Model Fisa Eng 18.docx

Ministerul Sănătății al Republicii Moldova Universitatea de Stat de Medicină și Farmacie ”Nicolae Testemițanu” Catedra de Farmacologie și farmacologie clinică Șef catedră: Ghicavîi Victor –mc AȘM,profesor universitar Conducătorul grupei: Chianu Marin,asistent universitar

Lucrare instructiv-didactică (microcurația pacienților)

Student:Ciorici Victoria,gr.M1429 Facultatea: Medicină Nr.1

Chișinău 2019

Sex: female Nationality: RM

Address: Mun. Chisinau, Sec: Botanica Date of hospitalization: 23.11.16 at 19-00 o'clock

1.

Hospitalization diagnosis: Acute Bronchitis 2a.Clinical diagnosis: Acute Bronchitis

2. Patient history: the patient came to the hospital after episodes of dyspnea also the patient has a high fever father said, also that his daughter was compline before 2 years for the same symptoms.

3. Treatment history: the patient family during these episodes of dyspnea dexamethasone as inhalation ”Aerosol Dexamethasone”.

4. Objective data and PLAN OF LABORATORY INVESTIGATIONS: CBC. biochemical analysis of blood. C-Xray

The result of laboratory investigations: CBC: Hb – 11.9 RBC – 5.15 WBC: 17.3 * 10`3 / UL H Granulocytes: 15.2 H Lymphocytes – 6.3% - 1.1 *10’3 / UL Monocytes -5.6 % MCHC 32.0 HCT 37.1 MCV 72.0 PLT 247 ESR 10 Neutrophils S: 26 H , UNSEGMENTED NORMAL 64 Conclusion: increased WBC, WHICH its an indicator for inflammation …

biochemical analysis of blood : General Bilirubin – 8.5 micromol / l ( norm : 11 to 18 micromol / l) ; bilirubin bound - --- “0” micromol / l ( norm : 0-1 micromol / l) ; free bilirubin – 8.5 micromol / l ( norm :: 11 to 18 micromol / l) ;

gave her

ALAT -14.1 U / l; ASAT -25.4 U / l ; Glucose 5.5 / l ( standard 4 - 6.5 mmol / l ) ; X-Ray: Showed Acute Bronchitis

5. TREATMENT ANALYSIS:

Salbutamol O2 Nitrous Chloride Mg Sulphate Thiyophilline climasten Fluticazone drotavirine clarithromycin

Dosage - 23.11 24.11 GR Aerosol +++ +++ Inhalation + Inhalation

25.11 26.11 27.11 28.11 29.11 +++ + ++

+++ + +

Inhalation 0.15g 0.5g + 0.12g 0.04g + 0.5g

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+

+++ ++

+

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+

+ ++

+ +

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Salbutamol: it is short-acting β2 adrenergic receptor agonist, which works by causing airway smooth muscles to relax, in our patient it was administrated for relief of bronchoconstriction Side Effects: Common side effects include shakiness, headache, tachycardia, dizziness, and feeling anxious. Serious side effects, irregular heartbeat, and low blood potassium levels. It can be used during pregnancy and breastfeeding, but safety is not entirely clear.

Indications: It is used to treat asthma, exercise-induced bronchospasm, and chronic obstructive pulmonary disease (COPD). It may also be used to treat high blood potassium levels Theophylline: it’s a phosphdisterase 3 inhibitor drug which is preventing and treating symptoms of blockage of airway due to acute bronchitis. O2 inhalation: Patient has low saturation because of this we gave her and it’s a good choice for increasing the O2 saturation.

Clemastine: its first generation

H1 receptor antagonist, that’s drug act by inhibiting histamines and also can pass blood brain barrier and cause sedative effect they give the patient to check if it’s the allergy the cause of bronchitis, but after the results of Cbc it was approved that the patient have bacterial infection.

Drotaverine: is an antispasmodic drug, but an inhibition of the enzyme phosphodiesterase causing elevation of cyclic AMP levels is significant in our patient its not needed , only if she came with abdominal colic or pain otherwise it is not appropriate to give her.

Flutcazone: its inhaled glucocorticoids which act by making a bronchodilator and decreases inflammatory cells and mediators, its needed to administrate for the patient, its good choice , but not for along period because may cause candidiasis “oral” and dysphonia.

Clarithromycin: its Macrolide antibiotic which have a narrow spectrum of action act on gram positive bacteria, its act by inhibiting protein synthesis in bacteria, it’s a good choice as an antibiotic but we think that its better to give the patient an broad spectrum antibiotics, Sputum Culture was not made but the most common etiological factor is gram positive bacteria after viral , but the lab studies shows that we have bacterial etiology “CBC”. Its Hepatic enzyme inhibitor and should not be administered with other drug especially Theophylline.

6. Diaries (daily observation) In 25.11.2016 the patient status was stable, and there’s a slight symptoms which is cough. Heart rate was normal 89 beats/min and blood pressure was also normal Temperature the patient had 36.8 in the day. In general the status of the patient was improved. In 26.11.2016 : the patient Status Is better than how she came in first day so the treatment is effective the heart rate was normal 92 Beats/Min and temperature was 37.2..in general the status of the patient was very well after these drug administration the patient discharged to home at 29.11.2016.

7. CONCLUSION: the treatment is appropriate and have shown that the patient improved and her status start to be good, and we agree with the treatment. (Suggest your own treatment plan)

8. Personal Drug Selection (select the most efficient and harmless drugs) Drugs

Conclusion

Efficacy

Inoffensivity Acceptability Price (Side (Contraindications) Effects)

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