CASE PRESENTATION ON

ASTHMA
BY: SHYAMALIMA ROY
22Q0316
GAUTHAM COLLEGE OF PHARMACY
ESI HOSPITAL,INDIRANAGAR,BANGLORE
 WHAT IS ASTHMA ?
Asthma is a chronic respiratory condition characterized
by airway inflammation, bronchial
hyperresponsiveness, and airflow obstruction. Effective
management of asthma involves a multidisciplinary
approach, including accurate diagnosis,
pharmacological and nonpharmacological interventions,
patient education, and regular monitoring. This case
presentation aims to provide a comprehensive overview
of asthma management through the detailed analysis of
a patient case.
 PATIENT DEMOGRAPHIC DETAILS:
• NAME: XYZ
• AGE: 55 Y
• Sex : FEMALE
• WEIGHT: 68 KG
• DATE OF ADMISSION: 29/01/2024
• DATE OF DISCHARGE: 2/02/2024
• UNIT/WARD:FEMALE GENERAL WARD
1.SUBJECTIVE EVIDENCE:

• H/O cough with expectorants.

HISTORY OF PRESENTING ILLNESS:
• The patient complaints for cough for 2-3 years.
PAST MEDICAL HISTORY:
Asthma for 2 years.
PAST MEDICATION HISTORY:

• Nothing significant.
PAST SURGICAL HISTORY:
• Nothing significant.
SIGNIFICANT FAMILY HISTORY:
• Nothing significant.
2.OBJECTIVE EVIDENCE:

• GENERAL PHYSICAL EXAMINATION:

A 55 Years old female patient moderatly, conscious ,
co-operative, alert to time ,place and person.
VITAL EXAMINATION:
TEMP : Normal
BP:208/100mmHg
PR:80b/m
RR: 20b/m
SpO2 : 98%
PHYSICAL EXAMINATION:
PALLOR ICTERUS CYANOSIS CLUBBING LYMPHADONEPATHY IDEMA
- - - - - -
SYSTEMS:

• CNS:NAD
• RS: Increased Respiration
• CVS:S1S2+
• PROVISIONAL DIAGNOSIS:
• Based on the subjective,objective the patient
is provisionally diagnosed with acute
exhibition of asthama
LABORATORY TESTS:
SL TEST NORMAL VALUES ABNORMAL
VALUES
01 Hb M:13.5-18.0g/dl 15.7g/dl
02 TC 4k-11kcells/mm³ 3900Cells/mm³
03 Platelet count 1.40-4.40lakhs/mm³ 2.1lakh/mm³
04 ESR M:0-20mm/hr NS
05 PT time Control-13.5sec NS
06 RBS 80-140mg/dl 92mg/dl
07 BUN 7-20.0mg/dl 28.0mg/dl
08 Albumin NIL NIL
09 Sugar NIL NIL
10 SGOT M:17-59U/L 30 U/L
11 SGPT M:<50 U/L 32 U/L
12 LDH 120-246 U/L 73.4 U/L
RADIOGRAPHIC DATA/OTHER DIAGNOSIS
TEST:
• ECG, ECHO is normal
• Chest x-ray found to be normal
3.ASSESSMENT:
• Based on subjective data (severe headache
from 10 days) (high blood pressure
208/100mmhg) patient confirmed
hypertension
GOAL OF THERAPY:

• Correction of significant hypoxemia.

• Rapid reversal of airflow obstruction.

• Development of a written action plan

in case of a further exacerbation.
4.PLANNING:
CURRENT MEDICATION:
BRAND NAME GENERIC DOSE FREQ ROA 01 02 03 04
NAME
Tab.Telvas-h Telmisartan 40/12. 1-0-0    
5
Tab Amlong Amlodipine 5mg 1-0-1    
Besilate
Monitor BP for    
4 hour
Inj.lasix frusemide 20mg IV    
C.B complex   
Tab.shelcale Calcium and 50mg 1-0-1   
vitamin d3
Tab.met-xl Metoprolol 25mg 1-0-0  
succinate
extended
 DISCHARGE MEDICATION:
BRAND NAME GENERIC NAME DOSE FREQ DURATION

