This document presents a case study of a 49-year-old male patient admitted to the hospital for generalized weakness, slurred speech, fatigue, fever, constipation, and cough for the past 3 days who has a history of epilepsy. Laboratory tests and investigations like CT scan and EEG were performed. Based on the subjective and objective evidence, the patient was assessed with epilepsy and hypertension. The goals of treatment were to relieve symptoms, control seizure frequency and severity, and improve quality of life. The patient's drug regimen and interactions are outlined, and the pharmacist notes duplication of paracetamol and lack of treatment for cough. The patient was counseled on medication adherence, diet, exercise, stress management, and lifestyle

1. CASE PRESENTATION ON
EPILEPSY

2. SUBJECTIVE EVIDENCE
PATIENT DETAILS
• NAME : Abc
• AGE : 49
• SEX : Male
• IP.NO : 81118
• DEPT. : Male general ward

3. • REASON FOR ADMISSION : c/o Generalized
weakness with slurred speech since 3
days,fatigue,fever on and off from 3
days,constipation,cough,expectoration
• PAST MEDICAL HISTORY : k/c/o Epilepsy
• PAST MEDICATION HISTORY : Eptoin 100mg

4. OBJECTIVE EVIDENCE
LABORATORY INVESTIGATION:
DATE 2/11 3/11/ 4/11 5/11 6/11 7/11 8/11
TEMP. 99.6 99.6 99.6 98.2 98.1 98.1 98.1
B.P.(mm
of Hg)
170/110 170/110 160/110 120/100 120/110 130/90 130/90
PULSE 80

5. BLOOD COUNT TEST
• Haemoglobin : 13.6g/dL
• Platelets : 1,68,000
Differential leukocyte count
• Lymphocytes : 26%
• Basophils : 0%
• Eosinophils : 1%
• Monocytes : 2%

6. RENAL FUNCTION TEST
• Urea : 22 mg%
• Serum Creatinine : 1.2 mg%

7. ELECTROLYTES TEST
• Sodium : 123 m.Eq/L
• Potassium : 4.8 m.Eq/L
• Chloride : 91 m.Eq/L

8. OTHER INVESTIGATIONS
• Chest X ray
• CT scan
• EEG

9. ASSESSMENT
Based on Subjective and Objective evidence
the patient was assessed with “HEAD INJURY
with EPILEPSY “ and “HYPERTENSION”

10. GOALS OF TREATMENT
• To releive signs and symptoms
• To control or reduce the frequency and
severity of seizures
• To improve the patient compliance
• Maintaining or restoring quality of life

11. DRUG CHART
BRAND NAME GENERIC
NAME
FREQ DOSE 2/11 3/11 4/11 5/11 6/11
T.Leripril Levetiraceta
m
1-0-1 500mg yes yes yes yes yes
T.Eptoin Phenytoin 1-1-1 100mg yes yes yes yes yes
T.Amlodipine Amlodipine 1-0-1 5mg yes yes yes yes yes
Inj.Ceftriaxone Ceftriaxone 1-0-1 1gm yes yes yes yes -
T.Paracetamol Acetaminop
hen
1-1-1 600mg yes yes yes yes -
T.Cusena Docusate
Na+Senna
0-0-2 100+80m
g
yes yes yes - -
IVF NS Normal
saline
SOS 500ml - yes yes Yes yes
T.Hifenac.MR Aceclofenac
+Paracetamo
l
1-0-1 100+650
mg
- - - yes yes
T.Nitrofurantoi Nitrofurantoi 1-0-1 100mg - - - - yes

12. DRUG INTERACTIONS
• Amlodipine + Phenytoin
Amlodipine will increase the level or effect of
phenytoin by affecting hepatic /intestinal
enzyme CYP3A4 metabolism.
• Levetiracetam + Acetaminophen
Levetiracetam decreases levels of
acetaminophen by increasing metabolism.
• Phenytoin + Acetaminophen
Phenytoin decreases levels of acetaminophen by
increasing metabolism

13. PHARMACIST INTERVENTION
• No proper treatment is given to releive cough
and expectoration.
• Drug duplication is found (paracetamol and
T.Hifenac
• No proper inference is given regarding
investigations done like chest x ray and EEG.

14. PATIENT COUNSELLING
• Take medications regularly and properly as indicated.
• Avoid more salt intake into your diet.
• Drink plenty of water to keep body hydrated.
• Get enough sleep.
• Intake Ketogenic diet which involces low in carbohydrates and high
in protein and fats.
• Try relaxation or slow breathing exercises when anxious or if you
begin to hyperventilate.
• Avoid white products like white sugar,table salt,white rice
• Take Epsom salt bath (2/3 times per week)
• Do exerises regularly like walking for 45mins but stop and rest if you
feel tired
• Manage stress and avoid stressful situstions.

15. THANK YOU