This document presents case presentations for hypertension, diabetes mellitus, and community acquired pneumonia for a patient named Pooja. It summarizes the subjective and objective findings, assessments, diagnoses, etiologies, need for therapy, and current medications for each condition. It also provides information on common electrolyte solutions, assessments of current antihypertensive, antidiabetic, antibiotic, and other supportive care therapies including generic and brand names, mechanisms of action, administrations, adverse effects and contraindications.
A soape note on uncontrolled hypertensionRomit Subba
This was our SOAPE note on Uncontrolled HTN. SOAPE S Stands for Subjective O stands for Objective A for Assessment P for Plan and E for Education . Patient have Uncontrolled HTN for which we being a pharmacist giving our rationale depending upon his/her SOAPE. Suggestions and comments are appreciated.
viral hepatitis is one of the chronic disease and can cured with proper treatment and care .Here is the case study on viral hepatitis for pharmacy students .
A soape note on uncontrolled hypertensionRomit Subba
This was our SOAPE note on Uncontrolled HTN. SOAPE S Stands for Subjective O stands for Objective A for Assessment P for Plan and E for Education . Patient have Uncontrolled HTN for which we being a pharmacist giving our rationale depending upon his/her SOAPE. Suggestions and comments are appreciated.
viral hepatitis is one of the chronic disease and can cured with proper treatment and care .Here is the case study on viral hepatitis for pharmacy students .
This case was presented during an Ambulatory Care rotation at 7th Avenue Clinic with Dr. Norwood in July 2011. I was assignment was to write a detailed SOAP Note regarding the case, summarizing pertinent problems and pharmacy-related recommendations
Related with cardio vascular system. Angina is Retrosternal chest pain which if left untreated can cause the higher complications with respect to cardiac health of human body. May be this is simple chest pain but if exceeds can cause major damage # prevention is better than cure :-)
Case Presentation in SOAP format on Ischemic Heart Disease with Acute Coronar...Umme Habeeba A Pathan
Heart diseases are major reason for mortality and morbidity. This is the case on how depression and stress can lead to Heart disease and worsen the QOL of patient. Little changes in food style and your attitude towards your health can save your heart.
PHARM-D INTERNSHIP ANNUAL REPORT PRESENTATION UNDER THE GUIDENCE OF DR.R.GO...DR. METI.BHARATH KUMAR
PHARM-D final Internship Report Presentation Under the Guidance of DR.R.Goutham Chakra
If Anyone need this they can contact me via
dr.m.bharathkumar@gmail.com
This case was presented during an Ambulatory Care rotation at 7th Avenue Clinic with Dr. Norwood in July 2011. I was assignment was to write a detailed SOAP Note regarding the case, summarizing pertinent problems and pharmacy-related recommendations
Related with cardio vascular system. Angina is Retrosternal chest pain which if left untreated can cause the higher complications with respect to cardiac health of human body. May be this is simple chest pain but if exceeds can cause major damage # prevention is better than cure :-)
Case Presentation in SOAP format on Ischemic Heart Disease with Acute Coronar...Umme Habeeba A Pathan
Heart diseases are major reason for mortality and morbidity. This is the case on how depression and stress can lead to Heart disease and worsen the QOL of patient. Little changes in food style and your attitude towards your health can save your heart.
PHARM-D INTERNSHIP ANNUAL REPORT PRESENTATION UNDER THE GUIDENCE OF DR.R.GO...DR. METI.BHARATH KUMAR
PHARM-D final Internship Report Presentation Under the Guidance of DR.R.Goutham Chakra
If Anyone need this they can contact me via
dr.m.bharathkumar@gmail.com
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
4. SUBJECTIVE
PATIENT COMPLAINS OF VERTIGO
OBJECTIVE
1) LAB PARAMETERS : BP: 130/90 mm/hg
2) MEDICAL HISTORY : HYPERTENSION
X 7YRS
3) MEDICATION HISTORY : TB
OLMESAR(1-0-0)
4) FAMILY HISTORY : NIL
5) SOCIAL HISTORY : NIL
5. Assessment
(1) Diagnosis
on the basis of subjective +objective + patient
complain +lab parameters the final diagnosis is
HYPERTENSION
(2) Etiology
It may be due to age , weight , life style …
(3) Need of therapy
If hypertension is not controlled or cured it can lead
to complications like :- MI , CCF , Arrthymia
9. Brand name :- INJ NS
Generic name :- normal saline
Class :- sterile solution
10. Assessment of current therapy
Brand name :- tb.olmesra
Generic name :- olmesartan
Class :- angiotensin II antagonist
m/a :- Olmesartan is a selective and competitive angiotensin
II Type 1 (AT1) receptor antagonist and hence it blocks the
vasocontrictor and aldosterone-secreting effects of
angiotensin II.
