A case study on hyperthyroidism, anemia
- 1. A Case Study On Hyperthyroidism, Anemia, Polyhydramnios,Hypotension and Post partum haemorrhage. 09408103 Pharm-D ( V year ) 1
- 2. PATIENT PROFORMA NAME: Mrs X SEX: FEMALE AGE: 35 HEIGHT : 150cm WEIGHT: 60kg BMI: 27 IP NO: 201221612 DEPT: OBG DOA: 10-12-13 DOD: 15-12-13 2
- 3. PROBLEMS 1.Hyperthyroidism 2.B/L Pedal oedema 3.Anaemia 4.Polyhydramnios 5. Hypotension 6.Post partum haemorrhage 3
- 4. SOAP NOTES SUBJECTIVE : A 35 years old female patient was admitted in hospital with C/O: Draining PV, pain in lower abdomen, pain while micturating and oedema on both legs.She didn’t had a significant past medical & medication history. She was a married lady. 4
- 5. OBJECTIVE INVESTIGATIONS DONE: PICCL(+)E(+). HAEMATOLOGY: Blood urea: 55(elevated) o Creatinine:1.77mg/dl(elevated) o Serum ferritin: 229.72(elevated) o Haemoglobin: 11.1(decreased) o AFI: 31.4cm(elevated) o FHR: 123 BPM 5 DATE 10th DEC 11th DEC 12th DEC 13th DEC 14th DEC 15th DEC TEMP N N N N N N BP 120/70 110/70 120/70 110/80 120/70 110/70 PULSE 72 73 72 73 72 72
- 6. ASSESMENT Based on the clinical evidences, the patient was diagnozed with Hyperthyroidism, B/L pedal oedema, Anemia, Polyhydramnios,Hypotension and Post partum haemorrhage. 6
- 7. PLAN OF TREATMENT 7 S.No DRUGS DOSE DAYS T.NAME G.NAME D1 D2 D3 D4 D5 D6 1 INJ. IVF Normal saline 100ml √ √ x x x x 2 T.Orofer XT Iron, Folic acid, calcium 100mg 1.1mg √ √ √ √ √ √ 3 T.Neomercazol e Carbimazole 5mg OD √ √ √ √ √ √ 4 INJ.Metrogyl Metronidazole 500mg OD x x √ √ √ √
- 8. 5 INJ.cal.gluco nate Calcium gluconate 10ml IV x x x √ √ √ 6 Packed cell 1 unit x x x √ √ √ 7 Syp.Piriton cs Chlorpheniramin e maleate 2tsp tds x x x x √ √ 8 INJ.Lasix Furosemide 1amp IV x x x √ √ √ 9 T.Dytor Torsemide 20mg OD x x x √ √ √ 10 T.Misoprost Misoprostol 50mg OD √ √ √ √ x x 8
- 9. DRUG INTERACTIONS- No significant drug interactions were found ADR- No significant ADR were found 9
- 10. PLAN OF TREATMENT DISCHARGE MEDICATION - 1. T.Torsemide, 2. Syp.piriton cs and 3. T.Neomercazole PATIENT COUNSELLING - Take Antacids to relieve Heart burn & Nausea which may be caused due to Polyhydramnios. Furosemide-Furosemide will make you urinate more often, so don’t panic.you may get dehydrated easily so avoid exposure to sunlight . Metronidazole-Skipping doses may also increase your risk of further infection & development of resistance to antibiotics. 10
- 11. Chlorpheniramine maleate- Advise patient medication may cause drowsiness or dizziness and not to drive or perform other activities requiring mental alertness until tolerance is determined. • Advise patient to take each dose without regard to meals, but to take with food if stomach upset occurs. MONITORING PARAMETERS- • Monitor the T3 & T4 levels for the control over the Thyroid functioning • Monitor the Hb & serum ferritin levels for the control over Anaemia 11
- 12. LIFE STYLE MODIFICATIONS- Anti-oxidants like vitamin C (lemon, orange, amla, sweet lime etc.), vitamin E (meat, liver, fish etc.) must be suggested as these reduce the iron from ferric state to its ferrous state (since iron can be absorbed only in its reduced form). Avoid sea foods as they contain high iodine content. Broccoli, soya products, cabbage, cauliflower, strawberries comprises a good diet for Hyperthyroidism FOLLOW UP- Review after 10 days 12
- 13. Thank you 13