Case presentation on appendicitis

1. CASE
PRESENTATION
By:
B.DHANALAKSHMI,
IV-Pharm.D,
08L81T0004,
RIPER.

2. PATIENT PROFILE
• NAME : XXXXX
• AGE : 48 YEARS
• SEX : MALE
• UNIT : MALE SURGICAL WARD
• DOA : 27-02-2012
• REASON FOR ADMISSION : PAIN IN
ABDOMEN SINCE EVENING.

3. CHIEF COMPLAINTS
 PAIN
 FEVER
 VOMITNG

4. ON EXAMINATION
 P/A – SOFT
 BP – 140/90 mm of Hg
 CVS – S1S2 +
 PULSE – 98/min
 TEMP – NORMAL
 SPO2 – 98%

5. PAST MEDICATION HISTORY
NOT KNOWN

6. FAMILY HISTORY
FARMER
MARRIED, HAS 3 CHILDREN
SOCIAL HISTORY
NOT KNOWN

7. ADVISES :)
 Sr. CREATININE – 0.9 mg/dL (0.6-1.1mg/dL)
 BLOOD UREA – 21 mg/Dl
 HIV & HBsAg : -ve
 BLOOD GROUP : O +ve

8. PARAMETER OBSERVED VALUE NORMAL VALUE
Hb 15.1 g/dL 11 – 16.5 g/dL
TC 16600/cum 3500 – 10000/cum
DC Lympocytes 14.9% 15 – 30 %
Midcells 3.2% 2-10%
Neutrophils 81.9% 40-70%
CLINICAL LABORATORY
INVESTIGATIONS

9. DIAGNOSIS:
ACUTE APPENDICITIS

10. DEFINITION:
IT IS THE ACUTE
INFLAMMATION OF THE VESTIBULAR ORGAN
- APPENDIX.

11. PRESENT MEDICATION
BRAND NAME GENERIC NAME R.O.A DOSE FREQ. FROM TO
INJ. T.T T.T I.M 0.5cc STAT 27/02
INJ. CEFAZOLIN CEFAZOLIN I.V 500mg TID 27/02 29/02
INJ.METROGYL METRONIDAZOLE I.V 500mg TID 27/02 29/02
INJ.TRAMADOL TRAMADOL I.V 50mg TID 27/02 29/02
INJ.PANTOP PANTOPRAZOLE I.V 40mg OD 27/02 29/02

12. F.A.R.M NOTES
FINDINGS:
* PAIN IN ABDOMEN, VOMITING.
* SURGERY DONE.
ASSESSMENT:
* APPENDICITIS
* POST SURGICAL INFECTION MAY OCCUR
RESOLUTION:
* APPENDECTOMY.
* PROPHYLATIC ANTIBIOTICS.
MONTORING:
* MONITOR PATIENT’S RESPONSE TO THERAPY.
* MONITOR PATIENT FOR INFECTIONS.

13. DRUG PATIENT COUNSELLING
PANTOPRAZOLE
WILL ADVICE THE PATIENT TO TAKE THE DRUG BEFORE
FOOD BECAUSE THESE ARE THE DRUGS THAT REQUIRE
ACTIVATION AT AN ACIDIC PH
.
WILL EDUCATE THE PATIENT TO TAKE THE DRUG
UNBROKEN OR UNCRUSHED.
TRAMADOL
 INSTRUCT TO TAKE DRUG ONLY AS PRESCRIBED.
 CAUTION PATIENT TO AVOID POTENTIALLY HAZARDOUS
ACTIVITIES THAT REQUIRE MENTAL ALERTNESS UNTIL
ADVERSE CNS EFFECTS OF DRUG ARE KNOWN.
CEFAZOLIN
 INSTRUCT PATIENT OF POTENTIAL ADRs.
 FOR PATIENTS ON SODIUM RESTRICTIONS, ASK TO
MONITOR ELETROLYTE LEVELS.
METRONIDAZOLE
 INFORM PATIENT THAT DRUG MAY CAUSE METALLIC
TASTE AND DISCOLOURED (RED OR BROWN) URINE.
 TELL PATIENT TO AVOID ALCOHOL AND ALCOHOL
CONTAINING PREPARATIONS DURING THERAPY AND FOR
ATLEAST 48HOURS AFTER LAST DOSE TO PREVENT
DISULFIRAM –LIKE REACTION.

14. THANK U……