This document contains a case study of a 51-year-old female patient presenting with numbness and tingling in both lower limbs and pain. Her medical history includes rheumatoid arthritis, seizures, cervical myelopathy, respiratory infections, and ear infections. Examination findings and test results including MRI, bloodwork, urine analysis, and culture sensitivity are presented. Her hospital treatment course including medications and progress are documented.
A 28-year-old female was admitted to the hospital for postpartum depression characterized by not feeding or accepting her baby and refusing to eat or speak. She was diagnosed with postpartum depression with cerebral venous thrombosis. Her treatment plan included levitaracetam, antibiotics, pantoprazole, ondansetron, enoxaparin, warfarin sodium, and mannitol to improve her quality of living and prevent complications while monitoring her platelet count and blood pressure. The physician recommended withdrawing levitaracetam, reducing anticoagulant doses due to her high platelet count, performing brain imaging, and adjusting anticoagulant dosing based on monitoring.
A 60-year-old male patient was admitted to the hospital for 6 days with cryptococcal meningitis and a low CD4 count of 37. He reported fever, headache, vomiting, and neck rigidity. Tests found cryptococci in his cerebrospinal fluid, confirming cryptococcal meningitis. He was started on amphotericin, fluconazole, flucytosine, and other medications to treat the infection and reduce symptoms while closely monitoring for side effects and toxicity. The patient's condition had not improved with prior outside treatment, so physicians aimed to suppress the infection and restore his immune function.
The document describes a 67-year-old male patient presenting with dyspnea, constipation, anorexia, abdominal pain and headache. Examination finds the patient semiconscious and oriented with abdominal discomfort and tender abdomen. Laboratory investigations show abnormal renal function, electrolyte imbalance and signs of infection. The patient is diagnosed with septic shock with acute renal failure of unknown etiology. Treatment includes antibiotics, diuretics, bronchodilators and corticosteroids to address infection, fluid overload and organ dysfunction with the goals of improving quality of life and preventing further health complications.
A 33-year-old female presented with severe cough, chest pain, vomiting, headache and fatigue. On examination, she had crackles in her lungs. Tests showed pneumonia in her right lung lobe. She was diagnosed with right lobar pneumonia and prescribed antibiotics, aspirin, pantoprazole, clopidogrel, atorvastatin, acetylcysteine, sorbitol, amlodipine, cetirizine and levofloxacin to treat the infection and reduce complications.
This document summarizes the medical history and examination of a 49-year-old female patient presenting with increasing lower back, hip, and knee pain. The patient has a history of diabetes, deep vein thrombosis, and hypercholesterolemia. A physical examination revealed pain on motion of the hips and right knee crepitus. X-rays showed degenerative changes consistent with osteoarthritis in the lumbar spine, hips, and right knee. Laboratory tests showed elevated blood glucose, HbA1c, and cholesterol levels. The provisional diagnosis is osteoarthritis with diabetes and hypercholesterolemia.
A 24-year-old male was brought in after ingesting approximately 70 ml of an insecticide containing chlorpyriphosphate and cypermethrins. He was semiconscious on examination. Laboratory tests showed low serum cholinesterase levels and elevated ammonia levels. MRI brain showed small focal areas of abnormal signal intensity in the cerebellum, likely representing subacute ischemic infarcts. He was treated with pralidoxime, atropine, antibiotics, pantoprazole, ondansetron, meropenem, piperacillin/tazobactam, montelukast/fexofenadine, acebrophylline and furosemide to manage organ
A 28-year-old female was admitted to the hospital for postpartum depression characterized by not feeding or accepting her baby and refusing to eat or speak. She was diagnosed with postpartum depression with cerebral venous thrombosis. Her treatment plan included levitaracetam, antibiotics, pantoprazole, ondansetron, enoxaparin, warfarin sodium, and mannitol to improve her quality of living and prevent complications while monitoring her platelet count and blood pressure. The physician recommended withdrawing levitaracetam, reducing anticoagulant doses due to her high platelet count, performing brain imaging, and adjusting anticoagulant dosing based on monitoring.
A 60-year-old male patient was admitted to the hospital for 6 days with cryptococcal meningitis and a low CD4 count of 37. He reported fever, headache, vomiting, and neck rigidity. Tests found cryptococci in his cerebrospinal fluid, confirming cryptococcal meningitis. He was started on amphotericin, fluconazole, flucytosine, and other medications to treat the infection and reduce symptoms while closely monitoring for side effects and toxicity. The patient's condition had not improved with prior outside treatment, so physicians aimed to suppress the infection and restore his immune function.
The document describes a 67-year-old male patient presenting with dyspnea, constipation, anorexia, abdominal pain and headache. Examination finds the patient semiconscious and oriented with abdominal discomfort and tender abdomen. Laboratory investigations show abnormal renal function, electrolyte imbalance and signs of infection. The patient is diagnosed with septic shock with acute renal failure of unknown etiology. Treatment includes antibiotics, diuretics, bronchodilators and corticosteroids to address infection, fluid overload and organ dysfunction with the goals of improving quality of life and preventing further health complications.
A 33-year-old female presented with severe cough, chest pain, vomiting, headache and fatigue. On examination, she had crackles in her lungs. Tests showed pneumonia in her right lung lobe. She was diagnosed with right lobar pneumonia and prescribed antibiotics, aspirin, pantoprazole, clopidogrel, atorvastatin, acetylcysteine, sorbitol, amlodipine, cetirizine and levofloxacin to treat the infection and reduce complications.
This document summarizes the medical history and examination of a 49-year-old female patient presenting with increasing lower back, hip, and knee pain. The patient has a history of diabetes, deep vein thrombosis, and hypercholesterolemia. A physical examination revealed pain on motion of the hips and right knee crepitus. X-rays showed degenerative changes consistent with osteoarthritis in the lumbar spine, hips, and right knee. Laboratory tests showed elevated blood glucose, HbA1c, and cholesterol levels. The provisional diagnosis is osteoarthritis with diabetes and hypercholesterolemia.
A 24-year-old male was brought in after ingesting approximately 70 ml of an insecticide containing chlorpyriphosphate and cypermethrins. He was semiconscious on examination. Laboratory tests showed low serum cholinesterase levels and elevated ammonia levels. MRI brain showed small focal areas of abnormal signal intensity in the cerebellum, likely representing subacute ischemic infarcts. He was treated with pralidoxime, atropine, antibiotics, pantoprazole, ondansetron, meropenem, piperacillin/tazobactam, montelukast/fexofenadine, acebrophylline and furosemide to manage organ
The document presents a case study of a 77-year-old male patient diagnosed with Parkinson's disease based on symptoms of slow movements, resting tremors, postural instability, and mask-like face. Laboratory tests and investigations revealed abnormalities. The patient was diagnosed with Parkinson's disease and mood disturbance. He was prescribed various medications including Syndopa Plus, Rosalect, and Loraazep and counseled on lifestyle modifications and managing his condition and medications.
This case study presentation involves a 61-year-old male patient with Parkinson's disease, urinary tract infection, and severe edema. He has a history of Parkinson's disease for 8 years and has had a Foley catheter for 1 year. Physical examination finds the patient semiconscious with swelling over his entire body. Laboratory tests show elevated creatinine and sodium levels, as well as pus cells in the urine, indicating urinary tract infection. The patient is diagnosed with Parkinson's disease with urinary tract infection and bacterial endocarditis of prosthetic heart valves. The goals of therapy are to improve quality of life, prevent further complications, and optimize the patient's current treatment plan.
