CASE STUDY AND PRESENTATION ON OSTEOPOROSIS.pptx

CASE STUDY AND PRESENTATION ON OSTEOPOROSIS

1. CASE STUDY ON OESTEOPOROSIS BY Sriram Thirunavukkarasu , PGP COLLEGE OF PHARMACEUTICAL SCIENCE & RESEARCH INSTITUTE NAMAKKAL . 1

2. CASE SUMMARY A 75 years old female patient was admitted in the hospital on 02.09.2022 with the chief complaints of severe back pain persistent in the lower back region. She has asthma since 10 years and undergone surgery to fix left wrist 2 years. She has no social history. She was conscious, oriented and afebrile. INJ.PANTOPRAZOLE, T.VITAMIN D3, T.CALCIUM, T.ALENDRONATE, T.PARACETAMOL,INHALER FLUTICASONE are the given drugs during hospitalization. 2

3. OSTEOPOROSIS A condition in which bones become weak and brittle. Low bone mass makes the skeletal bones very fragile due to which they become highly susceptible to fractures. It’s common complaints of the elderly and middle aged persons. Among the later, 80% of these are women which may occur highly in post- menopausal period. It is generally asymptomatic condition. PRIMARY OSTEOPOROSIS Idiopathic types involutional types SECONDARY OSTEOPROSIS 3 DEFINITION

4. PATHOPHYSIOLOGY 4

5. SOAPE ANALYSIS 5

6. SUBJECTIVE A 75 years old female patient was admitted in the hospital on 02.09.2022 with a chief complaints of severe back pain persistent in the lower back region. She has asthma since 10 years and undergone surgery to fix left wrist 2 years ago. 6

7. OBJECTIVE She was conscious, oriented and afebrile. The patient was diagnosed with osteoporosis. She has undergone radiological investigation: X ray of spine in lumbar region and has collapse between L4 and L5 prominently at L4 vertebrae. She has decreased Hemoglobin and calcium level. 7

8. PHYSICAL EXAMINATION CVS – S1,S2(+) CNS – NFND(+) GIT – P/A Soft(+) HEAD AND EYE – No injuries RS – NVBS(+) 8

9. VITAL SIGNS 9 S.NO PARAMETERS 02/09/2022 03/09/2022 04/09/2022 05/09/2022 NORMAL RANGE 01. BODY TEMPERATURE 98.4 98.0 98.6 98.2 97 – 99° F 02. BLOOD PRESSURE 110/80 120/80 110/90 120/80 120/80mmHg 03. PULSE RATE 92 90 82 80 60 – 100 beats/min 04. RESPIRATORY RATE 26 20 20 20 12 – 16 breaths/min 05. SPO2 97% 98% 97% 98% 88 – 95 %

10. LABORATORY INVESTIGATION 10 LAB INVESTIGATION 02.09.2022 NORMAL RANGE FULL BLOOD COUNT Hemoglobin 11.9 12 – 15 g/dL Total white blood cells count 6,200 4000 – 11300 cells/cu.mm Platelet 3,58,000 150000 – 450000 cells/µL

11. 11 RENAL PROFILE S. Cr 0.7 0.7 – 1.2 mg/dL SERUM ELECTROLYTES Na 143 133 – 145 mEq/L K 4.9 3.3 – 5.1 mEq/L Ca 1.8 2.15 – 2.55 mEq/L

12. SPECIFIC TEST Lumbar vertebral collapse between L4, L5 prominently at L4 vertebrae. 12 X RAY OF SPINE

13. ASSESSMENT The patient was diagnosed with Osteoporosis. 13 DIAGNOSIS

14. PLAN To increase the bone strength and rigidity through calcium supplements. To decrease bone reabsorption through bisphosphonate. To stop the oral corticosteroid for asthma management. 14 Goals Of Therapy

15. TREATMENT CHART 15 S.NO DRUG DOSE ROA FREQUENCY 2.9.22 3.9.22 4.9.22 5.9.22 01 Inj pantoprazole 40mg IV OD 02 Tab. Vitamin D3 2000IU P/O BD 03 Tab. Calcium 500mg P/O BD 04 Tab. Alendronate 70mg P/O OD 05 Tab. Paracetamol 650mg P/O OD 06 Tab. Fluticasone 50mcg P/O OD

16. 16 DRUG DOSE CATEGOERY INDICATION MECHANISM OF ACTION ADR INJ.Pantoprazole 40mg Antacid, Proton pump inhibitors Reduce the acid secretion Suppress the final step in gastric acid production forming a covalent bond to two side of ATPase Headache, Dizziness, Joint pain, diarrhea Vitamin D3 2000IU Vitamin supplement To treat osteoporosis Maintenance of normal level of serum calcium and phosphorous in the blood stream by enhancing the small intestine to absorb these materials form diet. Chest pain, Shortness of breath, growth problems Calcium 500 mg Calcium supplement To treat osteoporosis It acts by directly increasing calcium stores within the body Nausea, Vomiting, Heart burn, Stomach upset DRUG PROFILE

17. 17 DRUG DOSE CATEGORY INDICATION MECHANISM OF ACTION ADR Alendronate 70 mg Bisphospho nates To treat osteoporosis It works by suppressing the cell activity of osteoclasts, cells that cause destruction of bone. Diarrhea, Heart, Burn, Headache, Indigestion Paracetamol 650 mg NSAID Relieves pain (Analgesics) It works by blocking the release of certain chemical messenger that cause pain Stomach pain, Nausea, Vomiting Inhaler Fluticasone 500 mg steroids To relive symptoms of asthma It prevents the cells in the lungs and breathing tract passages from releasing chemical messengers that cause inflammation. This widens the airway. Sinus infection, Throat irritation, Bronchitis, voice change

18. DISCHARGE MEDICATION Continue the medication until revisit after 5days 18 S.NO DRUG DOSE FREQUENCY DURATION 1. Inh. Fluticasone 50 mcg OD 5 days 2. Tab. Pantoprazole 500mg OD 5 days 3. Tab. Vitamin D3 10mg OD 5 days 4. Tab. Calcium 40mg OD 5 days 5. Tab. Alendronate 650mg OD 5 days 6. Tab. Paracetamol 2000IU OD 5 days

19. PATIENT COUNSELLING DISEASE BASED COUNSELLING Osteoporosis is the diseased condition due to the weakness of bone. DRUG BASED COUNSELLING T.Pantoprazole should be taken 30 minutes before food. T.Paracetamol should be taken only if you have pain. Take calcium and alendronate on empty stomach. 19

20. DIET BASED COUNSELLING Do not consume cold beverages. Eat a well balanced diet. Eat calcium rich foods like dairy products milk etc., LIFESTYLE BASED COUNSELLING Diary expose to sunlight at least 30 minutes. Do breathing exercise regularly. Should not do heavy physical activity. Get enough rest. 20

21. 21 THANK YOU