Unfortunately in my experience punishment alone doesn’t work because the behavior is out of their control. I’m not saying they don’t know right from wrong and that bad behavior shouldn’t be punished, but when a solution for helping them manage their behavior better hasn’t been found, stricter rules and punishments usually escalate the behavior, not mitigate it. Impulse control is a real things and they’re brains are not wired to handle it. Particularly at her age, they don’t have the maturity to control their impulsive behaviors or control their strong emotions. If there’s no doc on call or her pediatrician is unavailable sounds like you’re going to have to ride it out and even with med changes things may get worse before they get better. My only other suggestions as you go thru a transition period are for someone to be watching her like a hawk every minute and keeping her busy and engaged as much as humanly possible. Even if you think she should be able to play alone at her age. Even if you don’t feel you have the time – make the time. It was the times when my son was alone in his room or playing with friends unattended by an adult that he got in the most trouble. If she’s in school pull her out and do a week of independent study st home. Lower expectations for chores if you need to. Anything you can do to lessen the opportunities for her to act out will make it easier to cope until you can start working with her therapist on better solutions.