This case presentation summarizes a 76-year-old male patient admitted to the hospital for atrial fibrillation and hypothyroidism. The patient presented with frothing from the mouth, loose stools, and breathlessness. Diagnostic tests showed abnormal thyroid and cardiac function. The patient was diagnosed with atrial fibrillation and hypothyroidism based on physical exam findings, lab results, echocardiogram, and information from the referring physician. He was prescribed various medications to treat his conditions and symptoms, including drugs to maintain normal heart rhythm and thyroid hormone replacement. His hospital course and treatment plan are outlined over several days.

1. CASE PRESENTATION
PHARMACOTHERAPEUTICS PRATICAL
N A M E : B H A S K A R PA N D E Y
P H A R M D 2 N D Y E A R

2. ATRIAL FIBRILLATION
AF Is a Common abnormal heart rhythm that happens when electrical
impulse fire off from different phase in the atria in disorganised way.
And is felt as an irregular heartbeat or pulse

3. ETIOLOGY
●Abnormal or damage to the heart structure.
● CORONARY HEART DISEASE
● LUNGS DISEASE
●SLEEP APNEA
● An overactive thyroid gland or other metabolic imbalance.
● Exposure to stimulants,such as medication,caffeine,tabacco or alcohol.

4. SIGNS AND SYMPTOMS
● PALPITATIONS
● FATIGUE
● CHEST PAIN
● SHORTNESS OF BREATH
● WEAKNESS
● REDUCE ABILITY TO EXERCISE

5. DIAGNOSIS AND TREATMENT
DIAGNOSIS : ECG ,ECHOCARDIOGRAM, BLOOD TEST , CHEST X-RAY
AND BLOOD TEST
TREATMENT: Prevent blood clots , which may decrease the risk of a stroke.
AND Maintaining a normal heart rhythm medication may include:
● Propafenone
● sotalol

6. CASE STUDY
PATIENT NAME: XXX AGE: 76 yrs SEX: M
WEIGHT: -
IP NO: 190806/00012
PROVISIONAL DIAGNOSIS: AF, HYPOTHYROIDISM.
SOCIAL HISTORY: NON VEGETARIAN AND ALCHOOL AND TOBACCO
PHYSICAL EXAMINATION
● General- Weak BP- 106/70MmHg
● Vital Sign- Temp. N, Pulse rate: 70
● Presenting Complaints- Hyperthyrosidism, loose stool, Vomiting,
breathessness.

7. SUBJECTIVE
Patient XXX admitted in hospital due to
• ATRIAL FIBRILLATION
• Frothing from mouth
• Loose stools
OBJECTIVE
After review and interpretate the laboratory data &
infornation given by parents physician diagnosed to patient
have Atrial fibrillation with hypothyrodism.

8. •After reviewing and observing laboratory data, other diagnostic parameters
with physical examination of patient physician prescribed the medication for
patient-
•Rx
Tab Vasta 10mg BD
Inj. Ondansetron 1A
Tab Furosemide 25 mg QD
Tab Thyroxin 5o mg QD
Tab Doxophylline 200mg BD
Inj, MVIT B12 1A
Nasal: ipravent.
ASSESSMENT

9. RESULT OF LABORATORY TEST
LAB. TEST NORMAL VALUE RESULT
TSH 04-4.9MU/L 14.44
T3 4.6-11.2 2.06
HB 13-17G/D 10.03
RBC 4.7-6.1McL 3.14
Monocytes 02-10 % 01%
Ferritin 12-300ng/ml 403

10. Echocardiography and Doppler Report. LVEF 55%
NO RWMA at rest
Normal IAS/IVS
Normal Pericadium
Normal IVC
Modrate TR and PAH
Sonography of Abdomen Liver size 101mm Normal
Echopattern Normal
CBD/PV: WNL
Gall Bladder: Minimally Distended
Pancreas Obs.Cured by bowl gas
Spleen 79mm Normal
Both Kidneys Normal
Free Fluid Abdomen Absent

11. ASSESMENT / TREATMENT PLAN :-
DOA:-06-08-19 DOD:----------.
Day 1-
Seen by Physician.
Tab Vasta 10mg BD
Inj. Ondansetron 1A
Inj, MVIT B12 1A
Nasal: ipravent.
given
Advise –laboratory investigation

12. ASSESMENT / TREATMENT PLAN
Cont…
DAY 2
Atrial Fibrillation, Hypothyrodism confirmed by Lab Test.
Noted Medication Started
Day (3-5)-
fresh complaints: sickness chest pain headache and loose Stool
continue same treatment
Day6- Continue same Treatment.