Case presentation on lower respiratory tract, hypertention

case presentation

1. CASE PRESENTATION ON LOWER RESPIRATORY TRACT, HYPERTENTION, CONJUNCTIVTES , HEART DISEASES BY SHAHAN.K 2 nd year PHARMD JAMIA SALAFIYA PHARMACY COLLAGE

2. Lower respiratory tract infection Definition Lower respiratory tract infections are any infections in the lungs or below the voice box. These include pneumonia, bronchitis, and tuberculosis A lower respiratory tract infection can affect the airways, such as with bronchitis, or the air sacs at the end of the airways, as in the case of pneumonia.

3. Symptoms Symptoms of lower respiratory tract infections vary and depend on the severity of the infection. Less severe infections can have symptoms similar to the common cold, including a stuffed up or a runny nose a dry cough a low fever a mild sore throat a dull headache In more severe infections, symptoms can include: a severe cough that may produce phlegm fever difficulty breathing a blue tint to the skin rapid breathing ( tachypnea )

4. Hypertension  ( HTN  or  HT ) Definition Hypertension  ( HTN  or  HT ), also known as  high blood pressure  ( HBP ), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.  High blood pressure typically does not cause symptoms SBP: will be more than or equal to 120mmHg DBP: will be more than or equal to 80mmHg

5. symptoms Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a severe or life-threatening stage

6. CONJUNCTIVITIS DEFINITION Conjunctivitis is an inflammation or swelling of the conjunctiva. The conjunctiva is the thin transparent layer of tissue that lines the inner surface of the eyelid and covers the white part of the eye.

7. SYMPTOMS: People with conjunctivitis may experience the following symptoms: A gritty feeling in one or both eyes Itching or burning sensation in one or both eyes Excessive tearing Discharge from one or both eyes Swollen eyelids Pink discoloration to the whites of one or both eyes Increased sensitivity to light

8. ETIOLOGY 1 ) The Hy pertension mainly classified into two : 1 ) primary hypertension : ( without any specific reasons) 2)Secondary hypertension : (it is due to high blood pressure that caused by another medical condition or drug ). STAGES: 1) PREHYPERTENSION SBP :120- 129 mmHg DBP: 80-89 mmHg 2) HYPERTENSION STAGE 1 SBP:130-139mmHg DBP : 90-99mmHg 3) HYPERTENSION STAGE 2 SBP : greater than or equal to 140 mmHg 4) PREGNANCY INDUCED HYPERTENSION :because of increased production of hormones during pregnancy 2 ) Lower Respiratory tract infection :1) viral infection Eg : 1) chicken pox 2) influenza A 3 ) Conjunctivitis : 1) infective – bacteria virus fungal 2) allergic – pollen or mould spores 3) irritative 4) keroconjunctivitis associated with disease osf skin and mucous membrane

9. CLINICAL FEATURES : Lower respiratory tract infection systemic hypertension conjunctivtis Ischemic heart disease

10. SYMPTOMS: COUGH CHEST PAIN ABDOMINAL PAIN VOMITTING DIARRHOEA FEVER REDNESS OF EYES

11. LABORATORY FINDING: Neutrophils Lymphocytes serum urea serum sodium

12. OTHER TEST Accurate history physical examination supportive lab studies Bp X ray

13. NAME:XXXX AGE:92 yrs SEX:F DOA:07/12/18 DOD:---- CHIEF COMPLAINTS: Cough since 3 days breathlessness on exertion since 3 days swelling of legs since 3 days HISTORY OF PRESENTING ILLNESS: Patient was apparently well 3 days back when the developed cough with expectoration sputum is colorless not blood stained. C/o breathlessness on minimal activity like walking, talking, since 3 days , more laying down. H/O chest pain on exertion present

14. H/O redness of left eye with discharge since 2 days . No H/o abdominal pain vomiting diar fever . PAST HISTORY : No H/o DM or HYPERTENSION LAB EXAMINATION : leukocytes count total : 13100cumm Neutrophils : 79% Lymphocytes : 12% serum urea : 25mg/ dl serum sodium : 129 m Eq /R

15. DIAGNOSIS: Total blood count X-ray ECG Accurate history physical examination supportive lab studies Bp X ray

16. TREATMENT: BRAND NAME GENERIC NAME DOSE ROA FREQUENCY T. Prolomet XI Metaprolol 50mg oral 1-0-0 T.Ecospirin AV Aspirin+ atorvastatin 45/10mg oral 0-0-1 Inj rasix curosemide 20mg IV BID E/D moxiflox moxifloxacin 1 drop instill 1-1-1-1 T Dolo paracetamol 650mg oral sos Inj pan pantaprazole 40mg IV OD T. Tamiflu oseltamivir 75mg oral 1-0-1

17. ADVERSE EFFECT : Metaprolol - hypotension dyspnoea tachycardia Aspirin – prolonged bleeding time , GI disturbance Atorvastatin – muscle pain , weight gain alopecia ( sudden hair loss) Furosemide – hyperglycemia, hypertension , hypocalcemia ( lack of vitamin d) Pantaprozole - hyperglycemia GI infection nausea vomiting 6. 7. Paracetamol – GI disturbance , liver kidney damage Oseltamivir - anemia vomiting

18. Drug- Drug Interactions: Pantaprazole + Metaprolol : the metabolism of metaprolol can be decreased when combined with pantaprazole Metaprolol+Ipratropium brommide:The metabolism of Ipratropium bromide is decreased Metaprolol+Furosemide:Increased risk of adverse effect Metaprolol+Atorvastatin:Serum concendration of Metaprolol is

19. THANK YOU