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CASE PRESENTATION

ON
ANEMIA
BY:- J.Sandeep chakravarthy
Rg.no: 14Q1810
Pharm-D 4th year
Rmes college of pharmacy
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PATIENT DETAILS
Name : KAVERI
Age : 18 Years
Gender : Female
Address : Gulbarga
IP Number : 180843
Ward : General Medicine
Unit : Medicine Female A
DOA : 04/10/2018 11:31:24 am
DOD :08/10/2018

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REASONS FOR ADMISSION

Chief Complaints:
C/O Generalized weakness , Giddiness,
Nausea, after meal vomiting

History of present Illness::


Patient is referred in view anemia
No h/o bleeding, blood in stool.

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Past medical history:
Not known case of HTN/ DM/ TB/ ASTHMA

Past medication history:


Not known

Social Habits : Nothing significant


Family history: No relevant information
Marital status : Unmarried

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Day 1
General Examination:
Vital signs:

Temperature (oF) : Afebrile


Pulse rate (/min) : 80 bpm
Respiratory Rate (/min) : 16 cpm
BP(mm of Hg) : 90/60 mmHg

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LABRATORY INVESTIGATIONS:
TEST TEST VALUE REFERENCE
VALUE
BLOOD GROUP A+ -

Hb 4 gm/dl M- 13 -18 gm/dl


F- 11.5 -16.5 gm/dl
RBC 1.25M/cumm M- 4.5-5.9 M/cumm
F- 3.8-5.2 M/cumm

DLC- Neutrophils 72% 30 to 75%


Lymphocytes 12% 05 to15%

Monocytes 02% 02 to 10%


Basophils 00% 0 to 1 %
Eosinophil’s 00% 0 to 6%
LABRATORY INVESTIGATIONS:
TEST TEST VALUE REFERENCE
VALUE

Pus cells 3 to 4 p.v.f 0 to 4 p.v.f

Epithelial Cells 2 to 3 p.v.f 0 to 4 p.v.f

Billirubin Total 1.0 mg/dl 0.2 to 1.2 mg/dl

Billirubin (D) 0.5 mg/dl 0.1 to 0.4 mg/dl


Bile salt
Absent

Bile Pigment Absent


Final Diagnosis :

SEVERE ANEMIA

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BACK GROUND OF THE DISEASE

 DEFINATION
ETIOLOGY
 SIGNS & SYMPTOMS
TYPES OF ANEMIA
 PATHOPHYSIOLOGY
 PHARMACOTHERAPY

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DEFINATION OF ANEMIA
 According world health organisation
anaemia is described as a symptom
complex or disease recognised by fall in
oxygen carrying capacity of blood . It is
recognised by reduction in HB% Or
RBC% OR both.

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Anemia:

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Etiology of anemia
 Anemia is not an actual disease – its a
condition that is caused by some other
problems . There are three basic ways
BLOOD LOSS
 LOW PRODUCTION OF HEALTHY
RBCs
RAPID DESTRUCTION OF RBCs

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SEVERITY OF ANMEIA
• It categorized upon concentration
hemoglobin ranges
• Mild anemia : 9.5-13.0g/dl
• Moderate anemia : 8.0-9.5g/dl
• Sever anemia : <8.0g/dl
Symptoms of anemia :
Loss of appetite
Pale lips and brittle nails
Weakness and sore mouth
Fatigue
Tiredness, concentration problems
Difficulty swallowing
Rapid and irregular heart beat
Chest pain, dizziness .

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TYPES OF ANEMIA
• Iron deficiency anemia
• Megaloblastic anemia
• Pernicious anemia
• Hemorrhagic anemia
• Hemolytic anemia
• Thalassemia anemia
• Sickle cell anemia
• Aplastic anemia
Pathphysiology:
Anemia is usually caused by inadequate iron
intake through diet , inadequate absorption through
the gastro intestinal tract ,increased demand by the
body for iron(such as during pregnancy), blood loss
,iron loss due to dialysis in chronic renal failure.
Pharmacotherapy
Treatment for anemia depends on type ,cause and
severity of condition
Treatment may include dietary changes or
supplements ,medicines ,procedures or surgery to
treat blood loss

Dietary changes and supplements


Food should be healthy
Common supplements are B12 and folic acid
vitamin C and iron
MEDICINES
 ANTIBIOTICS
 BLOOD TRANSFUSION
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Other medicines
• Ferrous sulphate 210 mg TID
• Infuse 2 units PRBC s
• Ferrous gluconate
• Ferrus fumerate
• Ferrex 150 forte oral
• Folic acid oral
• Corvite 150 oral
Day 1 Treatment
S. No Prescribed Drugs Dose/ROA
Trade Name Generic Name
01. INJ Taxim Cefotaxime 1gm/ BID
IV
02. INJ Rantac Ranitidine 150mg/BID
IV
03. INJ Avil Pheniramine 45.5mg/ 2ml
maleate IV

04. INJ Dexona Dexamethasone 4.37mg/ml


Sos IV
Arrange for Blood transfusion
After cross matching.
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Blood transfusion :
 Under all aseptic precautions, start whole
blood transfusion initially at a rate of 6-8 drops/
mins, if no reactions occurs then increase the
flow rate to 12-14 drops/mins & watch for
reaction and inform to doctor
 INJ- Avil 1cc at the beginning of transfusion
INJ- Dexone (sos) if any reactions occurs

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Day 2
Vital signs
Temperature (oF) : Afebrile
Pulse rate (/min) : 80/bpm
Respiratory Rate (/min): 18 cpm
BP(mm of Hg) : 90/70 mmHg

ADV:
B-protein powder 1-0-1
CST…..

 Arrange for blood transfusion

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Day 3
Vital signs
Temperature (oF) : Afebrile
Pulse rate (/min) : 80bpm
Respiratory Rate (/min) : 20 cpm
BP(mm of Hg) :100/70 mmHg

ADV:
CST...

Arrange for blood transfusion


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Day 4
Vital signs
Normal

Arrange for blood transfusion

Patient doesn’t having any bleeding


Day 5
DISCHARGE
ADV:
 DISCHARGE MEDICATIONS

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SOAP
Subjective evidence Objective evidence
C/O Generalized Decreased HB
weakness , Giddiness,  Decreased RBC
Nausea, after meal
vomiting

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ASSESSMENT

As per Subjective and objective


evidence patient was diagnosed as
ANEMIA

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PLAN
GOALS OF THE TREATMENT
Short term goals:
Relief of symptoms.
Normalize and maintain RBC & HEAMOGLOBIN
To minimize Disease progression ANEMIA.

Long term goals:


Normalize HB
Prevent the complications
Improve the quality of life
Prevent exacerbation.

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MONITORING PARAMETERS
Disease Related:
HB
RBC

Drug related:
•Drug-Drug interactions

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DRUG-DRUG &
DRUG- FOOD INTRACTIONS

There are no drug-drug & drug-food interaction


b/w the prescribed drugs.
PATIENT COUNSELING
1. Regarding disease
•Disease and its complications
•Risk factors

2. About Medication:
•Indication of prescribed medicines
•Possible side effects
3. Life style modification

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Life style modification:

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•THANK YOU............

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