CASE PRESENTATION ON DENGUE FEVER

PRESENTED BY
M.U.Vyshnavi
II/VI PHARM.D
Y17PHDO412
 DEFINITION
 Dengue fever is a disease caused by a family of viruses transmitted
by mosquitoes.
 The female Aedes aegypti mosquito is the most important
transmitter or vector of dengue viruses.
 It is an acute infectious viral disease ,also known as break bone
fever
Etiology
EPIDEMIOLOGY
DIAGNOSIS
 STANDARD TREATMENT
• There is no specific antiviral treatment available.
• General recommendations include controlling fever and pain with
paracetamol rather than aspirin(aspirin may promote bleeding),
and increases fluid intake. Aspirin should not be given to children
under 12 yrs of age.
• No vaccine is discovered for the dengue viruses.
 PATIENT DEMOGRAPHICS

• Name: PQR
• Age/Sex : 42yrs
• Marital Status: Married
• Religion : Hindu
• Education/Economical status: illiterate/good
• DOA :15/02/19
• Ip.no/ Department:IP05629(1)/General medicine
• Diet: mixed diet
 SOAP ANALYSIS

Subjective data
a)Chief complaints:- Fever since 6 days, itching on hands and arms,
vomitings
b)Past medical history:- Hypothyroidism
c)Family history:- Nill
d)Social history:- Nill
 OBJECTIVE DATA
Laboratory values
• Total leukocyte count- 1900cells/cumm(4000-
11000)
• Platelet count – 0.40 lakhs/cumm(1.5-5)
• S.G.P.T- 72(7-56 units)
• S.G.O.T- 80(5-40 units)
Urine analysis
• Urine albumin- Trace
• Urine sugar- nill
• Bile salt- -ve
• Bile pigment- -ve
Dengue NSI test
• NSI Ag- reactive
• IgG- Non reactive
• IgM- Non reactive
 ASSESMENT

• Known case of thyroid from 5 years

• Based on the signs & symptoms / subjective & objective data
obtained the patient is assessed with dengue fever
 FINAL DIAGNOSIS

• Dengue fever
 DAY NOTES
VITAL SIGNS
DAY -1 DAY-2
• pulse:84 . pulse:84
• B.P:110/80 . B.P: 110/80
• R.R:24 . R.R: 24
• TEMP:110 degree F . Temp:108 degree F
DAY- 3 DAY-4
• pulse:82 . pulse:82

• B.P:110/90 . B.P:110/90
• R.R:22 . R.R: 22
• TEMP: 98 degree F .Temp:98 degree F
 PHARMACUETICAL CARE PLAN

Goals of Treatment
• To reduce itching on hands and arm
• To reduce vomitings
• To decrease fever
• To improve quality of life
 Treatment options

Pharmacological Treatment
1. Ondansetron
2. Pantoprazole
3. Dexamethasone
4. Carica papaya
5. Azithromycin
6. Fexofenadine
7. Menadione
 INJ.ZOFER

• Generic name : Ondansetron

• Class : Antiemetic
• Mechanism of action: selective 5-HT3 receptor antagonist,
blocking Serotonin , peripherally on vagal nerve terminals and
centrally in the chemoreceptor trigger zone
• Uses:To prevent nausea , vomiting
• Side effects: headache, Constipation, drowsiness.
• Contra indications :known to have hypersensitivity
• ADR’s : Constipation, Diarrhea, Dizziness
• Dose : 2cc, TID
 INJ.PANTOP

• Generic name :pantoprazole

• Class: Proton pump inhibitor
• Mechanism of action: Suppresses gastric acid secretions by
inhibiting the parietal cell H+/K+ ATP pump
• Uses: Gastro-duodenal ulcers
• Side effects: Altered sense of taste , Nausea or Vomiting
• Contra indications :Hypersensitivity
• ADR’s : Injection site Thrombophlebitis
• Dose : 40 mg / BD
 INJ.DECADRON

• Generic name :Dexamethasone

• Class : Anti inflammatory
• Mechanism of action:It is corticosteroid that prevents the release of
substance of the body that cause inflammation
• Uses: nausea ,vomiting
• Side effects: Severe allergic reaction
• Contra indications : Systemic Fungal infection
• Dose :2cc,start
 TAB.CARIPILL
• Generic name: carica papaya leaf extract
• Mechanism of action: papaya leaf is rich in enzymes like papain and
chymopapain.papaya leaf extracts inhibited heat induced and
hypotonicity-induced hemolysis of erythrocytes and these extracts
are likely to possess membrane stabilizing properties and protect
blood cells against stress induced destruction.and it also prevents
from platelet lysis.
• Uses: to increase the platelet count.
• Side effects: burning stomach, severe drowsiness
• Dose: 1100mg/TID
 TAB.AZEE

• Generic name : Azithromycin

• Class: Antibiotic
• Mechanism of action: It binds to the 50S subunit of the 70 s
bacterial ribosome, thus inhibiting RNA protein synthesis
• Uses: treat a wide variety of bacterial infections
• Side effects: Stomach upset, diarrhea , abdominal pain
• Contra indications : Hypersensitivity , Hepatic Dysfunction
• ADR’s :nausea , stomach pain
• Dose : 500 mg, BD
 TAB.ALLEGRA

• Generic name :Fexofenadine

• Class: Anti histamines
• Mechanism of action: Fexofenadine competes with free histamine
for binding at H1-receptors in the GI tract, large blood vessels, and
bronchial smooth muscle
• Uses: Allergic symptoms
• Side effects: cough
• Contra indications : Hypersensitivity , jaundice
• Dose : 120 mg ,BD
 TAB.KAPILIN

• Generic name :Menadione

• Class: Vitamins
• Mechanism of action : It occurs as a vitamin k acting as a
cofactor in synthesis of factor II , VII ,IX ,X
• Uses: Vitamin –k
• Side effects: Sweating, Dizziness
• ADR’s : Temporary flushing, taste changes, dizziness, rapid
heartbeat, sweating, shortness of breath
• Dose : 0.5 mg, OD
 MONITORING PARAMETERS

DISEASE SPECIFIC
• To Monitor elevated body temperature from time to time.
• To monitor of episodes of vomiting.
• To monitor the platelet count.

DRUG SPECIFIC
• Ulcer in oesophagus-Carica papaya
 PATIENT COUNCELLING

ABOUT DISEASE
• The patient was Councelled about disease that dengue fever is
caused by viruses like DENV sp’s due to un hygenic conditions.

ABOUT MEDICATION
• Continue the thyroid medication.
• Patient should take appropriate dose at appropriate time.
• Donot miss a dose.
• Donot take a double dose.
• Donot stop medication without consulting a doctor.
 LIFE STYLE MODIFICATIONS
• Drink plenty of water to avoid the dehydration
• Wholegrain cereals, thick skin fruits and green leafy vegetables must be
consumed
• Spinach, orange, coconut water ginger water, fruits and vegetable juices,
soup papaya leaf extract must be consumed
• Fried foods , oily food, junk food ,and spicy foods must be avoided
• Must avoid consuming the excess intake of coffee, tea, cocoa, and
caffeinated beverages
• They are suggested to take complete bed rest
• Apply mosquito repellent.
• Wear long –sleeves and long pants to cover your arms and legs to get rid of
mosquito.
• Use mosquito nets while sleeping
 DISCHARGE MEDICATION

MEDICATION :
 TAB .RANTAC 40 mg/OD
 Syp.carica papaya 10mg/TID