CASE PRESENTATION ON LIVER CIRRHOSIS Medical Presentation

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CASE PRESENTATION ON LIVER CIRRHOSIS BY K.Manasa Pharm D V Year 14CQ1T0010
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. CASE SUMMARY A 54 year old male patient was admitted in Male medical ward with IP Number 678675 on 22/12/18.
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. SUBJECTIVE EVIDENCE PRESENT COMPLAINTS: Abdominal distension since 15 days Bilateral pedal edema since 15 days Shortness of breathe since 10 days Loss of appetite since 1 week
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. PAST HISTORY : Jaundice since 1 year PERSONAL HISTORY: Known alcoholic since 2 yearsyears
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OBJECTIVE EVIDENCE
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VITALS GENERAL PHYSICAL EXAMINATION: SYSTEMIC EXAMINATION: CVS : S1S2 +ve CNS : Conscious RS : Clear P/A : Distended abdomen
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LABORATORY INVESTIGATIONS:
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. Other tests: CT scan of abdomen: cystic fibrosis and destruction of liver parenchymal cells.
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ASSESSMENT DIAGNOSIS: The patient was diagnosed as LIVER CIRRHOSIS
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PLAN GOAL OF TREATMENT: To treat bilateral pedal edema To treat cirrhosis of liver.
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TREATMENT CHART
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DRUG MONOGRAPHS Taxim: Class : 3rdGeneration Cephalosporins Category : Antibiotic MOA : Inhibits transpeptidation & there by inhibits bacterial cell wall synthesis ADR : Thrombophlebitis, Swelling, Rash Direction : Take the tab with glass of water with food within 30 min after a meal. USE : This is used to treat bacterial infections. It stops the growth of bacteria. Contraindication : colitis , renal impairment
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Lasilactone: Class : Loop diuretic Category : Thiazides MOA : Inhibits reabsorption of Nacl which causes increase in water in DCT ADR : Paresthesia,Drowsiness Contraindication: In renal & hepatic impairment patients USE : Used to reduce extra fluid in body and also used to treat high blood pressure. Direction : This can be taken either with/without food with a drink of water.
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. Pantium: Class : Proton pump inhibitor Category : Antacid MOA : Binds to H+/K+ ions and results in blockage of acid secretion. ADR : Dry mouth, abdominal. Discomfort Contraindication : Heart failure patients USE : Used to treat acidity related disorders Direction : Should be taken 30 min before a meal.
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. Tone: Class :Multivitamin Category : Anti anaemic MOA :Works in recovery process of damaged nerve cells ADR : Flushing, rashes, dizziness Contraindication: Pregnancy Use : Used in treatment of metabolic disorders, brain disorders etc.
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Ursoliv: Class :Tri-terpenes MOA : Decreases production of cholesterol by dissolving cholesterol in bile ADR : Nausea, skin itching Contraindication : Inflammatory bowel disease , chronic liver disease. USE : Used to improve liver functions. Direction : Should be taken with food.
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Optineuron: Class :B-complex vitamin supplements MOA :Promotes cal. Absorption in intestine & retention in kidneys thus it restores calcium levels. ADR : Numbness, vomiting, rashes Contraindication: Hypersensitivity USE : Used to treat or prevent vitamin deficiency.
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PHARMACIST INTERVENTION: Monitor the serum electrolytes levels. Monitor blood gases. Regular urine analysis done. RECOMMENDATIONS Furosemide+ Pantoprazole: Taking these medication together causes hypomagnesemia . So close monitoring & dose adjustment should be followed to avoid these consequences
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PATIENT COUNSELLING : About Disease : Alcohol consumption worsens the liver condition so avoid intake of alcohol. About Drugs : Furosemide along with pantoprazole may cause decrease in magnesium levels in body so time gap should be maintained. Pantoprazole should be taken before meal. Long term use can cause weak bones. Cefotaxim should be taken with food to avoid stomach upset.
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LIFE STYLE MODIFICATIONS: Intake of low salt and sodium diet. Fluid restriction <1 lt. Intake of Anti-oxidants. Monitor body weight. Complete cessation of alcohol. Avoid exposure to infections. Adhere to medication. Don’t skip the dose.
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THANK YOU