This case presentation discusses a 64-year-old male patient presenting with progressive weakness in both lower and upper limbs. He has a history of type 2 diabetes mellitus and hypertension. On examination, his blood pressure and blood sugar levels were elevated. He was diagnosed with diabetes mellitus, hypertension, and associated lower and upper limb weakness. He was treated with medications to control his blood pressure and blood sugar, as well as physiotherapy. His condition gradually improved over the course of his hospital stay.
Diabetes is a serious condition where your blood glucose level is too high. It can happen when your body doesn't produce enough insulin or the insulin it produces isn't effective. Or, when your body can't produce any insulin at all.
Diabetes is a serious condition where your blood glucose level is too high. It can happen when your body doesn't produce enough insulin or the insulin it produces isn't effective. Or, when your body can't produce any insulin at all.
Non-pharmacological Management of Diabetes Mellitus.pptxSamson Ojedokun
Diabetes mellitus DM, is a metabolic disorder of biomolecules characterized by chronic hyperglycemia due to defects in insulin synthesis or utilization or both
DM requires lifelong therapy. A multidisciplinary approach is needed to control glycemia, as well as to limit the development of its devastating complications and manage such complications when they do occur.
Increases cost of living and reduces life expectancy
diagnosis & complication of Diabetes mellitus including Diabetic ketoacidosis & HHS
anaesthesia managment for patient with DM posted for surgery both emergency and elective surgery
gestational diabetes mellitus
Definition : Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from impaired insulin secretion, insulin action [ insulin resistance ] or both .
The chronic hyperglycemia in DM is associated with long term damage dysfunction and failure of various organs
Is based on etiology not on type of treatment or age of the patient.
Type I(Beta cell destruction-absolute insulin deficiency)
Immune mediated Idiopathic
Type II
predominant insulin resistant with relative insulin deficiency
predominant secretory defect with insulin resistance
PROPER DISPOSAL OF UNUSED MEDICINES
Properly getting rid of unused or expired medicine protects people, animals, and the environment.
Use drug take-back system
Do Flushing to toilet/sink
Dispose with household trash
Return back to health care professionals (Pharmacist)
Store medicine as per label
Keep medicine in a cool, dry place that is out of the reach of children
Lock up medicine in a cabinet, drawer, or in safe place
Store in the original container, which has information about the medicine
Discuss with your pharmacist about proper storage of medications with respect to dosage form.
Don’t use liquid medications like syrup, ear drops, eye drops after they are crystallised
Don’t store medicine in a bathroom, Kitchen where humidity and temperature changes can cause damage
Don’t share your prescription medicine with anyone - a medicine that works for you may cause harm, even death, to someone else.
PROPER DISPOSAL OF UNUSED MEDICINES
Properly getting rid of unused or expired medicine protects people, animals, and the environment.
Non-pharmacological Management of Diabetes Mellitus.pptxSamson Ojedokun
Diabetes mellitus DM, is a metabolic disorder of biomolecules characterized by chronic hyperglycemia due to defects in insulin synthesis or utilization or both
DM requires lifelong therapy. A multidisciplinary approach is needed to control glycemia, as well as to limit the development of its devastating complications and manage such complications when they do occur.
Increases cost of living and reduces life expectancy
diagnosis & complication of Diabetes mellitus including Diabetic ketoacidosis & HHS
anaesthesia managment for patient with DM posted for surgery both emergency and elective surgery
gestational diabetes mellitus
Definition : Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia resulting from impaired insulin secretion, insulin action [ insulin resistance ] or both .
The chronic hyperglycemia in DM is associated with long term damage dysfunction and failure of various organs
Is based on etiology not on type of treatment or age of the patient.
Type I(Beta cell destruction-absolute insulin deficiency)
Immune mediated Idiopathic
Type II
predominant insulin resistant with relative insulin deficiency
predominant secretory defect with insulin resistance
Similar to CASE PRESENTATION ON HTN,DM,LIMB WEAKNESS (20)
PROPER DISPOSAL OF UNUSED MEDICINES
Properly getting rid of unused or expired medicine protects people, animals, and the environment.
