PHARMACOTHERAPEUTICS-II

A CASE STUDY ON: Δ ACUTE GASTRITIS

PRESENTED BY:
VIVEK VARDHANAN.P.H
16AF1T0028
Pharm-D 3rd Year
 Pharmacotherapeutics-II
Patient Name: P.Anitha Age/Gender: 58 yrs/Feamle
Admission No (OP/IP): 1072058
Physician/doctor: Dr.Lasya Department: General Medicine
Date of Admission: 27/1/19 Ward/Unit: Female Medical Ward-4
Provisional /admitting diagnosis: Δ ACUTE GASTRITIS
Chief complaints: Type-2 diabetes uncontrolled., HTN
C/O Vomiting- ① week, non bilious, H/O headache since 10 days (tight band like sensation),
C/O cough, chest discomfort, SOB since 15 days.
History of present illness: ↑’sed frequency of Micturation (burning)+ 15 days, high fever- from ① week
Past medical history: K/C/O D.M (type- 2), HTN. On Inj.Premix <25 20
Personal Habits:
Sleep: Normal Bowel and Bladder: Regular
Education: Inter Alcoholic/smoker: - ______
Diet: Mixed Family History: Nothing Significant

General Examination
Physical examination:
1. Vital signs:
Temperature(°F): 99.8° F Pulse Rate(/min): 88bpm
Respiratory Rate (/min ): 20cpm Blood Pressure(mm of Hg): 130/90 mm of Hg
2. SYSTEMS EXAMINATION
• CVS: S1S2+ RS: BLAE+
• GU and GI(abdomen): sof, non tender CNS: NAD
LAB_INVESTIGATIONS:

HB: 9 gm/dl (↓), HbA,C=14.1 % (↓)

RBC: 4.15 milli/cumm (↓)
PCV: 29.6 % (↓)
WBC (TC): 19,800 cells/ cumm (↑)
Platelet Count : 4.70 lakh/cumm (↑), Neutrophils- 86 (↑)

CONFORMATION DIAGNOSIS: Δ ACUTE GASTRITIS

C/O Rx
27/01/19 Day ① Inj,.pantop-40mgIU-OD
B.p- 110/80 mm of Hg Syp. Mucaine gel- 5ml- TID
R.R.- 18 cycles/min Inj.Emest- 4mg, I.V- TID
P.R: 102bpm Inj. Pipta 3- 4.5mg- I.V- TID
Salt cꜚ diet
Tba.Liyogen (After vomit subside)

28/01/19 Day ② Rx
P.R: 94pm CST
B.P: 90/60 mm of Hg add syp. Citralika- 10ml TID
C/O burning micturation
Rx
CST, neb, (dudin + Budecant), Inj. Metrogyl
29/01/19 Day ③ Syp. Reswas C S.
R.R- 84/min, B.P- 90/60 mm of Hg
Rx
CST + C.Doxy- 100mg 1-0-1
Inj. Rantac- 50mg 4 hriy
30/01/19 Day④ Tab. Dolo-650mg SOS
P.R- 88/ min. CVS- S1S2+ Tab. Atorvas- 20 mg OD

Rx
31/01/19 Day ⑤ CST cꜚ Tab. Clidipine_ 5mg Od
B.P- 140/80 mm of hg
R.R- 18/ min Discharge medications
DRUG CHART
S. Brand Generic Indication/ Dose ROA Frq. Duration
No Name Name class
1 Syp: Mucaine gel Alluminium + Mg antacid 5ml IV OD 27-1-19 to 31-1-19
Hydroxide

2 Inj: Emset Ondansetron Antiemetic 4mg PO TID 27/1/19 TO 31/1/19

3 Inj: Piptaz Peperacillin + Penicillin 4.5mg IV TID 27/1/19 TO 31/1/19

Tazobactum Antibiotic
4 Tab: liyogen Ferrous fumarate Iron supplement 20mg IV TID 27/1/19 TO 31/1/19

