Prescription Analysis of Pabna General Hospital.pdf

Mehedi Shah Shawon
PUST
MEDICINE WARD (FEMALE)
PATIENT PROFILE 01
 Name: Shanta
 Age: 20 years
 Sex: female
 Address: Gopalpur
C/C
 SOB
 Chest Pain
O/E
 BP: 100/80 mmHg
 Pulse: 70 beat/min.
 Anemia: absent
Diagnosis
 CBC
 USG of W/A
 Urine R/E
PRESCRIPTION ANALYSIS
Management
21.05.2022
 Diet: Normal
 Inf N/S 1L, Iv stat 25 d/min
 Tab Deleta (1+1+0)
 Tab Propanolol 10 (1+1+1)
 Cap. Dexilend (1+1+0)
 Tab Rivo 0.5 (0+0+1)
P/A
 Tab. Cefixim 400 (1+0+1)
P/A 31.05.22
InjAlgin 1 amp I/M stat
P/A 01.06.22
 Tab Algin (1+1+1)

Mehedi Shah Shawon
PUST
On examination, it was found that the patient had normal blood pressure as well as normal
pulse rate and absence of anemia.
Diagnosis of CBC and USG of W/A, Urine R/E was advised.
To manage these conditions physician took following measures:
No change on diet was accepted by the physician. Normal saline was administered
immediatelyto replace lost fluid and to prevent shock. Deleta(flupenthixol+melitacen) was
prescribed to treat anxiety which may arise due to SOB. Propanolol which is a beta blocker
was prescribed to prevent angina pectoris or tremor. Dexilend(dexlansoprazole) which is a
PPI was prescribed to block excess acid secretion.Rivo(clonazepam) was prescribed to
prevent any kind of seizure disorder. Cefixim(cefixime) was prescribed to treat possible
respiratory infection which may be causing SOB. Algin (tiemonium methylsulphate) is an
anticholinergic was prescribed to prevent any kind of muscle spasm.
No drug-drug or drug-food interactions were found.
Polypharmacy check: No incidence of polypharmacy was found within the prescription.
Prescription Errors:No incidence of administration,transcription and dispensing error.
Comment: As the patient was prescribed cefixime there might be a chance of allergic
conditions happening or improper bowel movement. So, this should be considered by the
physician.
Attachment of Prescription No. 01

Mehedi Shah Shawon
PUST
PATIENT PROFILE 02
 Name: Rashida
 Age: 45 years
 Sex: female
 Address: Shalgaria, Pabna.
C/C
 Abdominal pain.
 Constipation.
 Vertigo.
O/E
 BP: 100/60 mmHg.
Diagnosis:
 S. creatinine.
 RBS.
 CT Scan of brain.
 Abdomen X ray.
 Urine for ketone bodies.
Management
30.05.2022
 Diet: NPO TFO
 Inf N/S 1L, Iv stat 20 d/min
 Inj. Nalbun-20mg/2 mL 1 amp
I/M stat
 Inj. Emistat 8 1 amp I/V stat
 Inj. Omeprazole 40 I/V stat
 Supp. Glysup 2.3 gm 5 sticks
P/R stat
P/A 31.05.22
 Maxsulin R 100 S/C 30 min
B/M

Mehedi Shah Shawon
PUST
On examination, it was found that the patient had low blood pressure.
Diagnosis of RBS, CT scan of brain, Abdomen X-ray, Urine test for ketone bodies was
advised.
To manage these conditions physician took following measures:
Nothing by mouth was advised till further order. Normal saline was administered
immediately to replace lost fluid and to prevent shock.Nalbun (nalbuphine HCL) is a opioid
analgesic which was administered immediately to treat abdominal pain. Emistat is a 5-HT3
receptor antagonist was injected immediately to prevent nausea-vomiting. Omeprazole 40
was administered immediately to block excess gastric acid secretion. Glysupp is a osmotic
purgative which was injected to treat constipation. Maxsulin R which is a medium acting
insulin was prescribed to lower blood glucose level.
Polypharmacy check: No incidence of polypharmacy was found.
Comment: As the patient was prescribed Nalbun, there might be a chance of hypersensitivity
reaction happening. Nalbun is also associated with side effects like hypotension as the patient
had low bp it might cause problem for the patient. So, this had to be considered by the
physician.

