ACUTE GASTROENTERITIS WITH HEMATOCHEZIA

J. PRAVALIKA
19CE1T0013
PHARM-D 5TH YEAR
BHARAT SCHOOL OF PHARMACY
SUBJECTIVE

A 63 year old male got admitted to the hospital with..,

CHIEF COMPLAINTS:-
• Complaints of loose stools 10-12 episodes/day since yesterday night.
• Blood tingle in 6 episodes.
• Complaints of vomiting 4-5 days episodes since yesterday night.
HISTORY OF PRESENT ILLNESS:-
• Complaints of low grade fever since yesterday.
• Complaints of abdominal distension since morning.
• History of outside food intake yesterday night.
HISTORY OF PAST ILLNESS:-
• K/C/O HTN
FAMILY HISTORY:-
• Nil
OBJECTIVE
PHYSICAL EXAMINATION:-
• Blood pressure – 100/70mmHg
• Pulse rate – 90b/min
• CVS – s1s2+ve
• Lungs – BAE+
LABORATORY INVESTIGATIONS:-
• HGB – 15.6 g/dl
• WBC– 9,300/cumm
• Platelet count – 2.2lks/cumm
SERUM SAMPLE TEST:-
• Sodium – 141 mmol/L
• Potassium – 4.4 mmol/L
• Chlorine – 111 mmol/L
DIAGNOSIS – ACUTE GASTROENTERITIS WITH HEMATOCHEZIA
 THERAPEUTIC MANAGEMENT
S.N BRAND GENERIC CATEGORY DOSE FREQUENC ROUTE
O NAME NAME Y

1. OPTINEURON Thiamine + Nutritional 100ml OD IV

vitamin B6 + D- supplement
panthenol
2. PAN Pantoprazole Proton pump 40mg OD IV
inhibitor

3. ZOFER Ondansetron 5 HT-3 receptor 4mg SOS IV

antagonist

4. METROGYL Metronidazole Anti-protozoal 500mg TID IV

5. SPORLAC Lactobacillus Probiotic 100mg TID Oral

6. REDOTIL Racecadotril Anti-diarrheal 100mg TID Oral

ASSESSMENT

ETIOLOGY – Intake of contaminated food and water.

EVALUATE THE CURRENT THERAPY
 OPTINEURON – nutritional supplement and helps to improve the level of
vitamin B12 in the body.
 PAN – it is a proton pump inhibitor, it suppresses gastric acid secretion by
inhibiting the parietal cell H+/K+ ATP pump.
 ZOFER – it blocks the action of serotonin on 5-HT3 receptor present
peripherally on vagal nerve terminal.
 METROGYL – Inhibition of DNA synthesis leading to death of bacteria.
 RACECADOTRIL – It inhibits enkephalinase, a cell membrane peptidase
enzyme located in epithelium of small intestine, which causes hyper
secretion and producing anti-diarrheal effect.
EVALUATE FOR DRUG INTERACTIONS –
METRONIDAZOLE<>ONDANSETRON: Co administration of these
agents may prolong QT interval results in additive effects like
ventricular arrhythmias.

PLAN
GOALS
• Monitor diarrhea frequency.
• To ease the symptoms.
• Prevention or management of complications.
 DRUG PARAMETERS
DRUG TOXIC PARAMETERS THERAPEUTIC
PARAMETERS
PAN Head ache, dizziness, vertigo and Proton pump inhibitor
depression

ZOFER Head ache, fatigue, malaise, 5-HT3 receptor antagonist

bradycardia

OPTINEURON Diarrhoea, dizziness, itching, Nutritional supplement

headache

METROGYL Loss of appetite, rash ,itching Anti-protozoal

SPORLAC Dizziness, fatigue Probiotic

REDOTIL Swelling of face, tongue, lips, Anti-diarrheal

PATIENT EDUCATION
 About disease – An intestinal infection marked by diarrhea, cramps, nausea,
vomiting and fever. stomach flu is typically spread by contact with an
infected person or through contaminated food or water.
 About drugs
- Do not miss the dose
- Do not double the dose
- Check for drug-drug and drug-food interactions
 Life style modifications
• Avoid foods that can increase stomach acid production.
• Eat small meals that keep stomach from getting too full, and reduce gastric
pressure.
• Sleep with your head and shoulders elevated as it reduces gastric pressure.
• Use antacids as it neutralizes the gastric acid.
• Avoid outside food.