Medical Treatment Plan for a Patient with Hypertension, Stroke, and Hypoglycemia, Study notes of Pharmacology

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SOAP

Patient’s information

• NAME : XYZ
• Age : 70years
• Sex : male
• D.O.A: 6/8/
• D.O.D : 10/8/
• Ward/bed No :B51MMW/B5IM-M&D/GEN/05- 142

• Chief complaints: Slurring of speech,Altered sensorium.Persistent

hypoglycemia (RBS: 37 mg/dL).

• History of preset illnes : nil
• Past medication history: nil
• Past medical history: k/c/o Han and bog on treatment P/H/O Vc

strokes 5years ,back knee injury (8years back)

• Family history : nil
• Marital status:
• Allergies : nil
• Social history: alcohol: 50years(2/3 pottle/day), smoking (2-3 day

since 2018) , Tobacco (2-3 mg/dl)

O=objective

Laboratory investigation

• Hb 12. Laboratory investigations Date:6/8 Result Normal value
• N/l 80/
• Platlets count
• Sodium
• Potassium 4.
• Chloride
• Creatinine 0.
• S.Bilirubin 0.
• Direct bilirubin 0.
• SGPT
• SGOT
• S.Cortisol 12.
• Urea 1.

A=Assessment

1. Provisional diagnosis : Htn(2018),cv stroke (2018),physically illness

2. Final diagnosis: Hypoglycaemia in K/C/O Htn with P/H/O CV stroke

Eitology

• multifactorial,
• the need for multidisciplinary management to address acute

hypoglycemia,

• long-term hypertension control,
• and stroke prevention.
• multifactorial, emphasizing the need for multidisciplinary

management to address acute hypoglycemia, long-term hypertension

control, and stroke prevention

P=PLAN

• Current therapy 1.Inj.cefoperozone+salbutamol
• BN: sulbactom,cefobid
• GN: cefoperozone
• Dose: 1.
• Frequency: 12 hrly
• Duration: 3days
• Pharmacological class: third-generation cephalosporin antibioticThd-
• MOA: beta-2 adrenergic receptor agonists : stimulate beta-2 receptors in bronchial somooth muscles ,causing bronchodilation. Reduce airways resistance and facilitate airflows
• ADR :tremors,nervousness,palpitations,tachycardia,headache,dizziness
• c/I : Hypersensitivity to salbutamol or it’s component.
• Indication : asthma ,chronic obstructive pulmonary disease,Acute bronchitis Asthma.
• • Chronic obs pulmonary disease (COPD).
• • Acute bronchitis.

2.Inj.D25 in infusions

• BN :
• GN: dextrose monohydrate
• Dose : if 70< or sympatomatic
• Frequency : 4 days
• Duration : 4days
• Pharmacological class: glucose elevating agent /Hypertonic solution
• MOA : provide rapid sources of glucose which is immediately absorb in to blood stream.
• ADR : Hyperglycemia ,electrolytes imbalance,Headache
• C/I : hyperglycaemia or keto acidosis
• Indication :insulin overdose maintain, neonatal hyperglycemia,as a caloric supplement
• restores blood glucose levels in hypoglycemia andc provides a source of carbohydrate calo

4.Inj glycogen

• BN : -
• Gn : Glycogen
• Dose : 1mg
• Duration :sos
• Pharmacological clas s:Carbohydrate and metabolic substrate
• ADR : Local injection site reactions (pain, redness).Hypoglycemia or hyperglycemia (rare).Allergic reactions (very rare).
• MOA :Glycogen is a polysaccharide that serves as an energy reservoir in tissues. When injected, glycogen is broken down into glucose by glycogenolysis, supplying energy.
• Indication :Diagnostic research involving carbohydrate metabolism.Investigational use in glycogen storage diseases.
• C/I :Known hypersensitivity to glycogen or injection components.Uncontrolled diabetes mellitus (risk of dysregulated glucose response).

5 .inj ondansetron

• bN : zofran,ondem,Emset
• GN : Ondansetron
• dose : 4 ml IV
• Frquency: 8hrly sos
• duration : 1 days:
• pharmacological class: 5 - HT3 (serotonin) receptor antagonist
• MOA : Ondansetron blocks serotonin (5-HT3) receptors in the chemoreceptor

trigger zone (CTZ) and gastrointestinal tract, preventing nausea and vomiting.

• ADR : Headache,Dizziness,Constipation or diarrhea,QT prolongation (risk of

arrhythmias)Injection site reactions

• C/I: Hypersensitivity to ondansetron or other 5-HT3 antagonists,Congenital long

QT syndrome,Caution in severe hepatic impairment

• indication: chemotherapy,radiotherapy, surgery

7.Tab olmesartan

• BN Olmetec,Benicar,Olmezest
• Gn: Olmesartan
• Dose : 20mg
• Duration : 5days
• Frequency : 1 - 0 - 0
• Pharmacological class: Angiotensin II receptor blocker (ARB)
• MOA : Olmesartan selectively blocks angiotensin II type 1 (AT1) receptors, preventing angiotensin II from binding. This leads to:Vasodilation,Reduced aldosterone secretion,Decreased blood pressure
• ADR : Dizziness,Hypotension,Hyperkalemia,Renal impairment,Headache,Fatigue,Rare: Sprue-like enteropathy (severe diarrhea and weight loss)
• C/I: Hypersensitivity to olmesartan or any components of the formulation,Pregnancy (risk of fetal toxicity),Severe renal impairment or bilateral renal artery stenosis
• Indication : Hypertension (high blood pressure),As monotherapy or in combination with other antihypertensive agents.Cardiovascular risk reduction (indirectly by controlling blood pressure).

8.tab telmisartan

• BN : Micardis,Telma,Telsartan
• GN : Telmisartan
• Dose : 0.410 mh
• duration : 0- 0 - 1
• frequency : 5 days
• pharmcological class : Angiotensin II receptor blocker (ARB)
• MoA : Telmisartan selectively blocks angiotensin II type 1 (AT1) receptors, leading to: Vasodilation,Reduction in blood pressure,Decreased aldosterone release,Prevention of cardiac remodeling and renal damage
• ADR :Dizziness,Hypotension,Hyperkalemia,Fatigue,Back pain,Renal impairment
• C/I: Hypersensitivity to telmisartan or any of its components:Pregnancy (risk of fetal harm),Severe hepatic impairment,Bilateral renal artery stenosis
• indication : Hypertension (high blood pressure):Alone or in combination with other antihypertensives.Cardiovascular risk reduction in patients at high risk (e.g., those with coronary artery disease, diabetes, or a history of stroke).