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If signs of hypervolaemia are seen: furosemide slow, direct IV: 1 mg/kg without exceeding 20 mg/kg. – If present, treat any pulmonary or parasitic infection (malaria). 40 mg) PO Pregnant woman: 60 to 120 mg once daily or in 2 divided doses = 1 to 2 tab/day • Nutritional supplements if the basic diet is insufficient – For patients with sickle cell disease: long term treatment with folic acid PO: 5 mg/day. – Early treatment of malaria, helminthic infections etc. 39 Severe acute malnutrition Severe acute malnutrition Severe acute malnutrition is caused by a significant imbalance between nutritional intake and individual needs.
Morphine PO is the drug of choice. It may be necessary to increase doses over time according to pain assessment. Do not hesitate to give sufficient and effective doses. – Morphine, tramadol and codeine have similar modes of action and should not be combined. 34 1. A few symptomes and syndromes – Buprenorphine, nalbuphine and pentazocine must not be combined with morphine, pethidine, tramadol or codeine because they have competitive action. Treatment of nociceptive pain in pregnant and breast-feeding women Level 3 Level 2 Level 1 Analgesics paracetamol 1st and 2nd trimester 1st choice Pregnancy 3rd trimester and term 1st choice 1st choice contra-indicated possible avoid contra-indicated codeine possible tramadol possible The newborn infant may develop withdrawal symptoms, respiratory depression and drowsiness in the event of prolonged administration of large doses at the end of the 3rd trimester.
2) If the child cannot be re-examined: antibiotics are prescribed. • For children treated with antibiotics: advise the mother to bring the child back if fever and pain persist after 48 hours. – Choice of antibiotic therapy: • Amoxicillin is the first-line treatment: amoxicillin PO: 80 to 100 mg/kg/day in 2 to 3 divided doses for 5 days • Amoxicillin/clavulanic acid (co-amoxiclav) is used as second-line treatment, in the case of treatment failure. Treatment failure is defined as persistence of fever and/or ear pain after 48 hours of antibiotic treatment.