BACHELOR OF OCCUPATIONAL THERAPY (Hons.

)
FACULTY OF HEALTH SCIENCES
UNIVERSITI TEKNOLOGI MARA (UiTM)

UPH 654:
KNOW YOUR MEDICINE

CASE STUDY
.

NAME : NUR FATIHAH BINTI KAMAL

STUDENT ID : 2020869852

GROUP : HS2454C

FACULTY : HEALTH SCIENCES

LECTURER : NUR SABIHA BINTI MD HUSSIN

1.0 BACKGROUND

Mr K is a 47-year-old male of Malay ethnicity. He lives in Shah Alam, Selangor, with

his wife and four children - two boys and two girls. He is a primary school teacher. He has no

history of alcohol or smoking use. Before the onset of his condition, Mr K had a more active

lifestyle. He participates in more vigorous sports such as badminton, which he played weekly

and usually joined tournaments. After the onset, he changes the sports activity to a less active

sports, which is cycling. He has a BMI of 26.8 (overweight).

Mr K has a family history of diabetes and high blood pressure from his mother’s side.

While from his father’s side had a history of asthma, to which 4 of his siblings has the condition.

NAME Mr K

AGE 47 years old

BMI (WEIGHT/HEIGHT) 26.8 (75.25kg/167.6cm)

SOCIAL HISTORY Race: Malay

Religion: Islam

Occupation: Primary School Teacher

Marital Status: Married

Number of children: 4 (2 sons, 2 daughters)

Smoking/Tobacco use: No

Alcohol use: No
 PAST MEDICAL CONDITION Wolff-Parkinson-White (WPW) Syndrome

PAST MEDICATION 1. T. Pantoprazole 40m/g od

2. SL GTN PRN
3. T. Vastarel 20 mg TDS
4. T. Perindopril 2 mg od
5. T. Aspirin 150 mg od
6. T. Plavix 75 mg od
7. T. Atorvastatin 40 mg on

CURRENT MEDICAL CONDITION Atrial Flutter

CURRENT MEDICATION 1. Bisoprolol Fumarate 5 mg od

2. Flecainide Tablets 100 mg

Mr K was first diagnosed with unstable angina with Wolff-Parkinson- White (WPW)

TRO LMS and hypertrophic cardiomyopathy in January 2020 at the age of 46 years old. He

had experienced an abnormal increase in heart palpitation even during resting. To which he

went to Hospital Shah Alam ED for a check-up. The doctor had prescribed him several

medications for anticoagulation, cholesterol control, and prevention from a heart attack and

referred him to University Malaya Medical Centre (PPUM) for furthered examination. In March

2020, Mr K was diagnosed with Wolff-Parkinson-White (WPW) syndrome and Mr K was

treated using 3D CARTO for WPW ablation. “Wolff-Parkinson-White (WPW) syndrome is a

congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical

conduction through an accessory pathway that can result in symptomatic and life-threatening

arrhythmias” (Chhabra, Goyal & Benham, 2020).

During his recent medical check-up in April 2021 at PPUM, he was diagnosed with

atrial flutter based on the ECG report taken back in December 2020. The ECG was done due

to Mr K complaining of sometimes feeling of quicken heat rate even after the treatment. The

doctor had mention that Mr K can undergo the same treatment as before, but the success rate
is lowered compared to the first time. The doctor prescribed Mr K with two medication for his

current condition: Bisoprolol Fumarate 5mg (1/2 a pill, once a day) and Flecainide 100mg (1

pill, twice a day). At the same time, all his previous medications were discontinued except for

the bisoprolol fumarate.

2.0 MEDICATIONS

GENERIC NAME FLECAINIDE

BRAND NAME TAMBOCOR TABLET 100mg

SPECIFIC INDICATION - Ventricular Arrhythmias

- Supraventricular Arrhythmias
- Special Patient Group (Patients with
permanent pacemaker)
- Renal Impairment
- Hepatic Impairment

STRENGTH OF THE MEDICINES 100mg

DOSE OF THE MEDICINES Ventricular Arrhythmias: 100mg twice daily

INSTRUCTION The medicine is to be taken orally, 1 pill 2 times a

day. The medicines can be taken with or without
food.

FORMULATION OF THE Tablets

MEDICINES

ROUTE OF ADMINISTRATION Oral Administration

REGISTRATION NUMBER RN: 29282470

MEDICINE STORAGE - Store the medication at room temperature

away from direct light and moisture.
- Keep away from children and pets.
- Do not store in the bathroom
CONTRAINDICATIONS - Pre-existing in 2nd or 3rd degree AV block
with pacemaker
- Right bundle branch block associated with
left hemiblock without pacemaker.
- Cardiogenic Shock
- Heart Failure
- History of Myocardial Infarction (MI)
(Burgada Syndrome)

ADVERSE REACTIONS Commonly:

- Dizziness
- Giddiness
- Visual Disturbances
- Light-headedness

Occasionally:
- Nausea
- Vomiting

Rarely:
- Hallucination
- Amnesia
- Dyskinesia
- Convulsion
- Elevates Liver Enzyme

May occur in patient with structural heart disease.

- Pro-arrhythmic effects

Potentially Fatal
- Ventricular Tachyarrhythmia
- Myocardial Infarction (MI)

Others:
- Headache
- Tremor
- Peripheral Neuropathy
- Ataxia
 - Syncope
- Vertigo
- Increases Sweating
- Depression, Anxiety, Insomnia
- Mild Blood Cells Reduction

USE IN PREGNANCY AND Pregnancy

LACTATION - The medication is used during pregnancy to
treat maternal and foetal arrhythmias.
- Categories C: Reported of toxicity in animal
studies and infant hyperbilirubinemia was
also reported.

Lactation
- The medication is presents in breast milk in
significant amount but is not known to be
harmful.

SHAPE OF MEDICINE Round

COLOUR OF MEDICINE White

PHOTO
REFERENCES

Chhabra, L., Goyal, A. & Benham, M. D. (2020 Aug 10). Wolff Parkinson White Syndrome. In:

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. PMID:

32119324. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554437

Committee, J. F. (2018). BNF 76 (British National Formulary) September 2018 (76th Revised

edition). Pharmaceutical Press.

Monthly Index of Medical Specialities (MIMS). (n.d.). Flecainide. Retrieved from

https://www.mims.com/malaysia/drug/info/flecainide?mtype=generic#disclaimer

Monthly Index of Medical Specialities (MIMS). (n.d.). Tambocor. Retrieved from

https://www.mims.com/malaysia/drug/info/tambocor

Medscape. (n.d.). Retrieved from https://www.mims.com/malaysia/drug/info/tambocor