Mehedi Shah Shawon
PUST
Attachment of Prescription No. 02

Mehedi Shah Shawon
PUST
PATIENT PROFILE 03
 Name: Irin
 Age:26 years
 Sex: female
 Address: Gopalpur, Pabna
C/C:
 SOB
 Cough
O/E
 BP: 150/90 mmHg
 Spo2: 94%
 Heart Rate: 86/min
Diagnostics
 CBC
 Echo 2D
 S. creatinine
 D-dimer
Management:
30.05.22
 Diet: Normal
 O2 Inhalation stat 4-6 hourly
 Nebulization windel plus 6 hourly
 Inj. Lasix 2 amp iv stat
 Inj. Merotrax 500 mg 1 amp IV stat
& TDS
 Tab.Bizoran 5 mg+40 mg
 Tab. A-B1 (1+0+1)
 Tab. Monas 10 mg (0+0+1)
 Tab Esoprex 20 mg (0+0+1)
P/A 28.05.22
 Tab. Tignior 10
 Tab. Carvista 6.25 mg
 Tab. Ramoril 2.5 mg

Mehedi Shah Shawon
PUST
Prescription Analysis
On Examination, it was found that the patient had high blood pressure but heart rate, Spo2
was normal
Diagnosis advised by the physician was CBC, Echo 2D, S. Creatinine, D-dimer.
To manage the patient physician took following measure
The patient was admitted with SOB and severe cough. The doctor advised to continue normal
diet.O2 inhalation. Dexilend (Dexlansopraqzole) which is a proton pump inhibitor was
prescribe to control the gastric acid secretion which might lead to oesophagitis or GERD if
not controlled. Deleta(flupenthixol) which is an anxiolytic with Rivo(clonazepam) were
administered to treat seizure, anxiety and depression as the patient had SOB which might
make the patient anxious. To prevent any possibilities of myocardial infarction propranolol
(propranolol hydrocholride) was prescribed. Nasogastric tube was advised to use for carrying
food & medicine to the stomach. Cefixime which is a 3rd
generation cephalosporin was
prescribed to treat any kind of bacterial infection which might be the cause of chest pain.
Algin is a anticholinergic which was used to treat endocarditis or to prevent any kind of
spasm. No drug-drug or drug-food interactions were found in this prescription.
Comment: Caution should be taken before initiating furosemide for patients with
hypovolemia or dehydration, patients with an impaired renal function. Prolonged use of
benzodiazepines may result in dependence with withdrawal symptoms on cessation of
use. Montelukast may cause serious or life-threatening mental health changes.

Mehedi Shah Shawon
PUST
MEDICINE WARD (MALE)
PATIENT PROFILE 04
 Name: Nirob
 Age: 11 years
 Sex: Male
 Address: Ataykula, Pabna
 Bed no: 06
 Admission date: 29.05.2022
C/C
 Fever for 7 days
 Cough for 7 days
O/E:
 BP 110/80 mmHg
Management:
29.05.22
 Diet: Normal
 Tab.Monocast 10 mg (0+0+1)
 Tab.Renova 500 mg (1+1+1)
 Inj.Tyclav 1:2 1/2 vial
 Stat & 8 hourly
Tab.Clarin 500 mg (1+0+1)

