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    6 Ascites

    Uploaded by

    Madhuri Eega
    A case presentation on Ascites

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    6 Ascites

    Uploaded by

    Madhuri Eega
    6 views8 pages
    A case presentation on Ascites

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    © © All Rights Reserved

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    PPTX, PDF, TXT or read online from Scribd

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    A case presentation on Ascites

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    6 views8 pages

    6 Ascites

    Uploaded by

    Madhuri Eega
    A case presentation on Ascites

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 8

    CASE PRESENTATION ON ASCITES

    G.RAJAKUMAR
    H.T.NO:- 17057882003
    PHARM D Vth YEAR
    SUBJECTIVE
    REASON FOR ADMISSION:-
    A 63 years old male patient was admitted to hospital with chief complaints of
    -swelling of bilateral lower limbs with blisters,
    -abdominal distension
    -decreased urine output( fluid retension) despite diuretics,
    -Breathlessness since few months
    PAST HISTORY:-
    -DM Type- 2 (> 5years), Hypertension, Hypothyroidism, Thalassemia minor, atrial
    fibrillation
    Surgery/ procedure:-
    - ORIF left femur in 2019 (Open Reduction Internal Fixation)
    - (post abdominal paracentesis).
    PATIENT DETAILS :-
    • BMI- 38 kg/m2
    • Height - 159 cm
    • Weight- 94.3 kg
    OBJECTIVE
    When the doctor examined the patient , vitals were normal and sugar levels are as follows

    Observation ( mg/dl) 12/11 13/11 14/11 15/11 16/11


    Before breakfast 88 112 108
    Before lunch 99
    Before dinner 86 100 118 117
    After lunch 149
    After dinner 172

    INVESTIGATIONS:-

    Total leukocyte count 3.7 4-11x 103cells/mm3


    Platelets 1.68 140-440x103/mm 3
    Serum creatinine 2.12 0.6-1.4mg/dl
    Total bilirubin 0.7 1 mg/dl
    Direct bilirubin 0.4 Upto 0.25 mg/dl
    Alkaline Phosphatase 5.6 15-116 IU/L
    Alanine Transaminase 13 Upto 65IU/L
    Aspartate aminotransferase 15 Upto 37 IU/L
    INR 1.27 2-4
    Total protein 7.9 6-8 gm/dl
    Albumin 4.2, 2.7, 1.5 3.2-5.8 gm/dl
    Prothrombin time 16.3 11-14 sec
    Serum sodium 130 135-155mmols/L
    Serum potassium 4.4 3.6-5.5mmols/L

    Other Investigations :-
    • USG abdomen- mild hepatomegaly, prominent portal vein, moderate
    ascites.
    Clinical examination:-
    • Pedal edema : +ve
    • RS - bilateral basal crepts & decreased air entry.
    • 2d echo- moderate TR RVSP increased
    • Trunat- COVID – negative
    ASSESSMENT

    Based on subjective and objective information,the doctor ordered for the following
    medications .
    Trade Generic Dose Route Frequency Days
    T.Thyronorm Thyroxine sodium 125 mcg PO OD 4
    T.Cardarone XP Amiodarone 200 mg PO OD 4
    T.Folvite Folic acid 5 mg PO OD 4
    T.Minipress XL Prazosin Hydrochloride 5 mg PO OD only if BP >140/90 Stop on 14th
    Syp.Cremaffin Liquid paraffin+milk of 2tsp PO HS Stop on 14th
    magnesia
    T.Dilzem Diltiazem 30mg PO BD 5
    Inj.Dytor Torsemide 10mg IV QID 2
    Cap.Pan D Pantoprazole+ 1 tab(40 PO OD 4
    Domperidone mg +
    30mg)
    Trade Generic Dose Route Frequency Days
    T.Zoryl Glimepiride 0.5mg PO OD 4
    Inj.Lasix Furosemide 40mg IV BD 2 stop on 14/11
    T.Rifagut Rofaximin 550mg PO BD 4
    Duphalac syp Lactulose 10ml PO HS 2

    DISCHARGE MEDICATIONS:-
    Trade Generic Dose Route Frequency
    T.Thyronorm Thyroxine sodium 125mcg PO OD Empty stomach
    T.Cardarone X Amiodarone 200mg PO OD Atrial fibrillation
    T.Folvite Folic acid 5mg PO OD Thalassemia minor
    T.Dilzem Diltiazem 30mg PO BD Atrial fibrillation
    Cap.PAN-D Pantoprazole+ 40mg PO 7OD Dyspepsia
    Domperidone
    T.Zoryl Glimepiride 0.5mg PO OD Diabetes
    T.Rifagut Rifaximin 550mg PO OD Antihepatic encephalopathy measures
    Trade Generic Dose Route Frequency
    Syp.Duphalac Lactulose 10ml PO OD(at bedtime) Constipation
    T.Rencap Folic acid, 1tab PO OD Multivitamin
    methylcobalamin,Biotin
    T.Dytor Torsemide 20mg PO BD Cardiac edema

    PLANNING
    Goals to achieve :-
    • To reduce the symptoms.
    • To decrease the progression of the disease
    • To provide proper treatment
    Monitoring parameters:-
    • Monitor BP twice daily at 8am and 8pm at home
    • Monitor sugar level.
    Points to patient:-
    • Drugs – take T.cardarone,T.Dilzem,T.Rifagut and T.Rencap,T.Dytor(10am-1pm) After breakfast.
    Take T .Zoryl Before breakfast and syrup.Dhuphalac at bedtime
    • Reduce excess salt intake
    • Avoid alcohol consumption and sigarette smoking
    • Practice regular exercise
    • DISEASE – Buildup of fluid in the space between the lining of the abdomen and the abdominal
    organs.

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