Administration :- may be taken with or without food
Adr :- Dizziness, headache, abdominal pain, dyspepsia,
diarrhoea, gastroenteritis, nausea, chest pain, bronchitis,
cough, pharyngitis, rhinitis, arthritis, back pain, fatigue
c/I :- pregnancy and biliary obstruction
11. Generic name :- tb. rozuvastatin
Class:- dislypedemic agent
Brand name :-tb rozustat
m/a :-Rosuvastatin is a selective and competitive inhibitor of HMG-CoA
reductase, the rate-limiting enzyme in cholesterol synthesis. It increases the
number of hepatic LDL receptors on the cell surface, enhancing uptake and
catabolism of LDL. It also decreases apolipoprotein B, triglycerides and
increases HDL.
Administration :-May be taken with or without food.
Adr :- Headache, dizziness, constipation, nausea, vomiting, abdominal pain,
myalgia, chest pain, peripheral oedema, depression, insomnia
c/I :- Severe renal impairment, active liver disease, unexplained persistent
elevations of serum transaminases; hypersensitivity. Pregnancy, lactation.
12. Brand name :- inj Rantac
Generic name :- Ranitidine
Class :- Antacids , antirefulx agents and anti
ulcerant
m/a :- Ranitidine blocks histamine H2-receptors in
the stomach and prevents histamine-mediated
gastric acid secretion.
Administration :- Should be taken on an empty
stomach. Take 15-30 min before meals.
Adr :- Headache, dizziness. Rarely hepatitis,
thrombocytopaenia, leucopaenia, hypersensitivity,
confusion, gynaecomastia, impotence, somnolence,
vertigo, hallucinations.
c/I :- Porphyria.
14. SUBJECTIVE
PATIENT COMPLAINS OF VERTIGO
OBJECTIVE
1) LAB PARAMETERS : urine sugar 4+
2) MEDICAL HISTORY : Diabetes x 5yrs
3) MEDICATION HISTORY : tb.xilia M2 fort(1-0-1)
tb.Galvus met (0-0-
1)
1) FAMILY HISTORY : NIL
2) SOCIAL HISTORY : NIL
15. Assessment
(1) Diagnosis
on the basis of subjective +objective + patient
complain +lab parameters the final diagnosis is
DIABETES
MELLITUS
(2) Etiology
It may be due to age , weight , life style …
(3) Need of therapy
If diabetes is not controlled or cured it can lead to
complications like :-
Neuropathy,nephropathy.retinopathy…..
16.
17. Assessment of current
therapy
brand name :- lantus
Generic name :- insulin glargine
Class :- insulin preparation
m/a :- Insulin lowers blood glucose levels. It regulates
carbohydrate, protein and fat metabolism by inhibiting
hepatic glucose production and lipolysis, and enhancing
peripheral glucose disposal.
Administration :-Take before meals.
Adr :- Hypoglycaemia, insulin resistance, lipoatrophy,
hypokalaemia, blurred vision.
c/I :- Hypoglycaemia.
18. Contd.
Brand name :- insuman rapid
Generic name :- insulin human
Class :- insulin preparation
m/a :- nsulin lowers blood glucose levels. It regulates
carbohydrate, protein and fat metabolism by inhibiting
hepatic glucose production and lipolysis, and enhancing
peripheral glucose disposal.
Adminitration :- Take before meals.
Adr :- Hypoglycaemia, insulin resistance, lipoatrophy,
hypokalaemia, blurred vision.
c/I :- Hypoglycaemia.
19. contd.
