GASTROENTERITIS is a gastroenterologist.pptx

GASTROENTERITIS

1. Presenter, XYZ 3 rd Pharm.D CASE PRESENTATION

2. DEMOGRAPHIC DETAILS NAME: XYZ AGE : 45y SEX : F UNIT : FMW I.P.No : 23566/14 DOA : 27/04/14 DOD : 30/04/14

3. COMPLAINTS ON ADMISSION Loose stools from 2 days Pain in abdomen, nausea since 2days

4. PHYSICAL EXAMINATION General: CVS : S1,S2 + RS : NVBS+ CNS : conscious P/A : tenderness over umbilical region and gastric region Vitals: BP :110/70mmHg temp: 96F

5. LAB DATAS Haematology : Hb: 13.2gm%(10-14) WBC: 16100 (3.7-5.6cells/cumm) DLC: N: 70%(40-75) L: 25%(20-40) E: 2%(1-6) M:3%(2-10) ESR: 70mm/hr (0-30) Routine biochemical: Blood urea: 39mg/d l(5-25) S.Cr: 1.2mg/dl(.7-1.4) Chloride: 98mmol/ l(123-135) Potassium: 3.8mmol/l(3.5-5) Urine analysis: color: pale yellow E p.cells: 8-10/Hpf Pus cells : plenty

6. PROVISIONAL DIAGNOSIS ?acute gastroenteritis with hypovolemia .

7. SOAP ANALYSIS Subjective evidence Loose stools Abdominal pain nausea Objective evidence WBC:16100cells/cumm ESR: 70mm/hr Chlorides:98mmol/l Ep.cells:8-10/Hpf Pus cells:plenty

8. ASSESSMENT Based on subjective and objective evidence the case is assessed as AGE is a inflammation of the gastrointestinal tract that involves stomach and small intestine resulting in diarrhoea, vomiting, abdominal pain and cramping. ACUTE GASTROENTERITIS

9. GOALS OF THERAPY Patient specific: To relive loose stools, nausea, abdominal pain. Disease specific: to reduce ESR, WBC level. To bring back chloride to normal. To reduce epithelial cells, pus cells.

10. TREATMENT drugs route dose freq 27/10 28/10 29/10 30/10 I.ofloxacin i.v 100ml 1-0-1 / / / / I.ondonsetron i.v 1amp 1-1-1 / / / I.pantoprazole i.v 40mg 1-0-0 / bid / / T.sporolac O 2-2-2 / / / / T.Racedotril o 100mg 1-1-1 / / / / IVF-NS RL i.v 3pint 1pint / / / I. Metronidazole i.v 100ml 1-1-1 / / / / T.Dicycloverine HCL O 10mg 1-0-1 / / / /

11. OFLOXACIN : first generation fluroquinolones. MOA- inhibit DNA replication. ADR- headache PANTOPRAZOL : proton pump inhibitor. MOA-it inhibit the final common step in gastric acid secretion. ADR-pruritis ONDONSETRON : antiemetic MOA-it is a selective 5HT3 antagonist. ADR-sensation of warmth,bronchospasm,urticaria IVF-NS, RL : It is an e lectrolyte replenisher. Dicycloverine Hcl: (GIT spasm) ADR: exacerbation of glaucoma, restlessness.

12. PLANNING The therapy is rational. OFLOXOCIN- 1 st choice of drug for gastroenteritis ONDONSETRON- for vomiting METRONIDAZOLE- gastroenteritis DICYCLOVERINE Hcl- to relive pain. RACEDOTRIL- to relive diarrhoea NS, RL- electrolyte replenishment.

13. PROGRESS CHART date BP(mmHg) PR(bpm) RR(cpm) 27/10 110/70 80 20 28/10 120/70 84 22 29/10 110/80 84 22 30/10 110/70 72 20

14. DISCHARGE MEDICATION T.metronidazole-500mg(tid) T.sporolac-(bid) Patient is advised to avoid spicy food.

15. PATIENT COUNSCELING Disease: It is caused by bacterias/viruses and mainly caused by H.pylori bacteria, rotavirus. Medication: Metronidazole- take with or immediately after food. Avoid alcohol. Diet: -avoid spicy, junk food. -drink more fluids. -take nutritional food. -maintain good hygine. AGE is a inflammation of the gastrointestinal tract that involves stomach and small intestine resulting in diarrhoea, vomiting, abdominal pain and cramping .

16. Thank you