Acute renal failure develops quickly when the kidneys fail to filter waste, while chronic kidney disease involves a slow loss of function over time that is not always apparent initially. Both can cause

1. ClinicalPharmacy Semester 10th
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ACUTE RENAL FAILURE
Acute kidney failure occurs when your kidneys suddenly become unable to filter
waste products from your blood. When your kidneys lose their filtering ability,
dangerous levels of wastes may accumulate, and your blood's chemical makeup may
get out of balance.
Acute kidney failure or acute kidney injury develops rapidly, usually in less than a
few days. Acute kidney failure is most common in people who are already
hospitalized, particularly in critically ill people who need intensive care.
Acute kidney failure can be fatal and requires intensive treatment. However, acute
kidney failure may be reversible. If you're otherwise in good health, you may recover
normal or nearly normal kidney function.
CHRONIC KIDNEY DISEASE
 Chronic kidney disease, also called chronic kidney failure, describes the
gradual loss of kidney function. When chronic kidney disease reaches an
advanced stage, dangerous levels of fluid, electrolytes and wastes can build up
in your body.
 In the early stages of chronic kidney disease, you may have few signs or
symptoms. Chronic kidney disease may not become apparent until your kidney
function is significantly impaired.
 Treatment for chronic kidney disease focuses on slowing the progression of the
kidney damage, usually by controlling the underlying cause. Chronic kidney
disease can progress to end-stage kidney failure, which is fatal without artificial
filtering (dialysis) or a kidney transplant

2. ClinicalPharmacy Semester 10th
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Student Name: Date: 4/26/2021
Patient Demographics:
Name: XYZ Age:65yrs Gender: male Ht/Wt:
Chief Complaint:
Abdominal pain for 10 days
History Of Present Illness
Abdominal pain, pricking type, more during at night. Swelling, Difficulty in breathing Abnormal
urine color, Frequent urination at night, Fatigue, fever No H/O Abdominal distension. Muscle
cramp.
Past Medical History:
Diabetes mellitus for past 20 yrs. Hypertension for past 25 yrs. Taking medication such as STATINS
Diagnosis:
Chronic Renal parenchymal disease.
VITAL SIGNS
SIGNS 1 Normal Comment
BP 160/70
mmHg
120/80
mmHg
Raised
Temp 98.60F 99.60F Normal
RR
PR 79 bpm Normal
RIPHAH INTERNATIONAL UNIVERSITY
Riphah Institute of Pharmaceutical Sciences
PHARMACOTHERAPY REVIEW (Patient Case)

3. ClinicalPharmacy Semester 10th
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LAB TEST INTERPRETATION
Lab Tests 1 Normal INTERPRETATION
RBC 4.26x1012/L 3.8-5.9×1012/L Normal
Hb 9.5g/dl 12-14g/dl Decreased
HCT
Platelet 173.0x109/L 130-400x109/L
WBCS 6.2x109/L 4.5-10.5×109/L Normal
Urea
Na
K+
Phosphate 7.5 mg/dl 2.5-4.5 mg/dl Raised
Creatinine 2.2mg/dl 0.6-1.3 mg/dl Raised
GFR 14ml/min
Bilirubin
ALP
MCHC 29.7g/dl 32-36g/dl Decrease
ESR 38mm/hr 0-20mm/hr
MCV 92.9 FL 80-100FL Normal
HCT 23.2% 35-50% Decreased
MCH 27.6pg 27- 34pg Normal
Urine Analysis
color Brown
Albumin +
Other Investigations
ECG Sinus rhythm inferior myocardial infraction.
X-RAY Left lung lower lobe consolidations, Bilateral infiltrates.
USG Abdomen & Pelvis B/L Chronic renal parenchymal diseases. B/L Small renal cortical cyst.

4. ClinicalPharmacy Semester 10th
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Rx
1. Inj taxim 2gm BD
2. RANTAC 50mg OD
3. BCT (multivitamin) BD
4. Dolo 650mg BD
5. Deri 20mg BD
6. Lasix 40mg BD
7. Procrit 100mg OD
8. Calcium carbonate 2mg OD
9. Hamengeol 40mg OD
10. Januvia100mg OD
11. Flovas 2mg OD

5. ClinicalPharmacy Manual Semester 10th
PRESCRIPTION ANALYSIS FORM
Dr. Name Dr. Akram
Specialization Nephrologist
Patient Name XYZ
Age 65yrs
Weight
Diagnosis Chronic Renal parenchymal disease
Other Details (If any) Diabetes mellitus for past 20 yrs. Hypertension for past 25 yrs. Taking medication such as STATINS
SuggestedCorrections in
Prescription (Missing Name,
Age, Wrong strength, dose,
frequency, etc..)
Nothing
R IP HAH IN T E R NATIONA L UN IVE R S ITY
Riphah Institute of Pharmaceutical Sciences

6. ClinicalPharmacy Manual Semester 10th
Rx Dosage
Form
Brand Generic Strength Class Frequen
cy
Duration Instructions
12. Inj taxim inj Taxim Cefotaxime 2gm cephalosporin BD 1 week
13. RANTAC Tab RANTAC Ranitidine 150mg histamine receptor
antagonists
OD 1 week Ranitidine
should be
administered 30
minutes before
consuming
food
14. BCT
(multivtamin)
tab BCT Vit B+ vit C Multivitamin BD 1 week
15. Dolo tab Dolo Paracetamol 650mg Analgesic BD 1 week
16. Deri inj Deri Theophylline +
Etophylline
20mg Bronchodilators BD 1 week
17. Lasix tab Lasix Furosemide 40mg Loop diuretics BD 1 week Furosemide
should be
administered 1 hr

7. ClinicalPharmacy Manual Semester 10th
before
consuming
food or2 hrs
afterfood.
18. Procrit Inj procrit Erythropoietin 100mg Glycoprotein
hormone
OD 1 week
Calcium
carbonate
tab Calcium
carbonate
Calcium carbonate 2mg Antacids OD 1 week Calcium carb
should be taken
5 mins before
the food as it
causes faster
absorption of
calcium carb.
19. Hamengeol tab Hamengeol Propranolol 40mg Beta blockers OD 1 week
20. januvia tab Januvia sitagliptin 100mg Dipeptidyl
peptidase-4 (DPP-
4) inhibitors.
OD 1 week
21. Flovas tab Flovas Pitavastatin 2mg Statins OD 1 week

8. ClinicalPharmacy Manual Semester 10th
DRUG INTERACTIONS ANALYSIS FORM
Software Drug Interactions Effects
Drug.com Sitagliptin And Furosemide Oral furosemide oral increases levels of sitagliptin-metformin oral
by unspecified interaction mechanism.
Propranolol And Theophylline Beta blockers antagonize theophylline effects, while at the same
time increasing theophylline levels and toxicity (mechanism:
decreased theophylline metabolism). Smoking increases risk of
interaction.
Beta blockers are sometime contraindicated in patient
having difficulties in breathing, so it can be switch to other
classes of drugs such as ACE INHIBITORS and ARB
drugs.