Use drug take-back system
Do Flushing to toilet/sink
Dispose with household trash
Return back to health care professionals (Pharmacist)
Store medicine as per label
Keep medicine in a cool, dry place that is out of the reach of children
Lock up medicine in a cabinet, drawer, or in safe place
Store in the original container, which has information about the medicine
Discuss with your pharmacist about proper storage of medications with respect to dosage form.
Don’t use liquid medications like syrup, ear drops, eye drops after they are crystallised
Don’t store medicine in a bathroom, Kitchen where humidity and temperature changes can cause damage
Don’t share your prescription medicine with anyone - a medicine that works for you may cause harm, even death, to someone else.
PROPER DISPOSAL OF UNUSED MEDICINES
Properly getting rid of unused or expired medicine protects people, animals, and the environment.
Cerebral venous thrombosis is the cerebral vein thrombosis of dural sinus and/or cerebral veins.
The incidence of cerebral venous thrombosis is estimated at 0.2-0.5/1 lakh/year.
0.39 deaths/million of 56million population.
The mortality of CVT probably varied b/w 20% and 50%.
Inherited thrombophilia:- prothrombin gene mutation, protein S and C deficiency, ant thrombin deficinecy,dysfibrogenemia
Vascular injury:- nephrotic syndrome
Medication:- estrogen, heparin
Other medical illness:- CHF, IBD, HIV,Surgery, Trauma.
Age:- Above 50 years
Surgery
Accidents
Medications
Vascular injury
Pregnancy
Other medical illness:- CHF, IBD, HIV
Isolated intracranial hypertension syndrome: headache, vomiting, papilledema, visual disturbance
Focal syndrome :- focal deficits, seizures (focal/generalized) or both
Encephalopathy:- multifocal signs, mental status changes, stupor or coma.
Venous infarction
Haemorrhage
Subarachnoid haemorrhage
Pulmonary embolism
Epilepsy
Anaemia is a condition where there is a decrease in the total amount of red blood cells in or haemoglobin in the blood or a lowered ability of the blood to carry oxygen.
ETIOLOGY :blood loss and decreased red blood cell production.
SYMPTOMS : feeling tired, weakness, shortness of breath.
EPIDEMIOLOGY: Anaemia is a common, multifactorial condition among older adults.
RISK FACTORS :chronic infections such as osteomyelitis , SLE
COMPLICATIONS : lack of energy, increased risk of infections, heart and lung problems
SPONDYLOSIS AND GASTROENTERITIES
INTRODUCTION:-
Spondylosis (spinal osteoarthritis) is a degenerative disorder
It may affect the cervical(neck), thoracic(mid-back), lumbar(low-back) regions of the spine
It may cause loss of normal spinal shape and function
Commonly seen in individuals after the age of 40 years
Spondylosis refers to the degenerative changes in the spine such as bone spurs and degenerating intervertebral discs
Spondylosis changes in the spine are frequently referred to as osteoarthritis
Degeneration of cervical intervertebral disc and the secondary degeneration of cervical intervertebral joints, leads to injury of spinal cord, nerve roots and vertebral artery, and shows corresponding signs and symptoms
Lumbar spondylosis:-
Lumbar spondylosis is a medical condition in which chronic pain is experienced by the patient in the lumbar region (lower back) due to compression of the intervertebral discs
Age:- The discs are dehydrate, become thinner and become harder, then provide less support to the vertebrae resting on the discs
Repetitive strain injury (RSI) caused to lifestyle like driving, travelling, intense work in farm, who carry loads on their head
Congenital deformity:- stenosis of cervical spinal canal
Genetics:- if family has history
Mental health :- depression, anxiety
CASE PRESENTATION ON CHRONIC KIDNEY DISEASE AND URINARY TRACT INFECTIONCHANDANAC24
CASE PRESENTATION ON CHRONIC KIDNEY DISEASE AND URINARY TRACT INFECTION
CHRONIC KIDNEY DISEASE
DEFINITION:-
Chronic kidney disease (CKD) is defined by a reduction in the glomerular filtration rate (GFR) and/or urinary abnormalities or structural abnormalities of the renal tract.