CASE STUDY ON UTI AND OBSTRUCTIVE JAUNDICERajesh Dutta
A 63-year old female presented with abdominal pain, yellow urine, and burning urination. Lab work showed elevated liver enzymes and bilirubin consistent with obstructive jaundice. Imaging revealed gallstones obstructing the common bile duct, causing jaundice. She was diagnosed with urinary tract infection, obstructive jaundice, and gallstones. Treatment included antibiotics, antacids, and antispasmodics.
This case presentation summarizes a 36-year-old male admitted with acute ischemic stroke presenting with right hemiparesis and reduced vision in the right eye. Diagnostic workup including CT scan revealed an acute infarct in the left occipito-parietal region. He was diagnosed with acute ischemic stroke and treated with medications including aspirin, clopidogrel, atorvastatin, and mannitol. His symptoms improved over his hospital stay and he was discharged on aspirin and clopidogrel with counseling on medication adherence and lifestyle modifications to prevent further complications.
Case Presentation on STROKE (Subarachnoid Hemorrhage)nayanadiv
A 45-year old female presented with generalized tiredness, drowsiness, confusion and seizures. Lab tests and CT scan revealed early hydrocephalus, a suspicious lesion in the fourth ventricle, and subarachnoid hemorrhage due to aneurysm rupture. She was admitted to the neuro ICU and started on treatments including dexamethasone, nimodipine, pantoprazole, paracetamol, fosphenytoin, mannitol and ondansetron to relieve symptoms, repair the bleeding vessel, prevent complications and recurrence. The pharmacist provided counseling on disease, drugs, lifestyle modifications and points to the physician regarding monitoring and potential drug interactions.
case presentation on cervical spondylosis by naveennaveen ramavatu
A 70-year-old female was admitted with complaints of giddiness, neck pain, headache, and leg pain. Diagnostic tests showed cervical spondylosis and hypertension. She was treated for 5 days with medications including pantoprazole, clopidogrel, rosuvastatin, betahistine, lorazepam, and lactulose. Her symptoms improved and she was discharged on a regimen including pantoprazole, clopidogrel, rosuvastatin, and betahistine to monitor for recurrence of symptoms.
Case presentation on Quadriparesis with Guillain barre syndrome
Quadriparesis is a condition characterized by weakness in all four limbs (both arms and both legs).
The weakness may be temporary or permanent.
Quadriparesis is different from quadriplegia.
In quadriparesis, a person still has some ability to move and feel their limbs.
In quadriplegia, a person has completely lost the ability to move their limbs.
The document summarizes the case of an 82-year-old male patient diagnosed with nephrotic syndrome. It includes details of the patient's medical history, symptoms, lab investigations, biopsy results, medications, and discharge instructions. The patient was started on diuretics, antibiotics, lipid-lowering drugs, thyroid medication, and corticosteroids to treat the condition. The document also provides suggestions to monitor for potential drug interactions and complications related to the patient's treatment and disease.
This document summarizes the case of a 44-year-old male patient admitted to the hospital with seizures, vomiting, decreased appetite, and weakness in his limbs. Lab results found increased creatinine, BUN, and decreased chloride levels. A CT scan found no abnormalities in the brain but soft tissue swelling in the frontal region. Based on the subjective and objective patient data, the patient was diagnosed with a cerebrovascular accident, hypertension, and stage 4 chronic kidney disease. The treatment plan focused on rehabilitation, medication, monitoring the patient's condition, and counseling on lifestyle changes and managing the disease.
The document summarizes the medical history and hospital course of a 52-year-old male patient admitted with weakness on the left side of his body and loss of speech. He was diagnosed with a cerebrovascular accident (CVA) or stroke in the right side of the brain based on his symptoms and a CT scan showing an infarct in the right occipital region. He had a history of hypertension. Over five days in the hospital, he was given treatments including mannitol, phenytoin, antibiotics, amlodipine, and aspirin to control his blood pressure, prevent seizures and infection, and reduce stroke risk. His vital signs and lab results improved before being discharged.
Lennox-Gastaut Syndrome- A Case Study: By RxVichuZ!! :)RxVichuZ
This document summarizes the case of a 16-year-old male patient admitted to the neurology department for recurrent seizures. The patient has a history of Lennox-Gastaut syndrome diagnosed at NIMHANS. During his 3-day hospital stay, his vital signs and lab tests were monitored daily. He was treated with multiple antiepileptic drugs including injections of methylprednisolone, acetazolamide, pyridoxine, clobazam, phenytoin, levetiracetam and topiramate to control his seizures. His treatment appeared to show improvement in his condition before being discharged.
A 69-year-old male was admitted with right knee pain, nausea, and vomiting. Examination found pain in the right knee and osteoarthritis of the right knee was assessed at grade 3. Investigations including x-rays and blood tests were performed. The patient was given various medications including injections of Magnexforte, Pantocid, Tramadol, Zofer, Trenexia, Clexane, and Dynaparaque to reduce pain and anxiety and provide a comfortable environment for recovery.
This case presentation discusses a 17-year-old male patient who presented with two episodes of seizures, vomiting, headache, unconsciousness, abnormal talking, and tightness in the limbs. Based on examination findings of perinatal hypoxia, mild cerebral atrophy, and abnormal EEG and brain mapping, the patient was diagnosed with primary generalized symptomatic seizures, auditory processing disorder, and mild mental retardation. The treatment plan included intravenous anti-seizure, antacid, anti-emetic, and antibiotic medications along with oral medications for discharge. The goals of treatment were to control seizure frequency and minimize side effects to allow for a normal life.
Case presentation on Cerebrovascular accident (Stroke)HAMMADKC
This document presents a case report of a 76-year-old male patient admitted to the neurology department with complaints of forgetting, left hand weakness, slurred speech, and incontinence. The patient has a history of hypertension, previous cerebrovascular accident, and fall from bed. Examination and investigations including MRI and angiogram confirmed the diagnosis of cerebrovascular accident. The patient was treated with medications like citicoline, levetiracetam, atorvastatin, and aspirin. His condition improved and he was discharged with advice on medications and lifestyle modifications to prevent further strokes.
Case on type II diabetes mellitus with peripheral neuropathy with hypertensionVineetha Menon
This document describes the case of a 38-year-old female patient admitted to the hospital for giddiness, generalized weakness, burning and tingling sensations in the lower limbs, and blurry vision. She has a history of type 2 diabetes for 3 years and hypertension for 1 year. On examination, she was found to have elevated blood pressure and blood glucose levels. She was diagnosed with type 2 diabetes with peripheral neuropathy and hypertension. Her symptoms improved with treatment including medications to control her blood pressure and blood glucose over her 5 day hospital stay.
Mr. X, age 37, was admitted with fever, abdominal pain, nausea, vomiting and blood in urine. He has a history of diabetes, hypertension and chronic kidney disease. Laboratory tests showed renal dysfunction, anemia and high blood glucose. He was diagnosed with chronic kidney disease, uremic gastritis and cholelithiasis. The patient was treated with antibiotics and other medications. The pharmacist recommended additional supplements and lifestyle modifications to control symptoms and slow disease progression.