5 Syp: Citralika Citric acid + Citric Alkanizing agent 10ml P/O OD 28/1/19 TO 31/1/19
salts

6 C.Doxycycline Doxycycline Tetracycline 100mg P/O BD 28/1/19 TO 31/1/19

antibiotic

7 Inj: Metrogyl Metronidazole Antibiotic 500mg IV 8th 29/1/19 TO 31/1/19

mitamidazole hrly

8 Inj: Rantac Ranitidine H2-Blocker 50mg IV BD 28/1/19 TO 31/1/19

9 Syrp:Reswas LS Ambroxol+Levo Mucolytic agent 10ml P/O TID 29/1/19 to 31/1/19

salbutamol
+guaifenesin

10 Tab:Clidipine Clinidipine Calcium channel. 5mg P/O OD 31/1/19

Locker
PHARMACEUTICAL CARE ISSUES (ADR, DI,
Rationality, Patient intervention etc.):
The given prescription was found to be “RATIONAL”

 No Adr’s found

 No Interactions
 SOAP NOTES:

SUBJECTIVE EVALUATION:
A 58 years, female patient was admitted in the general medicine with
chief C/O vomiting, cough, chest discomfort, high grade fever and H/O
Headache, ↑’sed frequency of Micturation.
OBJECTIVE EVALUATION:
On lab investiagtion, it was found that Hb- 99gm/dl(↓), RBC-
4.15milli/cumm(↑), PCV=29.6%(↓), WBC(Tc)-19,800 cells/cumm(↑),
Neutrophils- 86%(↑).
ASSESSMENT:
Based on subjective and objective evaluation, it was found that, patient
was diagnosed as Δ ACUTE GASTRITIS.
C/O Rx

27/01/19
B.p- 110/80 mm of Hg
R.R.- 18 cycles/min
3 NS - 100 ml
Inj,.pantop-40mgIU-OD
Syp. Mucaine gel- 5ml- TID
Inj.Emest- 4mg, I.V- TID
Inj. Pipta 3- 4.5mg- I.V- TID
Salt cꜚ diet
Tba.Liyogen (After vomit subside)

28/01/19 CST
B.P: 90/60 mm of Hg add syp. Citralika- 10ml TID
P.R: 94pm

29/01/19 CST, neb, (dudin + Budecant), Inj. Metrogyl

R.R- 84/min, B.P- 90/60 mm of Hg Syp. Reswas C S.

CST + C.Doxy- 100mg 1-0-1

30/01/19 Inj. Rantac- 50mg 4 hriy
P.R- 88/ min. CVS- S1S2+ Tab. Dolo-650mg SOS
Tab. Atorvas- 20 mg OD

31/01/19 CST cꜚ Tab. Clidipine_ 5mg Od

B.P- 140/80 mm of hg
R.R- 18/ min
 PATIENT COUNSELLING
REGARDING DISEASE CONDITION:
Acute gastritis- sudden inflammation/ swelling in the lining
of the stomach/ gastritis affect the stomach.
REGARDING MEDICATION CONDITION:
Syp.Citralika- 10ml taken thrice a day, used to make the urine less
acidic.
Adr’s- gastrointestinal ulceration, anxiety, diuresis.
Inj.Meterogyl- 500mg taken IV 8th hrly, it is an antiporosoal which
helps in treating infcetions in the stmoach, genital areas.
Adr’s- blurred vision, convulsions, skin rash, hypertension,
dizziness.
Tab. Clidipine- 5mg taken orally once a day, it is a Ca 2+ channel
blocker blood vessels is used for management of high B.P.
REGARDING LIFESTYLE MODIFICATIONS:
Eat 6 small meals instead of 3 big meals.
Use an Antacid, and avoid fat.
Avoid alcohol.
Maintain diet and avoid citrus fruits.
Stop cigarette smoking
Avoid fatty foods.
DISCUSSION:
ACUTE GASTRITIS it is a sudden inflammation or swelling in the lining of
the stomach. Gastritis directly affects the stomach.

Aetiology:
Injury; bacteria; virus; stress; ingesting irritations such as alcohol, NSAAIDS;
Steroids; spicy foods.

Symptoms:
Loss of appetite; indigestion; black stools; nausea; vomiting.

DX:
Complete blood count; stool test; esophagogastroduodenoscopy/
endoscopy; gastric tissue biopsy; x-ray.

RX:
Antibiotics; combination of antibiotics like (Clarithromycin + Amoxicillin);
metronida3ole; proton pump inhibitors; H-2 (histamine) blockers; antacids.