PRESCRIPTION FOR AN ADULT MALE OF UNCOMPLICATED CHLOROQUINE RESISTANT FALCIPARUM MALARIA
Name : Doctor’s
name:
Age : Reg
No.:
Sex:
Address:
Diagnosis:
PLASMODIUM VIVAX MALARIA(RADICAL CURE)
Rx
·
Tab
CHLOROQUINE ( 150 mg base )
Dispense
10 tabs
4
tablets stat followed by 2 tablets after 12 hours
1 tablet
BD on 2nd & 3rd day
·
Tab
PRIMAQUINE 7.5 mg
Dispense 28 tablets
1
tab
to be taken twice daily for 14 days
Review after 15 days
Signature of the doctor
Date
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