It may serve the academic needs of medical & pharmacy students

1. A Case Study On Advanced
Alzheimer’s disease
09408103
Pharm.D ( V year)
5-12-2013

2. • A 84 years male patient was admitted in the hospital on 1st
December, 2013.
C/o-Heamaturia since morning
H/o-Burning micturition
K/c/o Diabetes/Hypertension/Cerebral atropy with senile psychosis
PAST MEDICAL HISTORY-Lumbar disc disease (on treatment)
PAST MEDICATION HISTORY-
Donepezil 10 mg
Quitipin 50 mg
PERSONAL HISTORY/SOCIAL HABITS- Non smoker
Non alcoholic
Not a drug abuser
PHYSICAL EXAMINATION-PICCLE(Normal)

3. O/E-
SYSTEMIC EXAMINATION-
TEMP 98.4 F
PULSE RATE 88 /min.
BLOOD PRESSURE 100/70 mm of Hg
RESPIRATORY
RATE
22 breaths/min.
CVS S1 S2 +
RS BAE +
CNS Abnormal
P/A soft

4. • LAB INVESTIGATIONS-
Hb-6.9 g/dl (↓)
RBC-7.5 millions/cu.mm
ESR-20 mm/hr (↑)
PCV-45%
DC-
Total WBC -1o,ooo cells /cu.mm
Neu Lym Eos Mon Bas
60% 30% 6% 3% 1%

5. RBS-145 mg/dl (↑)
BUN-45 mg/dl (↑)
creatininine-1.4 mg/dl (↑)
URINE ANALYSIS-
Appearance- clear
PH- 6
Sugar- Nil
Blood- Present
Bile salts- Nil
Bile pigments- Nil
RBC- Nil
Pus cells- Plenty (↑)

6. DIAGNOSIS-
Advanced Alzheimer’s disease
Type-2 Diabetes mellitus
Hematuria

7. TREATMENT-
DRUG CHART
BRAND GENERIC DOSE ROA FREQUENCY DURATION
INJ.Zanocin Ofloxacin 200mg IV BD 5days
INJ.Rantac Ranitidine 150mg IV BD 5 days
INJ.Avil Pheniramine 1 cc IV OD 3 days
INJ.Decadran Dexamethas-
-one
1 cc IV OD 3 days

8. T.Macorate
CR
Magnesium
valproate
500 mg P/O BD 5days
T.Eptoin Phenytoin 100 mg P/O BD 5 days
T.Levipill Levetiracetam 500 mg P/O OD 5 days
T.Syndopa
plus
Levodopa +
Carbidopa
125 mg P/O BD 5 days
Ciplox eye
drops
Ciprofloxacin 2 drops Opthalmic BD 5 days

9. • DISCHARGE ADVICE-
T.Martifer Nitrofurantoin 100mg 0-0-1 30 days
T.Rantac Rantidine 150
mg
1-0-1 30 days

10. SOAP NOTES-
SUBJECTIVE-
A 84 years male patient was admitted in the hospital
complaining of Hematuria since morning, burning micturition & with
known previously diagnozed case of Alzheimer’s disease.
OBJECTIVE-
Hb-6.9 g/dl (↑)
ESR-20 mm/hr (↑)
RBS-145 mg/dl (↑)
BUN-45 mg/dl (↑)
creatinine-1.4 mg/dl (↑)
Pus cells-plenty (↑)

11. ASSESMENT-
The patient is with a known case of Alzheimer’s disease &
Diabetes mellitus-type 2.
Now the patient is diagnosed with a condition called
‘Hematuria’.
PLAN OF TREATMENT-
The patient is treated with Antibiotics,H2-receptor
antagonists,Corticosteroids,Anti-epileptic drugs & Dopamine agonists.

12. • DRUG INTERACTIONS-
Phenytoin <---------->Levodopa (Significant)
• Phenytoin decreases the effects of Levodopa by unknown
mechanism.
• Monitor closely.

13. PATIENT COUNSELLING-
• Hematuria is not life threatening .
• Improve & maintain the hygienic conditions for the patient.
• Give the medications exactly as prescribed by the physician at the right
time.
• Do not give any OTC drugs or home remedies without consulting the
physician or pharmacist.
• In case of any side effects or serious illness immediately report to the
physician & pharmacist.