔﺑ ﻥﺯﺍﻮﺘﺑ ﺖﻧﺍ ﻚﻟﻮﻘﻫ
ﻭﺃ ﻪﻄﻠﺟ ﻪﻠﻴﳚ ﻪﻧﺍ ﻪﻴﻟﺎﻤﺘﺣﺎﺑ ﺶﻴﻌﻳ ﺎﺌﺑ ﺖﻧﺍ ﺭﺎﺘﺧﺍ ،.

C/Acute coronary syndrome &Ischemia
ﻮﻜﺸﻳ ﻝﺎﺒﻘﺘﺳﻻﺍ ﻰﺠﻴﻫ ﺾﻳﺮﳌﺍﻚﻴﻟﺇ ﻡﻻﺁ ﺓﺩﺎﺣ ﺭﺪﺼﻟﺎﺑﻪﻠﻤﻌﺗﻭ ﺐﻠﻗ ﻢﺳﺭﻰﻗﻼﺗ ﻝﺍ ﺕﺎﻣﻼﻋ
Ischemia
ﻑﻭﺮﻌﻣ ﺾﻳﺮﳌﺍ ﺎﻧﺪﻨﻋ ﺎﻨﻫﺎﺳﺎﺳﺃ ﺩﺍﺫ ﻂﻐﺿ ﺾﻳﺮﻣ ﻪﻧﺍﺕ ﻪﻴﻠﻋﻡﻻﺁ ﻰﻠﻟﺍ ﺭﺪﺼﻟﺍ
sympathetic pathway ﺩﺎﺣ ﻉﺎﻔﺗﺭﺍ ﺐﺒﺴﺘﻫ ﺎﻫﺭﻭﺪﺑﰲ ﻡﺪﻟﺍ ﻂﻐﺿ
ﻥﻮﻜﻴﺑ ﻢﻬﺟﻼﻋ ﻝﻭﺩ ﻰﺿﺮﳌﺍ :
R/Nitrate
R/BB
R/morphine
ﻮﻟﻭﺔﻟﺎﳊﺍ MI ﻱﻭﺎﻧﻭ ﺎﳍ ﻖﻠﻌﺗ streptokinase ﻂﻐﻀﻟﺍ ﻞﻠﻘﺗ ﻚﻓﺪﻫ ﻰﻘﺒﻳﱃﺇ ﻥﻭﺩ ﺎﻣ
ﻝﺍ180/100

65. D/Acute intracranial stroke Hag. Vs Infarction
ﻹﺍﺓﻮﺧ ﰲ ﺃﻷﺍﻭ ﺦﳌﺍ ﺽﺍﺮﻣﰲ ﺍﻮﻔﻠﺘﺧﺍ ﺏﺎﺼﻋ ﺃﰲ ﻢﻜﺤﺘﻟﺍ ﻪﻴﳘ ﻝﺍHypertensive
emergency ﰲ ﻰﺿﺮﻣﺔﺘﻜﺴﻟﺍ ﺔﻴﻏﺎﻣﺪﻟﺍ
ﻢﻬﻳﺃﺭﻭﻥﺇ ﻦﻣ ﻥﻮﻧﺎﻌﻳ ﺀﻻﺆﻫ ﻰﺿﺮﳌﺍ Disturbed Brain auto
regulation
ﺭﺪﻗ ﻅﺎﻔﳊﺍ ﺍﻭﺪﻳﺮﻳ ﻢﻫﻭﻥﺎﻜﻣﻹﺍ ﻰﻠﻋﺕﺍﺩﺍﺪﻣﺇ ﺦﻤﻠﻟ ﺀﺎﻣﺪﻟﺍ ﻦﻣ ﻪﻴﻓﺎﻛGood perfusion
ﺩﺍﺩﺰﺗ ﻻ ﻰﺘﺣﺔﻟﺎﳊﺍ ﺍﺀﻮﺳ
ﺐﻴﻃﺐﻴﺴﻧ ﻩﺪﻛ ﺾﻳﺮﳌﺍ ؟
ﻹﺍﺓﻮﺧ ﰲ ﻷﺍ ﺐﻠﻘﻟﺍ ﻪﻴﻌﲨﺔﻴﻜﻳﺮﻣ AHA ﺍﻮﻟﺎﻗﻞﺧﺪﺘﻧ ﰲ ﺕﻻﺎﳊﺍﺔﻴﻟﺎﺘﻟﺍ :
ﺾﻳﺮﻣ ﻙﺪﻨﻋ ﻮﻟ Infarction stroke
ﻂﻘﻓ ﻞﺧﺪﺗﺍﺫﺇ ﻂﻐﻀﻟﺍ ﻥﺎﻛﻰﻠﻋﺃ ﻦﻣ220/120
ﻑﺪﳍﺍﻭﻲﻠﻟﺍ ﻝﺪﻌﲟ ﻂﻐﻀﻟﺍ ﻝﺰﻨﺗ ﻚﻧﺍ ﻮﻫ ﻪﻘﻘﲢ ﺐﻟﺎﻄﻣ١٠ ﱃﺍ١٥ %
ﻻﺇ ﻮﻟﺍﺖﻧ ﻫﻡﺪﺨﺘﺴﺘ Thrombolytic ﻹﺔﺑﺍﺫ ﺔﻄﻠﳉﺍ ﻂﻐﻀﻟﺍ ﺽﺎﻔﺧﺎﺑ ﻚﻟ ﺢﻤﺴﻳ ﺎﻨﻫﱃﺇ
ﻥﻭﺩ ﺎﻣ185/110
ﻙﺭﺎﻴﺧ ﻥﻮﻜﻴﺑ ﻩﺩﻭﰲ ﻮﻫ ﻯﺩ ﺕﻻﺎﳊﺍ
R/sodium nitroprusside IV
ﻰﻨﻌﻳ ﻡﻼﺳ ﺎﻳﺎﻧﺃ ﺾﻳﺮﻣ ﺐﻴﺴﻫﺔﻄﻠﳉﺍ ﻪﻄﻐﺿﱄﺎﻋ ؟

