This is a case study prepared on cholecystitis (gall stones).For academic purpose of pharma D , and also for study aspects.

1. Cholelithiasis
• CASE STUDY BASED ON DISEASE
CHOLELITHIASIS
PREPARED BY
MARTIN SHAJI
Pharm D
NIRMALA COLLEGE OF PHARMACY(NICP) , KADAPA

2. • Patient name – Mr. x OP no. – 4367
• Admission date- 8/1/19
• Age-58
• Sex-M
• Department- GMW
PATIENT DEMOGRAPHY

3. CHIEF COMPLAINTS;
Pain in the right upper part of the abdomen and between
the shoulder blades, some times back . In addition to
pain, nausea, and vomiting, Abdominal irritations and
indigestion , feeling over thirst.
PAST MEDICAL HISTORY
Elevated cholesterol level still 1 year.
ALLERGY :(food/drug/other)
No known allergies.
PERSONAL HISTORY AND HABITS:
Diet: Mixed
Sleep: normal
FAMILY HISTORY:
Nothing significant.

4. GENERAL EXAMINATIONS
1. Physical examination:
Vital signs:
Temperature (oF): afebrile Pulse rate (/min):
80beats
Respiratory Rate (/min): 25 cycles
Blood Pressure (mm of Hg): 120/80mm of Hg
Obesity noticed.
2. Systems Examination:
CVS: S1, S2 +
RS: Clear

5. PLANNING
1. Abdominal ultrasound, Followed by
other imaging techniques such
as ERCP and MRCP should done.
2. LIPID PROFILE TEST

6. LAB INVESTIGATIONS
• Lipid profile test;
• Total cholesterol:230mg/dl [140-200mg/dl]
• Triglycerides :200mg/dl [60-150mg/dl ]
• High density lipoprotein :32mg/dl [40-75 mg/dl ]
• Low density lipoprotein:170mg/dl [50-130 mg/dl ]

8. SOAP NOTES
SUBJECTIVE EVALUATION
A 58 years old male patient was admitted with experience referred
pain on right abdomen and between the shoulder blades. In
addition to pain, nausea, and vomiting.
OBJECTIVE EVALUATION:
On Examination, the patient was conscious & coherent.
ASSESSMENT:
Based on subjective & objective evaluvation and also
after abdominal ultrasound scan confirmed it as
CHOLELITHIASIS/ gall bladder stone.
(A positive Murphy's sign is a common finding on physical
examination during a gallbladder attack.)

9. {cholelithiasis}
CONFIRMATORY DIAGNOSIS

10. Sl.No. Drug
Indication ROA Dose.
Frequenc
yGeneric Name
1. ursodeoxycholic
acid
Gallstone Solubilizing
Agents oral 200mg BID
2. Colestipol Bile acid sequestrant
oral 5mg BID
3. Omega 3 Omega-3 fatty acids
oral 2gm BID
4. Ondansetron inj Antagonist
oral 4mg sos

11. PHARMACIST INTERVENTIONS
1. The prescribtion was rational.
2. No DDI or ADRs were found.

12. To reduce your risk of developing gallstones,
Maintain a normal body weight,
Exercise regularly,
Eat three well-balanced meals every day.
Eat plenty of foods containing fiber and calcium, and avoid
alcohol and foods high in saturated fat.
If you're overweight, reduce your weight, but don't try to
lose weight too fast.
Your healthcare provider can help you come up with a plan for
healthy weight loss..
PATIENT COUNSELING- Instructions for patient

13. 2.T.Colestipol (trade names Colestid(’Cholestabyl) is a bile acid sequestrant
used to lower blood cholesterol, specifically low-density lipoprotein (LDL).
PLANNING-Regarding medication.
3.Omega-3 fatty
acids .
Decrease triglycerides; may increase HDL levels
T.Bile acid sequestrants
The liver then produces more bile acids to replace those that have been lost.
body uses cholesterol to make bile acids, this reduces the level of LDL
cholesterol circulating in the blood.
1.T.Ursodiol is used to dissolve certain types of gallstones, to prevent
gallstones from forming in obese patients who are losing weight rapidly, and to
treat a certain type of liver disease (primary biliary cirrhosis). Ursodiol is a bile
acid.

14. DISCUSSION
Cholelithiasis is the presence of one or more calculi
(gallstones) in the gallbladder. In developed countries,
about 10% of adults and 20% of people > 65 yr have
gallstones. Gallstones tend to be asymptomatic. The
most common symptom is biliary colic; gallstones do not
cause dyspepsia or fatty food intolerance. More serious
complications include cholecystitis; biliary tract
obstruction (by stones in the bile ducts
[choledocholithiasis]), sometimes with infection
(cholangitis); and gallstone pancreatitis. Diagnosis is
usually by ultrasonography. If cholelithiasis causes
symptoms or complications, cholecystectomy is
necessary.

17. NON-PHARMACOLOGICAL TREATMENT
Surgery to remove the gallbladder
(cholecystectomy). Your doctor may
recommend surgery to remove your
gallbladder, since gallstones frequently
recur. Once your gallbladder is removed,
bile flows directly from your liver into your
small intestine, rather than being stored
in your gallbladder.