38. Tolentino, Michelle S.

1.) Px C.H. a 58 y/o male patient complains of recurrent head ache and easy fatigability, Upon consultation, BP readings are as follows:
160/90, 170/90 and 160/85. He is presently diagnosed Stage II Hypertension and was given Losartan 50mg tab ODHS and Bisoprolol
2.5mg tab OD as his take home medications.
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Px C.H. patient complains of recurrent head ache and easy fatigability

Age: 58
BP-160/90
170/90
160/85
Medication List: Losartan 50mg tab ODHS, Bisoprolol 2.5mg tab OD
A
There is a therapeutic duplication in the regimen because both Bisoprolol and Losartan are Antihyertensive drugs which
can alleviate side effects like hypotension
P
Consult the physician about the matter and suggest to omit one of the drugs
2.) Px F.A a 3 y/o female (wt: 14 kgs) was brought to USTH ERCD for consult due to diarrhea with blood streaked stools. Fecalysis showed
Browncolored stool of water consistency and RBC +, pus cell 100/hpf. Trimethoprim+Sulfamethoxazole 200mg/40mg/5ml (1 tsp) q12h was
prescribed and Zinc supplementation was initiated. However px FA was found to be G6PD deficient based on history noted.
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O

A
P

Patient has a diarrhea accompanied with blood steaked stools

Age:
Fecalysis- brown colored stool of water consistency
(+) RBC
With pus cell 100/hpf
Medication List: Trimethoprim+Sulfamethoxazole 200mg/40mg/5ml (1 tsp) q12h
Zinc supplementation
Trimethoprim+Sulfamethoxazole is contraindicated with patients with G6PD deficiency because it causes hemolytic anemia
Call the attention of the physician to switch the it to another antibiotic because the one prescribed is contraindicated to the patient

3. Px G.D. a 17 y/o female was rushed to the emergency due to loss of consciousness, CBC results were as follows: Hgb = 5.1 , RBC = 2.38 ,
HCT = 0.16 , MCV= 65.30 , MCH = 21.5 . Physician immediately ordered 2 units PRBC for transfusion
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Px G.D female was rushed to the emergency due to loss of consciousness

Age: 17 yrs
CBC : Hgb = 5.1 , RBC = 2.38 , HCT = 0.16 , MCV= 65.30 , MCH = 21.5
The physician ordered only 2 prbcs(packed red blood cells). 1 prbc could raise the hemoglobin levels by 1 g/dL. Patient only has Hgb
value of 5.1g/dL which is very low compared to the female normal value of hgb which is 12-15g/dL. Patient would need about 7 to 10 prbcs
Inquire to the physician if he could increase the prbc to be delivered for transfusion to compromise the quantity that the patient is needing