66. ﺍﻮﻟﻮﻘﻳ ﺓﺪﻬﻌﻟﺍﻭ ﻢﻬﻴﻠﻋ ) ﺾﻳﺮﳌﺍ ﺐﻧﺫﻭﰲ ﻢﲠﺎﻗﺭ ( ﻥﺇ ﻉﺎﻔﺗﺭﻻﺍ ﺐﺒﺳﺊﺟﺎﻔﳌﺍ ﰲ ﻡﺪﻟﺍ ﻂﻐﺿﰲ ﻰﺿﺮﳌﺍ
ﺏ ﻑﺮﻌﻳ ﺎﻣ ﻮﻫ ﻝﻭﺩ
impaired neurogenic control of cardiovascular
system
ﱄﺎﺘﻟﺎﺑﻭ ﻊﻗﻮﺘﻣ ﻂﻐﻀﻟﺍ ﻩﺪﺣﻮﻟ ﻝﺰﻨﻳﱃﺇ ﻌﻴﺒﻄﻟﺍ ﻪﺗﻻﺪﻌﻣﺔﻴ ﻞﺒﻗﺔﻄﻠﳉﺍ ﺙﻼﺛ ﺪﻌﺑﱃﺇ ﻪﺴﲬﻡﺎﻳﺃ ﺙﻭﺪﺣ ﻦﻣ
ﺔﻄﻠﳉﺍ ﺎﲥﺍﺫ .
ﺽﺮﻔﺑ ﺐﻴﻃﻥﺇ ﻥﺎﻛ ﺾﻳﺮﳌﺍ Hag. stroke
ﻝﺍ ﻊﻨﻣ ﻮﻫ ﺎﻨﻫ ﻚﻓﺪﻫ re-bleeding
ﻰﻨﻌﻳﻞﺧﺪﺘﺗ ﻂﻐﻀﻟﺍ ﻮﻟ ﻰﻠﻋﺃ ﻦﻣ١٨٠/١٥٠
ﻚﺗﺩﺎﻴﺳﻝﻭﺎﲢ ﺀﻭﺪﲠ ﻂﻐﻀﻟﺍ ﻝﺰﻨﺗﺔﺳﻼﺳﻭ ﻝﺪﻌﲟ٢٠ ﱃﺇ ٢٥%
ﺭﺎﻴﺘﺧﻻﺍﻭﻞﺜﻣﻷﺍ ﻥﻮﻜﻳ ﻝ
dihydropiridine calcium blocker

