colonic ulcers presentation

1. CASE
PRESENTATION ON
COLONIC ULCERS
WITH T2DM
BY
L.KIRAN KUMAR REDDY
PHARM-D 5TH YEAR
GNI-SOP

2. SUBJECTIVE EVIDENCE
• Distension of abdomen
• constipation
• Objective evidence
• Fbs: 141
• Two linear ulcers, one at hepatic hexure,another spleenic
hexure,biopsy taken and sent for Hpe
• Evidence of bowel loops are dilated with multiple air fluid levels
noted

3. ASSESSMENT
• From the subjective and objective evidence the case was
diagnosed as Colonic ulcers
• Symptomatic treatment was given for the management
• FINAL DIAGNOSIS
• colonic ulcers

4. TREATMENT OPTIONS
• Corticosteroid to reduce inflammation
• Antibiotics to treat infection
• Fluid and electrolyte .maintainence
• Surgical treatment
• Proctoiolectomywith ileostomy
•

5. MEDICATION CHART
Generic name Roa, dose
,frequency
T useand duration
Ofloxacin IV, 100ml,bd Antibiotic prophylactic
25/10- 29/10
Metronidazole IV, 100ml ,tid Antiprozoal 25/10to
29/10
Tramadol IV,1amp,bs Opioid analgesic
25/10to 27/10
Pantoprazole IV, 40mg ,od PpI 26/10-28/10
Human actrapid
insulin
SC,tid Anti diabetic

6. Proctolysis enema
Sodium
Biphosphate and
Phosphate
Start,od Treat constipation
Ondansetron IV,4mg ,stat Antiemetic 29/10
Dicyclomine with
mefenamicid acid
Po, 10mg,250mg For abdominal pain
and muscle pain 29
10
Rabeprazole Po, 20mg, bd Opioid 29/10

7. GOALS OF THE TREATMENT
• Goals of the treatment is to reduce the inflammation. That
causes symptoms
• Balance the fluids and electrolyte levels in the body
• Problems identified
• Drug interactions

8. OFLOXACIN + TRAMADOL
• Severity : major
• Effect : increased risk for seizure
• Management: monitor the patient any stop the drugs when
the seizure symptoms appear
• 2.Oflaxacin with insulin
• Severity: moderate
• Effect: increased risk of hypoglycemic or hyperglycemic

9. • Management: closely monitor the blood glucose level and
adjust the dose of Insulin
• 3)Metronidazole + oflaxacin
• Severity: minor
• Effect: increased QT prolongation and arrhythmias
• Management:consider Each monitor at base line during
concurrent therapy

10. PATIENT. COUNSELLING
• About disease : ulcerative colitis is a long term condition that results in
inflammation and ulcers of the colon and rectum. The primary
symptom of active disease is abdominal pain and diarrhea mixed with
blood, weight loss, fever, anemia may also occur.
• About medications : Don’t skip the dose , if you miss the dose take as
soon as you remember If it is the time for next dose skip the missed
dose
• Life style modification s
• Try to avoid fat food such as butter , margarine , and fried foods
• Drink plenty of fluids

11. • Eat small meals
• Do exercise regularly
• Avoid spicy foods and caffeine
• Do regular relaxation and breathing excercise