2. PATIENT PROFILE
NAME : XXX
AGE : 45 yrs
SEX : FEMALE
DOA : 22-02-18
COMPLAINTS ON ADMISSION :
• Generalized tiredness
• Drowsiness
• Confusion
• Seizures
Past history : 1 episode of seizures
Medication history : NIL
Family history : NIL 2
7. ASSESSMENT
According to the subjective and objective evidence the diagnosis was
made to be SAH (SUBARACHNOID HEMORRHAGE) due to aneurysm
rupture and treatment was started .
PLANNING
The patient was admitted in Neuro ICU
Physicians planning
• Take lifesaving measures
• Relief symptoms
• Repair of the bleeding vessel
• Prevention of complications
• Prevention of recurrence
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9. CURRENT MEDICATIONS
Inj.DEXONA
• To suppress the immune system
• ADRs include electrolyte imbalance , bone degradation , increased blood
pressure
T. NIMODIPINE
• Treat SAH
• ADRs include decreased blood pressure , slow heart rate
T.PANTOPRAZOLE
• Reduce acidity
• ADRs include headache , diarrhea , nausea and vomiting
T.PHENYTOIN
• Treat seizures
• ADRs include nystagmus , peripheral neuropathy , gingival hyperplasia
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10. T.PARACETAMOL
• Treat pain
• ADRs include allergic reactions
Inj. FOSPHENYTOIN
• Treat seizures
• ADRs include nystagmus , slurred speech , euphoria , tinnitus ,
dysgeusia
Inj.MANNITOL
• Decrease fluid volume to treat cerebral edema
• ADRs include headache , dehydration
Inj.ONDANSETRON
• Treat and prevent nausea and vomiting
• ADRs include constipation , allergic reactions , fatigue , flushing
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11. PHARMACIST INTERVENTION
PATIENT COUNSELLING
DISEASE
Subarachnoid hemorrhage (SAH) refers to bleeding within the
subarachnoid space, which is the area between the brain and the
tissues that cover the brain.
Symptoms includes:
• neck pain
• numbness throughout your body
• seizures
• confusion
• decreased vision
• double vision 11
12. DRUGS
• Nimodipine , fosphenytoin , mannitol and phenytoin should be avoided
during driving and operating machineries as it may cause dizziness and
avoid alcohol consumption
• Pantopazole may decrease the magnesium level in blood therefore
magnesium levels must be checked regularly and it may also decrease
calcium level therefore calcium supplements may be taken
• Paracetamol should not be taken in a dose of > 4 g /day and avoid
alcohol intake
• Fosphenytoin and phenytoin may increase the blood sugar level
therefore it should be regularly monitored
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13. LIFE STYLE MODIFICATIONS
Lifestyle changes to reduce the chance of a stroke include :
• Avoid smoking
• A low-fat diet high in fruits and vegetables
• Drinking in moderation
• Exercising regularly
• Maintaining a normal body weight
These changes can reduce conditions that can contribute to strokes,
including high blood pressure, diabetes and carotid or other artery
disease.
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14. POINTS TO PHYSICIAN
• Blood electrolytes , blood counts , liver function , kidney function and
heart function must be regularly monitored as the patient is
administered with mannitol
• Fosphenytoin will decrease the level of dexamethasone therefore an
alternate drug may be used
• Phenytoin will decrease the level of ondansetron therefore an alternative
drug may be used
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