R/Norvasc
OR
R/Epilat retard
ﻷﺍ ﻰﻨﻌﴰﺍ ﻰﻘﺑ ﻝﺍﺆﺴﻟﺍﻳﻭﺩﺔ ﺩﻱ ﺕﺍﺬﻟﺎﺑ ؟
ﻷﺍ ﻪﻃﺎﺴﺒﺑﻳﻭﺩﺔ ﺩﻱ ﺲﻜﻌﺗ ﲑﺛﺄﺗﺔﻄﻠﳉﺍ ﻰﻠﻋﺔﻴﻋﻭﻷﺍ ﺔﻳﻮﻣﺪﻟﺍ ﱵﻟﺍ ﺎﺑ ﺦﳌﺍ ﺪﲤﻡﺪﻟ
Antagonize cerebral vasospasm that occur with
intracranial Hag.
ﻪﻴﻟﻭﻼﺻﺃ ﺑﻰﻘﺒﻴ ﻴﻓﻪ Vasospasm؟
ﺩﻱ ﺔﺑﺎﺠﺘﺳﺍ ﻢﺴﺠﻠﻟ ﻪﻴﻌﻴﺒﻃﰲ ﻪﻟﻭﺎﳏﻑﺎﻘﻳﺇ ﻒﻳﺰﻨﻟﺍﻓﻞﻤﻌﻴﺒ VC

67. Hypertensive encephalopathy E/
ﺍﻮﻔﻠﺘﺧﺍ ﺍﻭﺩﺮﺑ ﺎﻨﻫﰲ ﺏﺎﺒﺳﺃ ﺎﻬﺛﻭﺪﺣ،
ﺍﻮﻤﺴﻘﻧﺍﱃﺇ ﲔﻘﻳﺮﻓ :
ﺪﻳﺆﻳ ﻖﻳﺮﻓﻥﺇ ﺔﻠﻜﺸﳌﺍ ﺏ ﺕﺃﺪﺑ Brain Hyper perfusion ﺊﺟﺎﻔﻣ ﻯﺩﺃ ﱃﺇ
Cerebral Edema
ﺪﻘﺘﻌﻳ ﻖﻳﺮﻓﻭﻥﺃ ﺔﻠﻜﺸﳌﺍ ﺩﺎﺣ ﻉﺎﻔﺗﺭﺎﺑ ﺕﺃﺪﺑ ﰲ ﻡﺪﻟﺍ ﻂﻐﺿﻯﺩﺃ ﱃﺇ ﺔﺑﺎﺠﺘﺳﺍ ﻞﻤﻌﺑ ﺦﳌﺍ ﻦﻣ
Vasospasm ﻪﻟﻭﺎﺤﻤﻛﺓﺮﻄﻴﺴﻠﻟ ﻪﻴﻤﻜﻟﺍ ﻰﻠﻋﺔﻠﺋﺎﳍﺍ ﺀﺎﻣﺪﻟﺍ ﻦﻣﺔﻘﻓﺪﺘﳌﺍ ﻪﻴﻠﻋ
ﻝﺍﻭ vasospasm ﻩﺭﻭﺪﺑﻯﺩﺃ ﱃﺇ cerebral ischemia
ﻩﺩ ﺾﻳﺮﳌﺍ ﻢﻬﳌﺍ ﺐﺒﺴﻟﺍ ﻦﻋ ﺮﻈﻨﻟﺍ ﻑﺮﺼﺑﻭﻲﺠﻴﻫ ﻦﻣ ﻰﻜﺘﺸﻳﻪﻳﺇ ؟
ﺽﺍﺮﻋﻷﺍ ﺔﻋﻮﻨﺘﻣ ﻉﺍﺪﺻ ﲔﺑ ﺎﻣ ﻠﻠﻏﺯ ؛ﺔ ﲔﻌﻟﺎﺑ ؛ﺀﻲﻗ ﻰﻠﻛ ﺞﻨﺸﺗ ؛ﻭﺃ ﻲﺋﺰﺟ ﻰﺘﺣ ﻭﺃ ﺩﺮﳎ ﺏﺍﺮﻄﺿﺍﰲ
ﻲﻋﻮﻟﺍ ﺩﺎﺣ ﻉﺎﻔﺗﺭﺎﺑ ﺐﺣﺎﺼﻣﰲ ﻡﺪﻟﺍ ﻂﻐﺿ .
ﻡﺍﺪﺨﺘﺳﺎﺑ ﻥﻮﻜﻴﺑ ﻰﻘﺑ ﺝﻼﻌﻟﺍ:
R/sodium nitroprusside IV
؟ﺕﺍﺬﻟﺎﺑ ﻩﺩ ﻰﻨﻌﴰﺍ
ﻪﻧﻷ ﻉﺮﺳﻷﺍ ﻼﻤﻋﻞﻗﻷﺍﻭ ﻰﻠﻋ ﺍﲑﺛﺄﺗcerebral blood flow
ﻝﺪﻌﲟ ﻂﻐﻀﻟﺍ ﺾﻔﺧ ﻮﻫ ﺝﻼﻌﻟﺍ ﻦﻣ ﻚﻓﺪﻫ 20% ﰲ ﺔﻋﺎﺴﻟﺍ ﱃﻭﻷﺍ
ﺔﻇﻮﺤﻠﻣ ﻩﲑﺧﺃ ﰲ ﻝﻭﺩ ﻰﺿﺮﳌﺍ :
ﻁﱰﺸﻳ ﻻﻥﺃ ﻡﺪﻟﺍ ﻂﻐﺿ ﻉﺎﻔﺗﺭﺍ ﺀﺍﺪﺑ ﺪﻬﻋ ﻖﺑﺎﺳ ﻪﻟ ﺾﻳﺮﳌﺍ ﻥﻮﻜﻳ ،

