GASTROENTERITIS
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A 90-year-old female presented with vomiting, loose stools and dehydration. Laboratory tests revealed electrolyte abnormalities, anemia, and atrial fibrillation. She was diagnosed with acute gastroenteritis, anemia, and atrial fibrillation. She was treated with antibiotics, antiemetics, proton pump inhibitors, and antiarrhythmics. The pharmacist intervened to advise on diagnosing and treating the patient's anemia.
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This document provides information on acute pancreatitis including:
1. The epidemiology, causes, pathophysiology, clinical presentation, investigations, management, and complications of acute pancreatitis are summarized. Gallstones and alcohol are the most common causes.
2. Laboratory markers like lipase and amylase are used to diagnose, while CT, MRI, and ultrasound can identify complications like fluid collections and necrosis. Treatment involves fluid resuscitation, pain management, and treating any organ dysfunction.
3. Complications include pancreatic and extra-pancreatic complications like fluid collections, necrosis, infection, and vascular or bowel issues. Infected necrosis requires antibiotics while severe cases may require drainage procedures or surgery.
ACUTE RENAL FAILURE-ARF.
Acute renal failure is a condition where the kidneys fail to remove waste from the blood and regulate fluids, electrolytes, and pH balance. An 80-year-old female presented with nausea, vomiting, and abdominal pain for one week. Laboratory tests showed elevated BUN and creatinine levels consistent with acute renal failure. She has a history of hypertension, stroke, back pain, and anemia. Treatment included steroids and monitoring of kidney function through blood and urine tests.
CASE PRESENTATION - Copy.pptx TYPE OF ANEMIA
This document presents a case study of a 46-year-old male admitted with microcytic hypochromic anemia and a history of alcohol use and acute portal vein thrombosis. Laboratory tests confirmed microcytic hypochromic anemia. Imaging found chronic liver disease and portal vein thrombosis. The treatment plan included iron supplementation, vitamins, antacids, and albendazole. The pharmacist recommended considering thrombolytics for the portal vein thrombosis and removing albendazole since its indication was unknown.
Addisons disease and its management
This document provides information on Addison's disease, including its causes, signs and symptoms, diagnostic tests, treatment, and nursing care. Addison's disease is a condition where the adrenal glands do not produce enough cortisol and aldosterone hormones. It can develop from autoimmune disease, infections, surgery, or other reasons. Left untreated, it can cause low blood pressure, high potassium, and even an adrenal crisis. Treatment involves replacing the missing hormones with medications like hydrocortisone and fludrocortisone. Nurses monitor patients and provide education on managing the condition.
stroke
A 42-year old male patient presented with symptoms of right-sided body weakness, slurred speech, and loss of consciousness. He was diagnosed with a hemorrhagic stroke caused by a left capsulaganglionic bleed based on his MRI results. He was treated with medications to control blood pressure and prevent further complications. Through physical therapy and treatment, the patient's symptoms improved and he was discharged upon being able to follow commands and having normal vital signs.
ascites-140326120942-phpapp01.pptx
The document describes a case of a 42-year-old male with a history of alcohol use who presented with abdominal distension, discomfort, and fever and was found to have ascites, hepatosplenomegaly, and evidence of cirrhosis on further workup and evaluation. Diagnostic paracentesis revealed an ascitic fluid analysis consistent with tuberculosis peritonitis, and the patient was started on antitubercular treatment with improvement.
Pancreatitis
This document provides an overview of pancreatitis, including its epidemiology, pathophysiology, etiology, clinical presentation, workup, severity scoring systems, treatment, prognosis, and complications. It defines acute and chronic pancreatitis and describes the reversible inflammation of the pancreas that occurs in acute pancreatitis. Key points include that the annual incidence is 13-45 per 100,000 people, the pathophysiology involves premature activation of digestive enzymes within the pancreas rather than the intestines, and treatment depends on the severity but generally involves IV rehydration and pain management for mild cases and more aggressive monitoring and support in an ICU for severe cases.
14. a case study on diabetes mellitus type 1 with diabetic ketoacidosis cp in...
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A CASE PRESENTATION ON CHRONIC KIDNEY DISEASE(CKD)- (1).pptx
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Case Report : Integrating Review Inflammation and Commorbid diseases
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Drug disposal brochure
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.
MIGRAINE, CVT
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
ANEMIA
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
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 LEG CELLULITIS
This case presentation discusses a 68-year-old male patient admitted to the hospital with complaints of swelling and redness in his right leg for 4 days along with fever and nausea. He has a history of type 2 diabetes mellitus and hypertension. Examination revealed cellulitis in the right leg. He was diagnosed with leg cellulitis and treated with antibiotics, antipyretics, and medications to control his diabetes and hypertension. His treatment plan included monitoring his condition closely and counselling him on managing his health conditions and medications.