Brand name :- tb xilia
Generic name :- glimipride + metformin
Class :- antidiabetic agent
m/a : -Glimepiride stimulates the insulin release from functioning
pancreatic β-cells and inhibits gluconeogenesis at hepatic cells. It
also increases insulin sensitivity at peripheral target sites. Metformin
decreases hepatic gluconeogenesis, decreases intestinal absorption
of glucose and improves insulin sensitivity (increases peripheral
glucose uptake and utilisation).
Administration :- oral
Adr :- Diarrhoea, vomiting, metallic taste, rash, isolated transaminase
elevations, cholestatic jaundice, allergic skin reactions,
photosensitivity reactions, leukopaenia, agranulocytosis,
thrombocytopaenia, haemolytic anaemia, aplastic anaemia,
pancytopaenia, blurred vision.
c/I :- Hypersensitivity diabetic ketoacidosis (DKA); renal dysfunction;
CHF (CHF), patients undergoing radiological studies; acute or
chronic metabolic acidosis. Pregnancy, lactation.
20. Contd.
brand name :tb,galvus met
Generic name :- metformin
Class :- antidiabetic agent
m/a :- it is a dipeptidylpeptidase-4 (DPP-4) inhibitor that improves
glycaemic control by preventing DPP-4 from inactivating the
incretin hormones glucagon-like peptide-1 and glucose-dependent
insulinotropic polypeptide, thus prolonging incretin activity in
response to ingestion of nutrients. This increases insulin
sensitivity, decreases glucagon secretion and improves β-cell
function.
Administration :- Should be taken on an empty stomach. Take
before meals.
Adr :- Hypoglycaemia, delayed gastric emptying, nausea and
vomiting. Flu-like symptoms, headache and dizziness may occur.
22. SUBJECTIVE
PATIENT COMPLAINS OF COUGH AND FEVER
OBJECTIVE
1. LAB PARAMETERS : T :- 101.4 F
2. MEDICAL HISTORY : NIL
3. MEDICATION HISTORY :
4. FAMILY HISTORY : NIL
5. SOCIAL HISTORY : NIL
23. (1) Diagnosis
on the basis of subjective +objective + patient
complain +lab parameters the final diagnosis is
community aquired pneumonia
(2) Etiology
It may be due to age , weight , life style …
(3) Need of therapy
If is not controlled or cured it can lead to
complications like :-
24.
25. Treatment
class antibiotic Dose Organisms
1. Penicillin G 10 lac units IV 4 hourly S. pneumoniae and other gram-positive cocci
2.
Erythromycin
Azithromycin
Clarithromycin
500 mg PO 6 hourly
500 mg PO once daily x 3 days
250 mg PO 12 hourly x 10 days
All above + legionella, mycoplasma and chlamydia
3.
Ciprofloxacin
Sparfloxain
400 mg IV 12 hourly (750 mg PO 12
hourly)
200-400 mg OD x 7-14 days
All above + H. influenzae
4. Cephotaxime 1 gram 12 hourly S. aureus, aerobes
5. Metronidazole 500 mg IV 8 hourly (500 mg PO 8 hourly) Anaerobes
6. Gentamycin 5 mg/kg IV 8 hourly in 3 divided doses Gram-negative bacilli like Klebsiella, pseudomonas
7. Amphotericin 50 mg daily up to 2 grams total dose Fungi
26. Assessment of current
therapy
Brand name :- inj deriphyllin
Generic name :- theophyllin
Class :- Antiasthmatic & COPD Preparations
m/a :- Theophylline competitively blocks phosphodiesterase which
increases cAMP tissue concentrations causing bronchodilatation,
diuresis, CNS and cardiac stimulation, and gastric acid secretion.
Administration :- May be taken with or without food.
Adr :- Nausea, vomiting, abdominal pain, diarrhoea, headache, insomnia,
dizziness, anxiety, restlessness, tremor, palpitations.
c/I :- Hypersensitivity to xanthine derivatives, porphyria.
27. brand name :- inj emeset
Generic name :- ondansetron
Class :-antiemetics /supportive care therapy
m/a :-Ondansetron antagonises 5-HT3 receptor, blocking serotonin, both
peripherally on vagal nerve terminals and centrally in the chemoreceptor
trigger zone.
Administration :- Should be taken with food.