68. ﻝﺍ ﻥﻮﻜﻳ ﺪﻗ Hypertensive encephalopathy ﻮﻫﻝﻭﺃ ﺽﺍﺮﻋﺃ ﻉﺎﻔﺗﺭﺍ
ﺙﺪﳛ ﺪﻗﻭ ﻡﺪﻟﺍ ﻂﻐﺿﺹﺎﺨﺷﻷ ﻪﻴﻌﻴﺒﻃ ﻁﻮﻐﺿ ﻯﻭﺫ
ﺃ ﻦﻣﻭ ﺮﻬﺷﺽﺍﺮﻣﻷﺍ ﻟﺍﻲﻠ ﻑ ﺾﻳﺮﳌﺍ ﻞﺧﺪﺗHypertensive
encephalopathy
ـﻟﺍ ﻢﻫ
acute glomerular nephropathy / Eclampsia

ﺏ ﺎﻴﺴﻣﻼﻛﻹﺍ ﰿﺎﻌﺗﻭ:

R/Mgso4
AND / OR
R/methyldopa
AND / OR
R/hydralazine

AND / OR
R/Nitroprusside

ـﻟﺍ ﺽﺮﻋ ﻰﻬﺘﻧﺍ ﺍﺬﻜﻫHypertension Emergency

69. ﺎﺳﺩﺎﺳ :
HYPERTESION Urgency
ﺕﺎﻴﻔﺸﺘﺴﳌﺍ ﻝﺎﺒﻘﺘﺳﺍ ﰲ ﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻟﺍ
ﻢﻠﻘﺑ :ﺩ / ءﻼﻋ
ﺔﺒﺴﻨﻟﺎﺑ ﻊﻔﺗﺮﳌﺍ ﻂﻐﻀﻟﺍ ﺕﻻﺎﳊﻲﻠﻟﺍ ﺠﻴﺘﺑﻲ ﰲ ﻝﺎﺒﻘﺘﺳﻻﺍ ،
ﻲﻠﻟﺍﻭ ﻥﻮﻜﻳ ﻥﺎﻴﻌﻟﺍ ﻦﻜﳑﻝﻭﺃ ﻑﺮﻌﻳ ﻩﺮﻣﻥﺇ ﻂﻐﺿ ﻩﺪﻨﻋﻭﺃ ﺍﻮﻫﻼﺻﺃ ﻦﻣ ﰿﺎﻌﺘﻴﺑﻂﻐﻀﻟﺍ ﺪﺧﺎﻳ ﻰﺴﻧ ﻦﻜﻟ
ﺝﻼﻌﻟﺍﻭﺃ ﻂﻐﺿ ﺖﲢ ﻊﻗﻭﱯﺼﻋ
ﻥﻮﻜﻴﺑﺎﺟﻱ ﻦﻣ ﱰﻛﺍ ﻂﻐﻀﺑ١٨٠ ﻰﻠﻋ١١٠ ﻭﺃ ﻩﺪﻛ ﻦﻣ ﱰﻛﺍ
ﻝﺍ ﻰﻠﻋ ﻞﺋﻻﺩ ﺪﺟﻮﺗ ﱂ ﻥﺇ ﺎﻣ ﺔﻟﺎﺣ ﰲ ﺍﺬﻫEnd Organ Damage
ﻩﺩ ﻥﺎﻴﻌﻟﺍ ﻊﻣ ﺎﻨﻓﺪﻫﻥﺇ ﺎﻨﺣﺇ ﺵﻮﻠﻠﻘﻧ ﺎﻣ ﻦﻜﻟ ﻪﻄﻐﺿ ﻪﻠﻠﻘﻧﺔﻋﺮﺴﺑ ، ﻫ ﺎﻨﻓﺪﻥﺇ : ﻝﺪﻌﲟ ﻪﻠﻠﻘﻧ٢٥ %
ﻝﻼﺧﻝﻭﺃ ﲔﺘﻋﺎﺳ
ﻝ ﻪﻟﺰﻨﻧ ﻝﻭﺎﳓ ﻩﺪﻛ ﺪﻌﺑﻭ١٦٠ /١٠٠ ﰲ ﲔﺘﻋﺎﺳ ﻝﻼﺧﱃﺇ ﻊﺑﺭﺃ ﺕﺎﻋﺎﺳ
ﻦﺴﺣﻷﺍﻭ ﻥﺇ ﺎﻨﺣﺇ ﻪﻄﻐﺿ ﻪﻠﻄﺒﻈﻧ ﻡﻮﻴﻟﺍ ﺪﻌﺑﻭ ﻡﻮﻳ ﻩﺪﳌ ﻩﺩ ﻝﺪﻌﳌﺍ ﻦﻋ ﻂﻐﻀﻟﺍ ﺶﻠﻠﻘﻧ ﺎﻣ
ﺐﻴﻃﻪﻳﺇ ﻷﺍﺔﻳﻭﺩ ﻲﻠﻟﺍ ﺎﻬﻣﺪﺨﺘﺴﻧ ﻦﻜﳑ ؟
ﻪﻠﻳﺪﻧﺃﺪﻳﺭﻭ ﺲﻛﺯﻻ ﻝﻮﺒﻣ ﻞﻀﻋ ﻭﺃ ٢٠ ﻢﳎ ﻭﺃ٤٠ ﺔﻟﺎﳊﺍ ﺐﺴﺣ ﻰﻠﻋ ﻢﳎ - ﲔﺗﻮﺑﺎﻛ ﺹﺮﻗ ﻱﺪﻧ ﻦﻜﳑ ﻭﺃ
٢٥ ﻥﺎﺴﻠﻟﺍ ﺖﲢ ﺪﳊ٣ ﺹﺍﺮﻗﺃ - ﲏﺘﺴﻧﻭ ﺺﻧﺔﻋﺎﺳ ﻭﺃ ﻡﺎﻤﳊﺍ ﻞﺧﺪﻳ ﻥﺎﻴﻌﻟﺍ٣ ﺕﺍﺮﻣﺎﻤﻬﻳﺃ ﻞﺼﺣﻝﻭﻷﺍ
ﺑﻭﻘﻟﻭ ﻩﺎﻨﺴﻗ ﺐﻴﻃ ﻂﻐﻀﻟﺍ ﺲﻴﻘﻧ ﻩﺪﻛ ﺪﻌﺲﻛﺯﻻ ﻩﺪﺣﺍﻭ ﻥﺎﻤﻛ ﻪﻠﻳﺪﻧ ﻦﻜﳑ ﺶﻟﺰﻧﺎﻣ ﻪﺴﻟ ﻩﺎﻨ .