CASE PRESENTATION ON CHRONIC KIDNEY DISEASE AND URINARY TRACT INFECTION
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 ECLAMPSIA
This document presents a case of a late preterm newborn male infant with a history of antenatal eclampsia in the mother. The infant presented with respiratory distress and hyperbilirubinemia at birth. He was treated with antibiotics, oxygen, phototherapy, and supportive care. His condition improved and he was discharged on day 7. Key factors included his late preterm gestation, respiratory issues possibly due to prematurity, and jaundice likely associated with prematurity and breastfeeding. His mother's history of eclampsia during pregnancy was also noted.
CASE PRESENTATION ON HTN,DM,LIMB WEAKNESS
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.
CASE PRESENTATION ON HTN ,TYPE 2 DM,PANCREATITIS
This document presents a case of a 55-year-old male patient admitted with complaints of retrosternal and epigastric pain. He has a history of hypertension for 23 years and is overweight. Diagnostic tests confirmed acute pancreatitis, hypothyroidism, hypertension, and type 2 diabetes. The patient was treated with medications like amlodipine, glimepiride, levothyroxine, pantoprazole, and analgesics. His treatment goals were to relieve symptoms, avoid complications, maintain a healthy weight and lifestyle modifications. He required monitoring of electrolytes, renal function, thyroid levels and glucose levels.
CASE PRESENTAION ON BRONCHITIS
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...
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 Presentation
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 ...
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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GASTROENTERITIS
- 1. CASE PRESENTATION ON ACUTE GASTROENTERITIS Presented by:- CHANADANA.C III PHARM D 17Q3306
- 2. PATIENT DEMOGRAPHIC DETAILS:- • NAME:- XYZ • GENDER:-Female • AGE:-90yrs • DOA:-25-8-19 • DOD:-26-8-19 • WARD:-General ward
- 3. SUBJECTIVE EVIDENCE:- C/O Vomiting, loose stools and dehydration
- 4. PATIENT HISTORY:- • Past medical history:- N/K/C DM, HTN • Past medication history:-NS • Family history:-NS • Social history:-NS • Allergies:-NKA • Diet:-Veg
- 6. OBJECTIVE EVIDENCE:- • Sodium:- 125mmol/L (135-148mmol/L) • Chloride:- 94mmol/L (98-107mmol/L) • RBC:-3.93million cells/ cumm • Hemoglobin:- 11.7g/dL • Hematocrit:-34% • Neutrophills:- 88.7% • Lymphocytes:- 7.9% • BP:-160/90mmHg • ECG abnormality shows atrial fibrillation • Ultrasound and abdomen pelvis shows dysentry
- 8. ASSESSMENT:- From the objective and subjective evidence the patient has • Acute gastroenteritis • Atrial fibrillation • Anaemia
- 9. PHARMACEUTICAL CARE PLAN:- GOALS OF THERAPY:- • To reduce the signs and symptoms • To increase the patient QOL • To reduce the complication • To provide medication for untreated disease
- 10. TREATMENT OPTIONS:- • Antibiotics:- Ofloxacin, levofloxacin • Antiprotozoal:-Metronidazole, Tinidazole, Secnidazole • Antiemetic's:-Ondansetron, Granisetron • Proton pump inhibitor:- Pantoporazole, Omiprazole • Antiarrhythmic :- Amiodarone, Digoxin
- 11. TREATMENT CHART:- Brand name Generic name Dose Freque ncy ROA Day-1 Day-2 Oflox Ofloxacin 200mg 1-0-1 IV IVF IVF 75ml/hr 1-1-1 IV Metrogyl Metronidazole 100mg 1-1-1 IV Pantop Pantoprazole 40mg 1-0-0 IV Onden Ondansetron 4mg 1-1-1 ORAL Amiodarone Amiodarone 600mg ORAL Ecospirin Aspirin 75mg 0-0-1 ORAL Digoxin Digoxin 6.25mg ½-0-0 ORAL
- 12. MONITORING PARAMETER:- • ECG • Ultrasound and abdomen pelvis • Blood pressure monitoring • Serology • Electrolytes monitoring
- 13. PROBLEMS IDENTIFIED:- • Anaemia is not diagnosed • There is no treatment given for anaemia
- 14. PHARMACIST INTERVENSION:- • Anaemia should be diagnosed • Advice to give proper treatment for Anaemia
- 15. PATIENT COUSELLING:- • About Medication:- Take medications properly in the given frequency and route Inform if any ADR occurs Inform if any uncomfortable feel occurs due to medicines Inform if any hypersensitivity occurs
- 16. • About Disease:- Gastroenteritis is an inflammation in the gastrointestine Explain nature of conditions Explain about risk factors Explain about complications of disease • About Lifestyle modification and diet:- Decrease stress level Take rest • About diet:- Avoid fatty food Drink sufficient water Eat vegetables and fruits
- 17. THANK YOU