by,

RAMESH.KASARLA

Pharm.D (PB 1st yr)

Roll no:3

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INTRODUCTIONGastroenteritis is an illness caused by infection and or

inflammation of he digestive tract. It is characterisedby nausea,vomiting,diarrhea and stomach cramps.

The most common cause is a virus, which tends to spread very easily. Less common causes of include bacteria or food poisoning.

An infection may be caused by bacteria or parasites in spoiled food or unclean water.

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CAUSES: Gastroenteritis has many causes. Viruses and bacteria

are the most common.

Bacteria: Escherichia coli, salmonella,compylobacter,

shigella.

Viruses: Adenoviruse, Rotaviruse, norovirus.

Parasites: Giardia - The most frequent cause of waterborne diarrhea causing giardiasis.

Cryptosporidium - Affects mostly people with weakened immune systems, causes watery diarrhea

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SUBJECTIVE:

CHIEF COMPLAINT: - MR.KL, a 30 yrs old male patient was admitted in hospital with complaint of fever with chills since 3 days and abdominal pain associated with loose stools since 3days.

HISTORY OF PRESENT ILLNESS: - The patient was presented with vomitings and fever associated with chills.

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OBJECTIVE: -

ALLERGIES: - No known drug allergy.

PHYSICAL EXAMINATION:

GENERAL APPEARANCE: - Height -175cm weight – 71.2kg BMI -23.4

Vital signs:-Pulse: - 72beats/minute.RR:-22breaths/minute.BP: - 110/80 mm of Hg.Temperature: - Afebrile.Pain: - 0/10

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LABORATORY INESTIGATIONScomplete blood count

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TEST RESULT REFERENCE VALUE

Hemoglobin 17.5* 12-16g/dl

Hematocrit 52.3 45-55

RBC 5.25 3.7-5.6million/mm3

MCV 100* 75-95fl

MCH 33.49* 26-32

Platelets 380 140-440 x 103/ mm3

Neutrophils 56% 40-75%

Llymphocytes 26% 20-45%

Eosinophils 16%* 1-10%

ESR 05 0-10

ELECTROLYTES:

RENAL FUNCTION TESTS:

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TEST RESULT REFERENCE VALUE

Na+ 132* 135-145mmol/dL

K+ 3.4* 3.5-4.5mmol/dL

Cl־ 95* 98-107mmol/dL

TEST RESULT REFERENCE VALUE

Urea 48* 15-38

Serum creatinine 1.0 0.5-1.2

BUN 22* 7-18

Globulin 3.7* 1.8-3.6

Prealbumin 15* 19.5-35.8

Malarial anigen detection test: negative

CBC with ESR- negative

Ultrasound whole abdomen-negative

Peripheral smear:

RBC: Normocytic, normochromic

WBC: monocytosis

Platelets: adequate on smear

DIAGNOSIS: Chronic gastroenteritis

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DRUG CHARTDRUG NAME GENERIC NAME DOSE ROUTE FREQENCY INDICATION

Inj.NEKSIUM esomeprazole 40mg IV OD Gasrtitis

Inj.ZOFER ondansetron 8mg IV TID Vomiting

Inj.ZANOCIN ofloxacin 200mg IV BID Antibiotic

IVF.DNS Normal saline 100ml/hr IV Hydration

C.DAROLAC lactobacillus 1 cap PO TID Probiotic

C.REDOTIL racecadotril 1cap PO TID Diarrhea

C.RIFAGUT rifaximin 400mg PO BD Diarrhea.

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ASSESSMENT:MR.KL 30yr old male patien was admitted in hospital

with complains of fever with chills since 3 days and abdominal pain associated with loose stools since 3days.

VOMITING AND DIARRHOEA: Antiemitics ONDANSETRON, antidiarrhoeal RACECADOTRIL and

RIFAGUT was given and probiotic (T.DOROLAC) which normalizes the presence of intestinal flora.

HYDRATION: the patient was hydrated by administering IVF.DNS.

GASTRITIS:INJ.NEKSIUM(esomeprazole) was given for gastritis.

ANTIBIOTIC:INJ.ZANOCIN(ofloxacin) was given as antibiotic.10

PLAN:RECOMMENDATIONS:

Check the vital signs

Check and monitor the electrolyte levels and renal function tests

Strictly monitor urine input-output levels

Avoid giving fruit juices and carbonated drinks until the diarrhoea has stopped

Drink plenty of fluids. An electrolyte replenisher or rehydration liquid may be helpful.

After diarrhea and vomiting stop, drink small amounts of clear liquid such as tea and flat ginger ale or lemon/lime soda.

After tolerating soft food for two or three days, gradually return to a normal diet.

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DISCHARGE MEDICATIONS:

T.ZOFER(ondansetron)-4mg per oral if necessary for vomiting.

C.DAROLAC(lactobacillus)-1 cap per oral,threetimes a day as probiotic.

C.REDOTIL(racecadotril)-1 cap per oral, three times a day if necessary for diarrhea.

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THANK YOU

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