Paranoid schizophrenia is a psychiatric condition.

1. A CASE STUDY ON PARANOID SCHIZOPHRENIA WITH OBSESSIVE
COMPULSIVE DISORDER
PRESENTED BY :
Shaik Shaheera
IV PHARM D
19AB1T0024.
UNDER THE GUIDANCE OF :
Dr. Ranakishore pelluri
Associate professor.
VIGNAN PHARMACY COLLEGE
(Approved by AICTE, PCI-New Delhi and affiliated to JNTUK)
Vadlamudi, Guntur (dist), pin.code: 522213

2. NAME : XXX
GENDER : Female
SEX : 23 years
DEPT : PSYCHIATRY
D.O.A : 27-09-2011
D.O.D : 06-10-2011
PATIENT DETAILS-

3. SUBJECTIVE-
C/O:-
• Talking with herself.
• Laughing herself.
• Violent and obsessive behaviour.
• Decreased sleep and appetite since 3 days.

4. OBJECTIVE-
PAST MEDICAL HISTORY:
• K/C/O :Acute schizophrenia
• She was admitted with similar complaints in the month of January 2011
PAST MEDICATION HISTORY: nil
HISTORY OF PRESENT ILLNESS :
patient was brought with the complaints of decreased sleep, appetite, violent obsessive behaviour,
talking to self and laughing herself. History of poor self-care and believing that god is speaking with her.
PAST SURGICAL HIATORY : nil
FAMILY HISTORY/ALLERGIES: nil

5. PHYSICAL EXAMINATION:
GENERAL EXAMINATION:-
TEMPERATURE :- Afebrile
PULSE RATE :- 82/min
RESPIRATORY RATE :- 20/min
BLOOD PRESSURE :- 120/80mmHg
SYSTEMIC EXAMINATION:-
CVS :- S1S2 +
CNS :- NFND
RS :- BAE +
GI :- Soft

6. LAB INVESTIGATIONS:
PARAMETERS RESULT- DAY 1 REFERENCE
Hb 13.3 g/dl 12-15 g/dl
Packed cell volume 40.8 % 37-46 %
DC-P 61.4 % 40-70 %
Lymphocytes 31.7 % 20-40%
Esinophills 3.5% 1-6%
Monocytes 2.8 % 2-10%
basophills 0.6% < 1%

7. LAB INVESTIGATIONS:
PARAMETERS RESULT- DAY 1 REFERENCE
BILURUBIN(Total) 1.1 U/L 0.3-1.2 U/L
BILURUBIN(Direct) 0.1U/L 01-0.3 U/L
ALT 18 U/L 15-37 U/L
AST 16 U/L 30-65 U/L
Albumin 3.5 mg/dl 3.5-5 mg/dl
Alkaline phosphatase 188 U/L 188 U/L

8. ASSESMENT-
A 23 years old female patient with K/C/O acute schizophrenia was presented with C/O
talking with herself, Laughing herself, Violent and obsessive behaviour, decreased sleep and
appetite since 3 days was diagnosed to have chronic schizophrenia with obsessive compulsive
disorder.

9. PLAN-
DRUGS GENERIC NAME DOSE FREQUENCY ROA DURATION
Tab. SHIZODON RISPERIDONE 2mg HS P/O 10days
Tab. OLENZ OLANZAPINE 10mg TID P/O 10 DAYS
Tab. ATEVAN LORAZEPAM 2mg OD P/O 10 DAYS
Tab. LIVOGEN FERROUS FUMERATE 50mg OD P/O 10 DAYS
Tab. PACITANE BENZHEXOL (trihexyphenidyl) 2mg OD P/O 10 DAYS
Inj. HALIDOL HALOPERIDOL 5mg/ml Stat IM -
Inj. PHENARGAN PROCHLORPHENTHIXOL 50mg Stat IV -
Inj. CLOPIXOL DEPOT ZUCLOPENTHIXOL 200mg Stat @ 9 AM IM -

10. Drug interactions-
Haloperidol + prochlorperazine →
Haloperidol + zuclopenthixol acetate →
Haloperidol + risperidone →
lorazepam + olanzapine →
zuclopenthixol acetate + olanzapine →
zuclopenthixol acetate + prochlorperazine →
Risperidone + prochlorperazine →
Risperidone + zuclopenthixol acetate →
increased risk of cardiotoxicity , Torse-de-pointes.
increased risk of QT prolongation .
increased risk of QT prolongation .
potentiation of excessive sedation and cardiorespiratory depression.
potentiation of excessive sedation and cardiorespiratory depression.
potentiation of excessive sedation and cardiorespiratory depression.
increased risk of cardiotoxicity , Torse-de-pointes .
potentiation of excessive sedation and cardiorespiratory depression .

12. FARM NOTES-
PROBLEM 1 :-
 Finding – lorazepam + olanzapine.
 Assessment – concurrent use may potentiate excessive sedation and cardiorespiratory
depression .
 Monitoring - Monitor ECG regularly .
PROBLEM 2 :-
 Finding – Zuclopenthixol + olanzapine .
 Assessment - concurrent use may potentiate excessive sedation and cardiorespiratory
depression .
 Monitoring - Monitor ECG regularly .