Mehedi Shah Shawon
PUST
On examination, the blood pressure of the patient was found normal.
The patient was admitted to hospital with fever and cough for 7 days.
To manage the patient physician took following measures:
Monocast(montelukast) which is a leukotriene receptor antagonist was used to treat seasonal
allergic rhinitis. Tyclav(amoxicillin+clavulanic acid) which is indicated as a broad spectrum
penicillin &Clarin (clarithromycin) which falls under macrolides category was used
immediately to prevent/treat acute exacerbation of chronic bronchitis or mycobacterial
infection. As the patient was presented with fever so Renova (Paracetamol) which is a
antipyretic agent was used for the symptomatic management of fever.
No drug-drug or drug-food interactions were found in this prescription.
Comment: Before initiating therapy with amoxicillin/clavulanic acid, careful enquiry should
be made concerning previous hypersensitivity reactions to penicillins, cephalosporins or
other beta-lactam agents. Serious and occasionally fatal hypersensitivity reactions (including
anaphylactoid and severe cutaneous adverse reactions) have been reported. These reactions
are more likely to occur in individuals with a history of penicillin hypersensitivity. If an
allergic reaction occurs, amoxicillin+clavulanic acid therapy must be discontinued and
appropriate alternative therapy should be instituted.

Mehedi Shah Shawon
PUST
PATIENT PROFILE 05
 Name: Abdul Kuddus
 Age: 65 years
 Sex: Male
 Address: Kamarbari, Pabna
 Date of Admission: 30.05.2022
C/C:
 Vomiting for several times
 Vertigo
 Weakness
O/E
▪ BP: 90/50 mmHg
Diagnosis:
 CBC
 S.Creatinine
 RBS
 PBF
Management:
25.12.20
 Diet: NPO, TFO
 Inj. N/S (1L) +5%
DNS (1L) I/V stat 20d/min
 Inj. Paloxi 0.075 amp 1
I/V stat & BD
 Inj. Omeprazole 40 1
vial I/V stat & BD
1.05.22
BT 3 unit

Mehedi Shah Shawon
PUST
On examination, it was found that the patient was hypotensive, which might potentially lead
to shock and ultimately coma.
CBC, S.creatinie, RBS, PBF test were advised by the physician for diagnosis as the patient
was very weak.
The patient was admitted with vertigo and weakness and NPO (nothing by mouth) was
advised by physician till further order. To manage the dehydration and save the patient from
shock, normal saline was administered as an intravenous infusion immediately at 20
drop/min rate two times a day. Inj. Paloxi which is an antiemetic agent was given
immediately by iv route to control vomitingand it was prescribed two times a day.
Omeprazole was injected immediately to control the acid related dyspepsia or peptic ulcer
events.
Comment: Paloxi is contraindicated in patients having Hypersensitivity to the active
substance.As palonosetron may increase large bowel transit time, patients with a history of
constipation or signs of subacute intestinal obstruction should be monitored following
administration.

Mehedi Shah Shawon
PUST
PATIENT PROFILE 06
 Name: Mohiuddin
 Age: 20 years
 Sex: Male
 Address: Bagha, Rajshahi
 Date of admission: 20.05.2022
C/C
 Poisoning (Bhang)
 Restlessness.
Advice
 Referred to mental hospital.
Management:
30.05.22
 Diet: Normal
 Tab Risdon 2
 Tab Deprex* Tab
Cyclid 5
 Tab. Esocon 20
 Inf N/S 1L IV stat
15d/min.
 Tab Rivo 0.5

Mehedi Shah Shawon
PUST
The chief compliant of the patient was restlessness and it was said that he was poisoned with
Bhang.
The patient was also referred to the mental hospital so he had some mental problem.
Normal Diet was no problem for the patient. Normal saline was infused due to poisoning as it
may cause fluid abnormality. Rivo(clonazepam) was prescribed to calm the patient and to
prevent epilepsy episodes. Risdon 2 was prescribed to manage psychotic disorders like acute
or chronic psychosis, mania, schizophrenia. Depres (flupenthixol) which is a anxiolytic was
prescribed to treat depression, anxiety, dysphoria. Cyclid (procyclidine HCL) was prescribed
to parkinsonism or drug induced extrapyramidal syndrome. Esocon(esomeprazole) was
prescribed to treat any kind of heartburn which may arises due to other medications
administered.
Comment:

