A female teacher presented with slurred speech, mouth deviation, and weakness on the right side of her body. Examination revealed decreased strength and sensation on the right side. Laboratory tests showed elevated blood sugar and white blood cell count. She was diagnosed with ischemic stroke and right hemiplegia due to her history of diabetes and hypertension. She was treated with heparin, pantoprazole, mexon plus, clopidogrel, atorvastatin, citicoline, and discharged on pantoprazole, clopidogrel, atorvastatin, metformin, and amlodipine. She was advised to follow up in 10 days.

1. CASE PRESENTATION
ISCHEMIC STROKE
N.LOHITHA
REG NO :
320020
3 PHARM.D

2. CHIEF COMPLAINTS
• Slurred speech
• Deviation of mouth
• Right upper and lower limb
• Abdomen hard

3. ON EXAMINATION
• Drowsiness
• NL fold decrease on right
• Bulk –N
• Tone decreased right upper and lower limbs
• Power 1/5/1/5

4. • Past medical history: DM,HTN
• Past medication history:glyciphage 500mg DM
,amlodipine 5mg HTN
• Past surgical history: NIL
• Occupation:Teacher
• Smoking:NO
• Alcohol: YES
• Diet:Diabetic Diet
• Martial status : Married

5. LABORATORY INVESTIGATIONS
PARAMETERS RESULTS NORMAL VALUE
SERUM CREATININE 1.1mg/dl 0.6-1.4mg/dl
TOTAL CHOLESTROL 190mg/dl 150-250mg/dl
TRIGLYCERIDES 110mg/dl 50-150mg/dl
LDL-CHOLESTROL 39mg/dl >=35mg/dl
HDL-CHOLESTROL 129mg/dl <160mg/dl
VLDL-CHOLESTROL 22mg/dl 10-30mg/dl
SERUM SODIUM 143mmol/L 135-155mmol/L

6. PARAMETERS RESULTS NORMAL VALUES
RBS *190mg/dl 70-150mg/dl
HAEMOGLOBIN 14.2gm% 13.5-18.0gm%
PCV 42% 40-54%
RBC TOTAL COUNT 4.9 millons/cmm 4.5-6.5millons/cmm
PLATELETS COUNT 3.1lakhs/cmm 1.5-4.0lakhs/cmm
WBC TOTAL COUNT *10,000cells/cmm 4000-10000cells/cmm
SERUM POTASSIUM 4.0mmol/L 3.5-5.3mmol/L

7. DIAGNOSIS
• CVA
• AIS
• Right hemiplegia
• RIF age

8. DRUG CHART
BRAND
NAME
DOSE ROA FREQUENCY START
DATE
STOP
DATE
HEPARIN 500IU IV BD 28/1/23 1/2/23
PANTOP 40mg ORAL OD 28/1/23 1/2/23
MEXONPLUS 100ml IV OD 28/1/23 1/2/23
CLOPITAB 75/150mg ORAL OD 28/1/23 1/2/23
ATOCAR 80mg ORAL OD 28/1/23 1/2/23
CITICOLINE 500mg ORAL BD 28/1/23 1/2/23
Metformin 500mg ORAL OD 28/1/23 1/2/23
Cremaffin 30ml ORAL 28/1/23 1/2/23

9. • Patient condition was hemodynamically
stable during discharge.
Review after 10 days
DISCHARGE MEDICATION
BRANDNAME DOSE FREQUENCY
PANTOCID OD 40mg
CLOPITAB-A OD 75/150mg
ATOCAR OD 80mg
METFORMIN BD 500mg
AMLODIPINE OD 5mg