CHN 113 - Section 2

Republic of the Philippines
Biliran Province State University

(formerly NAVAL STATE UNIVERSITY)
ISO 9001:2015 CERTIFIED
School of Nursing and Health Sciences
Name: Ivy Jane N. Nierves Year Level: III Date: ___________ Grade: __________
SECTION 2
ASSIGNMENT NO.2
Understand the scenario and answer the questions.
Mr. Cruz is a 39-year-old gentleman initially presented to a community health center with widespread skin lesions on the face,
torso and the triceps aspect of the right arm. He was referred the neighbouring district hospital with allergies. The lesions were
long standing and had evolved relatively slowly. He was otherwise well although concerned about patches of anaesthetic skin
on his face and on the soles of his feet. He denied any past medical history although his blood pressure was incidentally raised
at 150/93 mmHg. He smokes occasionally and drank moderate amounts of alcohol. On examination, Mr. Cruz had widespread
skin nodules and scaly plaques with characteristically thick dermis on his cheeks and feet. He had thick facial nodules and there
was evidence of eyebrow loss; symptoms consistent with early leonine facies. This appearance and the description of lesion
anaesthesia and peripheral neuropathy were highly suggestive of lepromatous disease. He also had a slight discomfort in his
right upper quadrant and mild testicular tenderness and swelling. Due to limited resources, the only suitable laboratory
investigations available were a full blood count and urea and electrolytes. The only abnormality was a mildly raised white cell
count (12x109 /L). Mr. Cruz has clinical diagnosis of Leprosy as defined by the WHO standard diagnostic criteria.
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Consequently, he was referred to a central hospital for treatment with multidrug chemotherapy.(100 mg Dapsone, 50 mg
Clofazimine and 600 mg Rifampicin for 12 months).
QUESTIONS:
1. What are signs and symptoms supports the diagnosis of leprosy?
• Lepromatous – multiple lesions, Loss of lateral portion of eyebrows (madarosis), corrugated skin (leonine facies), septal
collapse (saddle nose)
• Skin Lesion – Hyopigmented, No sensation, Macules or plaques, No hair, Annular shape, No sweating
• Facial skin thickening - Loss of nasal septum
• Early/Indeterminate – hypopigmented / hyperpigmented anesthetic macules/plaques
• Tuberculoid – solitary hypopigmented hypesthetic macule, neuritic pain, contractures of hand and foot, ulcers, eye involvement
example: keratitis.
2. What possible confirmatory tests needs to be conducted to the patient?
- Skin lesion biopsy (acid fast staning)
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- Lepromin test
- Skin smear test
- Serology
- PCR (DNA)
3. What are available community health programs available to Mr. Cruz?
- MDT-RA 4073 (home meds) - National Leprosy Control Program This program has made effective antibiotics available for
decades. For this reason, leprosy patients do not have to be segregated in a special hospital because medicine can be taken at
home.
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4. Make a Drug Therapeutic Record of the drugs given to Mr. Cruz.
DRUG THERAPEAUTIC RECORD
Hospital: ____________________________________________ Ward: _________________________________

Hospital No: _______________________________
Name of Patient: _____________________________________ Age: __________________________________
Sex: ______________________________________
Address: ____________________________________________ Date of Admission: ______________________
Physician/(s): ______________________________
Chief Complaint/(s): ___________________________________ Diagnosis:
________________________________________________________________________________
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DRUG CLASSIFICATION INDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES
Avlosulfon Antibacterial  Treatment of  Reticulocyte  Determine periodic dapsone

leprosy (due to increase
Brand Name Therapeutic Classification  blood levels.
susceptible
 hemolysis
strains of
Dapsone Mycobacterium  hemoglobin

 Perform liver function tests in patients
leprae) and decreases
diaminodiphenyl sulfone who complain of malaise, fever, chills,
dermatitis
 methemoglobine anorexia, nausea, vomiting, and have
herpetiformis
mia jaundice.
Generic Name Drug Classification
 Tachycardia
 Fever  Dapsone therapy is usually suspended

100 mg  Prophylaxis of until etiology is identified.
 Headache
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Category C
Dose Pregnancy Category
OD
Frequency
toxoplasmosis  Phototoxicity
in severely-
 Abdominal pain  Monitor severity of anemia.
immunocompr
omised  Nausea
Orally
patients;
 Pancreatitis
Route of Mechanism of Action alternative
Administration agent for  vomiting.
Pneumocystis
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DRUG THERAPEUTIC RECORD
Hospital: ____________________________________________ Ward: _________________________________

Hospital No: _______________________________
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Sex: ______________________________________
Physician/(s): ______________________________
________________________________________________________________________________
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DRUG CLASSIFICATION INDICATION ADVERSE EFFECT