Tab . LASIX Furosemide 50mg 1-0-0 30 days

Tab . AMLONG Amlodipine 5mg 0-0-1 30 days

C.B complex Vit b 30days

Tab. MET-XL Metoprolol succinate 50mg 0-1-0 30days

SHELCALE Calcium and vitamin 500mg 0-1-0 30days

d3
 4.PATIENT COUNSELLING:
1.Tab.lasix
Lasix is a loop diuretic
(water pill)that prevents.
Your body from absorbing
Too much salt. This allow
the salt to instead be
Passed in your urine . Lasix
Is used to treat fluid
Retention (edema)in
People with congestive
 heart failure ,liver disease , or a kidney disorder
Such as nephrotic syndrome. Lasix is also used
To treat high blood pressure (hypertension).
. WARNINGS:
You should not use lasix if you are unable to
Urinate. Using more than your recommended
Dose will not make this medicine more effective .
high doses of furosemide may cause irreversible
Hearing loss.
Before using lasix , tell your doctor if you have
Kidney disease , enlarged prostate , urination
Problem , cirrhosis or other liver disease etc.
Tell your doctor if you have recently had an ,MRI
(magnetic resonance imaging )or any type of
Scan using a radioactive dye that is injected into
Your veins .Do not take more of this medication
Than is recommended. If you are being treated
For high blood pressure , keep using lasix even
If you feel fine . High blood pressure often has no
 Symptoms.
. HOW SHOULD YOU USE LASIX ?
Take lasix exactly as prescribed by your doctor .
Follow all direction on your Prescripition label and
Read all medication guides or instruction sheets.
Do not use more then your recommended dose .
High doses of furosemide may cause irreversible
hearing loss . Lasix will make your urinate more
Often and you get dehydrated easily. Your blood
Pressure will need to checked often and you may
 Other medical tests. If you have high blood
Pressure ,keep using lasix even if you feel well
High blood pressure often has no symptom. If you
Need surgery , tell the surgeon ahead of time that
That you are using lasix. Store at room temperature
Away from moisture , heat , and light .
. WHAT HAPPEN IF YOU MISS A DOSE?
Lasix is sometime used only once , so you may not
Be on a dosing schedule .if you are using the
Medication regularly ,use the medicine as soon as
You can , but skip the missed dose if it is almost
Time for your next dose . Do not use two doses
At one time.
. WHAT HAPPEN IF YOU OVERDOSE?
Seek emergency medical attention or call the
Poison help line at 1-800-222-1222.
Overdose symptoms may include feeling very
Thirsty or hot , heavy sweating , hot and dry skin
Extreme weakness , or fainting.
 . WHAT SHOULD YOU AVOID WHILE USING
LASIX?
Avoid getting up too fast from a sitting or lying
Position , or you may feel dizzy .Avoid becoming
Dehydrate .follow your doctors instruction about
The type and amount of liquids you should drink
While you are using lasix .Drinking alcohol with
This medicine can cause side effects . Lasix could
Make you sunburn more easily aviod sunlight or
Tanning beds .wear protective clothing and
sunscreen when you are outdoors.if you have
High blood pressure , ask your doctor or
pharmacist before taking any medicine that can
Raise your blood pressure , such as diet pills or
Cough-and –cold medicine.
.LASIX SIDE EFFECTS:
Get emergency medical help if you have signs of
An allergic reaction to lasix (hives ,difficult
breathing , swelling in your face or throat )or a
Severe skin reaction.
LASIX MAY CAUSE SERIOUS SIDE EFFECTS. CALL
YOUR DOCTOR AT ONCE IF YOU HAVE:
.a light-headed feeling ,like you might pass out;
.Ringing in your ears ,hearing loss;
.muscle spasms or contractions;
.pale skin ,easy bruising ,unusual bleeding ;
COMMON LASIX SIDE EFFECTS MAY INCLUDE:
.Diarrhea ,constipation ,loss of appetite;
.numbness or tingling;
.headache , dizziness ;or
.blurred vision;
. WHAT OTHER DRUGS WILL EFFECT
LASIX?
Sometime it is not safe to use certain medicine
At the same time .some drugs can effect your
Blood levels of other drugs you use, which may
Increase side effects or make the medicine less
Effective. If you take sucralfate ,take your lasix
Dose 2 hours before or 2 hours after you take
Sucralfate.
. ADR REPORTING:
.Reporting of ADR can be done by filling the form
(link attached below)and sending the mail to pvpi
@ipcindia .net or [email protected] or
through the PVPI mobile app.
.or Dial toll free helpline number-1800-180 3024
(9:00AM to 5:30pm, Working days).
.https://cdsco.gov.in/opencms/export/sites/
CDSCO WEB/pdf-documents/consumer section
PDFs/ADRRF 2.pdf .
2.Tab .amlong
. INDICATIONS
AND USAGE:
Amlong is a calcium channel
Blocker and may used alone
or in combination with
Antihypertensive and
