single vessel disease

Case of Single Vessel Disease

• By

Vignesh.G

5th Pharm.D

Demographic details • Name: XYZ• Age:65yrs• Sex:Female• Weight:81Kg• Admission Date:02/01/15• Discharge Date:05/01/15 • Ward:Semi-Private(4th floor)

Subjective-Current Complaint And History OF Illness• C/o neck pain and headache since 2days with giddiness• H/o Fever and Cough• H/o Retrosternal chest pain radiating to right upper limb

since 4pm on admission day

K/C/o DM & HTN

Objective evidenceVITALS Day 1 Day 2 Day 3 Day 4

Temp(F) 98.6 99.2 98.7 98.6

RR(cpm) 15 18 18 20

Pulse(bpm) 85 82 84 80

BP(mmHg) 184/111 160/100 140/90 120/80

Radiographic Data• ECG – RS, ST Elevation• ECHO revealed RWMA with severe LV Dysfunction• Angiogram revealed – single vessel disease

PTC Angioplasy

Treatment DetailsBrand Name Dose Date Begin Date Ended Frequency

Inj.Dolbutamol 2.5mcq/Kg 03/01/15 04/01/15 1-0-1

T. ecosprin 150mg “ 05/01/15 1-0-1

T. Cardivas 3.125mg 04/01/15 “ 1/2-0-1/2

T.Pantodac 40mg 03/01/15 05/01/15 1-0-1

T.Atorva 40mg 03/01/15 05/01/15 0-0-1

T.Telma 40mg 03/01/15 05/01/15 1-0-0

T.clopilet 75mg 03/01/15 05/01/15 1-0-1

• Inj Dolbutamide: dolbutamine- It is a synthetic catecholamine. It helps heart pump better by strengthening the heart muscle.

ADRs-upset stomach, tingling sensations, leg cramp, increasing fatigue.

• T.Ecosporin: Its an Antiplatelet. It inhibits cyclooxygenase, which is responsible for the synthesis of prostaglandin and thromboxane. It inhibits platelet aggregation.

T.Cardivas: It is an alpha- and beta-blocker, prescribed for heart failure and high blood pressure.  It relaxes blood vessels and slowing heart rate to improve blood flow and decreases blood pressure.

ADRs-disorientation, sudden unusual weight gain, Dizziness, fatigue, headache

• T.Pantop: PPI Class of drug acts by inhibiting the proton pump found on cell that stomach uses to produce acid.It prevents the excess flow back of acid into foodpipe thus relieving the heart burn.

ADRs- overdosing may cause negative ionotropy effect by inhibition of H+/K+ ATPase enzyme in myocardium.

Atorvastatin: Statins- these are HMG CoA reductase inhibitors. They inhibit HMG CoA and thus prevents the conversion of HMG to mevalonate thus hindering the cholesterol pathway,increasing the HDL level.

ADR-Myopathy,Rhabdomyolysis,diarrhea

,dyspepsia,nausea

Telma: sartans-these are AT2 receptors antagonists-vasodilations. As well act in PPAR-y regulating the insulin & glucose metabolism.

ADR- edema,irregular Heart beat.

• Clopidogrel: It is theonopyridine class of antiplatelets. Inhibits the platlet activation by acting in P2Y12 receptor of ADP in cell membrane of platlets thus inhibition of fibrin and so platelets.

• ADR- neutropenia, bleeding, thrombotic thrombocytopenia purpura

Discharge MedicationsBrand name Dose frequency ROA Duration

T.Ecosprin 150mg 1-0-1 P/O 7days

T.Clopilet 75mg 1-0-1 P/O 7days

T.Aztor 40mg 0-0-1 P/O 7days

T.cardivas 3.125mg 1-0-1 P/O 7days

T.Telma 40mg 1-0-0 P/O 7days

T.Pantodac 40mg 1-0-0 P/O 7days

T.Glycomet 500mg 1-0-0 P/O 7days

Patient counselling• To have more plant proteins-soy chunks,nuts,grains as

they have low saturated fats.• Increase intake of omega 3 fats- Fish,walnuts,greenleafy• Olive, canola, peanut oil should be used for cooking.• Avoid processed and baked food as they have high

triglycerides level.• Decrease weight, do regular exercise,walking (30Min) .• Eat more rice bran,fruits as they are more fibrous as

soluble fibers can bind to bile instead cholesterol.• Balanced diet, reduce salt to 2g a day.

THANK YOU