BOOKS FOR DOCTORS

Therognosis

    What patients want during a consultation is appropriate treatment and to know the likely result of the treatment.

    This book assists doctors in their choice of treatment and gives a guide to the likely prognosis of the patient’s condition.

    The data it contains is available to be used in print or electronically.

THEROGNOSIS

Therapy and Prognosis

FORMAT

Disease  [Abbreviation]

(Alternate Name)

Ther:    A commonly recognised form of therapy OR other recognised forms of treatment

    AND additional therapy that may be required

    ADD  additional types of therapy if above does not prove effective

    1. First step in a therapeutic crescendo or format

    2. Second and subsequent steps in a crescendo or format are numbered sequentially

Prec:    Precautions that should be observed in the treatment of this disease. For further information on contraindications, precautions, adverse reactions, interactions, use in pregnancy, use in children, dosage and administration consult a pharmacopaea such as MIMS or MIMS Annual

Prog:    Prognosis. The expected result of treatment, statistically treated if appropriate

See also Other  Relevant Diseases

SAMPLE ENTRIES:-

Schizophrenia

Ther:   • Acute:

            For control and sedation:

            Haloperidol 10-20 mg IV or IM every 2 hours

    OR chlorpromazine orally  OR thioridazine orally

    ADD  diazepam IM or IV for agitation

            For control without sedation:

            Haloperidol orally at night only  OR trifluoperazine orally OR olanzapine OR risperidone

            • Chronic:

            Oral antipsychotics (eg. clozapine, haloperidol, olanzapine, risperidone,   thioridazine, trifluoperazine) OR fluphenazine IM monthly for poor compliance

            AND psychotherapy in selected patients

            AND environmental manipulation

            ADD behavioural therapy

Prec:    Dystonic reactions to therapy possible - give benztropine IV or IM

Prog:   Reasonable control in most cases. Relapses common. No specific cure

Scleroderma

(Systemic Sclerosis)

Ther:   Complex. No specific therapy but treat symptomatically with following support:-

            - Physiotherapy regularly.

            - Avoid cold.

            - ACE inhibitor for hypertension.

            - Antibiotics for chest and other infections.

            - D-penicillamine OR  cyclophosphamide for severe skin and deep organ involvement.

            - Calcium channel blocker for Raynaud's phenomenon and pulmonary hypertension.

            - proton pump inhibitors AND/OR cisapride for gastro-oesophageal reflux.

    Other medications that may be useful include low molecular weight heparin, prostacyclin infusions, probucol, colchicine and oxygen

Prog:   Five year survival 50% overall. Poorer prognosis with major organ involvement. May

             stabilise or regress temporarily before progressing

Scoliosis

Ther:   • Adolescent, growth not complete

            < 20° - observe

            20-30° - brace if progressive

            > 30° - brace and/or surgery

            • Adult, growth complete

            < 45° - no treatment practical

            > 45° - surgery

Prec:   Careful observation and family cooperation essential.

Prog:   Good if detected early.