70. ﺍ ﺪﻤﲝ ﰎ ﰲ١٠ /٥ /٢٠٠٩
ﺀﺎﻬﺘﻧﻻﺍ ﻦﻣ:

COMMON MISTAKES
In
DOCTOR'S PRESCRIPTIONS
By
Dr / Abdullah Rabie3 Ezz
BENHA Medical School – EGYPT
ـــﻟ ، ﺮﻳﺪﻘﺘﻟﺍﻭ ﺮﻜﺸﻟﺍ ﺺﻟﺎﲞ ﻡﺪﻘﺗﺃ:
١ / ﻂﺑﺍﺮﻟﺍ ﻰﻠﻋ ﺎﲥﺭﺎﻳﺯ ﻊﻴﻄﺘﺴﺗ ، ﺔﻴﻧﻭﱰﻜﻟﻹﺍ ﺮﺼﻣ ﺐﻃ ﺕﺎﻳﺪﺘﻨﻣ ﺀﺎﺒﻃﺃ ﻊﻴﲨ:
www.egymedicine.net/Http:/
٢ / ﺪﻣﺎﺣ ﺢﻣﺎﺳ ﺭﻮﺘﻛﺩ " ﺏﺎﺼﻋﻷﺍﻭ ﺦﳌﺍ ﻲﺋﺎﺼﺧﺃ"
٣ / ﺢﻣﺎﺳ ﺭﻮﺘﻛﺩ ﺎﻳﺮﻛﺯ " ﺔﺟﺮﳊﺍ ﺕﻻﺎﳊﺍ ﺐﻴﺒﻃ"
٤ / ﻞﻜﻴﻫ ﺭﻮﺘﻛﺩ٧٧ " ﻝﺎﻔﻃﻷﺍ ﺐﻃ ﻲﺋﺎﺼﺧﺃ"
ﻪﺗﺎﻛﺮﺑﻭ ﺍ ﺔﲪﺭﻭ ﻢﻜﻴﻠﻋ ﻡﻼﺴﻟﺍﻭ