antianginal agents for the
Treatment of :
.Hypertensive(1.1)
.Coronary artery disease (1.2)
. DOSAGE FORMS AND ADMINISTRATION:
.2.5mg , 5mg , and 10mg tablets(3)
. WHO SHOULD NOT USE AMLONG?
Do not use amlong if you are allergic to
amlodipine (the active ingredients in amlong ),
Or to the inactive ingredients . Your doctor or
Pharmacist can give you list of these ingredients.
. WHAT SHOULD YOU TELL TO YOUR
DOCTOR BEFORE TAKING AMLONG?
Tell your doctor about any prescription and non
prescription medicine you are taking , including
Natural or herbal remedies tell your doctor if
you:
.ever had heart disease.
.ever had liver problems.
. HOW SHOULD YOU TAKE AMLONG?
. Take amlong once a day , with or without food.
.It may be easier to take your dose if you do it at
same time everyday ,such as with breakfast
or dinner ,or at bedtime . Do not take more than
. If you miss a dose , take it as soon as you
remember . Do not take amlong if it has been
More than 12 hours since you missed your last
Dose . Wait and take the next dose at your
regular time.
.while you are taking amlong ,do not stop taking
Your other prescription medicines , including any
other blood pressure medicine , without
Talking to your doctor.
.if you took too much amlong , call your doctor
Or poison control center , or go to nearest
hospital emergency room right away.
. WHAT SHOULD YOU AVOID WHILE TAKING
AMLONG?
.DO Not start any new prescription or non
prescription medicines or supplements, unless
You check with your doctor first.
. WHAT ARE POSSIBLE SIDE EFFECTS OF
AMLONG?
Amlong may cause the following side effects .
Most side effects are mild or moderate:
.headache.
.swelling of your legs or ankles.
.tiredness , extreme sleepiness.
.stomach pain , nausea.
.dizziness.
.flushing (hot or warm feeling in your face).
.arrhythmia (irregular heartbeat).
.heart palpitations (very fast heartbeat)
It is rare , but when you first start taking amlong
Or increase your dose, you may have a heart
attack or your angina may get worse . if that
Happens, call your doctor right away or go
directly to a hospital emergency room.
. HOW DO YOU STORE AMLONG?
Keep amlong away from children store amlong
Tablets at room temperature (between 59*and
86*F).keep amlong out of the light . Do not
store in the bathroom. Keep amlong in a dry
Place.
. GENERAL ADVICE ABOUT AMLONG?
Sometime , doctors will prescribe a medicine for
Condition that is not written in the patient
Information leaflets. Only use amlong the way
Your doctor told you to . Do not give amlong to
other people , Even if they have the same
Symptoms you have .it may harm them.
You can ask your pharmacist or doctor for
information about amlong , or you can visit
the pfizer website at www.pfizer.com. Or call
1-800-438-1985.
. ADR REPORTING:
.Reporting of ADR can be done by filling the form
(link attached below)and sending the mail to
pvpi
@ipcindia .net or [email protected] or
through the PVPI mobile app.
.or Dial toll free helpline number-1800-180 3024
(9:00AM to 5:30pm, Working days).
.https://cdsco.gov.in/opencms/export/sites/
CDSCO WEB/pdf-documents/consumer section
PDFs/ADRRF 2.pdf .
 3. cap.b complex
. USES
This product is a
combination of b vitamins
Used to treat or prevent
Vitamin deficiency due to
poor diet , certain illness,
Alcoholism or during
pregnancy .vitamins are
important building blocks
Of the body and help keep
You in a good health . B vitamins include
thiamine, riboflavin, niacin/niacinamide, vitamin
B6 , vitaminB12, folic acid and pantothenic acid.
Some brands of Bvitamin also contain ingredients
such as vitamin C , vitamin E ,biotin or zinc.
. HOW TO USE VITAMIN B COMPLEX
CAPSULE:
Take this medication by mouth , usually once daily
or as directed . Follow all directions on the
product package . If you have any question
Ask your doctor or pharmacist .if you are taking
A brand that contains vitamin C ,take this
By mouth with a full glass of water(240milliters)
unless your doctor directs you otherwise.
If you are taking a liquid product, use a
medication –measuring device to carefully
Measure the dose . Do not use a household
Spoon .some liquid products need to be shaken
Before each dose . Some products that contain
vitaminB12 need to be placed under the tongue
And held there before swallowing . follow label
Directions carefully to get the most benefits.
Take this medication regularly in order to get the
most benefits from it . to help you remember,
. SIDE EFFECTS:
Mild upset stomach or flushing may occur . These
Effects are usually temporary and may dissappear
As your body adjust to this product .if any of