The document discusses venous thromboembolism (VTE), specifically deep vein thrombosis (DVT). It describes the causes, risk factors, clinical presentation, and diagnostic evaluation of VTE. It then presents a case study of a patient with systemic lupus erythematosus who presented with right upper extremity DVT and swelling. The document outlines her medical history and examination findings. It analyzes her multiple acute conditions, including VTE, lupus flare, acute kidney injury, anemia, and suspected UTI. Finally, it discusses recommended treatment and management options for VTE, antiphospholipid antibody syndrome, and her other conditions based on clinical practice guidelines.
case presentation on generalized epileptic seizures in pediatricsMohammed Masiuddin
This document summarizes a pediatric clerkship, including various cases seen (viral pyrexia, meningitis, asthma), monitoring parameters for pediatric vital signs and biomarkers, commonly used drug classes and examples, and a case presentation on generalized epileptic seizures in a 3-year old female patient. The case is diagnosed as cryptogenic epilepsy based on symptoms and EEG results. Standard therapy of antiepileptic drugs like carbamazepine, phenytoin, and sodium valproate is outlined. The patient's current therapy of phenytoin, midazolam, and sodium valproate is assessed, with goals of reducing seizure activity and preventing complications. Monitoring parameters and lifestyle modifications are recommended to manage the condition.
A 36-year-old female presented with pain and tingling in her left hand and fingers that progressed to her arm and neck, as well as blurred vision in her right eye for 15 days. MRI revealed acute demyelinating optic neuritis. She was diagnosed with multiple sclerosis and right optic neuritis. Treatment included intravenous methylprednisolone, gabapentin, prednisolone, supplements, amlodipine for hypertension, and pantoprazole for acidity. Her medications, diet, disease monitoring, and follow up were discussed to manage her multiple sclerosis and symptoms.
A 45-year-old male presented to the ICU with chest pain, sweating, backache and vomiting. Examination found normal vitals except elevated heart rate. Tests showed elevated cardiac enzymes and ECG changes consistent with ST-elevated myocardial infarction (STEMI). He was treated with fibrinolytics, anticoagulants, antiplatelets and beta blockers. Over subsequent days his symptoms improved and he was discharged on aspirin, clopidogrel, atorvastatin and metoprolol with counseling on cardiac risk factors and medications.
This powerpoint is a case presentation, that explains the case of ADCHF, with comorbidities, comprising HTN, CAD and DLP.
A summary on the recent advancements in HF management, along with justification of therapy provided, has been elucidated.
A note on home remedies and counselling tips has also been provided.
The document presents a case study of a 77-year-old male patient diagnosed with Parkinson's disease based on symptoms of slow movements, resting tremors, postural instability, and mask-like face. Laboratory tests and investigations revealed abnormalities. The patient was diagnosed with Parkinson's disease and mood disturbance. He was prescribed various medications including Syndopa Plus, Rosalect, and Loraazep and counseled on lifestyle modifications and managing his condition and medications.
This case study presentation involves a 61-year-old male patient with Parkinson's disease, urinary tract infection, and severe edema. He has a history of Parkinson's disease for 8 years and has had a Foley catheter for 1 year. Physical examination finds the patient semiconscious with swelling over his entire body. Laboratory tests show elevated creatinine and sodium levels, as well as pus cells in the urine, indicating urinary tract infection. The patient is diagnosed with Parkinson's disease with urinary tract infection and bacterial endocarditis of prosthetic heart valves. The goals of therapy are to improve quality of life, prevent further complications, and optimize the patient's current treatment plan.
CASE STUDY ON UTI AND OBSTRUCTIVE JAUNDICERajesh Dutta
A 63-year old female presented with abdominal pain, yellow urine, and burning urination. Lab work showed elevated liver enzymes and bilirubin consistent with obstructive jaundice. Imaging revealed gallstones obstructing the common bile duct, causing jaundice. She was diagnosed with urinary tract infection, obstructive jaundice, and gallstones. Treatment included antibiotics, antacids, and antispasmodics.
This case presentation summarizes a 36-year-old male admitted with acute ischemic stroke presenting with right hemiparesis and reduced vision in the right eye. Diagnostic workup including CT scan revealed an acute infarct in the left occipito-parietal region. He was diagnosed with acute ischemic stroke and treated with medications including aspirin, clopidogrel, atorvastatin, and mannitol. His symptoms improved over his hospital stay and he was discharged on aspirin and clopidogrel with counseling on medication adherence and lifestyle modifications to prevent further complications.
Case Presentation on STROKE (Subarachnoid Hemorrhage)nayanadiv
A 45-year old female presented with generalized tiredness, drowsiness, confusion and seizures. Lab tests and CT scan revealed early hydrocephalus, a suspicious lesion in the fourth ventricle, and subarachnoid hemorrhage due to aneurysm rupture. She was admitted to the neuro ICU and started on treatments including dexamethasone, nimodipine, pantoprazole, paracetamol, fosphenytoin, mannitol and ondansetron to relieve symptoms, repair the bleeding vessel, prevent complications and recurrence. The pharmacist provided counseling on disease, drugs, lifestyle modifications and points to the physician regarding monitoring and potential drug interactions.
case presentation on cervical spondylosis by naveennaveen ramavatu
A 70-year-old female was admitted with complaints of giddiness, neck pain, headache, and leg pain. Diagnostic tests showed cervical spondylosis and hypertension. She was treated for 5 days with medications including pantoprazole, clopidogrel, rosuvastatin, betahistine, lorazepam, and lactulose. Her symptoms improved and she was discharged on a regimen including pantoprazole, clopidogrel, rosuvastatin, and betahistine to monitor for recurrence of symptoms.
Case presentation on Quadriparesis with Guillain barre syndrome
Quadriparesis is a condition characterized by weakness in all four limbs (both arms and both legs).
The weakness may be temporary or permanent.
Quadriparesis is different from quadriplegia.
In quadriparesis, a person still has some ability to move and feel their limbs.
In quadriplegia, a person has completely lost the ability to move their limbs.
The document summarizes the case of an 82-year-old male patient diagnosed with nephrotic syndrome. It includes details of the patient's medical history, symptoms, lab investigations, biopsy results, medications, and discharge instructions. The patient was started on diuretics, antibiotics, lipid-lowering drugs, thyroid medication, and corticosteroids to treat the condition. The document also provides suggestions to monitor for potential drug interactions and complications related to the patient's treatment and disease.
This document summarizes the case of a 44-year-old male patient admitted to the hospital with seizures, vomiting, decreased appetite, and weakness in his limbs. Lab results found increased creatinine, BUN, and decreased chloride levels. A CT scan found no abnormalities in the brain but soft tissue swelling in the frontal region. Based on the subjective and objective patient data, the patient was diagnosed with a cerebrovascular accident, hypertension, and stage 4 chronic kidney disease. The treatment plan focused on rehabilitation, medication, monitoring the patient's condition, and counseling on lifestyle changes and managing the disease.
The document summarizes the medical history and hospital course of a 52-year-old male patient admitted with weakness on the left side of his body and loss of speech. He was diagnosed with a cerebrovascular accident (CVA) or stroke in the right side of the brain based on his symptoms and a CT scan showing an infarct in the right occipital region. He had a history of hypertension. Over five days in the hospital, he was given treatments including mannitol, phenytoin, antibiotics, amlodipine, and aspirin to control his blood pressure, prevent seizures and infection, and reduce stroke risk. His vital signs and lab results improved before being discharged.
Lennox-Gastaut Syndrome- A Case Study: By RxVichuZ!! :)RxVichuZ
This document summarizes the case of a 16-year-old male patient admitted to the neurology department for recurrent seizures. The patient has a history of Lennox-Gastaut syndrome diagnosed at NIMHANS. During his 3-day hospital stay, his vital signs and lab tests were monitored daily. He was treated with multiple antiepileptic drugs including injections of methylprednisolone, acetazolamide, pyridoxine, clobazam, phenytoin, levetiracetam and topiramate to control his seizures. His treatment appeared to show improvement in his condition before being discharged.
