COLLEGE OF NURSING PHARMACY AND ALLIED HEALTH SCIENCES

Name:Cheza May B. Baldado

Year and Section: BS Pharmacy III - A

Subject PHARM 309 CLINICAL PHARMACY II

Title Acute Pancreatitis
Activity No No. 1
Introduction Acute pancreatitis (AP) is an inflammatory disorder of the pancreas
characterized by severe pain in the upper abdomen and increased serum
concentrations of pancreatic lipase and amylase.
Pancreatitis is split into acute and chronic types.
The pancreas carries out many tasks, including the production of digestive
enzymes. Symptoms include pain in the center of the upper abdomen,
vomiting, and diarrhea. The most common causes of acute pancreatitis are
gallstones and alcohol abuse. Acute pancreatitis starts suddenly, but chronic
pancreatitis is recurring or persistent.

Objective(s) At the end of the activity, the student should be able to:
1. Understand the pathophysiology of acute pancreatitis, its causes and
management
2. Identify diagnostic results related to the progression of the disease
3. Demonstrate effective clinical decision-making

Materials Book/Internet source.

and
Equipment

Procedure/ 1. Create a concept map for Mr. Jones based on the template. You can also
Instruction make your own template.

Discussion Bill Jones is a 48-year-old man who presents to the ED shortly after
midnight on a Friday night because of intense mid-epigastric pain radiating
to his back. He states that the pain started shortly after dinner the night
before but has progressively worsened, and he began vomiting around
midnight tonight. His past medical history states that he had alcohol
withdrawal seizures 8 months ago during which he suffered a small subdural
hematoma. He takes Valproic acid 250 mg twice daily since his seizure and
Advil 200 mg OTC several doses per day PRN for the management of his
pain.

Mr. Bill is employed as a groundskeeper at a golf course. He denies any

smoking and states that he used to consume six beers per day until 8 months
ago when he had a withdrawal seizure but now drinks only on weekends a
total of about six beers; he reports sharing a couple of pitchers with two
friends last night with dinner. Drinks at least two cups of coffee each
morning.

Physical assessment findings include: BP 98/55, P 122, RR 30, T 38.9°C;

Wt 89 kg, Ht 5'10''. Pain is elicited on light palpation of left upper and mid-
epigastric region.
 COLLEGE OF NURSING PHARMACY AND ALLIED HEALTH SCIENCES

Significant Laboratory Findings

TEST RESULT REFERENCE RANGE
ELECTROLYTE PANEL
Glucose 375 mg/dL <140 mg/Dl
Sodium 128 mEq/L 135-148 mEq/L
Potassium 3.4 mEq/L 3.5-5.0 mEq/L
Carbon Dioxide 18 mEq/L 20-24 mEq/L
LIVER FUNCTION
Total bilirubin 0.6 mg/dL 1 mg/dl
Albumin 3.2 mg/dL 3.5-5.0 g/dl
AST 342 U/L 10-40 u/l
ALT 166 U/L 7-56 u/l
Alk Phos 285 U/L 100-320 u/l
KIDNEY FUNCTION
BUN 35 mg/dL 7-2 mg/dl
Serum Creatinine 1.5 mg/dL 0.3-0.7 mg/dl
MINERALS
Calcium 7.2 mg/dL 8.0-10.5 mg/dl
Phosphatase 2.2 mg/dL 3.4 to 4.5 mg/dl
OTHERS
Amylase 1,555 IU/L 30 to 110 U/L
Lipase 2,220 IU/L 10 to 140 U/L

BAC (blood alcohol conc) 4 mg/dL Legally intoxicated: .08 %

(0.04%)
CBC
Lymphocyte 20% 25.0-35.0%
Monocyte 2% 4.0-9.0%
Neutrophils 72 55.0-65.0%
Eosinophil 1 0-7%
Basophil 1 0-2%
Lymphocyte 20% 25.0-35.0%
Hemoglobin 17 g/dL 12.0-16.5 g/dL
aPTT 19.3 sec 25-36 seconds
FASTING LIPID PROFILE
Triglycerides 982 mg/dL 31-108 mg/dL
Repeated Triglyceride 1,010 mg/dL 31-108 mg/dL
ARTERIAL BLOOD GAS
pH 7.31 7.35 - 7.45
HCO3 – 17 mEq/L 22-26 meq/L
URINALYSIS
p.H 7.2 5-9
Glucose >1,000 mg/dL 60-105 mg/dL
 COLLEGE OF NURSING PHARMACY AND ALLIED HEALTH SCIENCES

BRIEF PATHOPHYSIOLOGY CAUSES

Pancreatic inflammation caused Gallstones, followed by
by auto-digestion; reversible prolonged alcohol abuse, are the
pancreatic damage. leading causes of acute
pancreatitis.

ACUTE PANCREATITIS
is a pancreatic inflammatory condition
marked by intense discomfort in the
upper abdomen.

MANAGEMENT
IMPORTANT DIAGNOSTIC  Antibiotics, pain
MARKERS INDICATIVE OF
management, and
ACUTE PANCREATITIS vigorous IV fluid
resuscitation
Increased serum concentrations  Food restriction
of amylase and lipase levels
 Avoid consuming
alcohol.

**Adapted and modified from Chegg Study’s Expert Q&A Rheumatoid Arthritis

Reference(s):
Brazier, Y. (2017). All About Acute Pancreatitis. Retrieved from
https://www.medicalnewstoday.com/articles/160427

Chegg Study. (n.d.). Concept Map for Rheumatoid Arthritis. Retrieved from
https://www.chegg.com/homework-help/questions-and-answers/questions-1-
build-concept-map-ms-james-based-template-q50780070