Mehedi Shah Shawon
PUST
SURGERY & ORTHOPEDICSWARD
PATIENT PROFILE 07
o Name: Asad
o Age: 45 years
o Sex:Male
o Address: Ataykula, Pabna
o Admission date: 23.05.2022
 C/C
Cell injury to mouth
 Hx
 RTA
 Diagnosis
 CT scan of head
 CBC
Management
22.05.2022
 Diet-NPO TFO
 Inj. Flucloxacillin 500 mg-1vial I/V stat &
6 hourly.
 Inj. Ketorolac 30 mg- 1 amp I/M stat &
TDS
 Inj. Esomeprazole 40 mg- 1vial
I/V stat & BD
 Inj. Ceftriaxone 1g- 1vial I/V stat
& BD
 Inj Emistat 8mg 1amp iv stat &
BD
 Tab. p/c 500mg (1+1+1) * Inj. N/S
(1L) +5% DNS
(1L) I/V stat 20d/min

Mehedi Shah Shawon
PUST
CBC and CT scan of Head was advised for diagnosis by the physician as the patient
The patient had a history of RTA.
The patient was presented with cell injury to mouth for which NPO was advised because he
had to undergo surgery afterwards. 5% DNS were injected as an intravenous infusion of a
carbohydrate source. It was injected immediately and two times a day. To relieve pain
Ketorolac inj which is a analgesic & P/C (Paracetamol+Caffeine) were injected. He was also
given Flucloxacillin & Ceftriaxone to treat any kind of possible infection on the injury site or
surgical prophylaxis. Emistat was injected to symptomatic relief of nausea & vomiting as
well as prevention of post-operative nausea, vomiting. Esomeprazole was prescribed to
control the gastric pH fluctuation which may arise due to antibiotic administration or surgery
induced nausea, vomiting.
No drug-drug interactions have been found in this prescription.
Comment: Flucloxacillin, Ceftriaxone should be given with caution to patients with a history
of allergy, especially to drugs. Before initiating therapy with flucloxacillin, ceftriaxone
careful enquiry should be made concerning previous hypersensitivity reactions to β-
lactams.Ketorolac is contraindicated in patients with previously demonstrated
hypersensitivity to ketorolac. This induce allergic reactions (severe anaphylactic-like
reactions have been observed in such patients). Such reactions have included asthma, rhinitis,
angioedema or urticaria.

Mehedi Shah Shawon
PUST
PATIENT PROFILE 11
 Name: Anowar
 Age: 23 years
 Sex: Male
 Address: Arifpur, Pabna
C/C:
 Cut / Cell injury (Accidental)over
left wrist.
Management
22.05.2022
 Diet-Normal
 Inj. Flucloxacillin 500 mg-1vial I/V
stat & 6 hourly.
 Inj. Toradolin 30 mg- 1 amp I/M
stat
& TDS
 Inj. Esomeprazole 40 mg- 1vial I/V
stat & BD
 Inj. Ceftriaxone 1g- 1vial I/V stat &
BD
 Inj. Vaxitet 1 amp

Mehedi Shah Shawon
PUST
The patient was presented with cell injury. Normal diet was advised and to relieve pain.
Toradolin (ketorolac tromethamine) which is a potent non-opioid analgesic was injected IM
immediately. Flucloxacillin & Ceftriaxone which is a penicillinase resistant penicillin was
injected immediately for surgical prophylaxis and to prevent any kind of bacterial infection
on the wound. Vaxitet IG which is a toxoid vaccine was injected to provide temporary
passive immunity in the prevention and treatment of tetanus. Esomeprazole was prescribed to
prevent NSAID related ulceration or ulceration which may arise due to antibiotic
administration.
Comment:

Mehedi Shah Shawon
PUST
PATIENT PROFILE 12
 Name: Asad
 Age: 45 years
 Sex:Male
 Address: Ataykula, Pabna
Reason for Admission:
 Cell injury to mouth
Hx:
 RTA
Diagnostics:
 CT scan of head
 CBC
Management
22.05.2022
 Diet-NPO TFO
 Inj. Flucloxacillin 500 mg-1vial
I/V stat & 6 hourly.
 Inj. Ketorolac 30 mg- 1 amp I/M
stat & TDS
 Inj. Esomeprazole 40 mg- 1vial
I/V stat & BD
 Inj. Ceftriaxone 1g- 1vial I/V stat
& BD
 Inj Emistat 8mg 1amp iv stat &
BD
 Tab. p/c 500mg (1+1+1)
 Inj. N/S (1L) +5% DNS
(1L) I/V stat 20d/min