CKD refers to an irreversible deterioration in renal function that usually develops over a period of years.
Initially, manifests only as a biochemical abnormality but, eventually, loss of the excretory, metabolic and endocrine functions of the kidney leads to clinical symptoms and signs of renal failure.
ETIOLOGY:-
Diabetes mellitus
Interstitial diseases
Glomerular diseases
Hypertension
Reno vascular disease
Unknown
CLINICAL FEATURES:-
Polyuria and nocturia
Proteinuria
Haematuria
Hypertension and fluid overload
Uraemia
Anaemia
Electrolyte disturbances
URINARY TRACT INFECTION
Urinary tract infection refers to the presence of organisms in the urinary tract together with symptoms and signs, of inflammation.
Refers to presence or absence, of functional or structural abnormalities within the urinary tract.
Infections of the urinary tract can be divided into two general anatomic categories :
Lower tract infection (Urethritis, cystitis)
Upper tract infection (pyelonephritis)
CASE PRESENTATION ON BRONCHITIS
PATIENT DEMOGRAPHIC DETAILS
Patient name:-MNN
Age:-20yrs
Gender:-Male
IP no.:-698/698
DOA:-10-01-2017
CHIEF COMPLAINTS ON ADMISSION
C/O Fever with chills since 1week
C/O Cough since 1week
PATIENT HISTORY
Patient medication history:-NS
Patient medical history:-NS
Social history:-NS
Family history:-NS
Allergies:-NKA
CASE PRESENTATION ON ACUTE CORONARY SYNDROME ,ANTERIOR WALL MYOCARDIAL INFARC...CHANDANAC24
CASE PRESENTATION ON ACUTE CORONARY SYNDROME ,ANTERIOR WALL MYOCARDIAL INFERCTION,HYPERTENSION,TYPE-2 DIABETES MELLITUS,MODERATE LV DYSFUNCTION
PRESENTED BY:-
Chandana C
2nd pharm-D
SSCP
PATIENT DEMOGRAPHIC DETAILS:-
NAME:-Chow……..
AGE:-67years
GENDER:-Male
WEIGHT:-64Kg
HEIGHT:-162cm
BMI:-24.4Kg/m2
IP NO.:-19020189
DOA:-14-2-2019
DOD:-16-2-2019
NAME:-Chow……..
AGE:-67years
GENDER:-Male
WEIGHT:-64Kg
HEIGHT:-162cm
BMI:-24.4Kg/m2
IP NO.:-19020189
DOA:-14-2-2019
DOD:-16-2-2019
NAME:-Chow……..