A 69-year-old male was admitted with right knee pain, nausea, and vomiting. Examination found pain in the right knee and osteoarthritis of the right knee was assessed at grade 3. Investigations including x-rays and blood tests were performed. The patient was given various medications including injections of Magnexforte, Pantocid, Tramadol, Zofer, Trenexia, Clexane, and Dynaparaque to reduce pain and anxiety and provide a comfortable environment for recovery.
This case presentation discusses a 17-year-old male patient who presented with two episodes of seizures, vomiting, headache, unconsciousness, abnormal talking, and tightness in the limbs. Based on examination findings of perinatal hypoxia, mild cerebral atrophy, and abnormal EEG and brain mapping, the patient was diagnosed with primary generalized symptomatic seizures, auditory processing disorder, and mild mental retardation. The treatment plan included intravenous anti-seizure, antacid, anti-emetic, and antibiotic medications along with oral medications for discharge. The goals of treatment were to control seizure frequency and minimize side effects to allow for a normal life.
Case presentation on Cerebrovascular accident (Stroke)HAMMADKC
This document presents a case report of a 76-year-old male patient admitted to the neurology department with complaints of forgetting, left hand weakness, slurred speech, and incontinence. The patient has a history of hypertension, previous cerebrovascular accident, and fall from bed. Examination and investigations including MRI and angiogram confirmed the diagnosis of cerebrovascular accident. The patient was treated with medications like citicoline, levetiracetam, atorvastatin, and aspirin. His condition improved and he was discharged with advice on medications and lifestyle modifications to prevent further strokes.
Case on type II diabetes mellitus with peripheral neuropathy with hypertensionVineetha Menon
This document describes the case of a 38-year-old female patient admitted to the hospital for giddiness, generalized weakness, burning and tingling sensations in the lower limbs, and blurry vision. She has a history of type 2 diabetes for 3 years and hypertension for 1 year. On examination, she was found to have elevated blood pressure and blood glucose levels. She was diagnosed with type 2 diabetes with peripheral neuropathy and hypertension. Her symptoms improved with treatment including medications to control her blood pressure and blood glucose over her 5 day hospital stay.
Mr. X, age 37, was admitted with fever, abdominal pain, nausea, vomiting and blood in urine. He has a history of diabetes, hypertension and chronic kidney disease. Laboratory tests showed renal dysfunction, anemia and high blood glucose. He was diagnosed with chronic kidney disease, uremic gastritis and cholelithiasis. The patient was treated with antibiotics and other medications. The pharmacist recommended additional supplements and lifestyle modifications to control symptoms and slow disease progression.
The document discusses venous thromboembolism (VTE), specifically deep vein thrombosis (DVT). It describes the causes, risk factors, clinical presentation, and diagnostic evaluation of VTE. It then presents a case study of a patient with systemic lupus erythematosus who presented with right upper extremity DVT and swelling. The document outlines her medical history and examination findings. It analyzes her multiple acute conditions, including VTE, lupus flare, acute kidney injury, anemia, and suspected UTI. Finally, it discusses recommended treatment and management options for VTE, antiphospholipid antibody syndrome, and her other conditions based on clinical practice guidelines.
case presentation on generalized epileptic seizures in pediatricsMohammed Masiuddin
This document summarizes a pediatric clerkship, including various cases seen (viral pyrexia, meningitis, asthma), monitoring parameters for pediatric vital signs and biomarkers, commonly used drug classes and examples, and a case presentation on generalized epileptic seizures in a 3-year old female patient. The case is diagnosed as cryptogenic epilepsy based on symptoms and EEG results. Standard therapy of antiepileptic drugs like carbamazepine, phenytoin, and sodium valproate is outlined. The patient's current therapy of phenytoin, midazolam, and sodium valproate is assessed, with goals of reducing seizure activity and preventing complications. Monitoring parameters and lifestyle modifications are recommended to manage the condition.
A 36-year-old female presented with pain and tingling in her left hand and fingers that progressed to her arm and neck, as well as blurred vision in her right eye for 15 days. MRI revealed acute demyelinating optic neuritis. She was diagnosed with multiple sclerosis and right optic neuritis. Treatment included intravenous methylprednisolone, gabapentin, prednisolone, supplements, amlodipine for hypertension, and pantoprazole for acidity. Her medications, diet, disease monitoring, and follow up were discussed to manage her multiple sclerosis and symptoms.
A 45-year-old male presented to the ICU with chest pain, sweating, backache and vomiting. Examination found normal vitals except elevated heart rate. Tests showed elevated cardiac enzymes and ECG changes consistent with ST-elevated myocardial infarction (STEMI). He was treated with fibrinolytics, anticoagulants, antiplatelets and beta blockers. Over subsequent days his symptoms improved and he was discharged on aspirin, clopidogrel, atorvastatin and metoprolol with counseling on cardiac risk factors and medications.
This powerpoint is a case presentation, that explains the case of ADCHF, with comorbidities, comprising HTN, CAD and DLP.
A summary on the recent advancements in HF management, along with justification of therapy provided, has been elucidated.
A note on home remedies and counselling tips has also been provided.
The patient, a 50-year-old female, presented with headache, vomiting, breathlessness and decreased urine output. She had a history of rheumatic heart disease for 4 years and was on warfarin therapy. Investigation revealed subdural hematoma which resolved after stopping warfarin. The final diagnosis was rheumatic heart disease with severe mitral stenosis, pulmonary hypertension, congestive cardiac failure, atrial fibrillation and warfarin-induced acute subdural hematoma.
The patient, P. Adilaxmi, a 35-year-old female, was diagnosed with a urinary tract infection and renal calculi complicated by type 2 diabetes. She presented with low backache, swelling of the lower limbs and face, and was on antidiabetic medication. Laboratory tests and ultrasound confirmed the diagnosis and showed renal abnormalities. She was treated with antibiotics, analgesics, and antidiabetic drugs, and her symptoms improved over time, allowing her discharge after 8 days.
This document provides an overview of heart failure, including its prevalence, causes, diagnosis, and management. It discusses that heart failure is common and costly, with the most common causes being coronary artery disease and other non-ischemic factors. Diagnosis involves clinical evaluation as well as tests like echocardiogram and BNP levels. Management focuses on treating the underlying hemodynamics with diuretics and devices, as well as the neurohormonal abnormalities with medications like ACE inhibitors, ARBs, beta blockers, and aldosterone antagonists.
Case presentation on cervical myeloradiculopathyHema Sree
Cervical myeloradiculopathy is dysfunction of the spinal cord and nerve roots in the neck caused by compression. A 58-year-old male presented with neck pain radiating to his arms and legs, difficulty walking, and increased urination. MRI showed compression at C4-C5 and C5-C6 from osteophytes and disc bulges. He was diagnosed with cervical myeloradiculopathy and prescribed medications, physical therapy, and lifestyle changes to reduce pain and prevent further injury.
This document presents a case study on acute cerebrovascular accident (CVA). The patient, a 71-year-old male, presented with right-sided weakness and involuntary hand tremors. Medical history revealed prior heart disease and cardiogenic stroke. Examinations found neurological deficits and imaging showed recent and chronic brain infarcts. The diagnosis was acute CVA and seizure disorder. Treatment included medications to prevent seizures, dissolve clots, lower cholesterol and blood pressure. The goals of therapy were to restore brain blood flow, reduce symptoms, prevent complications and improve quality of life.