Gastrointestinal: Abdominal and epigastric pain, diarrhea,
Lamprene antimycobacterial Lepromatous leprosy, nausea, vomiting, GI intolerance
Brand Name Therapeutic Classification including dapsone- Ichthyosis and dry skin.
resistant
lepromatous leprosy, and Rash and pruritus
Clofazimine
bright-red Dapsone-sensitive Ocular: Conjunctival and corneal pigmentation due to crystal
iminophenazine
multibacillary leprosy deposits, dryness, burning, itching, irritation
dye
Discoloration of urine, feces, sputum, sweat
Generic Name Drug Classification
Increased blood glucose Increased ESR
Skin: Phototoxicity, erythroderma, acneiform eruptions, monilial

50 mg Category C
cheilosis
Dose Pregnancy Category
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OD Clofazimine works by
binding to the guanine bases
Frequency of bacterial DNA, thereby
blocking the template
function of the DNA and
Orally inhibiting bacterial
Body fluid discoloration and other skin reactions
proliferation.
Gastrointestinal: Bowel obstruction, GI bleeding, anorexia,
Route of Mechanism of Action
constipation, weight loss, hepatitis, jaundice, eosinophilic
Administration
enteritis, enlarged liver
Ocular: Diminished vision
Nervous: Dizziness, drowsiness, fatigue, headache, giddiness,
neuralgia, taste disorder
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DRUG THERAPEUTIC RECORD
Hospital: ____________________________________________ Ward: _________________________________

Hospital No: _______________________________
Sex: ______________________________________
Physician/(s): ______________________________
________________________________________________________________________________
DRUG CLASSIFICATION INDICATION ADVERSE EFFECT

CNS: Ataxia, behavioral changes, chills,
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Rimactane Antimycobacterial  As adjunct to treat confusion, difficulty concentrating,

Antitubercular tuberculosis caused by all dizziness, drowsiness, fatigue, fever,
strains of mycobacterium generalized numbness, headache,
paresthesia, psychoses
 To eliminate meningococci CV: Hypotension, myopathy, vasculitis
from nasopharynx of EENT: Conjunctivitis, discolored saliva,
asymptomatic carriers of tears, and sputum; mouth or tongue
Neisseria meningitidis soreness; periorbital edema
ENDO: Adrenal insufficiency, blood
glucose alterations (patients with diabetes),
visual disturbances
discolored feces, elevated liver function test
results, epigastric discomfort, flatulence,
heartburn, hepatitis, nausea,
pseudomembranous colitis, vomiting
GU: Acute renal failure or tubular necrosis,
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discolored urine, elevated BUN and serum

uric acid, hematuria, interstitial nephritis,
menstrual disturbances, renal insufficiency
HEME: Agranulocytosis, decreased
hemoglobin, disseminated intravascular
coagulation, eosinophilia, hemolytic
anemia, leukopenia
MS: Arthralgia, extremity pain, muscle
weakness, myalgia
RESP: Shortness of breath, wheezing
SKIN: Discolored skin and sweat,erythema
multiforme, flushing, pemphigoid reaction,
pruritus, rash, Stevens-Johnson syndrome, toxic epiderm
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CHN 113 - Section 2

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CHN 113 - Section 2

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Republic of the Philippines

Biliran Province State University

Understand the scenario and answer the questions.

Biliran Province State University

1. What are signs and symptoms supports the diagnosis of leprosy?

2. What possible confirmatory tests needs to be conducted to the patient?

- Skin lesion biopsy (acid fast staning)

Biliran Province State University

3. What are available community health programs available to Mr. Cruz?

Biliran Province State University

4. Make a Drug Therapeutic Record of the drugs given to Mr. Cruz.

DRUG THERAPEAUTIC RECORD

Hospital: ____________________________________________ Ward: _________________________________

Biliran Province State University

DRUG CLASSIFICATION INDICATION ADVERSE EFFECT NURSING RESPONSIBILITIES

Avlosulfon Antibacterial  Treatment of  Reticulocyte  Determine periodic dapsone

Dapsone Mycobacterium  hemoglobin

 Fever  Dapsone therapy is usually suspended

Biliran Province State University

Dose Pregnancy Category

Biliran Province State University

DRUG THERAPEUTIC RECORD

Hospital: ____________________________________________ Ward: _________________________________

Biliran Province State University

Name of Patient: _____________________________________ Age: __________________________________

Biliran Province State University

DRUG CLASSIFICATION INDICATION ADVERSE EFFECT

Skin: Phototoxicity, erythroderma, acneiform eruptions, monilial

Biliran Province State University

Biliran Province State University

DRUG THERAPEUTIC RECORD

Hospital: ____________________________________________ Ward: _________________________________

DRUG CLASSIFICATION INDICATION ADVERSE EFFECT

Biliran Province State University

Rimactane Antimycobacterial  As adjunct to treat confusion, difficulty concentrating,

Biliran Province State University

discolored urine, elevated BUN and serum

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Name of Patient: ___ Age:

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