Mehedi Shah Shawon
PUST
CBC and CT scan was advised for diagnosis by the physician.
The patient had a history of trauma.
The patient was presented with cell injury to mouth for which NPO was advised because he
had to undergo surgery afterwards. 5% DNS were injected as an intravenous infusion of a
carbohydrate source. It was injected immediately and two times a day. To relieve pain
Ketorolac inj which is a analgesic & P/C (Paracetamol+Caffeine) were injected. He was also
given Flucloxacillin & Ceftriaxone to treat any kind of possible infection on the injury site or
surgical prophylaxis. Emistat was injected to provide symptomatic relief from nausea &
vomiting as well as prevention of post-operative nausea, vomiting. Esomeprazole was
prescribed to control the gastric pH fluctuation which may arise due to antibiotic
administration or surgery induced nausea, vomiting.
No drug-drug interactions have been found in this prescription.
Comment:

Mehedi Shah Shawon
PUST
PATIENT PROFILE 13
 Name: KhabirMolla
 Age: 50 years
 Sex: Male
 Address: Atghorea, Pabna
 Date of admission: 23.05.2022
C/C
 Chest pain for 3 days.
O/E
 BP- 80/60 mmHg
Diagnosis:
 Trop I (ELISA)
 S.creatinie
 ECG
 RBS: 10.7 mmol/L
Advice:
 Complete bed rest

Mehedi Shah Shawon
PUST
On examination, it was found that the patient had low bp.
Diagnosis advised by the physician was Trop I,RBS,S.creatinine,ECG.
The patient had no change in diet. Four Neoclog plus(clopidrogel+aspirin) tablet was
prescribed as a dual antiplatelet therapy (DAPT) and it had to be administered immediately.
Atova 40(atorvastatin) which is a statin was prescribed to prevent any kind of myocardial
infarction and to reduce elevated cholesterol and it had be administered immediately also.
Tab pantonix (pantoprazole) was prescribed to treat/prevent any kind of GERD, ZE
syndrome or peptic ulcer disease which may cause the chest pain.
Nidocard(nitroglycerin) was prescribed for acute relief from an anginal attack or prophylaxis
of angina pectoris. Vastor MR which is also a antianginal drug was prescribed for
symptomatic relief of angina pectoris as it was not properly controlled by the patient. The
paient was advised to take complete bed rest cause stress can make him more vulnerable.
No drug-dug or drug food interactions were found.
Comment:

Mehedi Shah Shawon
PUST
Labour Ward
Patient Profile 14
 Name: Rahim
 Age: 65 years
 Sex: Male
 Address: Ram Chandrapur, Pabna
 Admission date: 23.05.2022
C/C
 Cut injury to both leg
 Injury to chest
H/O
RTA
 Diagnostics:
o CBC
o X-ray both leg
o Chest X-ray
Management
23.05.2022
* Diet-N
* Inj. Flucloxacillin 500 mg-1vial I/V
stat & 6 hourly.
* Inj. Ketorolac 30 mg- 1 amp I/M stat
& TDS
* Inj. Esomeprazole 40 mg- 1vial
I/V stat & BD
* Inj. Ceftriaxone 1g- 1vial I/V stat
& BD
* Inj. Vaxitet IG 1 amp
* Inj. Emistat 8mg 1amp iv stat & BD