How to manage adverse events from oncologic treatments.pdfLanceCatedral
This document provides guidance for managing adverse events from oncologic treatments. It discusses hypersensitivity reactions, extravasation reactions, nausea/vomiting, diarrhea, mucositis, and fatigue - describing prevention, assessment, and treatment strategies. The target audience is internists who are well-positioned to care for cancer patients experiencing side effects from their treatments.
The document discusses headaches, their prevalence, types, symptoms, evaluation, treatment and management. It notes that 90% of individuals experience at least one headache per year, with 40% experiencing severe headaches. It describes the most common primary headache types as migraine (16%), tension-type (69%) and cluster (0.1%). Secondary headaches are often caused by infection, injury or vascular issues. Evaluation of headaches involves considering quality, severity, location, duration and time course. Serious underlying causes may present with worst-ever headaches, new headaches in older patients, or symptoms like fever or neurological issues. Treatment involves identifying and avoiding triggers, managing symptoms, and using medications like triptans, NSAIDs or preventive drugs.
The Subjective, Objective, Assessment and Plan (SOAP).the assessment will identify what the drug related/induced problem is likely to be and the reasoning/evidence behind it. This will include etiology and risk factors, assessments of the need for therapy, current therapy, and therapy options.
The patient, a 45-year-old female, presented with right-sided weakness, vomiting episodes, and left mouth deviation. She has a history of rheumatic heart disease and previous stroke. Laboratory tests revealed elevated liver enzymes and abnormalities in cell counts. She was diagnosed with cerebrovascular accident and hemiplegia due to a previous cardioembolic stroke. Her treatment plan includes anticoagulants, antiplatelets, statins, and physical therapy to manage symptoms and prevent future strokes.
A 72 year old male presented to the emergency department with fever, left lower quadrant abdominal pain, and vomiting. He was diagnosed with urosepsis caused by E. coli based on blood and urine cultures. Over the next few days, he developed sepsis, acute kidney injury requiring dialysis, and metabolic encephalopathy. He was treated with intravenous antibiotics, vasopressors, dialysis, and other supportive care. After 6 days of treatment, his condition gradually improved.
Anaesthesia Management Thyroid by Dr. Animesh19anisingh
1. The document discusses thyroid anatomy, physiology, and hormone synthesis. It describes hyperthyroidism, its causes, pathophysiology, clinical features, and treatment options including antithyroid drugs, radioactive iodine, surgery, and management of thyroid storm.
2. Anesthesia management for hyperthyroid patients focuses on preoperative preparation to render the patient euthyroid, careful induction and hemodynamic control during surgery, and monitoring for complications like thyroid storm.
3. Recurrent laryngeal nerve injury is a potential surgical complication and may require re-intubation if bilateral. Careful anesthesia aims to avoid exacerbating the hypermetabolic state in hyperthyroid patients.
Cases in cardiology --LMB-- part one -- PART TWO-- MAGDI SASI 2016cardilogy
This patient presented with progressive dyspnea, fatigue on exertion, and recent palpitations. On examination, she had an irregular pulse, low blood pressure, and a malar flush. ECG showed atrial fibrillation with rapid ventricular response and echo revealed severe mitral stenosis.
The incorrect statement is that she needs valve replacement. Current guidelines indicate valve replacement is indicated for symptomatic patients with mitral valve area <1.5cm2 who are unsuitable for percutaneous mitral balloon valvuloplasty. This patient should first undergo repeat echo and consideration of cardioversion and rate control medications before deciding on invasive treatment.
This document provides guidelines for treating heart failure cases using the 2016 ESC Guidelines. It defines heart failure and discusses diagnostic algorithms. It presents 4 clinical case scenarios to illustrate how to apply guideline recommendations in primary care patients presenting with heart failure symptoms. For each case, it analyzes diagnostic tests, identifies treatments, and describes how to initiate and titrate medications like ACE inhibitors and beta-blockers. The document also covers topics like imaging tests, classifications of heart failure, treatment objectives, and algorithms for managing reduced ejection fraction.
This document provides information on nephrotic syndrome, specifically defining it as a clinical syndrome characterized by heavy proteinuria, hypoproteinemia, edema, and hypercholesterolemia. It describes the epidemiology, classification, pathophysiology, clinical manifestations, investigations, diagnosis, management, and prognosis of nephrotic syndrome. The key points are that minimal change disease is the most common type, presenting with edema, ascites, weight gain, and respiratory distress in children aged 1-10 years. Investigations show proteinuria, hypoalbuminemia, and normal renal function. Management involves steroid therapy, addressing complications, and educating parents on infection prevention and immunization.
The document discusses several topics related to acute coronary syndrome including cardiogenic shock, acute myocardial infarction, congestive heart failure, and arrhythmias. It provides definitions and pathophysiology of cardiogenic shock, acute coronary syndrome, and discusses management strategies including use of inotropes, vasopressors, intra-aortic balloon pump counterpulsation, and revascularization. It also discusses definitions and management of acute coronary syndromes including unstable angina and myocardial infarction and the role of antiplatelet and anticoagulation therapies.
Similar to Rheumatoid arthritis with cervical myelopathy (20)
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Light House Retreats: Plant Medicine Retreat Europe
Rheumatoid arthritis with cervical myelopathy
1. R A W ITH CER VICA L M YELO PATHY W ITH SEIZ U R E DISO R DER
By faith I mean a vision of good one cherishes and the enthusiasm that pushes one to seek its fulfillment regardless of obstacles.