these effects last or gat worse, tell your doctor
Or pharmacist promptly . if your doctor has
Directed you to use this medication , remember
That your doctor has judged that the benefits to
You is greater than the risk of side effects. Many
People using this medication do not have serious
Side effect. A serious allergic reaction to this
drug is rare .however get medical help right
Away if you notice any symptoms of serious:
.rash, itching.
.swelling (especially of the face/tongue/throat).
.severe dizziness , trouble breathing.
This is not a complete list of possible side effects
If you notice other effects not listed above,
Contact your doctor or pharmacist.
. PRECAUTIONS:
Before taking this product , tell your doctor or
Pharmacist if you are allergic to any of its
ingredients , or if you have any other allergies
This product may contain inactive ingredients,
Which can cause allergic reactions or other
problems .talk to your pharmacist for mor
Details. If you have any of the following health
Problems , consult your doctor or pharmacist
Before using this product.
.diabetes.
.Liver problems.
.vitaminB12 deficiency (pernicious anemia).
Before having surgery, tell your doctor or dentist
About all the products you use (including
Prescription drugs , non prescription drugs , and
Herbal products).
. WHAT HAPPEN IF YOU OVERDOSE?
If someone has overdose and has serious
symptoms such as passing out or trouble
Breathing. Call 911 otherwise , call a poison
Control center right away. US residents can call
their local poison control center at 1-800-222-
1222. Canada center. Symptoms of overdose
May include .
.stomach pain.
.nausea.
.vomiting.
.diarrhea.
. WHAT HAPPEN IF YOU MISS DOSE?
IF you are taking this product on a regular
schedule and miss a dose , take it as soon as
You remember . If it is near the time of the next
dose ,skip the missed dose. Take your next dose
At the regular time .do not double the dose to
Catch up.
. HOW DO YOU STORE B COMPLEX:
Refer to storage information printed on the
Package . If you have any questions about
storage, ask your pharmacist . Keep all
medication away from children and pets.
. ADR REPORTING:
.Reporting of ADR can be done by filling the form
(link attached below)and sending the mail to pvpi
@ipcindia .net or [email protected] or
through the PVPI mobile app.
.or Dial toll free helpline number-1800-180 3024
(9:00AM to 5:30pm, Working days).
.https://cdsco.gov.in/opencms/export/sites/
CDSCO WEB/pdf-documents/consumer section
PDFs/ADRRF 2.pdf .
 4.Tab.met-xl
met-xl 25 tablet is classified
Under the group of medication
known as
Beta-blocker . It is prescibed
For the management of
Conditions such as high blood
pressure , angina
Pectoris(chest pain),heart
Failure ,arrhythmias(irregular
heartbeats ) and palpitation
As well as for the prevention of heart attacks
and migraines.
. USES:
THE USES OF MET-XL 25MG TABLET INCLUDE.
. Management of high blood pressure.
. management of angina pectoris(chest pain).
. prevention of heart failure.
. management of arrhythmias or palpitations.
. prevention of heart attack and migraine.
. DIRECTION FOR USE OF MET-XL 25MG
TABLET 20:
. Swallow the entire tablet without crushing or
Breaking it.
. take it with or without food, but it is
recommended at a fixed daily time for better
Results.
. SIDE EFFECTS OF MET-XL 25MG
TABLET20:
THE COMMON SIDE EFFECTS ARE:
.. Headache.
. dizziness.
. unusual tiredness.
. slow heartbeat.
. low blood pressure ,which might make you
faint
Or dizzy.
. feeling short of breath when exercising.
. stomach ache.
. WHAT HAPPEN IF YOU OVERDOSE?
In case of an accidental overdose of met-xl 25
Tablet ,seek immediate medical attention by
Hospital . signs of an overdose may include:
. severe hypotension.
. sinus bradycardia .
. atrioventricular block.
. heart failure.
. cardiac arrest.
. impairment of counsciousness / coma,nausea,
Vomiting,and cyanosis.
. WHAT HAPPEN IF YOU MISS DOSE?
IF you miss a dose of met-xl 25 tablet , take it
Once you remember . However ,avoid repeating
. HOW DO YOU STORE MET-XL TABLET:
. Met-xl 25 tablet should be stored at room
temperature , at 25*C.
. please protect it from light and moisture.
. keep away from children.
. do not use this medicine after the expiry date
Has passed.
. ADR REPORTING:
. Reporting of ADR can be done by filling the form
(link attached below)and sending the mail to pvpi
@ipcindia .net or [email protected] or
through the PVPI mobile app.
. or Dial toll free helpline number-1800-180 3024
(9:00AM to 5:30pm, Working days). . .
.https://cdsco.gov.in/opencms/export/sites/
CDSCO WEB/pdf-documents/consumer section
PDFs/ADRRF 2.pdf .
 5. Tab.Shelcal

