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    Cardiogenic Pulmonary Edema.: Name: Age: Sex: IP No: Doa: Dod

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    Lucky Niha
    This document summarizes the case of an 88-year-old male patient admitted with cardiogenic pulmonary edema. The patient presented with shortness of breath, coughing blood, sweating, anxiety, and pale skin. Examinations revealed edema, abnormal vital signs, and lung abnormalities. The patient was diagnosed with cardiogenic pulmonary edema likely due to left ventricular failure. He was prescribed multiple medications including diuretics, bronchodilators, and antibiotics. The pharmacist identified some drug therapy problems and made recommendations to optimize the patient's treatment plan.

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    Cardiogenic Pulmonary Edema.: Name: Age: Sex: IP No: Doa: Dod

    Uploaded by

    Lucky Niha
    64 views7 pages
    This document summarizes the case of an 88-year-old male patient admitted with cardiogenic pulmonary edema. The patient presented with shortness of breath, coughing blood, sweating, anxiety, and pale skin. Examinations revealed edema, abnormal vital signs, and lung abnormalities. The patient was diagnosed with cardiogenic pulmonary edema likely due to left ventricular failure. He was prescribed multiple medications including diuretics, bronchodilators, and antibiotics. The pharmacist identified some drug therapy problems and made recommendations to optimize the patient's treatment plan.

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    Ni Harika

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    This document summarizes the case of an 88-year-old male patient admitted with cardiogenic pulmonary edema. The patient presented with shortness of breath, coughing blood, sweating, anxiety, and pale skin. Examinations revealed edema, abnormal vital signs, and lung abnormalities. The patient was diagnosed with cardiogenic pulmonary edema likely due to left ventricular failure. He was prescribed multiple medications including diuretics, bronchodilators, and antibiotics. The pharmacist identified some drug therapy problems and made recommendations to optimize the patient's treatment plan.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    64 views7 pages

    Cardiogenic Pulmonary Edema.: Name: Age: Sex: IP No: Doa: Dod

    Uploaded by

    Lucky Niha
    This document summarizes the case of an 88-year-old male patient admitted with cardiogenic pulmonary edema. The patient presented with shortness of breath, coughing blood, sweating, anxiety, and pale skin. Examinations revealed edema, abnormal vital signs, and lung abnormalities. The patient was diagnosed with cardiogenic pulmonary edema likely due to left ventricular failure. He was prescribed multiple medications including diuretics, bronchodilators, and antibiotics. The pharmacist identified some drug therapy problems and made recommendations to optimize the patient's treatment plan.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 7

    Exp no:1

    Cardiogenic Pulmonary Edema.


    Dt:

    Name: M.kalayan Age: 88yrs


    Sex: Male IP No:1603183
    DOA:29-09-2020 DOD:05-10-2020

    Chief Complaints:
     Overwhelming of pulmonary edema is difficulty breathing,
     Coughing up blood,
     Excessive sweating,
     Anxiety, and
     Pale skin.

    History Of Present Illness:


    A 88yr male patient was prepared with complaints of wheezing , shortness of
    breath and altered sensorium since 20days. He had history of fever with
    thrombopenia one month back, followed with altered behaviour. He is non
    alcoholic, non smoker and takes mixed diet. From 3 days his urine output was
    decreased and constipation was observed.
    Patient was conscious. He is pallor and pedal edema was obeseved up to Knees.
     On physical examinations his vital signs were
     BP:130/50mmHg,
     PR:100beats/min,
     RR: 20cycles/min,
     CVS: S1S2+
     RS: Creps,Rhonchi
     CNS: Consicous,coherent and occasionally talks irrelevantly.
     Abdomen: Distension and Suprapublic dullness.
     CT brain scan showed age related diffuse cerebral atrophy.
     2D echo cardiography showed maildly dilated RA and RV, mild TR with
    PAH.
     Ultrasonography reported moderate hydrouretero nephrosis.

    Problem list:
     Cardiogenic Pulmonary edema

    CURRENT MEDICATIONS:
    DRUG DOSE FREQUENCY ROUTE START DATE STOP DATE

    Inj.Optineuron 2amp OD Ⅳ 29-09-2020 04-10-2020

    Inj.Bactrimfort 3gm BD Ⅳ 30-09-2020 04-10-2020


    e
    Inj.Pantop 1amp BD Ⅳ 30-09-2020 01-10-2020

    Neb.Asthalin 2nd hourly 30-09-2020 01-10-2020

    Neb. Duolin 6th hourly 30-09-2020 01-10-2020


    Budecort
    Tab.Azitral 500mg BD PO 01-10-2020 04-10-2020

    Tab.Synasma 400mg BD PO 30-09-2020 03-10-2020

    Tab.Amifru OD PO 01-10-2020 03-10-2020

    Tab.Dytor 10mg OD PO 02-10-2020 04-10-2020

    Tab.Benformat 1 tablet OD PO 03-10-2020 O4-10-2020


    plus
    Tab.Pantop 40mg OD PO 02-10-2020 04-10-2020

    SUBJECTIVE AND OBJECTIVE EVIDENCE:


     Patient was presented with complaints of wheezing, shortness
    of breath.
     Decreased urine output and constipation.