CASE STUDY
RIDDHI
PAWASKAR
2. 01 Work Summary
02 Hospital Introduction
03 Successful Medical Cases
04 Work Plan
Subjective data
NAME: LMN AGE: 51 SEX: F DOA: 01/12/19
CHIEF COMPLAINTS:
i. Numbness with tingling sensation in both lower limbs
ii. Pain ++
RA seizure CM-Riddhi 2
3. 20%
25%
15%
40%
65%
OBJECTIVE DATA
Medical history
k/c/o RA with seizure with cervical
myelopathy since 2Y
LRTI : 20/9/19
Chronic mastoiditis: 13/4/17
Otitis media: 17/3/17
Positive Family history for seizures
No significant Social H/O or allergies
RA seizure CM-Riddhi 3
4. 20%
25%
15%
40%
65%
OBJECTIVE DATA
Medical history
k/c/o RA with seizure with cervical
myelopathy
LRTI : 20/9/19
Chronic mastoiditis: 13/4/17
Otitis media: 17/3/17
Positive Family history for seizures
No significant Social H/O or allergies
GENERAL: Moderate
Pt. on ventilator endotracheal tubing with BIPAP
Foley’s catheter
VITALS: BP:130/80 Temp: 98F SpO2: 98%
CVS: S1 S2 no murmur
CNS: drowsy, obeys, moves all limbs
RS: AE bilateral crepts+
GI: soft, tender
EXT: severe ache, altered sensation
PAS: 7/10
RA seizure CM-Riddhi 4
5. PREVIOUS MEDICATIONS
LRTI : 20/9/19
RA seizure CM-Riddhi 5
MEDICATIONS CONSTITUENT
1) Tab . Zorax CV BD Acyclovir 400mg
2) Tab. Ultracet OD Paracetamol/Acetaminophen
(325mg) + Tramadol (37.5mg)
3) Tab. Xysal OD Levocetirizine 5mg
4) Syp Vitacan 5ml BD MULTIVITAMIN WITH CO Q10 &
LYCOPENE
5) Otrivin nasal drops SOS Xylometazoline 0.1%
7. LAB INVESTIGATION: MRI
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RA seizure CM-Riddhi 7
CERVICAL SPINE:
Cervical spondylitis with partial disc degeneration
Widening of atlanto-occipital & atlanto-axial joints and erosion of odontoid with
posterior displacement
Mild cervico-medullary compressive myelopathy consistent with Atlanto-Axial
dissociation due to RA
Posteriocentral disc protrusions C3-4 & C6-7
Mild cord and exiting bil. C4, C7–nerve root compressions
8. LAB INVESTIGATION
HAEMOTOLOGY
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RA seizure CM-Riddhi 8
i. Hb: 13g/ dL
ii. ESR: 68ML/HR
iii. NEUT: 90%(40-70%)
iv. LYM: 8%(20-45%)
v. WBC: 13100/cumm
vi. MCHC: 30.44 fl(32-36)
vii. MCH: 24.86 fl(27-32fl)
S.BUN- 4.5mg/dL (5-25mg/dL)
S.Creat- 0.7mg/dL (0.8-1.4mg/dL)
SGPT- 27 U/L (upto 40 IU/L)
SGOT- 18 U/L (upto 40 IU/L)
RBG: 116 mg/dL(60-120mg/dL)
S.Na:122mEq/L(125-135mEq/ L)
9. LAB INVESTIGATION
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RA seizure CM-Riddhi 9
URINALYSIS
• Yellow, clear
• RBC: 3-4/hpf
• Proteins , sugar, ketone
bodies, Bile salts &
pigments: Ab
• Urobilinogen: 0.2
• Pus cells: 5-6/hpf
• Epithelial cells: 4-5/hpf
• Crystalloids,bacteria:Ab
ECG
Sinus tachycardia with
QT Prolongation
10. LAB INVESTIGATION
CULTURE SENSITIVITY TEST
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RA seizure CM-Riddhi 10
E.coli isolated
RESISTANT:
Ampicillin
Salbactam
Co trimaxazole
Ceftzidime
Ceftriaxone
Cefoperazone
Cefepime
Cefotaxime
Tazobactam
Gatifloxacin
Levofloxacin
Norfloxacin
Ofloxacin
Tetracyclin
INTER MEDIATE –
SENSITIVE:
Amikacin
Meropenem
Netilmycin
Piperacillin-Tazobactam
SENSITIVE:
Nitrofurantoin(78%)
Imepenem(80%)
Gentamycin(82%)
Colistin(86%)
11. BP:128/81
HR:75
RR: 19
Inj. XTUM
stopped due to
allergy.
Inj. CLAVUM
started
Tb. Etiozola
OD,rest ct all
BP 130/80
BP: 130/80
Inj NORAD
tapered off by
0.5ml/hr
BP: 110/70
PR 80/min
Progress Chart
Tramadol BD jt. pain
BP,SpO2 N
Giddiness
drowsy
Dyspnea decreased
afebrile
No new complaints No new complaints
RA seizure CM-Riddhi 11
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PATIENT NAME: XYZ HOSP. NO:
AGE: yr WEIGHT: kg SEX:
M/F:Male
DATE OF ADMISSION: 11 /02/18
DATE OF DISCHARGE: 14/02/18
COMPLAINTS ON ADMISSION :
MEDICAL HISTORY :
MEDICATION HISTORY : -
SOCIAL HISTORY:
FAMILY HISTORY: NS
PREVIOUS ALLERGIES: N/S
PHYSICAL EXAMINATION: moderately build and nourished, conscious and co-operative
GENERAL - no P I C C L E
VITAL SIGNS - PR: 90 /min ; BP : 110/80mmhg, R.R:- N/A,
HEENT - N/S
CVS - S1 S2 heard; no murmurs
RS - N/S
GIT - N/S
GU - N/S
EXT - reflexes were normal.
CNS - conscious and oriented
PROVISIONAL DIAGNOSIS:
ROUTINE BIOCHEMICAL INVESTIGATIONS HAEMATOLOGY
Urea: mg/dl
S.Cr :mg/dl
Na: mEq/L
K: mEq/L
FBS:
PPBS:
RBS:
Tch :
TGs :
T Bili:
D Bili:
T. Prot:
Alb:
Glob:
AST:
ALT:
ALP:
HIV
HBSAG
RBC : Retics:
WBC: Hb:
N: PCV:
L: MCV:
M: MCH:
E: MCHC:
B: ESR:
Platelets:.
ECG IMAGING:
XR
USG
URINE ANALYSIS
pH: WBC:
Protein RBC:
Sugars: EP.
Blood: Casts:
Crystals:
Stool –
CT
MRI
DRUG WITH DOSE & ROUTE DURATION OF THERAPY
GENERIC NAME BRAND NAME
1
2
3
4
5
6
7
8
9
8
8
√ √ √ √
√
√ √ √ √
√ √ √ √
√
DISCHARGE MEDICATIONS:
DISCHARGE MEDICATIONS:
Patient not discharged
DAY INVESTIGATIONS
D1
D2
D3
PR – beats/min
BP – mmHg
PR – 80 beats/min
BP – mmHg
PR – 86 beats/min
BP – 100/80 mmHg
REVIEW:
Visit after 1 week
DRUG TREATMENT CHART: PROGRESS CHART:
Medication Dose and duration 1 2 3 4 5
+
13. ¤ GENERIC: Norepinephrine (2mg/Ml)
¤ CATEGORY: Alpha/Beta Agonist
¤ MOA:. Stimulates beta1-adrenergic receptors and alpha-adrenergic receptors causing increased contractility and heart rate as well as
vasoconstriction, thereby increasing systemic blood pressure and coronary blood flow; clinically, alpha effects (vasoconstriction) are
greater than beta effects (inotropic and chronotropic effects)
¤ INDICATIONS. Cardiogenic Shock ,hypotension,ACLS, septic sock: The 2016 Surviving Sepsis Campaign: International Guidelines for
Management of Sepsis and Septic Shock recommends norepinephrine as the first-choice vasopressor for management of septic shock
¤ CONTRAINDICATIONS: during anesthesia with cyclopropane,,sinus tachycardia,
¤ ADVERSE EVENTS: headache, anxiety, arrhythmias, bradycardia, respiratory difficulty, ischemic injury, or extravasation at the infusion
site.,plasma volume depletion, gangrene
¤ PREGNANCY: US FDA pregnancy category: C
¤ STD. DOSE: Initial dose: 8 to 12 mcg/min continuous IV infusion
Maintenance dose: 2 to 4 mcg/min continuous IV infusion( each ml contains 80 micrograms noradrenaline tartrate equivalent to 40
micrograms noradrenaline base)
Duration of therapy: Continue infusion until adequate blood pressure and tissue perfusion are maintained without therapy.
¤ Phentolamine is the local antidote for peripheral ischemia resulting from extravasation of norepinephrine
01
14. ¤ GENERIC: Levitaracetam
¤ CATEGORY: Anti epileptic
¤ MOA:. inhibition of voltage-dependent N-type calcium channels; facilitation of GABA-ergic inhibitory transmission through
displacement of negative modulators; reduction of delayed rectifier potassium current; and/or binding to synaptic proteins which
modulate neurotransmitter release.
¤ INDICATIONS: Focal (partial) onset, Juvenile myoclonic epilepsy, Primary generalized tonic-clonic seizures, Subarachnoid hemorrhage,
traumatic brain injury( short term seizure prophylaxis) STATUS EPILEPTICUS
¤ CONTRAINDICATIONS: Hypersensitivity (eg, anaphylaxis, angioedema) to levetiracetam or any component of the formulation
¤ ADVERSE EVENTS: infection, neurosis, drowsiness, asthenia, headache, nasopharyngitis, nervousness, abnormal behavior, aggressive
behavior, agitation, anxiety, apathy, depersonalization, depression, fatigue, hostility, hyperkinetic muscle activity, mental disorders,
outbursts of anger, personality disorder, emotional lability, irritability, laceration, and mood changes.