Adr :- Headache, malaise/fatigue, constipation; drowsiness, fever,
dizziness, anxiety, cold sensation; pruritus, rash; diarrhoea
c/I :- Use with apomorphine
28. Brand name :- inj cefzone
Generic name :- ceftriaxone + tazobactam
Class :-cephalosporins
m/a :-Ceftriaxone interferes with the biosynthesis of the peptidoglycan
component of the bacterial cell way by binding to and inactivating
penicllin-binding proteins (PBPs). Tazobactam is a penicillanic acid
sulfone derivative with β-lactamase inhibitory properties. It enhances
the activity of β-lactam antibacterials against β-lactamase-producing
bacteria.
Administration :-May be taken with or without food.
Adr :- anaphylaxis; diarrhoea; local reactions; blood dyscrasias; rash,
fever,
c/I :- Hypersensitivity to cephalosporins and β-lactamase inhibitors.
29. Brand name :- inj levotas
Generic name :- levofloxacin
Class :- quinolones
m/a :- Levofloxacin exerts antibacterial action by inhibiting bacterial
topoisomerase IV and DNA gyrase, the enzymes required for DNA
replication, transcription repair and recombination. It has in vitro
activity against a wide range of gram-negative and gram-positive
microorganisms.
Administration :-May be taken with or without food.
Adr :-Nausea, diarrhoea, constipation, headache, insomnia, inj site
reactions (IV). Ophthalmic: Transient decrease in vision, ocular
burning, ocular pain or discomfort,
c/I :- Hypersensitivity to levofloxacin or other quinolones
30. Brand name :- inj asthalin + budecort
Generic name :- budesonide
Class :- Antiasthmatic & COPD Preparations
m/a :-Budesonide controls the rate of protein synthesis, depresses the
migration of polymorphonuclear leukocytes, fibroblasts, reverses
capillary permeability and lysosomal stabilisation at the cellular level to
prevent or control inflammation.
Administration :-Should be taken with food.
Adr :- Loss of skin collagen and SC atrophy; local hypopigmentation of
deeply pigmented skin; dryness, irritation, epistaxis, rarely ulceration
or perforation of the nasal septum; smell and taste disturbances;
hoarseness and candidiasis of the mouth or throat.
c/I :-Hypersensitivity.
31. Brand name :- inj pipzar
Ganeric name :- piperacillin + tazobactam
Class :- penicillins
m/a :- Piperacillin has an antimicrobial activity against a wide range of
gm-ve organisms including K. pneumoniae, P. aeruginosa,
Enterobacteriaceae and against gm+ve organisms eg E. faecalis and
B. fragilis. Tazobactam is a penicillanic acid sulfone derivative with
beta-lactamase inhibitory properties. In combination, tazobactam
enhances the activity of piperacillin against beta-lactamase-producing
bacteria.
Administaration :-with or without food
Adr :- Diarrhoea, skin rashes, occasionally platelet mediated bleeding,
rigors, malaise, ulcerative stomatitis. Inj-site reactions such as pain
c/I : -Hypersensitivity.
32. Brand name :- syp.asthakind
Generic name :- dextromethorphan hydrochloride
Class :- Cough & Cold Preparations
m/a :- Dextromethorphan, a derivative of levorphanol, is an
antitussive agent. It has a central action on the cough center in the
medulla.
Administration :- Should be taken with food.
Adr :- Dizziness, GI disturbances.
c/I :- Patients at risk of developing resp failure. During an acute attack.
Patients receiving MAOI or for 2 wk after discontinuing them.
Persistent or chronic cough..
33. Brand name :- alerfix total
Generic name :- levocetirizine
Class :- Antihistamines & Antiallergics
m/a :-Levocetirizine, an active isomer of cetirizine, selectively inhibits
histamine H1-receptors.
Administration :- Immediate-release: May be taken with or without
food.
Adr :-Fatigue, somnolence, dry mouth, nasopharyngitis, pyrexia,
cough, epistaxis.
c/I :- End-stage renal disease
34. Brand name :- xykaa
Generic name :- diclofenac + paracetamol
Class :-Analgesics (Non-Opioid) & Antipyretics / Nonsteroidal Anti-
Inflammatory Drugs (NSAIDs)
m/a :- Diclofenac is a NSAID (NSAID). Paracetamol is an analgesic
and antipyretic. When used together, the actions of paracetamol set in
earlier and provides pain relief before the effects of diclofenac Na set
in.
