Chronic calcific pancreatitis

case presentaion on chronic calcific pancreatitis

1. CHRONIC CALCIFIC PANCREATITIS CASE PRESENTATION ON

2. TOPIC- PANCREATITIS PRESENTED BY-14Z91T0004 PHARMD III YEAR KVK COLLEGE OF PHARMACY

3. A 42 year old male patient has admitted with a chief complaints of back pain and vomiting .

4. PATIENT DEMOGRAPHIC DETAILS NAME- Debi Prasad jena AGE:- 42 years GENDER:- male IP NUMBER:- 1600059648 DEPARTMENT:- Gastroenterology

5. SUBJECTIVE FINDINGS CHIEF COMPLAINTS- back pain ,vomiting. SOCIAL HISTORY - Smoker-NO Alcohol-NO PAST MEDICAL HISTORY – NIL

6. VITALS Blood pressure:-140/90 mm of Hg Pulse rate:- 104 beats per minute Temperature:- Normal

7. OBJECTIVE ANALYSIS Test [normal value] Observed value Erythrocyte sedimentation rate [3-5mm/hr] 23 Post prandial blood sugar [<140gm/dL] 150 SGPT [0-40U/L] 45 Potassium [3-4.1mEq /L] 5.1

8. DIAGNOSIS ULTRA SONOGRAPHY-- Changes in the pancreas with calculi in dilated duct.

9. ASSESSMENT From the subjective , objective and ultra sonography reports it is clear that the patient is suffering from the chronic calcific pancreatitis .

10. . CALCIFIC PANCREATITIS It is an inflammation of the pancreas with the presence of stones in the pancreas and does not heal or improve. ETIOLOGY:- Heavy alcohol abuse Auto immune conditions Genetic mutation due to cystic fibrosis Blocked pancreatic duct [or] common bile duct Familial pancreatitis

11. PATHOPHYSIOLOGY calcification Pancreatitis occurrence may be by [alcohol consumption , gall stones, auto immune] ] Mislocation of cystic fibrosis transmembrane conductance regulator chloride channel in pancreatic duct cells Decrease in pancreatic HCo ₃ secretion Low pH of pancreatic juice lead to fluid mal secretion Protein plug formation in the pancreatic ducts Pancreatic stone formation Pancreatic juice out flow obstruction [obstructive pancreatitis]

12. Treatment plan DRUG NAME BRAND NAME CATEGORY DOSE ROUTE FREQUENCY 1 2 3 4 Cefditoren + pivoxil zostum cephalosporins 10ml IV BD + + + + rabeprazole Razo -d Anti- ulcerants 20ml IV OD + + + + ondansetron zofer Anti- emetic 4 mg IV TD + + + + Tramadol tramazac analgesic 50mg IV BD + + + + menadione VIT-K hemostatic 10mg IV OD + + + +

13. MECHANISM OF ACTION OF GIVEN DRUGS ZOSTUM-O:- Cefditoren + pivoxil M.O.A:- Cefditoren binds to 1 or more of the penicillin binding protein which inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting bio synthesize and arresting cell wall assembly resulting in bacterial cell death . ADR’S:- Diarrhea, nausea, headache, abdominal pain, dyspepsia, vomiting, hematuria, increased urine, WBC decreased hematocrit

14. TRAMADOL:- M.O.A:- Tramadol inhibits the reuptake of nor-epinephrine serotonin and enhances serotonin releases; it alters perception and response to pain by binding to µ receptors in the CNS. ADR’S:- Seizures, dizziness, headache, anxiety, gastro entities, constipation.  

15. RAZO-D:-Rabeprazole M.O.A:- rabeprazole is proton pump inhibitor that suppresses gastric acid secretion by inhibiting H⁺/k⁺ ATP ase at the secretory surface. ADR’S:- Dry mouth, angio edema, bronchospasm, parasthesia, taste disturbances.

16. VIT-K M.O.A:- it promotes hepatic synthesis of clotting factors II,ix,x . these thickens the blood and stops bleeding and serves as anti coagulant ADR’S:- Hemolytic anemia, glucose-6-phosphate defiency , neonatal, brain and liver damage

17. ZOFER= Odansetron M.O.A It is an anti emetic, prevents nausea and vomiting associated with emetogenic cancer therapy. Highly specific and selective serotonin receptor antagonist and with low affinity for dopamine receptors. Blocks serotonin receptors in the vomiting centre and nervous supplying the digestive system. ADR’S:- Headache, hiccups, flushing, warmth sensation, constipation, rash, urticaria, seizures

18. PATIENT COUNSELLING:- A low fat diet must be recommended. Drink plenty of fluids. Physical exercise and meditation may be helpful.