shelcal tablet is nutritional

Supplements used to manage
calcium deficiency in the
Body .it helps when your
calcium needs cannot be
Met through diet alone.
. USES:
. Calcium deficiency: helps manage low levels of
Calcium in the body .which can lead to weak
Bones and teeth.
. osteoporosis : support bone health and prevent
The risk of fractures in individuals with thinning
Bones.
. hypoparathyroidism : helps regulates calcium
Levels in the body for individuals with
underactive parathyroid glands.
. SIDE EFFECT OF SHELCAL TABLET:
TAKING THE SHELCAL TABLET MAY CAUSE SOME
SIDE EFFECT .HERE ARE FEW COMMON ONES TO
BE AWARE OF:
. Constipation : you may experience difficulty
Passing stools regularly.
. upset stomach: you might feel discomfort or
Pain in your stomach.
. WHAT HAPPEN IF YOU OVERDOSE?
Taking too much shelcal can lead to an overdose
Common side effects of an overdose include
constipation and upset of stomach. If you or
Someone else accidentally takes too much of
This medicine , seek immediate medical
Attention by contacting your doctor or visiting a
Nearby hospital.
. WHAT HAPPEN IF YOU MISS DOSE?
IF you forget to take a dose of shelcal tablet,
take it soon as you remember .if it’s almost
time for your next dose, skip the missed one and
Continue your regular schedule . never increase
. HOW TO STORAGE MET-XL TABLET:
. Store the shelcal tablet below 30*C.
. keep the product out of the reach of children
And away from light and moisture.
. use the product before its expiration date.
. ADR REPORTING:
. Reporting of ADR can be done by filling the form
(link attached below)and sending the mail to pvpi
@ipcindia .net or [email protected] or
through the PVPI mobile app.
. or Dial toll free helpline number-1800-180 3024
(9:00AM to 5:30pm, Working days).
. https://cdsco.gov.in/opencms/export/sites/
CDSCO WEB/pdf-documents/consumer section
PDFs/ADRRF 2.pdf .
PHARMACIST INTERVENTION:
• All the drugs prescribed are found to be
rational .(Right drug and Right route of
administration).
• No intervention found in the treatment chart.
THANK YOU