Administration :- with or without food
Adr :- GI disturbances, nephrotic syndrome, epigastric pain, nausea,
vomiting, diarrhoea, hepatitis, rash, pruritus, wheezing
c/I :-Hypersensitivity, active peptic ulcer or GI bleeding, history of
allergic responses to aspirin or other NSAIDs, acute porphyria.
35. Brand name :- mahaflox
Generic name :- moxifloxacin
Class :-Quinolones
m/a :-Moxifloxacin inhibits the topoisomerase II (DNA gyrase) and
topoisomerase IV required for bacterial DNA replication, transcription,
repair and recombination.
Administration :-Should be taken on an empty stomach. Take on an
empty stomach for rapid effect. Do not take w/in 1 hr of antacids, milk
or other dairy products.
Adr :- GI disturbances, CNS effects, hypersensitivity-type reactions
c/I :-Hypersensitivity
37. GOAL OF THERAPY
GENERAL GOAL
1. To improve patients quality of life
2. To prevent from further complications
3. slow progression of disease
PATIENT SPECIFIC GOAL :-
To cure patient complain of :-
Fever
Cough
Virtigo
38. MONITORING PARAMETER
Therapeutic monitoring
1. RANITIDINE :- monitor blood pressure regularly ,and serum pottasium
levels
2. ONDECETRON :- monitor liver function test
3. Levofloxacin:- monitor for blood glucose
4. Insulin glargin :-Hypoglycemia: May result from excessive insulin dose,
increased work
5. Dextromethorphan :- monitor for frequency of coughing
6. olmesar monitor blood pressure
7. Rosuvastatin, monitor blood tests to prevent from liver failure
8. salbutamol d monitor blood sugar levels regularly because
Salbutamol may cause your blood sugar to rise.
9. Rabeprazole:- monitor patients response to drug therapy
10.Metformin :- monitor blood glucose level and renal function test
39. Toxicity minitoring
1. insulin :- Fatigue, weakness, nervousness, confusion, headache,
diplopia, convulsions, psychoses, dizziness, unconsciousness, rapid or
shallow respiration, numb or tingling mouth, hunger, nausea, skin
pallor, moist or dry skin
2. Dextromethorphan :-dizziness,nausea
3. Rabeprazole :-check wether treatment Is supportive and symptomatic
4. Metformin :- observe for lactic acidosis
41. Points to patient
Diease related :-
Hypertension :- hypertension is a diagnosis given by a
doctor to a patient with long term increase of blood
pressure…it can be fatal and can create complications if
not treated
Diabetes :- diabetes is a disease in which the body isn't
utilizing the glucose or sugar we eat. This causes the sugar
to build up in the blood. If not treated can cause heart
disease, blindness, kidney failure, and poor circulation of
the lower extremities which leads to amputations.
Community acquired pneumonia :- Pneumonia is an
infection of the lungs that can cause mild to severe illness
42. Points to patient
1. RANITIDINE :- tell patient to report signs and symptoms of
angioedema immediately , swelling of eyes , lips or tongue
2. Ondecetron :-tell to report if hypotension or chest pain occurs
3. Levofloxacin :- adviced patient to take drug with plenty of fluids
4. Insulin :-Tell patient not to change brand, strength, type, or
dose without physician's knowledge.
5. Olmesartan must be taken regularly for it to work well.
Continue taking Olmesartan even when you feel better.
6. Rosuvastatin should not be taken at the same time as antacids
, antacids, take it at least 2 hours after you have taken
Rosuvastatin.
7. salbutamol Continue taking even when you feel better.
Stopping it may worsen the condition
8. Rabeprazole :-tablet should not be crushed or chewd.
9. Metformn :- not to change drug dose without medical approval
43. Lifestyle modification
Take pineapple juice
Eat more green vegetables
Avoid food rich in fat and energy
Limit salt intake to 1-2g /day
limit exposure to cigarette smoke
Wash your hands after and before the meal
Do exercise for 30 min every day.