case study of jaundice

pharm.d 3 year

1. MALE MEDICINE WARD

2. CHIEF COMPLAINTS C/O passing concentrated urine for 15 days C/O body weakness C/O loss of appetite C/O itch all over the body C/O passing pale colour stools

3. HISTORY OF PRESENT ILLNESS C/O yellow coloured eyes and discharge of yellow coloured urine.

4. PERSONAL HISTORY The patient has smoking habituate for more than 10 years. PAST HISTORY Not a k/c/o DM/PTB/HT/epilepsy

5. LAB INVESTIGATION PARAMETERS OBSERVATION PARAMETERS Blood pressure 120/80 mm/Hg 120/80 mm/Hg Random blood sugar 90 mg/dl 70- 11o mg/dl S. Urea 35 mg/dl 15-40 mg/dl S. sodium 140 mg/dl 135-145 mEq/l S. potassium 4.8 mEq/l 3.5-5 mEq/l S. creatinine 1.0 mg/dl 0.8-2 mg/dl S. Bilirubin (total) 1.5 mg/dl 0.2-1 mg/dl Direct bilirubin 0.8 mg/dl 0.2-0.4 mg/dl Indirect bilirubin 0.7 mg/dl 0.2-0.6 mg/dl SGOT 56 UI/I 5-45 UI/I SGPT 53 UI/I 5-40 UI/I

6. DIAGNOSIS OBSTRUCTIVE JAUNDICE

7. Inj. Cefotaxime 1gm IV BD Inj. Ranitidine 1cc IV BD Tab. prednisolone 5mg BD Tab. Liv 52 BD DRUG THERAPY

8. SOAP ANALYSIS

9. SUBJECT The subjective had a chief complaint of case of passing concentrated urine for 15 days. Yellow coloured eyes and discharge of yellow coloured urine. Smoking habituate for more than 10 years

10. OBJECT LAB INVESTIGATION PARAMETERS OBSERVATION PARAMETERS Blood pressure 120/80 mm/Hg 120/80 mm/Hg Random blood sugar 90 mg/dl 70-110 mg/dl S. Urea 35 mg/dl 15-40 mg/dl S. sodium 140 mg/dl 135-145 mEq/l S. potassium 4.8 mEq/l 3.5-5 mEq/l S. creatinine 1.0 mg/dl 0.8-2 mg/dl S. Bilirubin (total) 1.5 mg/dl 0.2-1 mg/dl Direct bilirubin 0.8 mg/dl 0.2-0.4 mg/dl Indirect bilirubin 0.7 mg/dl 0.2-0.6 mg/dl SGOT 56 UI/I 5-45 UI/I SGPT 53 UI/I 5-40 UI/I

11. ASSESSMENT OBSTRUCTIVE JAUNDICE Inj. Cefotaxime 1gm IV BD Inj. Ranitidine 1cc IV BD Tab. prednisolone 5mg BD Tab. Liv 52 BD

12. continue liv 52 for hepatoprotective until the patient free from the liver toxins. Continue prednisolone until the patient may gets free from allergic condition. Continue ranitidine because the patient may taken the NSAID it cause Hcl secretion so ranitidine may continued. planning

13. DRUG INTERACTIONS Corticosteroids are primarily metabolised by liver and may have enhanced effects in patients with liver disease. Dosage adjustments may be necessary in these patients. Ranitidine is partially metabolized by the liver. although dosage reductions are generally not necessary, therapy with ranitidine should be administered cautiously in patients with liver disease.