110 likes | 126 Vues
Pharmacotherapeutics-II. Malaria. Patient Demographics Patient name: Vishwanath I.P No : 25484 Unit : C Age : 40y rs Dept : Medicine Sex : Male Weight : 57 kg DOA : 10/ 12/12 DOD : 14/ 12 /12
E N D
Pharmacotherapeutics-II Malaria
Patient Demographics Patient name: Vishwanath I.P No : 25484 Unit : C Age : 40yrs Dept : Medicine Sex : Male Weight : 57 kg DOA : 10/12/12 DOD :14/12/12 BP : 122/90mmHgPR : 84bpm
Chief Complaints:- C/o: Fever & Chills since 8 days PM-HX :k/c/oDM Family medical history: k/c/o HTN(Ess) Food habits: Mixed Diagnosis : MALARIA
Laboratory data Hematology : Hb % : 12 gm % (11.5-16.5gm%) WBC : 9000 Cells/ cumm (5000-11000) ESR : 23 mm/hr (<10) Biochemistry : Urea : 21.3 mg %(10-50mg%) Serum creatinine :0.9mg %(0.6-1.2mg%) Urine Analysis: 10ml, P- yellow, clear.
SOAP NOTE Subjective Data: • fever and chills since 8 days • k/c/o T2DM-for which glabenclamide has been prescribed • k/c/o ESS.HTN- no drugs are given. • Objective data: • ESR-23mm/hr • increased acidicity of blood.
ASSESSMENT • problem 1:fever with chills It is due to release of merozoites into the blood stream from the burst hepatocytes. this process produces release of toxins in relapsed intervals which induces raise in temp.(fever) and chills. • problem 2:T2DM It is caused due to degeneration of beta cell in pancreas or due to loss of receptor perception to insulin. • problem 3: clinical Malaria It is due to bite of an anopheles mosquito carrying sporozoites of malarial parasites .incubation period is 48hrs to one week in healthy person. Can be a fatal disease in immuno-compremised patients.
Major drugs used in patient are: DISCHARGE DRUGS:--------- T.glucokind (glabenclamide)cont.
PLAN Artemisinin-basedcombination therapy (ACT) Use of antimalarial drugs singly has failed to the prevalence of malaria globally, particularly due to emergence of chloroquine-resistant followed by multi drug-resistance P. falciparum. the WHO has recommended that acute uncomplicated resistant falciparum should be treated only by combining one of the Artemisinin compounds with another effective erythrocytes schizontocide.
Advantages of ACT over other antimalarials are: • Rapid clinical and parasitological cure. • High cure rates >95%. • Absence of parasite resistance. • Good tolerability profile.
Drug interactions: Artisunate: Antimalarial potentiating action seen with mefloquine, primaquine & tetracycline. Primaquine: May inhibit metabolism of chloroquine. Avoid ethanol. Mepacrine may potentiate toxicity of primaquine.