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_Case Presentation Acute Pyelonephritis

Case presentation on Acute Pyelonephritis

Ayesha73
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_Case Presentation Acute Pyelonephritis

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  1. CASE PRESENTATION ON ACUTE PYELONEPHRITIS PRESENTATION BY: AYESHA ASIF ALI CLINICAL PHARMACIST

  2. SCENARIO A 55 yrs old female patient was admitted to the hospital with chief complaints of Increased urinary urgency and frequency with fever - on and off and abdominal and lower back pain since 4 days. Abdominal Pain aggravated since yesterday. She has Hypertension since 10 yrs, Diabetes Mellitus since 8 yrs and History of Nephrolithiasis in 2020.

  3. PATIENT DEMOGRAPHICS Name : Mrs Padmalatha Sex : F Age : 55 yrs Dept./Unit : Nephrology VITALS B.P(mmhg) : 150/ 90 P.R(bpm) : 85 R.R(cpm) : 22 Temp. (F) : 102.7 F Weight(kg) : 54 Allergies : NKDA

  4. SUBJECTIVE EVIDENCE CHIEF COMPLAINTS : Increased urinary urgency and frequency , fever and lower back pain. HISTORY: Past Medical History - HTN (since 10yrs), DM II - (since 8 yrs), Nephrolithiasis - 2020 Past Medication History - Atenolol - 25 mg PO OD Metformin - 500 mg PO TID Enteric coated Aspirin- 325 mg PO OD Social history - Occasional alcohol use on weekend. No history of smoking FAMILY HISTORY - Father died of MI at the age of 70

  5. OBJECTIVE EVIDENCE PROVISIONAL DIAGNOSIS : UTI , ?AKI • :Abnormal vitals Normal values • BP - 150/90 mmHg 120/80 mmHg • Temperature - Elevated 98.6°F (37°C) • Abnormal Lab values • Glucose - 240 100 mg/dL (fasting) • Haematocrit - 35 36.1% to 44.3% • Leucocytes - 14.1x103 4.3 - 10.8 x 109 cells per liter. • Platelets - 330 x 103 (150 to 450) x 103 per microliter. • HBA1C - 7.8% 4% - 5.6%. IMPRESSION - Urine Analysis : WBC - 3+ Gram -ve rods - 105 CFU/ml Hematuria - +ve Nitrite - +ve eGFR - 45 ml/min

  6. PLAN

  7. ASSESSMENT FINAL DIAGNOSIS : Acute Pyelonephritis HTN DM II Nephrolithiasis - 2020

  8. PHARMACIST’S INTERVENTION • Atenolol can be replaced with Telmisartan 40 mg OD as it has better effect in controlling systolic and diastolic blood pressure simultaneously. • Dapagliflozin + Metformin extended release should be added OD to effectively control the blood sugar. • Post discharge, Tramadol/Acetaminophen combination can be used SOS for chronic pain and Acetaminophen can be used for Mild pain instead.

  9. PATIENT COUNSELLING • Monitor BP and GRBS thrice a week • Follow Low salt diabetic diet • Take medications regularly and on time. • Follow up after 1 week. • Incase of any adverse event , report immediately.

  10. THANK YOU

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