PharmD 5th year case presentation on myocardial infarction.

1. CASE PRESENTATION ON MYOCARDIAL
INFARCTION
Presented By
Vaka komali (17DR1T0020)
Pharm.D 5th year

2. PATIENT PROFILE
Name: XXXXXXX
Age/Sex: 40 /M
Education: Illiterate
Marital Status: Married
IP No: 1702100357
Date of Admission: 20-5-2022
Date of Discharge: 25-05-2022

3. CHIEF COMPLAINTS
● Chest pain from 1Day,Radiating to left hand and
intrascapular region.
● 1 Episode of Vomiting.
● Shortness of breathe on exertion from 1 Day.

4. History
Past medical History:
• DM+ since 5Years
• HTN+ since 3Years
Past Medication History:
• T.Glizid 40mg BD
• T.Amlokind AT OD
Surgical History:
• S/P Umbilical hernia 2 years ago
Social History:
• Nil
Family History:
• Nil
Allergies:
• Nil
Covid Status:
• Negative(-)

5. Physical Examination:
• BP: 130/80 mm Hg
• Pulse: 80/min
• SPO2: 96%
Systemic Examination:
• CVS : S1S2 +
• P/A :Soft
• CNS : NAD
• RS: B/L crepts+
OBJECTIVE DATA

6. LABORATORY INVESTIGATION
S.NO INVESTIGATION PATIENT VALUE Reference value
1. Haemoglobin 10.2 mg/dl 12-16 mg/dl
2. Total RBC count 3.74 million/cumm 3.8-5.8 mg/dl
3. Neutrophils 82% 40%-70%
4. Lymphocytes 15% 15%-30%
5. Total Bilirubin 0.69 g/dl 1 g/dl
6. Conjugated Bilirubin 1.61 mg/dl 0-0.6 mg/dl
7. Unconjugated Bilirubin 2.0 mg/dl 0-0.4 mg/dl

7. OTHER INVESTIGATIONS
• ECG
• 2D ECHO
IMPRESSION
ECHO Finding:
• Fair LV Dysfunction EF :52%

8. ECG Findings:
• ST Segment Elevation

9. ASSESSMENT
• Myocardial Infarction(Inferior wall MI)

10. MEDICATION
S.No Name of Drug Dose Route Freq Day 1 Day 2 Day 3
1. INJ.STK 5 μg/kg/min IV Infusion
2. INJ. LMWH 0.6 ml S/C OD   X
3. INJ. Heparin 5000 U IV QID X X 
4. T.Clonazepam 0.25mg P/O HIS   
5. T.Ecosprin 0.25 mg P/O BD   
6. T.Clored 75mg P/O BD   
7. T.Rozavel 20mg P/O BD   
8. INJ. Pantoprazole 40mg IV OD   
9. T. Bisobis 5mg P/O OD   
10. INJ. Celrim 1gm IV BD   
11. T. Glizil 40mg P/O OD   

11. DRUG INTERACTIONS
• Aspirin and Clopidogrel : In combination because
unusual bleeding. Severe abdominal pain and weakness.
• Atorvastatin and clopidogrel: Stating may reduce the
effect of clopidogrel.
• Statin and Pantoprazole: May increase the blood levels
and effect of strain can cause liver damage.
• Pharmacist Interventions : Not given any IM Injections
during heparin given to the patient.

12. ADVERSE DRUG REACTIONS
● Echospirin causes GI irritation, haematuria, tinnitus, Gumbleading
● Clored causes headeck, dizziness
● Rozavel causes muscle pain, sleep problems
● Celrim causes nausea and vomiting

13. PATIENT COUNSELING
• Avoid Smoking
• Regular Exercise
• Take Low Salt Diet
• Take High Fibber Diet
• Regular Intake of Medication
• Regular follow up

14. DISCHARGE SUMMARY
● T. Clopivas AP 75/75 BD *7 Days
● T. Rozavel 20mg OD H/S
● T. Rabityde.D OD BBF
● T. Faropenem 200 mg BD
● T. Bisobis 5mg OD
● T. Glizid 40mg BD
● T. Zucapride 10 mg OD 2 PM

15. THANK YOU
Open for Discussion…….