Mehedi Shah Shawon
PUST
This patient had a history of RTA.
No examination was advised by the physician.
The patient was presented to hospital with cut injury to both leg & injury to chest.
Normal diet was permissible to the patient. To relieve pain from the surgery. Ketorolac
which is indicated to relive from moderate to severe pain was injected immediately and
8 hourly. The patient was also given Flucloxacillin (penicillinase resistant penicillin) &
Ceftriaxone which is indicated in case of septicemia, surgical prophylaxis, RTA were
administered immediately. 1 ampoule of Vaxitet IG which is a tetanus toxoid vaccine
was injected to provide temporary passive immunity in the prevention of tetanus.
Emistat was injected to symptomatic relief of nausea & vomiting. Esomeprazole was
prescribed to control the gastric Ph fluctuation or any kind of surgery induced nausea or
vomiting.
Polypharmacy check: No incidence of polypharmacy was found within the
prescription.
Comment:

Mehedi Shah Shawon
PUST
Patient profile15
o Name: Julekha
o Age: 26 years
o Sex: female
o Address: Kumarpur, Pabna
C/C
• Amenorrhea for 29 wks
• Abdominal pain
• Fever for 2 days
H/O
• Para: 1 NVD+ 1 Abortion
• Gravida: 3rd
• E.D.D: 29.07.2022
O/E
▪ BP: 120/80 mmHg
▪ Absence of anemia
Management
21.05.2022
• Diet: Normal
• Cap. Esomeprazole 20
• (1+0+1)
• Tab. P/C 500 mg
(1+0 +1)
• Tab. Hysomide 20
(1+1+1)

Mehedi Shah Shawon
PUST
On examination, it was found that the patient had normal bp and no anemia was found.
The patient had 3rd (gravida) with 29 (weeks) pregnancy with abdominal pain and came to
the hospital with fever for two times. The doctor advised that diet should be normal and
prescribed. To relief from abdominal pain, pain due to amenorrhea & fever p/c
(paracetamol+Caffeine) was prescribed. To relieve from genitourinary spasm hysomide
which is a antispasmodic agent was prescribed which will help reducing gastric and
intestinal motility. Hysomide falls under pregnancy category c, so there is a risk of fetal
abnormalities. Esomeprazole for management of gastric ph fluctuations which may arise due
to NSAIDS.

Mehedi Shah Shawon
PUST
PATIENT PROFILE 14
 Name: Shakila
 Age: 25 years
 Sex: female
 Address: Jalalpur, Pabna
C/C:
 Amenorrhea for 39 wks.
 LAP PVD
Hx
 Para: 1 NVD Gravida: 2nd
L.M.P?
 E.D.D:22.05.2022
O/E
 BP: 110/80 mmHg
 Anemia: absent
 Edema: absent
Management
Pre-natal order
21.05.2022
 Diet: Normal
 Inj. Cefradine 500 mg (1+1+1)
 Cap. Omeprazole 20 mg, (1+0+1)
 Tab. B/C (1+0+1)
Post-natal order
Given at 22.05.2022
 Diet: Normal
 Cap. Amoxicillin 500 mg (1+1+1+1)
 Cap. Flucloxacillin 500 mg (1+1+1+1)
 Tab. P/C 500 mg (1+1+1)
 Cap. Omeprazole 20 mg (1+0+1)
 Cap. Retinol A forte (50000 unit) 4 cap.
StatSusp.
 Voltalin 50 mg, 1 stick P/R stat &
S0S
 Tab. Domperidone 10 mg (1+1+1)

Mehedi Shah Shawon
PUST
On examination. It was found that the patient had normal bp and no presence of anemia.
The patient was presented in the hospital with amenorrhea and severe abdominal pain and
history was 2nd
(Gravida) with 39+ week’s pregnancy. Doctor advised normal diet to be
continued. Cefradine (cephradine) is generallyprescribed for treatment of bacterial infections
of the respiratory and urinary tracts and of the skin and soft tissues. It was also used for
surgical prophylaxis and to prevent any susceptible infection for pre-natal treatment and B-
complex for minimizing the risks of birth defects and some symptoms ofpregnancy. For the
management of acid related dyspepsia, heartburn and peptic ulcer Omeprazole was
prescribed.Acetaminophen and diclofenac were prescribed to treat fever and pain.
Retinol was prescribed for wound healing and resistance to infection.
Comment:

Prescription Analysis of Pabna General Hospital.pdf

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Prescription Analysis of Pabna General Hospital.pdf