AGE:-67years
GENDER:-Male
WEIGHT:-64Kg
HEIGHT:-162cm
BMI:-24.4Kg/m2
IP NO.:-19020189
DOA:-14-2-2019
DOD:-16-2-2019
PATIENT HISTORY:-
Past medical history:-Type-2 Diabetes mellitus, Hypertension
Past medication history:-He didn’t take medication for type 2 diabetes mellitus, on regular prescription for Hypertension
Social history:-NS
Family history:-NS
Allergies:-NKA
Diet:-Vegetarian
PROVISIONAL DIAGNOSIS:-
Acute coronary syndrome –anterior wall myocardial infarction, type 2 diabetes mellitus, hypertension, moderate LV dysfunction
FINAL DIAGNOSIS:-
Type 2 diabetes mellitus, Hypertension, ACS-AWMI, Moderate LV dysfunction
TREATMENT GOALS:-
Do PTCA for AWMI
Reduce infarct size
To reduce signs and symptoms
To prevent further complication
To reduce morbidity and mortality rate of diabetes mellitus, hypertension, AWMI
TREATMENT OPTIONS RECOMMENDED BY CLINICAL PHARMACIST:-
Beta blockers:-atenolol, metoprolol
Antiplatelet therapy:- ticagrelor, tirofiban, aspirin
Potassium channel activator:-nicorandil
ACE inhibitors:-Ramipril, captopril
Biguanides:-metformin
Sulfonylurea:-glimepiride, gliclazide, glipizide
HMG COA reductase inhibitors:- atorvastatin, rosuvastatin, simvastatin
PROBLEMS IDENTIFIED:-
There is no treatment given for diabetes mellitus
Heart rate is increased
Blood glucose level is elevated
PHARMACIST INTERVENSION:-
Prescribe medication for diabetes mellitus
Advice patient to take medication regularly for diabetes mellitus
Reduce heart rate
PATIENT COUNSELLING:-
ABOUT DISEASE AND MEDICATION :-
Educate patient about signs and symptoms and complications of disease
Educate about morbidity and mortality
Advice to take medication as per prescription
Educate about route of administration and time of administration
ABOUT LIFESTYLE MODIFICATION
Do physical exercise
Be physically active
Take rest
Take medication as per chart
ABOUT DIET:-
Consume fresh fruits and vegetables
Moderate carbohydrate intake
Low fat diet and dairy products
Reduce sugar and salt intake
Advice DASH diet
THANK YOU
Chandana C, Sree Siddaganga College of Pharmacy
18-04-2019
Hypertension, Ischemic Heart Disease, Diabetes Mellitus- Case PresentationCHANDANAC24
CASE PRESENTATION ON TYPE-II DIABETES MELLITUS, ISCHAEMIC HEART DISEASE WITH HYPERTENSION
Presented by:-
CHANDANA C
2nd PHARM.D
SREE SIDDAGANGA COLLEGE OF PHARMACY
Chief Complaints on admission:-
Hyperglycemia and chest pain
Provisional Diagnosis:-
Diabetes mellitus with Ischemic Heart Disease
Final Diagnosis:-
Type-II Diabetes mellitus , Ischaemic Heart Disease with Hypertension
Treatment goals:-
To relieve signs and symptoms
To prevent the complication
To prevent the progression of the disease
To achieve the targeted BP
To reduce hypertension, diabetes mellitus ,ischaemic heart disease morbidity and mortality
Problems Identified:-
Failure to receive the drugs
Overdose
Sub therapeutic
Route of administration
Dose frequency
Goals achieved:-
Reduction in BP
Pharmacotherapy initiated to control hypertension , diabetes mellitus
Symptoms are reduced
Monitoring parameters:-
Vitals(BP,HR,PR)
Serum creatinine
RBS(Random glucose test)
Hematological analysis
ECG
Adverse drug reaction
Patient Counselling:-
About disease:-
Educate the patient about Control
Risk factors
Complications
THANK YOU
CASE PRESENTATION ON HYPERTENSION, TYPE 2 DIABETES MELLITUS,CEREBRO VASCULAR ...CHANDANAC24
CASE PRESENTATION ON HYPERTENSION, TYPE 2 DIABETES MELLITUS,CEREBRO VASCULAR ACCIDENT
PATIENT DEMOGRAPHIC DETAILS:-
NAME:-AXAB
AGE:60yrs
GENDER:- Male
IP NO.:-18110362
DOA:-25-11-18
DOC:-30-11-2018
BMI:-25.2kg/m²
CHIEF COMPLAINTS:-
C/o Hiccups from 5 days with sensation of both UL and LL since 3 days , Chest discomfort, Left side weakness
PATIENT HISTORY:-
PAST MEDICAL HISTORY:-k/c/o Type 2 diabetes mellitus
PAST MEDICATION HISTORY:-on prescription since 10 yrs.
