On Stroke(CVA) with left middle CVA

1. CASE PRESENTATION
On Stroke(CVA) with left middle CVA
PRESENTED BY
RAJENDRA KUMAR
PHARM D 2 YEAR
ISF COLLEGE OF PHARMACY
DEPARTMENT OF PHARMACY PRACTICE
ISF College of Pharmacy, Moga
Ghal Kalann, GT Road, Moga- 142001, Punjab, INDIA

2. Patient details
NAME: xyz
AGE : 59 years
SEX: male
BLOOD GROUP :B+ve
2

3. Subjective evidence 3
• CHIEF COMPLAINTS : Right sided weakness(right arm and right leg
from last, inability to speak from last two days.
• BRIEF HISTORY: h/o fall following which patient got head injury, to left
arm following which amputation of left arm is done due to gangrene.
• PAST MEDICAL HISTORY :
Hypertension is there but no medication, no h/o DM, Epilepsy, TB, no
similar complaints in past.
• FAMILY HISTORY: No similar family history.
• ALLERGIES : Nil.
• PERSONAL HISTORY: Smoker , Chronic alcoholic, Non vegetarian

4. 4Objective evidence
• GENERAL
conscious, calm
BP:- 150/100 mm Hg
Respiratory system:- Normal VBS, R.R: 16/min
CVS:- s1 s2 normal no murmur
CNS:- Tone and power reduced

5. Lab Investigations 5
Tests Observed Normal
HB 11.4 mg/dl 14-18 mg/dl
PLT 3.29 lakh/cumm 1.5-4.0 lakh/cumm
Creatinine level 0.4 mg/dl 0.8-1.3mg/dl
UREA level 19 mg/dl 15-45 mg/dl
Total Bilirubin count 0.4 mg/dl 0.3-1.1 mg/dl
Alkaline Phosphatase level 293 IU/L 60-150 IU/L
SODIUM 136 mEq/L 135-155 mEq/L
POTASSIUM 4.2 mEq/L 3.5-5.5 mEq/L
CHLORIDE 100 mEq/L 98-107 mEq/L
RBS(random blood sugar) 154 mEq/L 70.0-140.0 mg/dl

6. ASSESMENT:
 On the basis of Subjective and objective
evidences,patient has been diagnosed with
cerebrovascular accident with left MCA
 A chest x-ray also done to identify Pulmonary or
cardiac pathology
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7. TREATMENT CHART :
DRUG GENERIC NAME DOSE ROUTE FREQUENCY
Inj. Augmentin Amoxycillin(1000mg+clavula
nic acid 200mg)
1.2gm iv TDS
Tab. Dalacin clindamycin 600mg RT feed BD
Inj. Ocid omeprazole 40mg iv OD
Tab. Ecosprin AV Asprin(75mg)+atorvast-
atin(20mg)
75/20mg oral HS
Tab. Librium chlordiazepoxide 10mg oral TDS
Tab. Telma Amlodipine(5mg)+telmisartan
(40mg)
5/40mg oral OD
Tab. Levipil levetiracetam 500mg oral BD
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8. PHARMACIST INTERVENTIONS:
 No medication is given to control blood sugar level of the
patient
 Assesment is done only on the basis of subjective and
objective evidences ,there is no CT scan of head ,MRI ,has
been done
 EEG must be done before prescribing levipil(anticonvulsant)
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9. PATIENT COUNSELLING:
 Patient is adviced to avoid smoking and alcohol intake as
these habbits can cause pulmonary and cardiac and other
complications.
 Patient must try to maintain a normal blood pressure by
minimising salt intake.
 Try to stay away from stressful conditions.
 Take the medication as per prescription.
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10. THANK YOU