¤ PREGNANCY: US FDA pregnancy category: C
¤ STD. DOSE: IV: Initial: 500 mg twice daily; increase every 2 weeks by 500 mg/dose based on response and tolerability to a maximum of
1.5 g twice daily.
02
15. ¤ GENERIC: TRAMADOL
¤ CATEGORY: Analgesic, Opioid
¤ MOA:. Tramadol and its active metabolite (M1) binds to μ-opiate receptors in the CNS causing inhibition of ascending pain pathways,
altering the perception of and response to pain; also inhibits the reuptake of norepinephrine and serotonin, which are
neurotransmitters involved in the descending inhibitory pain pathway responsible for pain relief
¤ INDICATIONS. Osteoarthritis, septic arthritis, RLS,Osteomyelitis
¤ CONTRAINDICATIONS: pediatric patients <12 years; postoperative management in pediatric patients <18 years who have undergone
tonsillectomy and/or adenoidectomy; significant respiratory depression; acute or severe bronchial asthma in the absence of
appropriately monitored settings and/or resuscitative equipment; GI obstruction, including paralytic ileus (known or suspected);
concomitant use with or within 14 days following MAO inhibitor therapy.
¤ ADVERSE EVENTS: pruritus, agitation, anxiety, constipation, diarrhea, hallucination, nausea, tremor, vomiting, and diaphoresis, insomnia
¤ PREGNANCY: US FDA pregnancy category: Not Assigned
¤ STD. DOSE: 50 to 100 mg orally every 4 to 6 hours as needed for pain
-For patients not requiring rapid onset of analgesic effect: Initial dose: 25 mg orally once a day; titrate in 25 mg increments every 3
days to reach a dose of 25 mg four times a day; thereafter increase by 50 mg as tolerated every 3 days
Maximum dose: 400 mg per day
03
16. ¤ GENERIC: ETIZOLAM
¤ CATEGORY: BENZODIAZEPINE
¤ MOA:. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to
chloride ions. This shift in chloride ions results in hyperpolarization (a less excitable state) and stabilization. Benzodiazepine receptors
and effects appear to be linked to the GABA-A receptors in limbic and reticular system
¤ INDICATIONS: Insomnia, Oral sedation prior to outpatient dental procedure, anxiety, disorder
¤ CONTRAINDICATIONS: Hypersensitivity to triazolam, other benzodiazepines, or any component of the formulation; concurrent therapy with
strong cytochrome P450 3A (CYP 3A) inhibitors (eg, itraconazole, ketoconazole, nefazodone, lopinavir, ritonavir).
¤ ADVERSE EVENTS: dizziness, insomnia, rebound insomnia, headache, and irritability., dystonia, syncope
¤ PREGNANCY: US FDA pregnancy category: X
¤ STD. DOSE: Initial dose: 0.25 mg orally once a day at bedtime
Maintenance dose: 0.125 to 0.25 mg orally once a day
Maximum dose: 0.5 mg/day
Duration of therapy: 7 to 10 days
04
17. ¤ GENERIC: DEXAMETHASONE 4 mg/mL (1 mL)
¤ CATEGORY: Anti-inflammatory Agent
Antiemetic
Corticosteroid, Systemic
¤ MOA:. Dexamethasone is a long acting corticosteroid with minimal sodium-retaining potential. It decreases inflammation by
suppression of neutrophil migration, decreased production of inflammatory mediators, and reversal of increased capillary permeability;
suppresses normal immune response. Dexamethasone's mechanism of antiemetic activity is unknown.
¤ INDICATIONS: synovitis of osteoarthritis, rheumatoid arthritis, acute and subacute bursitis, acute gouty arthritis, epicondylitis, acute
nonspecific tenosynovitis, and posttraumatic osteoarthritis., allergic, hematologic (eg, immune thrombocytopenia), dermatologic,
neoplastic, rheumatic, autoimmune, nervous system, renal, and respiratory origin; primary or secondary adrenocorticoid deficiency (not
first line); management of shock, cerebral edema,
CONTRAINDICATIONS: Hypersensitivity to dexamethasone or any component of the formulation; systemic fungal infections
Documentation of allergenic cross-reactivity for corticosteroids is limited.
¤ ADVERSE EVENTS: alteration in glucose tolerance, behavioral and mood changes, increased appetite, and weight gain; the incidence
generally correlates with dosage, timing of administration, and duration of treatment. polycythemia, abnormal coagulation,
polymorphonuclear leukocytosis
¤ PREGNANCY: US FDA pregnancy category C-BENEFIT SHOULD OUTWEIGH THE RISK
¤ STD. DOSE: Parenteral: dose: 0.5 mg to 9 mg IV or IM per day in divided doses every 12 hours
05
18. ¤ GENERIC: HYDROCORTISONE
¤ CATEGORY: Corticosteroid, Systemic
¤ MOA:May depress the formation, release, and activity of endogenous chemical mediators of inflammation (kinins, histamine, liposomal
enzymes, prostaglandins) through the induction of phospholipase A2 inhibitory proteins (lipocortins) and sequential inhibition of the
release of arachidonic acid. Hydrocortisone has low to intermediate range potency (dosage-form dependent).
¤ INDICATIONS: immune thrombocytopenia, warm autoimmune hemolytic anemia), allergic, gastrointestinal (eg, Crohn disease, ulcerative
colitis), inflammatory, neoplastic, neurologic (eg, multiple sclerosis), rheumatic (eg, antineutrophil cytoplasmic antibody-associated
vasculitis, dermatomyositis/polymyositis, gout [acute flare], mixed cryoglobulinemia syndrome, polyarteritis nodosa, rheumatoid
arthritis, systemic lupus erythematosus), and/or autoimmune origin.
¤ CONTRAINDICATIONS: systemic fungal infection,hypersensitivity, ITP
¤ ADVERSE EVENTS: Pancreatitis, HTN, Weight loss, seizures, eosinophilia
¤ PREGNANCY: US FDA pregnancy category: C
¤ STD. DOSE: 80 to 100 mg IM once a week for 1 to 4 week
06
19. ¤ GENERIC: Ceftriaxone (1000 mg) + Sulbactam (500 mg)
¤ CATEGORY: Antibiotic, Cephalosporin
¤ MOA: Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs)
¤ INDICATIONS: Pyelonephritis, noscomical pneumonia, UTI,
¤ CONTRAINDICATIONS: hypersensitivity to ceftolozane/tazobactam, piperacillin/tazobactam, other members of the beta-lactam class
¤ ADVERSE EVENTS: Fever, irregular heartbeat, dizziness, abdominal pain
¤ PREGNANCY: US FDA pregnancy category Not Assigned
¤ STD. DOSE: 1.5 g IV every 8 hours
Duration of therapy: 7 days
07
20. ¤ GENERIC: Amoxicillin ( 500mg) + Clavunate ( 125mg)
¤ CATEGORY: Antibiotic, Penicillin
¤ MOA: Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs)
¤ INDICATIONS: Aspiration Pneumonia, Bacterial Infection, Bone infection, Deep Neck Infection, Endocarditis, Epiglottitis, Intraabdominal
Infection, Joint Infection, Kidney Infections, Meningitis, Pelvic Inflammatory Disease, Peritonitis, Pneumonia, Sinusitis, Skin and
Structure Infection, Skin or Soft Tissue Infection, Surgical Prophylaxis and Urinary Tract Infection.
