Case presentation on APPENDICITIS

1. CASE PRESENTATION
ON
APPENDICITIS
Presented by
G. Radha
pharm. D Vth year
194T1T0017

2. PAST MEDICAL HISTORY ;-
• NILL
PAST MEDICATION HISTORY ;-
• NILL
ON EXAMINATION :-
VITALS DAY1 DAY2 DAY3 UNITS
B.P 110/70 110/70 110/70 mmofHg
P.R 82 72 78 BPM
SPO2 98 97 96 %
TEMPERATUR
E
98 98 98 ‘F

3. LABORATORY INVESTIGATIONS :-
CBP OBSERVED VALUE NORMAL VALUE
Hb 13.8 mg/dl 13.5-15.5 g/dl
WBC 18,000cells/cu mm 4000-- 11000cells/cu mm
RBC 4.5 million cells / cu mm 4.5-6.0million cells/ cu
mm
BLOOD UREA 18 mg/dl 5-20 mg/dl
S.CREATININE 1.3 mg/dl 0.7-1.35 mg/dl
BLEEDING TIME 1.0 minute 1-3 minutes
CLOTTING TIME 1.45seconds 3-7minutes

4. DIAGNOSIS ;-
Ultra sound abdomen is performed
Impression :-
Dilated tender appendix with loss
of compressibility is seen

5. SOAP NOTES :-
Subjective findings :-
• Stomach pain at night since 1day
• Vomitings of 2 episodes
• Loss of appetite
Objective findings :-
Ultra sound abdomen ; dilated appendix with loss of
compressibility is seen
Assesment :-
From subjective and objective findings the case is diagnosed as
appendicitis

6. TREATMENT :-
Appendectomy is done
• Inj.Pantop 40mg
• Inj.Zofer 2mg/ml
• Inj.Xylocaine 20mg/ml
• Inj.Sulcef 1.5gm
• Inj.Metrogyl 500mg /100ml
• Inj.Diclo 25mg/ml

7. DRUG CHART :-
DRUG
NAME
CATEG
ORY
MOA USE
ROA
FRE
QUE
NCY
DAYS
D1 D2 D3
Inj.pantop
[pantaprazol
e]
H+/k+
inhibotor
It inhibit final
step in gastric
acid production
Decrease
acid
secretion
IV OD + + +
Inj.zofer
[ondansetro
n]
5HT3
antagonist
It inhibits
seratonin
To treat
nausea
vomitings
IV BD + + +
Inj.xylocain
e[lidocaine]
Local
anesthetic
It blocks
VGSCs
Used to
numb an
area
IV OD + - -
Inj.sulcef
[cefaperazo
ne
salbactum
Cephalos
porin
&beta
lactamase
inhibitors
Inhibits cell
wall synthesis
To treat
bacterial
infections
IV BD + + +
Inj.metrogyl
[metronidaz
ole]
nitroimid
azole
It inhibits
protein
synthesis
Bacterial&
parasitic
infections
IV BD + + +

8. Disease information on appemdicitis:-
Definition;-
Appendicitis is the inflammation of the vermiform
appendix that develops most commonly in adolescents
and adults
Epidemiology;-
• Appendicitis is the most common acute surgical
condition of the abdomen
• Approximately 7% of the population will have
appendicitis in their life time
• With the peak incidence occuring between ages of 10
to 30 years

9. Etiology;-
Obstructive causes;-
• Fecalith that acculde the lumen of the appendix
• Swelling of the bowel wall
Non obstructive causes;-
• Haematogenous spread of infection
• Vascular occlusion
• Diet lacking fibres
• Less water intake

10. Pathophysiology;-
Due to etiologic factors
Obstruction of appendix
[due to fecalith ,tumor]
Increased intraluminal pressure
Results in severe pain[appendicitis]

11. SIGNS AND SYMPTOMS ;-
• Abdomial pain
• Nausea & vomiting
• Anorexia
• Constipation
• Diarrhea
• Fever

12. DIAGNOSIS;-
• CT scan
• Ultra sound-visualise tubular structure & cysts
• MRI

13. TREATMENT ;-
• Appendicectomy-It is a surgical procedure to
remove the appendix from the abdomen .It can be
performed with a small incision on the abdomen or
laproscopically
MEDICAL MANAGEMENT ;-
• Antibiotic therapy
• Anti inflammatory drugs
• Analgesics
• Fluid therapy

14. CRITICAL EVALUATION ;-
• Clinical condition --- Appendicitis
• Drug of choice --- surgery
• Dose --- Appropriate
• Dosage forms --- Appropriate
• Frequency --- appropriate
GUIDLINES;-
World Journal of Emergency Surgery

15. LIFE STYLE MODIFICATION ;-
• Avoid spicy foods
• Take plenty of water
• Improving posture of the body after the surgery

16. PATIENT COUNSELLING;-
REGARDING DISEASE;-
It is an inflammation of the vermiform appendix
REGARDING MEDICATION;-
• Inj.Pantop 40mg---to decrease acid level in stomach
• Inj.Zofer 2mg/ml—to treat vomitings and nausea
• Inj.Xylocaine 20mg/ml—to cause numbness during surgery
• Inj.Sulcef 1.5gm--- to treat bacterial infections
• Inj.Metrogyl 500mg /100ml---to treat bacterial &parasitic
infections
• Inj.Diclo 25mg/ml ----to treat pain

17. REFERENCE;-
Harsha mohan
WWW. Drugs.com