A 56-year-old male patient presented with a 2-month history of cough with whitish sputum, fatigue, weight loss, and fever. Examination found decreased liver enzymes and cavities on chest x-ray. Sputum tests were positive for acid-fast bacilli. He was diagnosed with pulmonary tuberculosis. Treatment included Paracetamol, Ceftriaxone, AKT4 (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol), and Amikacin.

1. TUBERCULOSIS
G.MAHESH
PHARM-D
VI YEAR
26-01-2014

2. Case
 Name: Ms. R Age: 56yrs
 Gender: M Depart: Chest&Tb
 D.O.A: 14-01-14 D.O.D: 19-01-14
 CHIEF COMPLAINTS:
C/O cough with expectoration which is whitish in
color since 2 months.

3.  HISTORY OF PRESENT ILLNESS:
Patient was apparently normal 2 months ago
when he developed cough with expectoration which is
whitish in color which is not foul smelling.
H/O fatigue, lethargy, weight loss of about 6 kg
and fever.

4.  PERSONAL HISTORY AND HABITS:
Normal bowel and bladder habits
SMOKER: Yes
ALCOHOLIC: Yes
 PHYSICAL EXAMINATION:
TEMP: 100
PR: 78/min
RR: 18/min
BP: 120/80 mm/Hg

5.  SYSTEMS EXAMINATION:
CVS: S1,S2 +
RS : Crepts
CNS: NFND
P/A: soft
LAB INVESTIGATION REPORT:
Hb : 13.5g/dl
RBC : 4.9million cells/cu mm
PCV : 39.4 %
WBC : 6,400 cells/cu mm
DC : P67. ; L32 ;E1.7 ;M2.9 ; B0.3

6. Platelet count : 3.02 lakhs/cu mm
Electrolyte profile:
Bicarbonate: 27 mmol/L

7.  Liver function tests:
Bilirubin Total : 0.9mg/dl
Bilirubin Direct : 0.2 mg/dl
SGOT (AST) : 9U/L
SGPT (ALT) : 17U/L
Total Protein : 7.1 g/dl
Albumin : 3.7 g/dl
Globulin : 3.4g/dl
Alkaline Phosphatase: 115 U/L

8.  Others: chest X ray: Significant cavities found
 Sputum AFB: A +
B+
 DIAGNOSIS:
PULMONARY TUBERCULOSIS

9. DRUG CHART
S:n
o
DRUGS DOSE FREQUENCY R.O.A DURATION
1. T.Para 500mg SOS PO 5 Days
2. Inj.Ceftrioxone 500mg BD IV 5 Days
3. T.AKT 4
(Isoniazid+Rifampi
cin+Pyrazenamide
+Ethambutol)
2I, R 1,
Z 1,E 1
2 Tabs 3 times
a week
PO 5 Days
4. Inj. Amikacin 250mg OD IV 2 Days

10. SONP NOTES:
 Subejective: A 56 years old male patient was admitted in the hospital
with c/o cough with expectoration which is whitish in color since
2 months .
H/O fatigue, lethargy, weight loss of about 6 kg and fever.
Personal history: He is a smoker and alcoholic
o Objective: systemic and physical examination was found to be normal
SGPT and SGOT were found to be Decreased.
chest X ray: Significant cavities found
Sputum AFB: A +
B+

11.  Assessment: PULMONARY TUBERCULOSIS .
 Plan : Patient was given treatment with T.Para ,
Inj.Ceftrioxone,T.AKT 4,Inj. Amikacin.

12. DISCUSSION:
 T.Para(Paracetamol):
 It is an analgesic and antipyretic drug used to relieve from fever and
pain. Take one tablet whenever required.
 Inj.Ceftrioxone:
 It is an antibiotic used to treat any infections. It is given twice daily.
 T.AKT 4:(Isoniazid+Rifampicin+Pyrazenamide):
 These drugs are given to treat active tuberculosis infection. Take 2
tablet of each thrice weekly.
 Inj. Amikacin:
 It is an antibiotic. This injection is given twice in a week