MHA IS A ANEMIA

1. CASE PRESENTATION
ON
MICROCYTIC HYPOCHROMIC
ANAEMIA
BY:BINDU BN
4th PHARM.D

2. The patient was a 46 year old
male from male ward of general
medicine department.
I.P NO : 123465
D.O.A : 20.01.2021

3. SUBJECTIVE
REASON FOR ADMISSION : c/o generalized weakness * 2
weeks
No c/o cough,fever,breathlessness.
No c/o abdominal pain, vomiting ,loose stools,abdominal
distension.
No c/o headache.
No other complaints.
PAST MEDICINE HISTORY : K/C/O ACUTE PORTAL VEIN
THROMBOSIS *2 WEEKS
NO h/o HTN,DM,THYROID DISORDER,ASTHMA
PAST MEDICATION HISTORY: TAB.Dabigza 150mg 1-0-1

4. SOCIAL HISTORY
• SOCIO ECONOMIC STATUS: LOWER MIDDLE CLASS
• PERSONAL HISTORY: NORMAL SLEEP AND APPETITE.
NORMAL BOWEL AND BLADDER MOVEMENT.
NO HISTORY OF WEIGHT LOSS/GAIN.
• ALCOHOL: H/O ALCOHOL(RUM) CONSUMPTION *10 YEARS 180-210
ML /DAY (STOPPED 10 YEARS BACK) .

5. OBJECTIVE EVIDENCE:
 VITAL SIGNS: PALLOR +
NO ICTERUS,CLUBBING,CYANOSIS,LYMPHADENOPATHY,
EDEMA.
GENERAL EXAMINATION: CONSCIOUS ,ORIENTED TO TIME
,PLACE AND PERSON.MODERATELY BUILT AND NOURISED.
SYSTEMIC EXAMINATION: RS NVBS ,NO ADDED SOUNDS
CVS-S1S2(+);NO MURMUR
P/A: Soft, non tender, organomegaly (spleenomegaly).

6. LABORATORY REPORTS
DATE NORMAL
VALUE
DAY 1 DAY 2 DAY 3 DAY 4
Blood Pressure(mmHg) 120/80 120/70 120/80 110/80 130/80
Pulse(bpm) 60-100 84 104 98 82

7. • Hb - 9.4 (13.5-17.5 g/dl)
• RBC - 4.26 (4.5- 5.5 million/cu.mm)
• WBC - 2.6 (4-11 thousand/cu.mm)
• PLATELET COUNT - 96 (150-400 thousand /cu.mm)
KIDNEY FUNCTION TEST:
UREA - 13 mg/dl (15-45)
CREATININE - 0.8 mg/dl (0.8-1.4)
ELECTROLYTES:
S.SODIUM – 137 (135-145 mEq/L)
S.POTASSIUM – 4.10 (3.5-5.1 mEq/L)
S.CHLORIDE - 110 (98-107 mEq/L)
S.CALCIUM – 7.4 (8.5-107 mEq/L)

8. ULTRASOUND- ABDOMEN AND PELVIS
IMPRESSION - CHRONIC LIVER PARENCHYMAL DISEASE
- PORTAL VEIN IS DILATED WITH HYPOECHOIEC CONTENTS
(SUGGESTIVE OF ACUTE PORTAL VEIN THROMBOSIS)
- SMALL UMBILICAL HERNIA
-BILATERAL MILD PLEURAL EFFUSION

9. HAEMATOLOGY
IMPRESSION:
o ERYTHROCYTES- MAJORITY OF ERYTHROCYTES ARE MICROCYTIC
HYPOCHROMIC .
oLEUCOCYTE-ARE DECREASED IN NUMBER .NORMAL IN
DISTRIBUTION.
oPLATELETS- ARE DECREASED IN NUMBER.

10. GOALS OF TREATMENT
• To reduce signs and symptoms(generalized weakness).
• To normalize blood cells count.
• To perform surgery for umbilical hernia post anemia treatment.
• To give blood transfusion.
• To improve patient’s quality of life.

11. TREATMENT PLAN
SL.
NO
TRADE NAME GENERIC NAME DOSE FREQUENCY 1 2 3 4 5 6
01 T.DABIGZA Dabigatran etexilate 150mg 1-0-1 √ √ √ √
√ √
02 T.OROFER Ferrous ascorbate and
folic acid
0-1-0 √ √ √ √
√ √
03 T.LIMCEE Ascorbic acid 500mg 1-0-0 √ √ √
√ √
04 T.RANTAC ranitidine 150mg 1-0-0 √ √ √
√ √
05 C.BECOSULES Z B complex with zinc 0-1-0 √ √ √
√ √
06 T.ALBENDAZOLE albendazole 400mg 0-0-1 √ √ √ √
√ √
07 INJ.OROFER-S iron sucrose 100mg in 100ml NS *2DAYS √ √ √ √
√ √

12. PHARMACIST INTERVENTION:
1) Portal vein thrombosis is properly not treated.
Thrombolytics(streptokinase,alteplase,tenecteplase) and drugs that
reduce portal blood pressure(ocetrotide) can be given.
2) Albendazole is given for unknown indication.
3) LIPID PROFILE can be done .

13. DRUG INTERACTONS
• DRUG-DRUG INTERACTIONS:
1)ranitidine + dabigatran : (moderate)
This combination may increase the risk of bleeding.
NO OTHER MAJOR DRUG INTERACTIONS
• DRUG-FOOD INTERACTIONS:
----------------------

14. PATIENT COUNSELLING:
Diet related – fiber foods
Drug related – albendazole should be taken with meal.
- take medications properly.
Life style modification-proper rest
- should not lift weight .
- should not climb stairs.