case presentaion on chronic calcific pancreatitis

1. CHRONIC CALCIFIC PANCREATITIS
CASE PRESENTATION ON

2. TOPIC- PANCREATITIS
PRESENTED BY-14Z91T0004
PHARMD III YEAR
KVK COLLEGE OF PHARMACY

3. A 42 year old male patient has
admitted with a chief complaints of back
pain and vomiting .

4. PATIENT DEMOGRAPHIC DETAILS
 NAME- Debi Prasad jena
 AGE:- 42 years
 GENDER:- male
 IP NUMBER:- 1600059648
 DEPARTMENT:- Gastroenterology

5. SUBJECTIVE FINDINGS
 CHIEF COMPLAINTS- back pain ,vomiting.
 SOCIAL HISTORY - Smoker-NO
 Alcohol-NO
 PAST MEDICAL HISTORY – NIL

6. VITALS
 Blood pressure:-140/90 mm of Hg
 Pulse rate:- 104 beats per minute
 Temperature:- Normal

7. OBJECTIVE ANALYSIS
Test [normal value] Observed value
Erythrocyte sedimentation rate [3-5mm/hr] 23
Post prandial blood sugar [<140gm/dL] 150
SGPT [0-40U/L] 45
Potassium [3-4.1mEq /L] 5.1

8. DIAGNOSIS
 ULTRA SONOGRAPHY-- Changes in the
pancreas with calculi in dilated duct.

9. ASSESSMENT
From the subjective , objective and ultra
sonography reports it is clear that the patient
is suffering from the chronic calcific
pancreatitis
.

10. . CALCIFIC PANCREATITIS
 It is an inflammation of the pancreas with the
presence of stones in the pancreas and does
not heal or improve.
 ETIOLOGY:-
Heavy alcohol abuse
Auto immune conditions
Genetic mutation due to cystic fibrosis
Blocked pancreatic duct [or] common bile
duct
Familial pancreatitis

11. PATHOPHYSIOLOGY
calcification
Pancreatitis
occurrence may be by
[alcohol consumption ,
gall stones,
auto immune]
]
Mislocation of cystic fibrosis transmembrane
conductance regulator chloride channel in
pancreatic duct cells
Decrease in pancreatic HCo₃ secretion
Low pH of pancreatic juice lead to fluid mal secretion
Protein plug formation in the pancreatic ducts
Pancreatic stone formation
Pancreatic juice out flow
obstruction [obstructive
pancreatitis]

12. TREATMENT PLAN
DRUG NAME BRAND NAME CATEGORY DOSE ROUTE FREQU
ENCY
1 2 3 4
Cefditoren + pivoxil zostum cephalosporins 10ml IV BD + + + +
rabeprazole Razo-d Anti-ulcerants 20ml IV OD + + + +
ondansetron zofer Anti- emetic 4 mg IV TD + + + +
Tramadol tramazac analgesic 50mg IV BD + + + +
menadione VIT-K hemostatic 10mg IV OD + + + +

13. MECHANISM OF ACTION OF GIVEN DRUGS
ZOSTUM-O:- Cefditoren + pivoxil
 M.O.A:- Cefditoren binds to 1 or more of the
penicillin binding protein which inhibit the final
transpeptidation step of peptidoglycan synthesis
in bacterial cell wall, thus inhibiting bio
synthesize and arresting cell wall assembly
resulting in bacterial cell death.
ADR’S:-Diarrhea, nausea, headache,
abdominal pain, dyspepsia, vomiting, hematuria,
increased urine, WBC decreased hematocrit

14.  TRAMADOL:-
 M.O.A:- Tramadol inhibits the reuptake
of nor-epinephrine serotonin and enhances
serotonin releases; it alters perception and
response to pain by binding to µ receptors in
the CNS.
 ADR’S:-Seizures, dizziness, headache,
anxiety, gastro entities, constipation.


15.  RAZO-D:-Rabeprazole
 M.O.A:- rabeprazole is proton pump
inhibitor that suppresses gastric acid
secretion by inhibiting H⁺/k⁺ ATP ase at the
secretory surface.
 ADR’S:- Dry mouth, angio edema,
bronchospasm, parasthesia, taste
disturbances.

16.  VIT-K
 M.O.A:- it promotes hepatic synthesis of
clotting factors II,ix,x . these thickens the
blood and stops bleeding and serves as anti
coagulant
 ADR’S:- Hemolytic anemia, glucose-6-
phosphate defiency, neonatal, brain and liver
damage

17.  ZOFER= Odansetron
 M.O.A It is an anti emetic, prevents nausea
and vomiting associated with emetogenic
cancer therapy. Highly specific and selective
serotonin receptor antagonist and with low
affinity for dopamine receptors. Blocks serotonin
receptors in the vomiting centre and nervous
supplying the digestive system.
 ADR’S:- Headache, hiccups, flushing,
warmth sensation, constipation, rash, urticaria,
seizures

18. PATIENT COUNSELLING:-
 A low fat diet must be recommended.
 Drink plenty of fluids.
 Physical exercise and meditation may be
helpful.