pharma

1. CASE PRESENTATION
PRESENTED by
THEJASRI.P
PHARM D
2ND YEAR
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2. CASE SUMMARY
• A MALE PATIENT AGE 52 YEARS ADMITTED IN GENERAL
DEPARTMENT WITH CHIEF COMPLAINT OF CHEST PAIN FOR 2
DAYS.
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3. SOAPANALYSIS
SUBJECTIVE DETAILS
NAME : Mr. X
AGE : 52 years
SEX : Male
OP/IP NO : 214059
DEPARTMENT:GENERAL
DOA : 1/11/2017
DOD : 7/11/2017
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4. 4
CHIEF COMPLAINTS: Chest Pain for 2 days
Aggravation in morning
PAST MEDICAL HISTORY : K/C/O Systemic Hypertension
C/O Chest pain
PAST MEDICATION HISTORY : Nil
SOCIAL HISTORY
ALCHOLIC : Nil
SMOKING : Nil
FAMILY HISTORY : Nil

5. 5
OBJECTIVE DETAILS
ON EXAMINATION: Conscious, Oriented
SYSTEMIC EXAMINATION
CVS- S1, S2 Normal
LOCAL EXAMINATION
VITAL SIGNS
VITAL
SIGNS
Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Day 7
BP 150/90 120/80 130/80 110/70 110/70 110/70 100/60
PR 100 90 100 80 72 64 60

6. LABORATORY INVESTIGATIONS
COMPLETE BLOOD COUNT
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PARAMETERS RESULTS NORMAL VALUE
Hemoglobin 17.7g/dl 12.2 -18.1 g/dl
RBC 5.97 4– 6.13 millions/µL
Platelets 278 140 – 425 Cells/cu mm
Total WBC 17.3 4.6-10.3 cells/µL
Neutrophil
82.5% 40-80%
Lymphocytes 12.8% 10-50%
Monocytes 2.7% 0-12%
Basophils 0.3% 0-2%
Eosinophil 1.7% 0-7%

7. 7
LIVER FUNCTION TEST
PARAMETER RESULTS NORMAL RANGE
Cholesterol 190 125-200mg/dl
Triglycerides 93 75-150mg/dl
HDL 47 30-60mg/dl
LDL 112 85-130mg/dl

8. 8
RENAL FUNCTION TEST
PARAMETERS RESULTS NORMAL RANGE
Urea 20 15-40mg/dl
Creatinine
1.0 0.6-1.6mg/dl

9. 9
SPECIFIC TEST
• ECG:
Anterolateral MI

10. 10
ASSESMENT
From the subjective and objective data analysis the patient was
identified with
• SYSTEMIC HYPERTENSION
• ACUTE CORONARY SYNDROME
• ANTERO LATERAL MYOCARDIAL INFARCTION

11. 11
TREATMENT PLAN
S.NO BRAND NAME DOSE FREQUENCY Day
1
Day
2
Day
3
Day 4 Day 5 Day6 Day7
1 T. Clopidogrel 75mg 1-0-1
Day4 -day7
1-0-0
✔ ✔ ✔ ✔ ✔ ✔ ✔
2 T. Ecosprin 325mg
Day4 –
day7
150mg
0-1-0
✔ ✔ ✔ ✔ ✔ ✔ ✔
3 T. Carloc 3.125mg ½-0-1/2
✔
4 T. Pantoprazole 40mg 1-0-0
✔ ✔
✔ ✔ ✔ ✔ ✔
5 T. Sorbitrate 5mg 1-1-1
✔
6 Aggramed infusion 6m/hr ✔
7 T. Nikoran 5mg 1-0-1 ✔ ✔ ✔ ✔ ✔ ✔ ✔
8 Inj. Heparin 8000
IU/ml
✔ ✔ ✔ ✔ ✔ ✔ ✔
9 T. Cardivas 3.125mg ½-0-1/2 ✔ ✔ ✔ ✔ ✔ ✔
10 T. Ramipril 2.5mg 1-0-0 ✔ ✔ ✔ ✔ ✔ ✔
11 T. Ivabradins 5mg 1-0-1 ✔ ✔ ✔ ✔ ✔ ✔

12. DISCHARGE SUMMARY
Date of Review: 7days 12
BRAND NAME DOSE FREQUENCY
T. Clopilet 75mg 1-0-0
T. Ecospirin 150mg 0-1-0
T. Cardivas 3.15mg ½-0-1/2
T. Pantocid 40mg 1-0-0(before food)
T. Nikos 5mg 1-0-1
T. Ramipril 2.5mg 1-0-0
T. Ivabradin 5mg 1-0-1

13. PHARMACIST INTERVENTION
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• Aspirin and Clopidogrel are interacted with Heparin.Moniter
closely
• Heparin and pantoprazole may increase risk for osteoporosis
hence multivitamin tablets should be given.
• Normally Aspirin 150 is administered for patients with CAD or
anginal pain but here Aspirin 325 is given.
• Clopidogrel is supposed to be given once a day but in this
case it is given twice.

14. PATIENT COUNSELLING
DISEASE BASED COUNSELLING:
• BLOOD PRESSURE CHECKED: high blood pressure
(hypertension) is a major risk factor for heart attack. Normal
BP is 120/80mmHg.
• CHOLESTEROL CHECKED : As high risk for MI, LDL “Bad”
Cholesterol should be lower than 100mg/dl.
• WEIGHT MANAGEMENT: BMI between 18.5-24.9kg/m2.
DRUG BASED COUNSELLING:
• T.Ecospirin: take with food or after meal to avoid GI upset.
• T.Pan: don't miss the dose
• TAB.Carvedilol: take tablet with or without food ,but try to take doses
at same time of day .if the doses missed don't take doses together
• T.Ramipril: first dose may make you feel dizzy . Report the doctor if
any signs of angioedema
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15. THANK YOU
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