CASE PRESENTATION ON ORAL HYPOGLYCEMIC ACID INDUCED HYPOGLYCEMIA Medical Presentation

Oha Indeced Hypoglycemia PowerPoint Presentation

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CASE PRESENTATION ON ORAL HYPOGLYCEMIC ACID INDUCED HYPOGLYCEMIA Presented by V.BHAVITHA PHARM D 5 YEAR 256213882025
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HYPOGLYCEMIA Hypoglycemia occurs when blood glucose levels fall below 4 mmol/L (72mg/dL). Whilst many of us think of diabetes as being a problem of high blood sugar levels, the medication some people with diabetes take medication that can also cause their sugar levels to go too low and this can become dangerous. CAUSES Whilst medication is the main factor involved in Hypoglycemia within people with diabetes.
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Too high a dose of medication (Insulin, Sulphopnylureas (such as glibenclamide, gliclazide, glipizide, glimepiride, tolbutamide) Prandial glucose regulators (such as repaglinide, nateglinide hypo causing tablets) Delayed meals Exercise Alcohol DIAGNOSIS Hypoglycemia is detected by measuring blood sugar levels with a glucose meter. Any blood glucose level below 4.0 mmol/L indicates that the individual has hypoglycemia. Urine tests do not detect hypoglycemia.
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SYMPTOMS Sweating Fatigue Feeling dizzy Being pale Feeling weak Feeling hungry A higher heart rate than usual Blurred vision Confusion Convulsions Loss of consciousness And in extreme cases, coma
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TREATMENT A mild case of hypoglycemia can be treated through eating or drinking 15-20g of fast acting carbohydrate such as glucose tablets, sweets, sugary fizzy drinks or fruit juice. Some people with diabetes may also need to take 15-20g of slower acting carbohydrate if the next meal is not due. A blood test should be taken after 15-20 minutes to check whether blood glucose levels have recovered. Severe hypoglycemia may require an ambulance, for example if loss of consciousness occurs or a seizure persists for more than 5 minutes. Severe hypos can be treated with glucagon if a glucagon injection kit is available and in date.
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SUBJECTIVE FINDINGS: Patient Demographics Patient name: NARSAMMA Age: 59 YRS gender: female IP no: 1805293 DOA: 28-2-2018 Clinical Presentation C/O peri convulsions, giddiness and fainted at her residence GRBS : 18 mg/dl Past Medical History: HTN since 5 years (not on medication since 2 months) Diabetic since 1 year (Glyciphage G1 /od/po) Surgical history : MVR since 2 years back
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OBJECTIVE DATA Vital signs Bp: 160/90 mm of hg PR: 77 bpm CBP Neutrophils: 81% Lymphocytes: 13% WBCs: Neutrophilia, Lymphopenia GRBS: 18 mg/dl
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OTHER INVESTIGATIONS 2D-ECHO: severe TR ECG: Atrial fibrillation, suspect lateral MI, low T wave (v4,v5), Rt axis deviation . LUNG X RAY: Pneumonia
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ASSESMENT From the subjective and objective findings the patient was diagnosed as OHA INDUCED HYPOGLYCEMIA WITH HTN WITH DM-T2.
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TREATMENT GOALS To quickly bring the level of blood glucose within the normal range to prevent serious brain damage To delay disease progression To improve patient quality of life
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DRUGS
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PROGRESS CHART 1st day GRBS at 7 am bbf – 49mg/dl 9 am abf – 149mg/dl 2nd day pt in normal diet, pt conscious, monitor GRBS 2nr hrly, w/f of hypoglycemia symptoms 3rd day normal diet, GRBS 8th hrly, leucocytosis, eosinophilia 4th day normal diet, wbc: 12000 Adr: warfarin induced rash 5th day patient is stable, monitor GRBS 8th hrly 6th day patient stable 7th day GRBS: 140mg/dl
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PROTHROMBIN TIME: 17.8 sec ADR OBSERVED Warfarin Sodium Skin Rash (Black Color Patches)
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PATIENT COUNSELLING Patient should follow proper medication. A glass of milk or fruit drink with honey are also useful Do not give diet drinks Should take healthy diet. Regular exercise Salt restriction food should take Testing blood sugar levels regularly can help you to understand when your sugar levels are dropping too low you can also lower your dose during or following certain activities (eg exercise or after having alcohol) to prevent a hypo occurring.
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DISCHARGE MEDICATIONS
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