MULTIPLE DISEASES REQUIRE VIGILANT MONITORING AND PROTOCOLS; A CASE REPORT
Riphah Institute of Pharmaceutical Sciences, Riphah International University, G7/4,7th Avenue, Islamabad, Pakistan.
Keywords: Blood pressure, diabetes, COPD, metabolic syndrome, pharmaceutical care
High blood pressure is regarded as “the silent killer” because it often has no warning signs or symptoms. About 60% of people who have diabetes also have high blood pressure. Diabetes mellitus and metabolic syndrome are common in patients with chronic obstructive pulmonary disease (COPD) because COPD directly increases the insulin resistance. Insulin resistance commonly occurs with obesity, dyslipidaemia and hypertension. Together these make up the ‘metabolic syndrome’, which is a major determinant of cardiovascular morbidity and mortality. Thus; the purpose of this case study is to understand the complexity of diseases that can arise problems in treatment regimes to avoid clinical errors for optimizing the therapy plans. A 58 year old male was presented in the medical ward of semi-private hospital, Rawalpindi, Pakistan with chief complaints of acute exacerbation of COPD, uncontrolled hypertension, known carotid artery stenosis and left sided chest pain. On the basis of his medical investigation, the physician prescribed him tablet Theograde(theophylline) 350mg ½ BID( twice a day), tablet Rast (rosuvastatin) 10mg 1 × HS (at night), Tablet Lasix (furosemide) 40mg 1 × O.D (once a day), tablet Minipress (prazosin) , tablet Panadol (paracetamol) 2× TDS(three times a day), tablet Famot (famotidine) 40mg 1 × O.D, Atem (Ipratropium bromide) nebulization three times a day, Ventolin (salbuatamol) nebulization four times a day, Brufen (ibuprofen) cream, steam inhalation three times a day and Injection Leflox(levofloxacin) 500mg IV × O.D. vital signs showed temperature 99°F, respiratory rate 21 breaths/ minute, Blood pressure 150/105, pulse 86/minute and PEFR 250 L/minute. Cyanosis and edema were observed. CVS= S1+S2+ loud R2. There were certain clinical and pharmaceutical inaccuracies were noted during the treatment. Thus; a rational clinical practice needed to implement health care system. Specially; the avoidable clinical errors are required to be addressed to optimize the regimens. The need of hour is a qualified pharmacist side by side with an experienced prescriber which will help to avoid the undesired health related consequences.