SOCIAL HISTORY:-Alcoholic
FAMILY HISTORY:-NS
ALLERGIES:-NKA
DIET:-Veg
PROVISIONAL DIAGNOSIS:-
TYPE 2 DIABETES MELLITUS AND HYPERTENSION
PHARMACEUTICAL CARE PLAN:-
SOAP ANALYSIS:-
TREATMENT GOAL:-
1.Reduce chief complaints
2.Reduce morbidity and mortality
3. Reduce weight
4. reduce infarct size
TREATMENT OPTIONS:-
1.ORAL HYPOGLYCEMIC AGENT:-
Metformin , glimepiride, tenegliptin
2.ANTIHYPERTENSIVE AGENTS:-ACE inhibitors, ARB s
3. ANTINEUROPATHI AGENTS:-diazepam
4. NSAID s
5.ANTIPLATELET DRUGS
PROBLEMS IDENTIFIED:-
There is no laboratory data for chest discomfort
There is proper long term discharge medication for hypertension
There is so many drugs for diabetes it may leads to polypharmacy
PHARMACIST INTERVENSION:-
1.Suggest to conduct lab test for chest discomfort
2. Suggest to prescribe long term medication for hypertension
3.Suggest to reduce drugs for diabetes mellitus
PATIENT COUNSELLING:-
1.Reduce weight
2.Avoid fatty food and alcohol
3.Intake more fiber rich food like berries, cereals…
4.Be physically active
5.Do physical exercise and walking
6.Reduce stress
7.Take medication properly
8.Regular check-ups
THANK YOU
Abbreviations:-
LL: Lower Limb
UL: Upper Limb
MRI: Magnetic Resonance Imaging
GRBS: Generalized Random Blood Sugar
PBS: Post Prandial Blood Sugar
NS: Nothing Significant
NKA: Nil Known Allergies
yrs: Years
veg: Vegetarian
ACE: Angiotensin Converting Enzyme
ARB: Angiotensin Receptor Blocker
NSAID: Non Steroidal Anti Inflammatory Drugs
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Embracing GenAI - A Strategic ImperativePeter Windle
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1. CASE PRESENTATION ON DIABETES
MELLITUS,HYPERTENSION WITH
B/L LOWER AND UPPER LIMB
WEAKNESS
PRESENTED BY:-
CHANDANA C
2nd PHARM D
SREE SIDDAGANGA
COLLEGE OF PHARMACY
2. HYPERTENSION:-
DEFINITION:-Hypertension is defined as a condition
where blood pressure is elevated to an extent that
clinical benefit is obtained from blood pressure
lowering.
COMORBIDITY:-
DIABETES MELLITUS(TYPE II):-It is a long term
metabolic disorder that is characterised by high blood
sugar, insulin resistance , and relative lack of insulin.
WITH PROGRESSIVE WEAKNESS B/L LOWER LIMB AND
UPPER LIMB
3. ETIOLOGY:-
1.PRIMARY HYPERTENSION(90-95%):-Also called as essential
hypertension. Cause is unknown in the majority of patients.
2.SECONDARY HYPERTENSION(5-10%):-
• Renal vascular disease
• Endocrine disorders
• Drugs
• Pregnancy, Phechromocytoma
• Obstructive sleep obnia
• Thyroid and parathyroid disorders
• Acromegaly
• Coarctation of the aorta
• Alcohol
• Renal paranchymal diseases
5. PATHOGENESIS:-
Blood pressure is the mathematical product of cardiac
output and peripheral resistance.
1.Increased cardiac output:-
• Increased cardiac preload
• Venous constriction
2.Increased peripheral resistance:-
• Functional vascular constriction
• Structural vascular hypertropy
6. DIAGNOSIS:-
Blood pressure should be measured using a well
maintained sphygmanometer of validated accuracy.
