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PROJECT

IN
CLINICAL PHARMACY
“Case Study”
Submitted by:
Alduheza, Shynne B.
Villoria, Christy Grace
Submitted to:
Mae Quenie A. Tiro, RPh.

January 2015

severe anemia. Clinical Manifestations: A. Isolated hypoxemia (i. in turn leading to a heart attack (Heart attacks caused by just artery narrowing are rare).e. the most important form of IHD. Angina pectoris. Chronic IHD with heart failure. Most ischaemic heart disease is caused by atherosclerosis. .ISCHAEMIC HEART DISEASE Rationale Ischemic Heart Disease (IHD) belongs to a group of cardiovascular diseases known as Coronary Artery Disease. It is usually felt as angina. or advanced lung disease is less deleterious than ischemia because perfusion (including metabolic substrate delivery and waste removal) is maintained. Of the three variants—stable angina. diminished transport of oxygen by the blood) induced by cyanotic congenital heart disease. but also reduced availability of nutrient substrates and inadequate removal of metabolites. C. and unstable angina—the latter is the most threatening as a frequent harbinger of MI. in which the duration and severity of ischemia is sufficient to cause death of heart muscle. usually present even when the artery lumens appear normal by angiography. especially if a large area is affected. Prinzmetal angina. Background Ischemic Heart Disease is characterized by reduced blood supply to the heart. CAD remains to be a major health problem in western countries and the rest of the world despite the advances in medicine. Ischemic heart disease (IHD) is the generic designation for a group of closely related syndromes resulting from myocardial ischemia—an imbalance between the supply (perfusion) and demand of the heart for oxygenated blood. so a blockage in the coronary arteries reduces the supply of blood to heart muscle. Myocardial infarction (MI).The coronary arteries supply blood to the heart muscle and no alternative blood supply exists.. Initially there is sudden severe narrowing or closure of either the large coronary arteries and/or of coronary artery end branches by debris showering downstream in the flowing blood. B. The reasons for this are multifactorial and are due to the advancing age of the population. It comprises not only insufficiency of oxygen. A heart attack causes damage to heart muscle by cutting off its blood supply. in which the ischemia is less severe and does not cause death of cardiac muscle. Ischaemia means a "reduced blood supply". The narrowing or closure is predominantly caused by the covering of atheromatous plaques within the wall of the artery rupturing.

Ecocef II. Drug Generic Name: Cefuroxime Chemical/ IUPAC Name: (6R.bactericidal . Mechanism of Action .has good stability against bacterial beta-lactamase and active against many ampicillin-resistant or amoxicillin-resistant strains . Cimex. Oral. Epidemiology Pathogenesiss CEFUROXIME I.antibacterial agent .broad spectrum .second generation cephalosporin .D. Sudden cardiac death.2. Parenteral.Zinacef (GSK).0]oct-2-ene-2-carboxylic acid.a well-characterised and effective antibacterial agent which has bactericidal activity against a wide range of common pathogens .good stability against bacterial beta-lactamase III. C16H16N4O8S Brand Name: a.Zinnat (GSK). Chemistry and Stability Pharmacology . Axet (Microlabs).7R)-3-{[(aminocarbonyl)oxy]methyl}-7-{[(2Z)-2-(2-furyl)-2-(methoxyimino) acetyl]amino}-8-oxo-5-thia-1-azabicyclo[4. Kefox. Zoltax. Panaxim b.inhibit bacterial cell wall synthesis Spectrum . Profurex.

cerviciti . Psedomonas. urticaria. tonsilitis. nausea.excreted by glomerular filtration and tubular secretion .aerobe gram-negative. cystitis. Enterococcus. Proteus vulgaris. Distribution ..upper respiratory tract infections: ENT infections. .rapidly hydrolysed in the intestinal mucosa and blood to release cefuroxime into the circulation .genito-urinary tract infections: pyelonephritis.lower respiratory tract infections: pneumonia.gonorrhea.SGOT. urethritis . acute bronchitis . Absorption .skin ans soft tissue infections: impetigo.distributed throughout the extracellular fluid C.optimum absorption: after meals .LDH) .not metabolised . pruritus.bioavailability: 37% (empty stomach). Elimination/Excretion . Legionella. vomitting . Pharmacokinetics A. etc. 52% (with food) B.Lyme disease VI. aerobe gram-positive.Infections: Overgrowth of Candida .33-50% bound to proteins .Hepatobiliary Disorders: transient increase of liver enzymes (SGPT. increased erythrocyte sedimentation rate .excreted unchanged in urine 66-100% approximately 50% of the administered dose is recovered in the urine within 12 hours V. furunculosis. sinusitis .Nervous System: headache.half-life: 80 minutes . Adverse Drug Events . dizziness .slowly absorbed from the gastrointestinal tract . otitis media. IV. erythema multiforme. positive coomb’s test. Caution A. abdominal pain.Gastrointestinal Disorders: diarrhea. Camphylobacter. Uses . acute uncomplicated gonococcal urethritis.Clostridium difficile. anaerobe . Listeria monocytogenes. Enterobacter.Others: skin rashes. pyoderma . MRSA.Blood and Lymphatic Disorders: eosinophilia. pharyngitits.

administered with caution during early months of pregnancy .no experience of using in children under 3 years of age E.ferricyanide test: false negative result VII. parenteral administration of treatment must be continued D.may cause dizziness: caution among those who would drive and operate machinery . Pregnancy . Pediatric .oral suspension may be used .drugs that reduce gastric acidity: lower bioavailability of Cefuroxime .low toxicity H. Contraindications . Drug Interactions .200 mg/kg/day (14 times the recommended maximum human dose based on mg/m2) and in rats at doses up to 1.no evidence of impaired fertility or harm to the fetus due to cefuroxime .excreted in human milk: discontinue in nursing mothers . Pharmaceutical Dosage Form . A. hepatitis B.should be used when needed F. powder for suspension.hypersensitivity to cephalosporins C.000 mg/kg/day (9 times the recommended maximum human dose based on mg/m2) .tablet. parenteral .anticoagulants: risk of increased side effects by cefuroxime .aminoglycosides and diuretics: renal toxicity . Chronic Toxicity .low toxicity G.reproduction studies have been performed in mice at doses up to 3.pregnancy category B .oral contraceptives: lower estrogen absorption and reduce efficacy of oral contraceptives .jaundice.tablets should not be crushed and unsutiable for children . Acute Toxicity . Warnings and Precautions .if there is no improvement within 72 hours.no experimental evidence of embryopathic or teratogenic effect .

use it as soon as possible. Title: B. Phase: I C. Administration . IM E. D. Clinical Studies Done A. If it is almost time for your next dose. Methodology: D.Tablet: not exceeding 30C and protect from light . IV. Rationale: E.250 mg and 750 mg vial F. Preparation .If you miss a dose of cefuroxime. . refrigerated immediately from 2-8C kept up to 10 days (reconstituted) .Parenteral: 24 hours VII. Results: . skip the missed dose and go back to your regular dosing schedule. Storage Conditions .250 mg and 500 mg tablet .Skipping doses or not completing the full course of therapy may decrease the effectiveness of the immediate treatment and increase the likelihood that bacteria will develop resistance and will not be treatable. Dosage .125/5 and 250/5 powder for suspension .with food C.B. Missed Dose .7-day treatment .Suspension: not exceeding 30C (unreconstituted). Do not use 2 doses at once.oral.

PATIENT PROFILE .