A 42-year old female patient presented with gastroenteritis and acute renal failure. She reported loose stools and vomiting for several days. Laboratory tests found elevated urea and creatinine levels indicating acute renal failure. She was diagnosed with acute gastroenteritis caused by Entamoeba histolytica and treated with intravenous antibiotics, antiemetics, and proton pump inhibitors. Her condition improved over the next few days with reduced vomiting and stool frequency.

1. CASE PRESENTATION ON
GASTROENTERITIS AND ACUTE
RENAL FAILURE
BY P DEEPAK
5th year Pharm D

2. PATIENT DEMOGRAPHIC DETAILS
PATIENT NAME-XYZ
PATIENT AGE- 42YEARS
SEX-FEMALE
DATE OF ADMISSION- 11-06-2013

3. SOAP FOR GASTROENTERITIS

4. SUBJECTIVE EVIDENCE
• C/o several episodes of loose stools since 3
days
• C/o several episodes of vomiting since one day
• H/o spasmodic type of abdominal pain

5. OBJECTIVE EVIDENCE
Pathology report:
• Stools are semisolid in nature
• Mucus present greenish in colour
• Entamoeba histolytica cyst seen
• N: 83%(40-75%)
• L: 10%

6. From subjective and objective evidence, it has been diagnosed as Acute
Gastroenteritis.
THERAPEUTIC GOALS:
Patient specific:- To prevent dehydration by making sure the body has enough
water and fluids.
Disease specific:- to prevent recurrence of disease
ASSESSMENT:

7. Assessment of current therapy-
Tab Pantoprazole: 40 mg IV 1-0-1
Inj Ondansetron 4mg IV 1-1-1
Tab Sporolac 2-2-2
Cap Doxycycline 300mg stat
Inj Ciprofloxacin 100ml IV 1-0-1

8. TREATMENT CHART
DRUGS DOS
E
ROU
TE
FREQUE
NCY
DAY1 DAY2 DAY3
Inj
Ciprofloxacin
100ml IV 1-0-1 + + stop
Inj
Metronidazole
100ml IV 1-1-1 + + stop
Inj Pantoprazole 40mg IV 1-0-1 + + Tab
Pantoprazole
Inj Ondansatron 4mg IV 1-1-1 + + 1-0-0/sos
T Sporolac 2-2-2 + + +
T Racecadotril 100m
g
P.O 1-1-1 + + +
Cap
Doxycycline
300m
g
P.O stat + stop

9. DAY PROGRESS
1 C/O6-7 episodes of loose stools ,C/o nausea.
No H/o vomiting/abdominal pain.PR:
84/min,BP:124/76mm Hg
2 Vomitings and loose stools reduced ,No abdominal pain
,BP: 124/76mm Hg,PR: 82 bpm
4 Patient comfortable
PROGRESS CHART

10. MONITORING PARAMETERS-
LABORATORY PARAMETERS-

11. SOAP FOR ACUTE RENAL FAILURE

12. SUBJECTIVE EVIDENCE
• C/o loose stools and vomiting

13. OBJECTIVE EVIDENCE
• Urea: 73mg %
• S. Cr: 3.2 mg%
• Cl: 114 mmol/lit
• K+: 3.2 mmol/lit
• Na+: 144 mol/lit
Urine analysis:
• RBC: 1-2/hpf
• Pus cells: 2-4/hpf
• Alb : traces
• Epithelial cells: 4-6/hpf
• Stools: semisolid containing greenish mucus
• Entamoeba cyst seen

14. ASSESSMENT
From subjective and objective evidence, it has been
diagnosed as Acute renal failure
THERAPEUTIC GOALS:
Patient specific:- To prevent dehydration by
making sure the body has enough water and
fluids.
Disease specific:- to prevent recurrence of disease

15. Assessment of current therapy-
Tab Pantoprazole: 40 mg IV 1-0-1
Inj Ondansetron 4mg IV 1-1-1
Tab Sporolac 2-2-2
Cap Doxycycline 300mg stat
Inj Ciprofloxacin 100ml IV 1-0-1

16. TREATMENT CHART
DRUGS DOS
E
ROU
TE
FREQUE
NCY
DAY1 DAY2 DAY3
Inj
Ciprofloxacin
100ml IV 1-0-1 + + stop
Inj
Metronidazole
100ml IV 1-1-1 + + stop
Inj Pantoprazole 40mg IV 1-0-1 + + Tab
Pantoprazole
Inj Ondansatron 4mg IV 1-1-1 + + 1-0-0/sos
T Sporolac 2-2-2 + + +
T Racecadotril 100m
g
P.O 1-1-1 + + +
Cap
Doxycycline
300m
g
P.O stat + stop

17. DAY PROGRESS
1 C/O6-7 episodes of loose stools ,C/o nausea.
No H/o vomiting/abdominal pain.PR:
84/min,BP:124/76mm Hg
2 Vomitings and loose stools reduced ,No abdominal pain
,BP: 124/76mm Hg,PR: 82 bpm
4 Patient comfortable
PROGRESS CHART

18. Patient counseling points
• THINGS TO AVOID WHILE RECOVERING:
• Alcohol
• Caffeine
• Dairy products
• Citrus products
• Fatty, greasy and/or fried foods
• Raw fruits and vegetables
• Aspirin
• Ibuprofen

19. • Food may be offered often in small amounts.
Suggested foods include:
• Cereals, bread, potatoes, meat
• Plain yogurt, bananas, fresh apples
• Vegetables