Other diagnostic test includes:-
• ECG
• Chest X-ray
• Ambulatory blood pressure monitor
7. DIABETES MELLITUS
• Diabetes mellitus is a group of metabolic
disorder , characterised by hyperglycemia ,
associated with abnormalities in carbohydrate
, fat and protein metabolism and resulting in
chronic complications including microvascular
, macrovascular and neuropathic.
CLASSIFICATION:-
Type 1:
• Immune mediated
• Idiopathic
8. Type 2:
• May range from predominantly insulin resistant ,
predominantly insulin deficient
• Other specific types
• Genetic defect of beta cell function
• Genetic defect in insulin action
• Diseases of the endocrine pancreas
• Drug or chemical induce
• Infections
• Uncommon forms of immune mediated diabetes
9. EPIDEMIOLOGY:-
• Type 1 DM usually develops in childhood or early
adulthood , all the some latent forms do occur type 1
DM accounts for up to 10% of all cases of DM and
results from autoimmune destruction of pancreatic
beta cells . This process is likely initiated by the
exposure of a genetically susceptible individual to an
environmental agent.
• Preclinical beta cell autoimmunity preceeds the
diagnosis of type 1 DM up to 9 to 13 years .
Autoimmunity may remit in some perhaps less
susceptible persons or can progress to beta cell failure
in others .
10. ETIOLOGY:-
• The exact cause of type 1 diabetes is unknown
usually , the body’s own immune system which
normally fights harmful bacteria and viruses
mistakenly destroys the insulin producing cells in
the pancreas other possible causes include
• Genetics
• Exposure to viruses and other environmental
factors
11. RISK FACTORS:-
• Family history is important in some cases of type
1 diabetes . If any of the family member with
type 1 diabetes , the risk of developing increases
• Race may be risk factor for type 1 diabetes it is
more common in white individuals than in people
of other races
12. PATHOGENISIS:-
• Type 1 diabetes mellitus is characterised by
absolute deficiency of insulin most often this is the
result of an immune mediated destruction of
pancreatic beta cells but rare unknown or idiopathic
processes may contribute.
• The auto immune process is meadiated by
macrophages and T - lymphocytes with circulating
and auto antibodies to various beta cells antigens .
The most commonly detected antibody associated
with type 1 DM is islet cell antibody.
13. DIAGNOSIS:-
Type 1 diabetes is usually diagnosed through a series of tests
• Fasting blood sugar > 126 on two separate tests
• Random blood sugar >200 along with symptoxal of diabetes
• Hemoglobin ALC >6.5 on two separate tests (glycosylated hb)
COMPLICATIONS:-
• Increased heart attack risk
• Eye problems , including blindness
• Infection on the skin
• Kidney damage
• High blood pressure
• High cholesterol
14. PATIENT DEMOGRAPHIC DETAILS:-
Patient name :- BGX
Age :- 64 years
Gender :- Male
BMI :- Normal
IP No. :-18110303
Unit :- GNW MALE- 1
Ward :- 184
DOA :- 21-11-2018
DOD :- 24-11-2018
16. PATIENT HISTORY:-
Past medical history:-K/C/O DM,HTN
Past medication history:-He taken medicines
Social history:-NS
Family history:-NS
Allergies:-NKA
Diet:-Mixed diet
21. DAY-2:-
• No other complaints
• Patient is concious,oriented
CVS:-S1S2+
BP:-120/70mmHg Fluid balance:-
PR:-80bpm Intake:-1230ml
Temp.:-Normal Output:-1450ml
SPO2:-95%
GRBS:-
6hr180mg/dl
14hr250mg/dl
20hr300mg/dl
• Adv. Rx as per chart
22. DAY-2 CONTINUED………
PHYSIOTHERAPY:-
PT:-Limb physiotherapy
Physiotherapy is defined as a treatment method
that focuses on the science of movement and helps
people to restore, maintain and maximise their physical
strength,function,motion and overall well-being by
addressing the underlying physical issues.