¤ CONTRAINDICATIONS: hypersensitivity to any members of the beta-lactam class, history of cholestatic jaundice or hepatic dysfunction
with amoxicillin/clavulanate potassium therapy, Severe renal impairment (creatinine clearance <30 mL/minute) and hemodialysis
patients,mononucleosis
¤ ADVERSE EVENTS: Fever, irregular heartbeat, dizziness, abdominal pain
¤ PREGNANCY: US FDA pregnancy category B
¤ STD. DOSE: 500 mg orally every 8 hours or 875 mg orally every 12 hours for 7 to 10 days
07
21. ¤ GENERIC: FUROSEMIDE
¤ CLASS: Diuretic
¤ MOA: Primarily inhibits reabsorption of sodium and chloride in the ascending loop of Henle and proximal and distal renal tubules,
interfering with the chloride-binding cotransport system, thus causing its natriuretic effect
¤ INDICATIONS: Management of edema associated with heart failure, cirrhosis of the liver (ie, ascites), or renal disease (including nephrotic
syndrome); acute pulmonary edema.
¤ CONTRAINDICATIONS: Hypersensitivity to sulfonamide-derived drugs; complete renal shutdown; hepatic coma and precoma; uncorrected
states of electrolyte depletion, hypovolemia, dehydration, hyperbilirubinemiaor hypoten
¤ ADVERSE EVENTS: electrolyte depletion, painful urination, syncope, SIADH
¤ PRECAUTIONS: Furosemide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and
electrolyte depletion.
¤ PREGNANCY: US FDA pregnancy category C
¤ STD. DOSE: Initial dose: 20 to 40 mg IV (slowly over 1 to 2 minutes) or IM once; may repeat with the same dose or increase by 20 mg no
sooner than 2 hours after the previous dose until the desired diuretic effect has been obtained.
Maintenance dose: Administer the dose that provided the desired diuretic effect once or twice a day.
08
22. ¤ Generic– Pantoprazole
¤ MOA–It is a proton pump inhibitor,inhibits H,K ATPase enzyme which secretes HCl in parietel cells of stomach
¤ Indications-Ulcers and reflux oesophagitis,GERD,Zollinger-Ellison syndrome
¤ Contraindication- Hypersensitivity
¤ Side effects- Headache, diarrhea, dizziness
¤ Pregnancy–US FDA pregnancy category Not Assigned:This drug is only recommended for use during pregnancy when
there are no alternatives and the benefit outweighs the risk.
¤ Warnings–Prolonged treatment (greater than 24-36 months) may cause vitamin B12 deficiency.
¤ Std. Dose–20-80 mg/day
¤ cause vitamin B12 deficiency.
.
09
23. ¤ GENERIC: Ondansetron
¤ CATEGORY: Anti emetic
¤ MOA: Ondansetron is a selective 5-HT3-receptor antagonist which blocks serotonin, both peripherally on vagal nerve terminals and
centrally in the chemoreceptor trigger zone
¤ INDICATIONS: CINV, Post operative nausea/vomitting,pregnancy associated nausea,vomitting. Gastric pareisis
¤ CONTRAINDICATIONS: Hypersensitivity, concomitant use with apomorphine
¤ ADVERSE EVENTS: confusion, dizziness, fever, fatigue, gastric pain
¤ PREGNANCY: US FDA pregnancy category: B
¤ STD. DOSE: recommended dose: 0.15 mg/kg IV, with the first dose (infused over 15 minutes) 30 minutes before the start of
emetogenic chemotherapy and subsequent doses given 4 and 8 hours after the first dose.
-Maximum dose: 16 mg per dose
10
24. ¤ MOA: The bacterial degradation of lactulose resulting in an acidic pH inhibits the diffusion of NH3 into the blood by causing the
conversion of NH3 to NH4+; also enhances the diffusion of NH3 from the blood into the gut where conversion to NH4+ occurs; produces
an osmotic effect in the colon with resultant distention promoting peristalsis
¤ INDICATIONS: acute & chronic constipation, hepatic encephalopathy
¤ CONTRAINDICATIONS: Patients requiring a low galactose diet
¤ ADVERSE EVENTS: Gaseous distention, belching, flatulence, borborygmi, abdominal discomfort (e.g.,
cramping). Dehydration and hyponatremia in infants.
¤ PREGNANCY: pregnancy category B
¤ STD. DOSE: Initial dose: 15 mL orally once a day. Therapy should be continued until normal bowel function resumes.
11
25. POINT TO PATIENT
About disease
Rheumatoid arthritis is disorder of joints
including severe pain and deformation
About medications
• Take medications as
prescribed
• Do not skip more than single
dose a day
• Report any adverse events,
this may be due to
medications
About lifestyle modification
About diet
RA seizure CM-Riddhi 25
27. POINT TO PHYSICIAN
GENERALLY AVOID: Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, may result in
profound sedation, respiratory depression. MANAGEMENT: The use of opioids in conjunction with benzodiazepines or other CNS
depressants should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary, the
dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect. Patients should be
monitored closely for signs and symptoms of respiratory depression and sedation. Severe cases of benzodiazepine withdrawal,
primarily in patients who have received excessive doses over a prolonged period, may result in numbness and tingling of extremities,
hypersensitivity to light and noise, hallucinations, and epileptic seizures.
MONITOR CLOSELY: Concomitant use of 5-HT3 receptor antagonists with tramadol may potentiate the risk of serotonin syndrome
and/or reduce the analgesic efficacy of tramadol. Serotonin syndrome has been reported with both 5-HT3 receptor antagonists and
tramadol, and combined use of these drugs may increase the risk.
MONITOR CLOSELY: Treatment with 5-HT3 receptor antagonists has been associated with dose-dependent prolongation of the QT
interval. Tramadol may also prolong the QT interval, and theoretically, coadministration of multiple agents that can prolong the QT
interval may result in additive effects and increased risk of ventricular arrhythmias such as torsade de pointes and sudden death. Cases
of torsade de pointes have been specifically reported.
MONITOR: Limited data suggest that furosemide and possibly other loop diuretics may potentiate the nephrotoxicity of some
cephalosporins. The exact mechanism of interaction is unknown, although furosemide has been shown to increase the plasma
concentrations and/or reduce the clearance of several cephalosporins such as cephaloridine and ceftazidime.
ETIZOLAM & LEVETIRACETAM: MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially
excessive or prolonged CNS and respiratory depression. Cautious dosage titration may be required, particularly at treatment initiation.
Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they
know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere
with their normal activities.
FUROSEMIDE & PANTOPRAZOLE: Monitoring of serum magnesium levels is recommended prior to initiation of therapy and periodically
thereafter if prolonged treatment with a proton pump inhibitor is anticipated or when combined with other agents that can cause
hypomagnesemia such as diuretics
28. POINT TO PHYSICIAN
MONITOR: The concomitant use of corticosteroids and agents that deplete potassium (e.g., potassium-wasting diuretics, amphotericin
B, cation exchange resins) may result in increased risk of hypokalemia. Corticosteroids can produce hypokalemia and other electrolyte
disturbances via mineralocorticoid effects, the degree of which varies with the agent (from most to least potent: fludrocortisone -
cortisone/hydrocortisone - prednisolone/prednisone - other glucocorticoids) and route of administration (i.e. systemic vs. local).