The patient, a 25-year-old male smoker, presented with a chief complaint of passing concentrated urine and yellow colored eyes and urine discharge for 15 days. Laboratory tests found elevated bilirubin levels. The patient was assessed with obstructive jaundice and prescribed injections of cefotaxime, ranitidine, prednisolone tablets, and Liv 52 tablets to treat the condition and its symptoms while addressing any potential drug interactions between the medications and the patient's liver condition.

1. NAME: KUMAR
AGE/SEX:25/M
WEIGHT:65
IPNO:19752
WARD/UNIT:MM/19

2. CHIEF COMPLAINTS
C/O passing concentrated urine for 15 days
C/O body weakness
C/O loss of appetite
C/O itch all over the body
C/O passing pale colour stools

3. HISTORY OF PRESENT
ILLNESS
C/O yellow coloured eyes and discharge of yellow
coloured urine.

4. PERSONAL HISTORY
The patient has smoking habituate for more
than 10 years.
PAST HISTORY
Not a k/c/o DM/PTB/HT/epilepsy

5. PARAMETERS OBSERVATION PARAMETERS
Blood pressure 120/80 mm/Hg 120/80 mm/Hg
Random blood
sugar
90 mg/dl 70- 11o mg/dl
S. Urea 35 mg/dl 15-40 mg/dl
S. sodium 140 mg/dl 135-145 mEq/l
S. potassium 4.8 mEq/l 3.5-5 mEq/l
S. creatinine 1.0 mg/dl 0.8-2 mg/dl
S. Bilirubin (total) 1.5 mg/dl 0.2-1 mg/dl
Direct bilirubin 0.8 mg/dl 0.2-0.4 mg/dl
Indirect bilirubin 0.7 mg/dl 0.2-0.6 mg/dl
SGOT 56 UI/I 5-45 UI/I
SGPT 53 UI/I 5-40 UI/I

6. OBSTRUCTIVE JAUNDICE

7. Inj. Cefotaxime 1gm IV BD
Inj. Ranitidine 1cc IV BD
Tab. prednisolone 5mg BD
Tab. Liv 52 BD

9. The subjective had a chief complaint of case of
passing concentrated urine for 15 days.
Yellow coloured eyes and discharge of yellow
coloured urine.
Smoking habituate for more than 10 years

10. OBJECT
PARAMETERS OBSERVATION PARAMETERS
Blood pressure 120/80 mm/Hg 120/80 mm/Hg
Random blood sugar 90 mg/dl 70-110 mg/dl
S. Urea 35 mg/dl 15-40 mg/dl
S. sodium 140 mg/dl 135-145 mEq/l
S. potassium 4.8 mEq/l 3.5-5 mEq/l
S. creatinine 1.0 mg/dl 0.8-2 mg/dl
S. Bilirubin (total) 1.5 mg/dl 0.2-1 mg/dl
Direct bilirubin 0.8 mg/dl 0.2-0.4 mg/dl
Indirect bilirubin 0.7 mg/dl 0.2-0.6 mg/dl
SGOT 56 UI/I 5-45 UI/I
SGPT 53 UI/I 5-40 UI/I

11. ASSESSMENT
OBSTRUCTIVE JAUNDICE
Inj. Cefotaxime 1gm IV BD
Inj. Ranitidine 1cc IV BD
Tab. prednisolone 5mg BD
Tab. Liv 52 BD

12. continue liv 52 for hepatoprotective
until the patient free from the liver toxins.
Continue prednisolone until the patient
may gets free from allergic condition.
Continue ranitidine because the patient
may taken the NSAID it cause Hcl
secretion so ranitidine may continued.

13. DRUG INTERACTIONS
• Corticosteroids are primarily metabolised by
liver and may have enhanced effects in patients
with liver disease. Dosage adjustments may be
necessary in these patients.
• Ranitidine is partially metabolized by the liver.
although dosage reductions are generally not
necessary, therapy with ranitidine should be
administered cautiously in patients with liver
disease.