CASE PRESENTATION ON TYPE-II DIABETES MELLITUS, ISCHAEMIC HEART DISEASE WITH HYPERTENSION Presented by:- CHANDANA C 2nd PHARM.D SREE SIDDAGANGA COLLEGE OF PHARMACY Chief Complaints on admission:- Hyperglycemia and chest pain Provisional Diagnosis:- Diabetes mellitus with Ischemic Heart Disease Final Diagnosis:- Type-II Diabetes mellitus , Ischaemic Heart Disease with Hypertension Treatment goals:- To relieve signs and symptoms To prevent the complication To prevent the progression of the disease To achieve the targeted BP To reduce hypertension, diabetes mellitus ,ischaemic heart disease morbidity and mortality Problems Identified:- Failure to receive the drugs Overdose Sub therapeutic Route of administration Dose frequency Goals achieved:- Reduction in BP Pharmacotherapy initiated to control hypertension , diabetes mellitus Symptoms are reduced Monitoring parameters:- Vitals(BP,HR,PR) Serum creatinine RBS(Random glucose test) Hematological analysis ECG Adverse drug reaction Patient Counselling:- About disease:- Educate the patient about Control Risk factors Complications THANK YOU

1. CASE PRESENTATION ON
TYPE-II DIABETES MELLITUS,
ISCHAEMIC HEART DISEASE
WITH HYPERTENSION
PRESENTED BY:-
CHANDANA C
2ND PHARM.D
SREE SIDDAGANGA COLLEGE OF
PHARMACY
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
1
25-10-2018

2. Patient Demographic Details:-
PATIENT NAME:-RXX
AGE:-56 YEARS
GENDER:-FEMALE
UNIT:-GMD
IP/OP NUMBER:-882/882
DOA:-13-01-2012
DOD:-14-01-2012
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

3. Chief Complaints on
admission:-
HYPERGLYCAEMIA AND
CHEST PAIN
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

4. Past medical history:-k/c/o Diabetes mellitus,
Ischaemic heart disease
Past medication history:- NS
Social history:- NS
Family history:- NS
Allergies:- NKA
Patient History:-
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

5. Provisional
Diagnosis:-
DIABETES MELLITUS WITH
ISCHAEMIC HEART DISEASE
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

6. Pharmaceutical Care Plan
Subjective Evidence Objective Evidence
• k/c/o Diabetes mellitus • BP:-120/86 mm Hg
• k/c/o Ischaemic Heart Disease • PR:-90 bpm
• Serum creatinine:-1.8 mg/dL
• RBS:-320 mg/dL
• RBC:-4.72 million cells/mcL
• WBC:-1400 cells/mcL
• PLT:-326 X103 mcL
• Hb:-9.3g/dL
• MCH:-19.4 pg/cell
• MCHC:-28g/dL
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

7. Final Diagnosis:-
TYPE-II DIABETES
MELLITUS , ISCHAEMIC
HEART DISEASE WITH
HYPERTENSION
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

8. Treatment goals:-
 TO RELIEVE SIGNS AND SYMPTOMS
 TO PREVENT THE COMPLICATION
 TO PREVENT THE PROGRESSION OF THE DISEASE
 TO ACHIEVE THE TARGETED BP
 TO REDUCE HYPERTENSION, DIABETES MELLITUS
,ISCHAEMIC HEART DISEASE MORBIDITY AND
MORTALITY
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

9. Treatment options:-
 NON PHARMACOLOGICAL METHODS
 DIURETICS
 ACE INHIBITORS
 ARB’S
 BETA BLOCKERS
 CALCIUM CHANNEL BLOCKERS
 CENTRAL AGONISTS
 STATINS
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
9
25-10-2018

10. SL. NO. BRAND NAME GENERIC NAME DOSE ROUTE FREQU
ENCY
DAY 1
1. Tab.Lozol Indapamide 1.5mg PO OD 
2. Inj.Lasix Furosemide 20mg IV BD 
3. Inj.Vasotec Enalapril 5mg IV OD 
4. Tab.Tenormin Atenolol 25mg PO BD 
5. Tab.Norvasc Amlodipine 5mg PO OD 
6. Tab.Ecosprin Aspirin 150mg PO OD 
7. Tab.Zocor Simvastatin 40mg PO OD 
8. Inj.Heparin Heparin 40mg IV BD 
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

11. Problems Identified:-
 FAILURE TO RECEIVE THE DRUGS
 OVERDOSE
 SUB THERAPEUTIC
 ROUTE OF ADMINISTRATION
 DOSE FREQUENCY
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

12. Goals achieved:-
 REDUCTION IN BP
 PHARMACOTHERAPY INITIATED TO CONTROL
HYPERTENSION , DIABETES MELLITUS
 SYMPTOMS ARE REDUCED
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

13. Monitoring parameters:-
 VITALS(BP,HR,PR)
 SERUM CREATININE
 RBS(RANDOM GLUCOSE TEST)
 HEMATOLOGICAL ANALYSIS
 ECG
 ADVERSE DRUG REACTION
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
13
25-10-2018

14. Patient Counselling:-
 ABOUT DISEASE:-
 EDUCATE THE PATIENT ABOUT CONTROL
 RISK FACTORS
 COMPLICATIONS
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
14
25-10-2018

15.  ABOUT THE MEDICATION:-
 DISCONTINUATION OF MEDICATION
 MEDICATION ADHERENCE
 FREQUENCY OF ADMINISTRATION
 ROUTE OF ADMINISTRATION
 MISSED DOSE
 ADVERSE DRUG REACTION
 ABOUT LIFE STYLE MODIFICATION:-
 DIET CONTROL- DASH DIET
 REDUCE SODIUM INTAKE TO LESS THAN 1.5G/DAY
 PHYSICAL EXERCISE
 RELAXATION
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018

16. THANK YOU
Chandana C, Sree Siddaganga College of Pharmacy, Tumkur
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25-10-2018