A 23-year-old female patient presented with pain in the right hip for 1 year and breathlessness on exertion. Physical examination revealed pallor and laboratory investigations showed iron deficiency anemia and vitamin D deficiency. She was assessed with iron deficiency anemia and vitamin D deficiency and prescribed injections of iron sucrose, calcium with vitamin D3 tablets, folic acid tablets, and pain medication. The pharmacist intervened to stop the pain medication after the indication ceased.

1. Department of pharmacy practice
Case study on Anemia& vitamin-D
Deficiency
PRESENTED BY:
NAME:JEEVA P
REG NO :P1520004
PHARM.D (P.B) IIYEAR

2. A 23 years female patient was admitted in the hospital.
C/O:
 Pain in right hip for 1 year
 Breathlessness on exertion 1 year
History of present illness: patient was apparently asymptomatic when she developed pain in
the right hip for past 1 year insidious in onset,progressive in nature,radiated to back,
aggravated on walking and relieving radiated in rest.The pain has increased in severity over
the past 4 month. The past also c/o breathlessness on exertion for past 1 year.Insidious in
onset,not associated with noisy breathing,cough. No HO palpitation ,syncope.
Past Medical History : No known comorbids
Past Medication History : NIL
Family History : Nil
Social History : Nil
2
SUBJECTIVE EVIDENCES

3. Physical examination:
 Patient is conscious, oriented,
 Temp-Afebrile
 Pulse-102 beats/min
 BP-100/60mmHg↓
 RR-22 breaths/min
 Pallor +
 Short statured,koilonychia +, Arm span -138cm
Systemic examination:
 CVS-S1S2+ no murmurus
 RS-BAE+
 CNS-NFND+
 P/A-Soft
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OBJECTIVE EVIDENCES

4. 4
Laboratory investigations:
mh
OBJECTIVE EVIDENCES
PARAMETERS OBSERVED VALUE NORMAL RANGE
HEMATOLOGICAL
HAEMOGLOBIN 7.2 13-17 g/dl
MCV 66.7 83-101 fl
MCH 16.8 27-32 pg
PCV 28.6 41-59 %
MCHC 25.2 31-35
Other special test:
Calcium 8.3 8.6-10.3 mg/dL
phosphate 2.8 2.8 to 4.5 mg/dL
PERPHERAL SMEAR: RBC: Microcytic hypochromic with Short statured,
koilonychia +, Arm span -138cm.

5. 5
ASSESSMENT
• Iron Deficiency Anemia
• Vitamin D Deficiency

6. DRUG DOSE ROA FREQ
Y
DAY(s)
1 2 3 4 5 6
T.paracetamol 500mg P/O TDS * * * * * *
T. shelcal
(calcium with D3)
500mg P/O BD - * * * * *
Inj.Enficer
(Iron sucrose )
200mg IV OD - * * * * *
T.Folic Acid 5mg P/O BD * * * * * *
T.Neurobion Forte 1mg P/O OD - - - * * *
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PLAN

7.  Drug - drug interaction :NIL
 Drug - food interaction : NIL
 Adverse Reaction : NIL
 Medication Error : NIL
GUIDELINE : For IDA, INJ.ENCIFER and T.folic acid were given by the ASH
(American Society of Haematology).
According to the guideline the given drugs are completely appropriate.
For vitamin D deficiency,According to the ICMR guidelines the given drug are
appropriate.
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CRITICAL CARE ANALYSIS

8. Pharmacist Intervention
 The given drug T.PARA 500mg was continued even after the
indication ceased and it was stopped after the pharmacist
intervened.
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9. Regarding disease:
 Iron deficiency anemia is the most common type of anemia,
and it occurs when your body doesn't have enough of the
mineral iron.
 Body needs iron to make hemoglobin. When there isn't enough
iron in your blood stream, the rest of your body can't get the
amount of oxygen it need
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PATIENT COUNSELING

10. Regarding drugs:
 T.PARA is given for the pain that you have in your hip.
 T.Shelcal will help increase calcium content in your body
 Inj.Encifer is given for increasing the iron content in your body.
 T.Folic acid is given for increasing the iron protein level in blood.
 T.Neurobion forte are adviced is given for the vitamin supplement
and pain in the hip.
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PATIENT COUNSELING

11. Regarding life style modification:
 Anemia is a condition in which you lack enough healthy red blood cells to carry
adequate oxygen to your body's tissues.
 Be sure to drink plenty of fluids to reduce dehydration and include fruits,
vegetables, and fibre in your diet each day.
 Iron pills often make your bowel movements dark or green.
 If you forget to take an iron pill, do not take a double dose of iron the next time you
take a pill.
 Keep iron pills out of the reach of small children.
 Regular medical checkup and treatment are important.
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PATIENT COUNSELING

12. 12