    Current medications:
     Inj.Bactrim forte 3gm/BD/Ⅳ
     Neb.Asthalin 2nd hourly
     Neb.Duolin Budecort 6th hourly
     Tab.Azitral 500mg/BD/PO
     Tab.Synasma 400mg/BD/PO
     Tab.Dytor 10mg/OD/PO

    ASSESSMENT:
    Etiology: Congestive heart failure.
    Risk factors:
     Left ventricular failure.
     History of lung disease, such as tuberculosis, chronic obstructive
    pulmonary disorder. (COPD).
     Kidney failure.
     Vascular disorders.

    EVALUATE NEED FOR THERAPY


    (EVALUATE CURRENT OR NEW THERAPY)
    Cardiogenic Pulmonary edema:
    Yes patient needs therapy to reduce symptoms and prevent possible
    complications like pulmonary hypertension, acute heart attack, cardiogenic
    shock, arrhythmias, electrolyte disturbances, respiratory arrest.

    PLANNING
    RECOMMEND DRUG TREATMENT (DRUGS TO BE AVOIDED;
    FURTHER TESTES)
     The effective dose of Amifru (Furosemide) is 40mg 1tablet daily.
    But it was not given in the prescription.
     When Asthalin or the Duolin given with diuretics like Furosemide
    and Torsemide causes hypokalemia. So Ipratropium bromide
    500mcg 1 unit dose vial can be administered 3 to 4 times a day.

    Goals of therapy:
     Reduce symptoms.
     Reduce the fluid in the lungs.
     Improve gaseous exchange and heart function.
    PATIENT EDUCATION
    Azithral(Azithromycin):
    Take the tablet once daily in the morning.
    Take low-sodium or low-salt diet, potassium supplements, and
    potassium-rich foods like bananans, raisins, and orange juice in your diet.

    Duolin with Budecort:


    Twist open the top of one unit dose vial and squeeze the contents in
    the nebulizer reservoir.
    Connect the nebulizer reservoir to the mouthpiece.
    Connect the nebulizer to the compressor.
    Sit in a comfortable, upright position; place the mouthpiece in your
    mouth and turn on the compressor.
    Follow the instructions provided to add the solution to the nebulizer
    and inhale the aerosol using the nebulizer.
    You should use your nebulizer continually for as long as your doctor
    recommends.

    Pantoprazole:
    Take the medicine at same time each day.
    Swallow this medicine as a whole, do not crush or chew the tablet .
    Take it 30min before meal, if it upsets your stomach then take it with
    food.
    DRUG THERAPY PROBLEM WORK SHEET:

    Type of problem Possible Cause Comment


    Needs different drug More effective drug Ipratropium bromide 500mcg 1 unit
    product available. dose vial can be administered 3 to 4
    times a day.

    Adverse drug reaction Unsafe drug for patient Azithromycin reacts with the pyridoxine
    and decreases the level or affect of
    pyridoxine by altering the intestinal
    flora, so dosing space is required.

    PHARMACEUTICAL CARE PLAN


    1.Medical problem list: Drug Interaction
    Current drug regimen: Azithromycin reacts with pyridoxine.
    Drug therapy problem: Decreases the level or affect of pyridoxine by
    altering the intestinal flora.

    Therapy recommendations: Dosing space is required for 2hrs.


    2.Drug therapy problem: Wrong Dose
    Current drug regimen: Azithromycin 500mg BD
    Therapy goals/ Therapy end points: To reduce the infection.
    Therapy recommendations: Azithromycin 500mg orally as a single
    dose on the first day followed by 250mg upto 2 or 5 days.
    3.Drug therapy problem: wrong dose
    Current drug regimen: Bactrim forte 3gm iv
    Therapy goals/ therapy end points: To reduce the infection.
    Therapy Recommendations: Bactrim forte of 8 to 10 mg/kg given in 2
    or 4 equally divided doses through for every 8 or 12 hours for upto 14 days.

    REFERENCES:
    1. www.webmd.com/.../mono-3223azithromycin+250%2F500+MG+..
    2. www.medindia.net/doctors/drug_information/doxofylline.htm
    3. www.healthkartplus.com/details/drugs/58409/amifru-40mg
    4. www.healthkartplus.com/details/drugs/64284/dytor-plus-10mg
    5. www.drugs.com/pantoprazole.html
    6. www.mayoclinic.org/disease.../pulmonary-edema/basics/.../con-200224
    7. www.nlm.nih.gov/medlineplus/ency/article/000140.htm
    8. Reference.medscape.com/drug-interaction checker
    9. http://www.inhousepharmacy.biz/p-630-duolin-inhalation.aspx
    10. https://www.nhlbi.nih.gov/guidelines/asthma/

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