- The patient, a 78-year-old female, presented with abdominal pain, nausea, vomiting and constipation for 3-4 days. - Tests showed elevated white blood cell count and signs of acute pancreatitis. She was assessed as suffering from acute pancreatitis and hypertension. - Her treatment plan included IV fluids, pantoprazole, ondansetron, and paracetamol for pain. She was also continued on her regular medications for hypertension. - She showed improvement over two days in symptoms and vital signs and was counselled on medication use and follow-up before being discharged.

1. CASE PREESNTATION
ON ACUTE PANCREATITIS

2. DEMOGRAPHY
Name :XYZ
Age :78 years
Sex :Female
Date of admission:20/09/2021
Date of discharge :22/09/2021

3. • Current complaints and history of present illness :
• C/O pain in abdomen, Nausea, vomiting for 3 days
• Burning sensation in abdomen
• Constipation 4 days ago
• Past medical history/past medication history:
• K/C/O HTN/past PTCA on treatment 5 years
• Rx T Ecospirin 150 mg 0-0-1
T Avas 20 mg 0-0-1
T Starpress XL 25 mg 1-0-0
SUBJECTIVE EVIDENCE

4. Sl no Vitals Day 1 Day 2
1 Temperature 98.6 F 98.6 F
2. RR 20 cpm 16 cpm
3 Pulse 82 bpm 70 bpm
4 BP 110/60 mmhg 110/70 mmhg
OBJECTIVE EVIDENCE –
PHYSICAL EXAMINATION

5. Sl No TEST NORMAL VALUE RESULT
1. GRBS <200 g/dL 115 g/dL
2. Sr.clorine 96-106Meq/L 104
3. Sr.k 3.5-5.1meq/L 3.5
4. Sr. Na 4135-145 Meq/L 136
5. Hb 11.5-16 g/dL 10.8
6. TC 4K-11K Cells/m 11290
7. Neutrophils 40-75% 88%
8. Lymphocytes 20-45% 8%
9. RBC 3.7-5.6m cells/m 3.8
10. PCV 34-48% 31.4%
11. Platelets 1.4 -2.4 cells 2.46
12. Sr.albumin 3.5-5g/dL 3.4
LAB DATA

6. From the objective and subjective evidence it was assessed that the
patient suffering from
• Acute pancreatitis
• Hypertension
ASSESSMENT

7. PLAN : TREATMENT GOALS
• Short term goals :
• Pain management
• Reduce symptoms
• Long term goals:
• Avoid securing
• Improve quality of life

8. Generic name Dose Frequency ROA Day 1 Day 2
Normal saline 250 ml 100 ml IV ● ●
Pantoprazole 40 mg 1-0-1 IV ● ●
Ondasetron 4 mg 1-1-1 IV ● ●
Hyocin butyl
bromide
20 mg 1-0-1 IV ● ●
Paracetamol 1g SOS IV ●
CURRENT MEDICATION

9. CURRENT MEDICATION
Brand name Generic name Dose Frequency ROA Duration
DOLO 650 Paracetamol 650 mg SOS P/O SOS
T avas Atorvastatin 20 mg 0-0-1 P/O TBC
T star press Metaprolol 25 mg 1-0-0 P/O TBC
T.Ecospirin Aspirin 150 mg 0-0-1 P/O TBC

10. MONITORING PARAMETERS
• Normal saline:
• Pantoprazole: it is a proton pump inhibitor, It is decreases the amount of acid
produced in stomach
• Ondasetron: it blocks the Actions of chemicals in the body that can trigger
Nausea and vomiting
• Hyoscine butyl bromide : it is a antispasmodic Medicine ,which is taken
relieve cramps in the stomach,intestine and bladder
• Paracetamol : it is analgesics and antipyretics used to Treat aches and pain
• Atorvastatin: it is HMG CoA Reductase inhibitor, It is used to Reduce risk of
gall-stone disease

11. • Disease specific:
• Pancreatitis is a disease in which the pancreas becomes inflamed,pancreatic
damage accurs when digestive enzymes are activated before they released into
small intestine and begin attacking pancreas
PATIENT COUNSELING

12. 1. Drug specific :
• Avoid irritating products
• Take proper medication
• Atorvastatin do not consume with grape fruit juice
• Aspirin, report in case of bleeding
Drug Drug interactions:
1. Atorvastatin and grape fruit concentrated use may increase alterstatic exposure (risk
of rhabdomylosis)
2. Aspirin-cellery : increased aspirin exposure leads to increase risk of bleeding
PATIENT COUNSELING

13. • Review after 1 week ,consult the respective medical provider with lab
report and past medical history
FOLLOW UP ADVICE

14. THANK YOU