joshua george 2nd PharmD T.JOHN COLLEGE OF PHARMACY BANGLORE

1. HYPERTENSION
CLASS: 2ND PHARMD
REG NO: 18Q1012
SUBJECT: PHAMACOTHERAPEUTICS-1

2. DEMOGRAPHIC DETAILS
• AGE: 40
• GENDER : male
• REASON FOR ADMISSION: complaints of giddiness(since 2 days),mild
chest discomfort (since 2 days)
• PAST MEDICAL HISTORY : Known case of hypertension
• PAST MEDICATION HISTORY : Tab. Chlorothiazide
Tab. Telmisartan
Tab. Spirinolactone

3. VITAL SIGNS
DATE 5/9/19 6/9/19
TEMP N N
BLOOD PRESSURE 200/100 mmHG 130/80 mmHG
PULSE RATE 121 BPM 102 BPM
RESPIRATORY RATE N N

4. LABORATORY INVESTIGATION
TEST TEST VALUE NORMAL VALUE
RBS 141 70-140 mg/dl
RDW 15 11.6-14%
TLC 11.2 4.5-11.0 X 109/L
LYMPHOCYTE 9.6 20-40%
NEUTROPHILES 79.1 40-75%

5. DIAGNOSIS
• Accelerated hypertension
• Unstable angina

6. PRESCRIBED DRUGS
SL.NO GENERIC NAME DOSE ROUTE OF
ADMINISTRATION
1 AMLODIPIN 5mg (STAT) ORAL
2 NITROGLYCERIN 0.6mg (STAT) IV
3 TORESIMIDE 10mg (STAT) ORAL
4 AMLODIPIN 5mg 1-0-1 ORAL
5 ISOSORBIDE
DINITRATE/HYDRALAZINE
20/34.5mg 1-0-1 ORAL
6 NEBIVOLOL 5mg 1-0-0 ORAL
7 BETAHISTIDINE 8mg 1-0-1 ORAL
8 TELMISARTAN 40mg 1-0-1 ORAL
DATES OF TREATMENTS
5/9/19 6/9/19
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7. PHARMACEUTICAL CARE PLAN
• THE TREATMENT GOAL :
 To reduce the chest discomfort
 To reduce the increased blood pressure towards normal
 To reduce giddiness

8. DRUG RELATED PROBLEM
SL.NO DRUG- DRUG INTERACTION SEVERITY EFFECTS
1 NEBIVOLOL + AMLODIPIN MODERATE BP AND HR
2 TORESIMIDE + NEBIVOLOL MODERATE HYPERKALEMIA

9. SL.NO DRUG NAME SIDE EFFECTS
1 AMLODIPIN DIZZINESS, LIGHTHEADEDNESS
2 NITROGLYCERIN ORTHOSTATIC HYPOTENSION
3 TORESIMIDE MUSCLE CRAMPS, UNSUAL DRY MOUTH
4 ISOLAZINE LOSS OF APPETITE
5 NEBIVOLOL PEDAL EDEMA, SHORTNESS OF BREATH
6 BETAHISTIDINE STOMACH UPSET, HEADACHE
7 TELMISARTAN CHANGES OF VISION, CHANGES IN URINATION FREQUENCY

10. MONITORING PARAMETERS
• Monitor for blood pressure
• Monitor blood parameters
• Monitor for any further complication and comorbid diseases

11. PATIENT EDUCATION
• Educate on importance of patient compliance
• Emphasize that nitroglycerin must be kept in an dark container, away
from heat or moisture
• Review direction on using NTG preventively that is should be taken 5
min before physical activity
• Warn the patient about Beta-blockers withdrawal
• Encourage smoking cessation for patient who smoke
• Proper diet, Recommend about DASH(Dietary associated to Stop
Hypertension), proper exercise, weight reduction.

12. DISCHARGE MEDICATION
SL.NO DRUGS DOSE AND DAYS
1 AMLODIPIN 5mg (OD) {MORNING, AFTER FOOD}
2 NEBIVOLOL 5mg (OD)
3 TELMISARTAN 40mg (OD)
4 BETAHISTIDINE 8mg (BD) {3DAYS, AFTER FOOD}