an case discussion on the topic UTI

1. URINARY TRACT INFECTION
NAME: JOSHUA GEORGE
CLASS: 3RD PHARMD

2. DEMOGRAPHIC DETAILS
• NAME: xyz
• AGE: 64yrs
• SEX: female
• WARD: Nephrology
• REASON FOR ADMISSION: C/O fever with chills, burning micturition,
pain in abdomen{these complaints was there from 5-6days}, vomiting
{since 4 days}, decrease In appetite{since 5 days}

3. VITAL SIGNS
DATE 13/2/21 14/2/21 15/2/21 16/2/21
TEMP (°F) 99 98.5 98.5 98.5
BP (mmHg) 130/70 120/60 120/60 120/60
PULSE RATE (BPM) 90 90 90 90
RESP. RATE 22 22 22 22

4. LABORATORY INVESTGATION
TEST TEST VALUE NORMAL VALUE
CRP >320mg/dl <10mg/dl
FBS 100mg/dl <100mg/dl
SERUM CREATININE 1.30 mg/dl 0.8-1.2mg/dl
SPECIFIC GRAVITY 1.005 1.002-1.003
PUS CELLS 6-8/hpf 0-2hpf
SERUM SODIUM 133mmol/l 135-145mmol/l
SERUM CHLORINE 95mmol/l 96-106mmol/l
SERUM CALCIUM 8.9mg/dl 8-10mg/dl
MAGNESIUM 2.4mg/dl 1.7-2.2mg/dl
BUN 9mmol/l 2.5-7.1mmol/l
RBC 10-12/hpf 0-3/hpf
EPITHELIAL CELL 3-4/hpf 2-3/hpf

5. OTHER INVESTIGATION
• ULTRA SOUND ABDOMEN AND PELVIS: Moderate fatty infiltration of
liver
• URINE APPEARANCE: Slight turbid, proteinuria, glycosuria,
haematuria

6. DIAGNOSIS
• URINARY TRACT INFECTION{UTI}

7. TREATMENT GOAL
• Eradicate the infection
• prevent urosepsis
• reduce the likelihood of renal damage

8. PHARMACOLOGICAL TREATMENT
S.NO PRESCRIBED DRUGS DOSE, ROA DATES OF TREATMENT
T.NAME GENERIC NAME
INJ.PIPTAZ PIPERCILLIN+TAZOBA
CTOM
4.5g (IV)
TAB.SILODAL SILODOSIL 6mg/PO (0-0-1)
TAB.DOMSTAL DOMPERIDONE 10mg/PO(1-0-1)
TAB.BUSCOPAN HYOSINE BUTYL
BROMIDE
10mg/PO(1-0-1)
INJ.PARACETAMOL ACETAMINOPHEN 1g (IV) (1-0-1)
INJ.PANTOPRAZOL PANTOPRAZOL
✔ ✔ ✔
✔ ✔ ✔
✔ ✔ ✔
✔ ✔
✔ ✔ ✔ ✔
✔ ✔ ✔ ✔
13/2/21 14/2/21 15/2/21 16/2/21
1.
2.
3.
4.
5.
6. 40mg(IV) (1-0-0)

9. ADVERSE EFFECTS
• PIPTAZ: rash, pururitis, constipation,headache,diarrhea,
nausea,vomiting
• SILODAL: orthostatic hypotension, dizziness, headache,nasal
congestion
• DOMSTAL: dizziness, headache
• BUSCOPAN: constipation,dry mouth,blurred vision, increased HR
• PCM: constipation,liver failure,pruritis
• PANTOP: abdominal pain, diarrhea, headache, gastritis,
thrombocytopenia

10. PATIENT COUNSELLING
• We should ask them to wipe from front to back after urinating or a
bowel movement.
• Using hygienic garments
• They should drink plenty of fluids.
• Regular follow up with RFT.
• Educate the patient about the importance of Medication adherence
especially the antibiotic regimen.

11. PHARMACIST INTERVENTION
• Urine culture test has to be conducted ( to check for causative
organism is Gram +ve or Gram –ve)
• Treatment with Narrow spectrum antibiotics
• HBA1C to be ordered and addition of oral hypoglycaemic agent