A small case study on TIA and looking for pharmacist interventions

1. Case study on
TRANSIENT ISCHEMIC ATTACK
Presented By:
B.Anjali Bhavanika
Roll No.: 1704-16-882-005
SNVPMV.

2. OBJECTIVE:
• This case presentation is to focus and determine
the betterment of treatment in early geriatrics. This
also promotes medical understanding for the
patient and pharmacists along with the doctor.
Demographic Details:
• 62 year old woman admitted with left upper and
lower limbs weakness and is unable to walk. She
also faces numbness.
• K/C/O HTN and DM for which she is on prior
treatment.
• Investigations adviced: CBP, RFT, LFT, CXR,
ECG, MRI, Brain plain.

3. LAB DATA
VITALS
Temperature: 98.6 F
BP: 140/80mmHg
HR: 80/min
RR: 25/min
SpO2: 96%
GRBS: 232mg/dL
haemoglobin 9.0 gm% 12-15
PCV 30% 36-46

4. MEDICATION
Sno Generic Name Dose ROA freq Class
1. Inj. Pantoprazole 10ml IV OD PPIs
2. Tab.Atorvastatin 80mg po OD HMG-CoA -rs
3. Tab.Clopidogrel 75mg Po OD Antiplatelet
4. Tab.Aspirin 150mg po OD Antiplatelet
5. Inj.Ondansetron 2ml IV OD Anti-emetic
6. Inj.Enoxaparin 0.4ml IV BID Anticoagulant
7. Inj.Citicoline 2ml IV BID Nutritional
supplement
8. Normal saline 100ml IV BID Electrolyte
replenisher

5. Pharmacist Intervention
• The patient shows signs of mild anaemia and
antiplatelets should be avoided till her blood
reports are normal.
• Clopidogrel could be given in a mixed dosage
form with Aspirin to avoid discomfort to the
patient.
• Clopidogrel, Aspirin and Enoxaparin shows
synergistic effect and may lead to internal
bleeding/bruising. Regular follow ups are
needed.
• Pantoprazole decreases efficacy of clopidogrel
as it affects CYP metabolism which forms a
clopidogrel metabolite. However there is no
clinically important effect of its co-administration.

6. THANK YOU