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    Cad Presentation 2

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    afrahahussain

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    Cad Presentation 2

    Uploaded by

    afrahahussain
    16 views10 pages

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    16 views10 pages

    Cad Presentation 2

    Uploaded by

    afrahahussain

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    © All Rights Reserved
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    CASE PRESENTATION

    CORONARY ARTERY DISEASE

    SUBMITTED TO SUBMITTED BY
    DR. MOHAMMED AWEZ ALI HAMEEDA NIKHATH
    DEPT OF PHARMACOTHERAPEUTICS-II 20111T0002
    SHADAN COLLEGE OF PHARMACY PHARM D 3 RD YEAR
    SHADAN COLLEGE OF PHARMACY
    SOAP ANALYSIS
    SUBJECTIVE DATA
    CHIEF COMPLAINTS: c/o slurring of speech and deviation of mouth to left side since
    2 days.
    HISTORY OF PRESENT ILLNESS: Patients has weakness in right side as well. Started
    apparently 2 days ago and gradually became severe.
    HISTORY OF PAST ILLNESS: No known case of hypertension,thyroid,DM.etc.,
    HISTORY OF MEDICATION: Not significant
    OCCUPATIONAL ADDICTIONS AND SOCIAL HISTORY: Not significant
    PERSONAL HABITS:
    • Diet: Mixed Sleep: Adequate
    • Appetite: Normal Bowel &Bladder: Regular
    ADDICTIONS: None.

    OBJECTIVE DATA
    PHYSICAL EXAMINATION :
    DAYS PULSE BP RESPIRATORY TEMPERATURE
    RATE RATE (SPo2)

    Day- 1 92 bpm 110/79mmhg 97% Afebrile

    Day-2 70bpm 120/80mmhg 95% Afebrile

    Day -3 86bpm 130/90mmhg 98% Afebrile

    SYSTEMIC EXAMINATION : CVS – S1 S2 -


    CNS – NAD
    RS - BLAE +
    Wheezing+
    P/A - SOFT
    PICKLE- Negative
    LABORATORY INVESTIGATIONS:
    Parameter Normal Range Observed value
    Hematology
    RBC count 4.3-5.9×1012/L 4.1×1012/L
    Haemoglobin 14-18 g/dL 11.7g/dL
    T.WBC 4-11×10⁹/L 7000
    Neutrophils 40-70% 64%
    Lymphocytes 20-40% 22%
    Monocytes 0-11% 02%
    Esinophills 0-8% 12%
    Platelet count 150-450×10⁹/L 1.9L
    Serum Electrolytes
    Na+ 135-145mEq/L 141.1mEq/L
    K+ 3.5-5mEq/L 3.1mEq/L
    Cl- 95-105mEq/L 103.6mEq/L
    Ca-total 8.5-10.5mEq/L 9.9 mEq/L
    Renal function test
    S.Cr 0.6- 1.2mg/L 1.1mg/L
    BUN 8-20mg/L 22.9mg/L
    Liver function test
    AST 0-35Units /L 40.2Units/L
    ALT 0-35Units /L 38.9Units/L
    ALP 30-120 Units/L 54.2Units/L
    Bilirubin(Total) 0.1-1mg/dL 0.5mg/dL
    Bilirubin(Direct) 0-0.2mg/dL 0.2mg/dL
    OTHER INVESTIGATIONS :
    • ECG
    • CT-brain

    ASSESSMENT
    Based on subjective and objective data, patient has been diagnosed with Coronary artery disease.
    PLAN
    STANDARD TREATMENT
    ▪ Administration of statins such as atorvastatin is agent of choice in these type of disease.
    ▪ Beta blockers are the first-line antihypertensive drugs for patients with CAD. If
    necessary, certain calcium channel blockers can be added to or substituted for beta
    blockers.
    ▪ Proton pump inhibitors are advised to reduce stomach acid.
    ▪ Antiemetic agents used to prevent nausea and vomiting associated with any kind
    of medication.
    ▪ Antibiotics are given for the treatment of any bacterial infection.
    ▪ Vitamin supplements are given to maintain vitamin levels in the body.
    TREATMENT GIVEN IN HOSPITAL
    BRAND NAME GENERIC NAME DOSE ROA FREQUENCY

    INJ Optineurin Calcium 100mg IV OD


    Pantothenate
    INJ PAN Pantoprazole 40mg IV OD

    INJ Zofer Ondansetron 4mg IV OD

    Tab Ecospirin Atorvastatin 150mg PO OD (morning)

    Tab Shelcal Calcium Carbonate 1 Tab PO OD

    Tab MVT Multivitamin 1 Tab PO OD

    Tab Atorvas Atorvastatin 40mg PO OD( night)

    INJ Monocef Ceftriaxone 1gm IV OD

    Tab Minipress Prazosin 1mg PO BD


    Hydrochloride
    PHYSIOTHERAP
    Y
    PATIENT COUNSELLING
    ABOUT THE DISEASE
    • Coronary Artery Disease is a condition that reduces the flow of blood to heart
    • It happens when arteries that supply blood become narrowed and hardened due to build up of
    Plaque
    • Symptoms are : Angina, Shortness of breath, Heart attack

    ABOUT THE MEDICATION


    • The Medication are to be followed as directed by Physician
    • Tab ECOSPIRIN (75mg) is to be taken in the morning after breakfast orally for 1 month
    • Tab MVT is to be taken anytime in a day that is only once a day after meals orally for 1 month
    • Tab PAN (40mg) is to be taken on an empty stomach before breakfast orally for 1 month
    • Tab MINIPRESS (1mg) is to be taken in the morning and night after meals for 1 month
    • Tab TELMA (40/25mg) is to be taken in the morning after breakfast for 1 month
    LIFESTYLE MODIFICATION :
    • Avoid alcohol and smoking.
    • Avoid fried foods, oily sauces, vegetable oil, butter, full fat dairy products etc.
    • Diet must consist of vegetables, fruits, whole grains, beans, legumes etc.
    • Increasing fruits and vegetables can help reduce risk of CAD.
    • Exercise regularly and maintain healthy weight.
    MONITORING PARAMETERS:
    Blood pressure, blood cholesterol levels , blood glucose levels are to be monitored strictly

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