2014-11-10-世界卫生组织-WHO_list_of_essential_medicines_necessary_to_treat_Ebola_cases_2页_215kb

WHO Essential Medicines for Ebola Treatment: Summary

Core Content

This document outlines an interim list of WHO essential medicines necessary for the treatment of Ebola cases, based on existing guidelines. It serves as a reference for donation, procurement, and preparedness in Ebola care settings. The list differentiates between Ebola Care Units (ECU) or Community Care Centres (CCC), which provide oral treatment and simple supportive/palliative care, and Ebola Treatment Centres (ETC) or Ebola Treatment Units (ETU), which handle more intensive care, including intravenous fluids and injections.

Main References

The list is derived from the following key guidelines:

• WHO Model List of Essential Medicines, 18th list, April 2013
• Clinical Management of Patients with Viral Haemorrhagic Fever: A Pocket Guide for the Front-line Health Worker, WHO, March 2014
• Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola, WHO, August 2014
• Filovirus haemorrhagic fever guideline, MSF, 2008
• Ebola response roadmap, WHO, August 2014

Key Information and Medicines

ECU/CCC (Community Level Care)

• Alcohol-based hand rub: Used for disinfection.
• Amoxicillin: Antibacterial.
• Loperamide: Antidiarrhoeal medicine for adults.
• Ascorbic acid (Vit C): Vitamin supplementation.
• Omeprazole: Antiulcer (for stress ulcer) and gastrointestinal upper-bleeding.
• Ondansetron: Antiemetic.
• Oral rehydration salts: Rehydration.
• Paracetamol: Fever and analgesic.
• Zinc sulfate: For diarrhoea in children.

ETC/ETU (Ebola Treatment Centres)

• Ampicillin: Antibacterial (in septic shocks management).
• Artemether + Lumefantrine: Antimalarial (follow national guidelines).
• Artesunate: Antimalarial.
• Artemether: Antimalarial.
• Azithromycin: Antibacterial.
• Ceftriaxone: Antibacterial (in septic shocks management).
• Chlorpromazine: Confusion and aggression in non-cooperative patients.
• Ciprofloxacin: Antibacterial (in septic shocks management).
• Diazepam (injection): Anxiety disorders, convulsions.
• Diazepam (gel or rectal solution): Anxiety disorders, convulsions.
• Dopamine: Cardiogenic shock.
• Doxycycline: Antibacterial.
• Epinephrine (adrenaline): To manage shocks.
• Ergometrine: For post-partum or post-abortion haemorrhage.
• Furosemide (injection): Diuretics in case of fluid overload.
• Gentamicin: Antibacterial.
• Glucose (hypertonic): Sign of hypoglycemia.
• Haloperidol: Psychotic disorders, violent behaviour.
• Hydrocortisone: Adjunct in emergency treatment of shocks/after transfusion.
• Insulin injection (soluble): Antidiabetic.
• Lidocaine: Local anaesthetic.
• Loratadine: Antiallergic and used in anaphylaxis.
• Magnesium sulfate: Eclampsia and severe pre-eclampsia.
• Metoclopramide (injection): Antiemetic.
• Metronidazole (injection): Antibacterial.
• Morphine (tablet and injection): Analgesic.
• Naloxone: Antidote for morphine.
• Oxytocin: For post-partum or post-abortion haemorrhage.
• Phenobarbital: Convulsions.
• Phytomenadione (Vitamin K): For bleeding.
• Potassium chloride: Correction of electrolyte disturbances.
• Ranitidine: Antiulcer (for stress ulcer).
• Retinol (Vitamin A): Vitamin supplementation.
• Salbutamol (aerosol): Difficult breathing/respiratory distress.
• Sodium bicarbonate: Metabolic acidosis.
• Sodium chloride (isotonic): Rehydration and medication administration.
• Sodium lactate (compound solution): Rehydration.
• Tetracycline (eye ointment): Antiinfective.
• Vitamin B Complex: Vitamin supplementation.

Notes

• Non-glass ampoules/vials are preferred for injectable medicines to prevent sharp injuries.
• Indications and specifications are provided for each medicine, ensuring appropriate use in different clinical scenarios.
• Supportive care is emphasized, particularly in ECU/CCC settings, with a focus on non-invasive and simple interventions.
• Infection control is a critical component of treatment, with guidelines for separating suspected and confirmed cases.