it is a case of Rhematoid artheroitis

1. RHEUMATOID ARTHRITIS
G.V. Nagaraju
Pharm D
Intern

2. NAME: Mr. xxxx AGE: 47 yrs GENDER: Male
DEPT: M-OW-I DOA: 22-01-17
History of present illness:
Patient was presented with the chief complaints
of morning stiffness and severe joint pain since 1
month, shortness of breath and hair fall since 3
months

3. Past medical history:
Severe rheumatoid arthritis since one year
Past medication history:
On prednisolone-5mg
OBJECTIVE
Physical examination:
BP:120/80 mm of Hg
Other: Anaemia, Oedema PR:78/min
GU(Genitourinary): Burning maturation
GI : Loss of appetite
ASSESSMENT
Rheumatoid Arthritis

4. Laboratory tests:
TEST RESULT VALUE NORMAL RANGE
Hb 12.6 11-16.5g%
PCV 36 35-50Vol%
Platelets 5 1.5-4lakhs/mm3
WBC 5,700 cells/mm3 4000-11000 cells/mm3
RBC 3.38 3.8-4.8 millions/cumm
Polymorphs 70 40 – 70 %
Uric acid 4.83 3.5-7.7 mg/dl
SGPT 14.6 30-45U/L
SGOT 52 50-40U/L
RF 16 Less than 15IU/ml
Uric acid 3.9mg/dl 2-5mg/dl

5. Treatment plan:
DRUG DOSE FREQUENCY
Tab.Methorexate 7.5mg BD
Tab.Folic acid 100mg BD
Tab.Prednisolone 5mg BD
Tab.Aceclofenac 600mg OD
Tab.Pantoprazole 40mg OD
Tab.Shelcal Calcium supplement OD

6. Therapeutic goals
• Improve quality of life
• Decrease joint pains
• Improve patient’s mobility
Therapeutic intervention
Methotrexate: given for the rheumatoid arthritis
Prednisolone : (anti inflammatory & immune suppressant) it is given
to reduce the inflammation
Aceclofenac: it is a pain killer
Pantoprazole: it is a proton pump inhibitor
Shelcal: it is a calcium supplement.

7. Description:
It (RA)is an autoimmune disorder that results in a
chronic systemic inflammatory disorder that
may affect many tissues and organs.
Pathophysiology:
1.AGenotic link with HLA-DR4 and related all
types of MHC class II and T class associated
protein PTPN 22.
2. Blockade of cytokine TNF.
3.The presence of auto antibodies to IgGFC known
as Rheumatoid arthritis.

8. Patient counselling
• Avoid smoking, keep away from smokers.
• Avoid alcohol.
• Do not lift heavy objects
• Advised to reduce the weight
• Avoid fatty foods
• Do mild exercise daily.
Follow up
• Check for ADR with the drugs.
• LFT and creatinine should be checked once in 3
months.

9. Thank You