Scribd
Upload
8 views

Minor

Uploaded by

Shaik.Shaheera 24
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
8 views

Minor

Uploaded by

Shaik.Shaheera 24
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 17

A CASE STUDY ON TRANSIENT ISCHAEMIC ATTACK[STROKE]

PRESENTED BY : UNDER THE GUIDANCE OF :


SHAIK.SHAHEERA Mr. SATEESH.S.GOTTIPATI
V PHARM D B.PHARM.,M.S(USA),R.PH(USA),CIP(USA)
19AB1T0024. Associate professor
Dean of academics and chief Preceptor
Department of pharmacy practice.

VIGNAN PHARMACY COLLEGE


(Approved by PCI-New Delhi and affiliated to JNTUK)
Accredited by NAAC A++ and NBA (B. Pharmacy)
An ISO 9001:2015, ISO 14001:2015, ISO 45001:2018 Certified Institution
Vadlamudi, Guntur (dist), A.P., India. pin.code: 522213
INTRODUCTION

• DEFINITION : A transient ischemic attack [ TIA] or mini stroke is caused by a


temporary disruption in the blood supply to part of the brain . The disruption in
blood supply results in a lack of oxygen to the brain leading to stroke. It is a
medical emergency.
• ETIOLOGY : High blood pressure
Cardiac arrythymias
Arterothrombosis
Atherosclerosis
Vasculitis
Plaques
Cardiac embolism
Artrial fibrillation.
• RISK FACTORS : HTN
DM
Smoking
Previous Hx of stroke
Obesity
Age
Alcoholism
Unhealthy diet
Physiological stress
Lack of regular physical exercise
Oral contraceptive pills.

• SIGNS AND SYMPTOMS : face – face droop / asymmetry.


arms – arms drift / arm weakness , numbness.
speech – slurring of speech.
• PATHOPHYSIOLOGY :

TIA[stroke]

temporary decline in oxygen supply

temporary reduction of blood flow in a neurovascular distribution

partial or total occlusion – typically from a thromboembolic event or


stenosis of vessels.
• DIAGNOSIS : Complete blood picture
Serum electrolyte levels
Coagulation studies
ECG
MRI
Carotid doppler
Ultrasonography
CT angiography
MR Angiography.

• TREATMENT : ANTI PLATELET DRUGS


ANTI COAGULANTS
STATINS.
• SURGERY : ANGIOPLASTY
CAROTID ENDARTERECTOMY .
PATIENT DETAILS

NAME : XXX
AGE : 36 YRS
SEX : FEMALE
IP NO : IPGN231000184
UMR NO : GN-231000412.
SUBJECTIVE

C/O :
slurring of speech
altered behaviour lasting for 30 min
light upper & lower limb weakness.

no C/O:
headache /seizures or loss of consciousness / jerky movements/ bowel and
bladder incontinence.
OBJECTIVE

Past medical history : Diabetes, HTN


Past medication history : Tab. Nicardioretard 10 mg
Tab. Glucoryl-M 0.5/500 mg
Past surgical history: nil
Past trauma history : nil
Social history : nil
Family history : nil significant
Surgeries : nil.
VITALS

BP : 130/80 mm hg
HR : 97 BPM
RR : 22/MIN
SPO2 : 98%
TEMP : 98.6 F
GRBS : 150 mg/dl
Physical examination : Normal
MRI
IMPRESSION :
Acute lacunar infarcts in left gangiocapsular region.
ECG
IMPRESSION :
Sinus Rythym
Low T wave
Poor Rwave
Slight ST depression.
ULTRASOUND
IMPRESSION : Mild hepatomegaly with grade 1 fatty infiltration, Umblical hernia.
CAROTID DOPPLER
IMPRESSION : No significant hemodynamic changes.
RFT,LFT,CUE,TFT,CRP : Normal.
PERIPHERAL SMEAR : Normal
RENAL DOPPLER : No features of renal artery stenosis.
SERUM ELECTROLYTES

SODIUM 143 MMOL/L 141

POTASSIUM 3.4 MMOL/L 3.2


LIPID PROFILE TEST
TOTAL CHOLESTROL 176 MG/DL HIGH >240MG/DL
NORMAL <200MG/DL
BOARDERLINE 201- 239
TRIGLYCERIDES 203 MG/DL NORMAL <150
BORDERLINE 151 – 199
HIGH 200-499
VERY HIGH >500

HDL CHOLESTROL 22 MG/DL 40-60


NON HDL CHOLESTROL 154 MG/DL 80-130
VLDL CHOLESTROL 41 MG/DL 5-30
LDL CHOLESROL 113 MG/DL 20-100
LDL CHOLESTROL/HDL 5.0 0.4-0.8
CHOLESTROL
TOTAL CHOLESTROL/HDL 8.0 1-5
RATIO
COMPLETE BLOOD COUNT
HB 14.1 G/DL 13.6 13.3 12.0-15.0
TOTAL WBC 7300 5500 5200 4000-11000
COUNT CELLS/CUMM

TOTAL RBC 5.05 5.01 4.87 4.5-5.5


COUNT MILLON/CUMM
PLATELET 2.94 2.80 3.07 1.5-4.0
COUNT LAKHS/CUMM
PCV 42 % 41 40 37-49
MCH 27.6 PG 27 27 27-32
MCHC 32.9 % 33 33.3 31.5-34.5
MCV 84 FL 82 82 83-101
ABSOLUTE 1679 1720 1664 1000-3000
LYMPHOCYTE
COUNT
NEUTROPHILL 3.0 2.0 2.0 0.78-3.5
LYMPHOCYTE
RATIO
ASSESMENT

A 36 years old female patient with known case of diabetes ,HTN came to
hospital with c/o slurring of speech, altered behaviour lasting for 30 min,
limb weakness was diagnosed with transient ischemic attack.
PLAN

Hospitalization
MRI brain
Monitoring blood sugar levels
Salt restriction, diabetic diet.

MEDICATION:
DRUG DOSE ROA FREQUENCY CATEGORY

INJ PANTOP 40MG IV OD PPI

INJ OPTINEURON 1AMP IV OD MULTI VITAMIN


SUPPLEMENT
TAB 10MG P/O BID CCB
NICARDIORETARD
TAB.ROSUVAS 40MG P/O HS STATIN

TAB.ASPISOL 75MG P/O OD ANTIPLATELET

TAB.CLOPITAB 75MG P/O OD ANTIPLATELET

SYP CREMAFFIN 75ML P/O SOS LAUXATIVE

TAB GLUCORYL M 0.5/500MG P/O BID ORAL HYPOGLYCEMIC


AGENT

INJ DOXYCYCLINE 100MG IV BID ANTIBIOTIC


DRUG INTERACTIONS

• FINDING- ASPIRIN-CLOPIDOGREL
ASSESMENT- Increased risk of bleeding
MONITORING- Monitor internal bleeding.
• FINDING- ASPIRIN-GLIMEPRIDE/METFORMIN
ASSESMENT- Increased risk of hypoglycemia
MONITORING- Monitor glucose levels .

You might also like