• General passive meets to both lower limb and upper
limb.
23. DAY-3:-
• Patient is concious, oriented.
• No fresh complaints.
BP:-120/80mmHg GRBS:-
PR:-90bpm 6hr280mg/dl
Temp.:-Normal 15hr337mg/dl
SPO2:-95%
Others:-well
• Adv. Rx as per chart
26. THERAPEUTIC GOALS:-
• To reduce signs and symptoms
• To achieve the target BP
• To reduce HTN related morbidity and
mortality
• To improve the QOL by making PT
understand about this disease
• Prevent further complication
27. TREATMENT OPTION:-
• Angiotensin II receptor blockers with the combination
of diuretic for the treatment of hypertension.
eg:-Telmisartan+chlorthalidone(Tazloc-CT)
Valsartan+hydrochlorothiazide(Diovan HCT)
• Sulphonylurea with the combination of biguanide to
treat the diabetes mellitus. They act by increasing
insulin release from the beta cells in the pancrease.
eg:-Glemepiride+metformin(Vasoglim-M2)
Glipizide+metformin
Chlorpropamide and glyburide+metformin
28. • Corticosteroid used to supress the immune system
and decrease inflammation
eg:- Prednisone, Methyl prednisolone
• Antacid for relieve heartburn, acid indigestion, by
neutralizing excess stomach acid.
eg:-Sodium bicarbonate, calcium carbonate,
magnesium carbonate, magnesium hydroxide
• Anticonvulsant neuropathic pain agent with diabetic
neuropathy
eg:-Pregabalin+methylcobalamin,gabapentin,
carbamazepine
• Multivitamin and multimineral medication to treat
or prevent vitamin deficiency due to certain illness
eg:-Snigmin-B,nutrilite,emergen-C
29. • Normal saline (sodium chloride) infusion is a
sterile solution used to treat low sodium levels
and fluid loss.
• Aquaretic drug that functions as a selective,
competitive vasopressin receptor 2 antagonist
use to treat hyponatremia associated with
congestive cardiac failure. eg:-Tolvaptan
30. PROBLEMS IDENTIFIED:-
• Methylprednisolone oral will decreases the level or
effect of tolvaptan oral by altering drug metabolism.
• Telmisartan oral and tolvaptan oral both increase
potassium levels in the blood and chlorthalidone oral
decreases potassium levels in the blood.
• Methylprednisolone oral , chlorthalidone oral
mechanism:-additive drug effects. There may be an
increased chance of low blood potassium.
• Chlorthalidone oral decreases effects of glimepiride oral
by opposing drug effects.
• Chlorthalidone oral decreases effects of metformin oral
by opposing drug effects.
• Methyl prednisolone oral decreases effects of metformin
oral by opposing drug effects.
31. PHARMACIST INTERVENSION:-
• The combination of valsartan-hydrochlorothiazide is
used instead of telmisartan-chlorthalidone.
• The combination of glipizide-metformin is used
instead of glimepiride-metformin.
• Stop the drug tolvaptan ,instead that use
conivaptan.
32. MONITORING PARAMETERS:-
• Vitals (BP,HR,PR,Temperature)
• Electrolytes test
• Renal function test(Serum creatinine)
• Haematology
• CSF analysis
• GRBS(General Random Blood Sugar)
33. PATIENT COUNCELLING:-
About disease:-
• Educate the patient about the causes, risk
factors and other aspects about the disease.
• Prevent further complication.
About medication:-
• Take prescribed medications as required by
the doctor.
• Do not miss or double the dose.
• Advice about drug interaction,drug dosage.
34. About life style modification:-
• Regular exercise(at least 30 minutes a day)
• Regular check up
About diet:-
• Eat healthy diet, including the DASH diet (eat more
fruits, vegetables, and low fat diary products, less
saturated and total fat).