1. CASE STUDY ON
PULMONARY TUBERCULOSIS
PREPARED BY :
D.LOGESHTHARAN
PHARM.D 2ND YEAR
(VISTAS)

2. PATIENT DEMOGRAPHIC
DETAILS
• Patient Name : Mr. X
• Age : 56 Years
• Gender : Male
• Date Of Admission : 14/01/2022
• Date Of Discharge : 19/01/2022
• Depart : Chest & TB

3. CHIEF COMPLAINTS
A 56 Years Old Male Patient Came To The Hospital With The
Complaints Of
 Cough with Expectoration Which is Whitish in Color Since 2 Months
Tiredness

4. HISTORY OF PRESENT
ILLNESS
Patient was apparently normal 2 months ago when he
developed cough with expectoration which is whitish in color which is
not foul smelling.
 H/O fatigue, lethargy, weight loss of about 6 Kg and fever.
PAST MEDICAL HISTORY : NIL
PAST MEDICATION HISTORY : NIL

5. PERSONAL HISTORY / SOCIAL HABITS
Normal bowel and bladder habits
SMOKER : YES
ALCOHOLIC : YES

6. OBJECTIVE EVIDENCE
• The Patient Is Conscious
• Febrile
• Temp : 100
• Pulse : 78 Beats/Min
• BP : 120/80mm Hg
• CVS :S1s2+ve
• RS : Crepts
• CNS : NFND
• P/A : Soft
PHYSICAL EXAMINATION SYSTEM EXAMINATION

7. LABORATORY
INVESTIGATIONS
PARAMETER OBSERVED VALUE NORMAL VALUE
HAEMOGLOBIN 13.5g / dl 14 – 18 g/dl
TC 39000/mm³ 32000-98000/mm³
ESR 40 mm in 1st hour 0-30 mm in 1st hour
PACKED CELL
VOLUME ( PCV)
39.3% 33-43 %
MCV 79 µm³ 76-100ͯµm³
RBC 4.9 millions/cu mm 3.6 – 5 millions/cu mm
TOTAL WBC 6,400 cells/cu mm 4500 – 11000 per µl
PLATELET COUNT 3.02 l/cmm 1.4 – 4.5 l/cmm
BICARBONATE 27mmol/L Below 3.0mg/dl
ELECTROLYTE PROFILE

8. LABORATORY
INVESTIGATIONS
PARAMETER OBSERVED VALUE NORMAL VALUE
LIVER
Bili (T) 0.9 mg/dl (< 1.0)
Bili (D) 0.2 mg/dl (< 0.2)
Bili (ID) 0.2 mg/dl (< 0.8)
SGPT 9 U/L (Upto 35)
SGOT 17 U/L (Upto 40)
T.Protein 7.19 g% (6.0 – 8.0)
Alk. Phosphatase 115 U/L (40 – 130)
Albumin 3.7 g% (3.2 – 4.5)
Glubulin 3.4 g% (2.3 – 3.5)

9. OTHER TESTS :
• Chest XRAY
• Sputum AFB
IMPRESSION :
• Chest XRAY – Significant Cavites Found
• Sputum AFB : A+ , B+
DIAGNOSIS :
• PULMONARY TUBERCULOSIS

10. ASSESSMENT
• From The Subjective And Objective Evidence The
Patient Is Assessed To Have
PULMONARY TUBERCULOSIS

11. TREATMENT
S.N
O
BRAND NAME GENERIC
NAME
DOSE FREQUENCY 1D 2D 3D
1 Inj.Ceftrioxone Ciprofloxacin 500 mg 1-0-1   
2 Inj.Amikacin Amikin 250 mg 1-1-1   
3 T.Para Sulfasalazine 500 mg 1-1-1   
4 T.AKT 4 Isoniazid,
Riampicin ,
Pyrazenamid
2I,R1
Z,E
1-0-1   

12. DRUGS ON DISCHARGE
S.N
O
BRAND NAME GENERIC
NAME
DOSE FREQUENCY 1D 2D 3D
1 Inj.Ceftrioxone Ciprofloxacin 500 mg 1-0-1   
2 Inj.Amikacin Amikin 250 mg 1-1-1   
3 T.Para Sulfasalazine 500 mg 1-1-1   
4 T.AKT 4 Isoniazid,
Riampicin ,
Pyrazenamid
2I,R1
Z,E
1-0-1   

13. DRUG INTERACTION :
Amikacin can sometimes cause kidney damage, and using
it with a cephalosporin antibiotic like ceftriaxone may
increase that risk.
Signs and symptoms of kidney damage may include
nausea , vomiting, loss of appetite, increased or decreased
urination, sudden weight gain or weight loss, fluid retention,
swelling, shortness of breath, muscle cramps, tiredness,
weakness, dizziness, confusion, and irregular heart rhythm.
cefTRIAXone = amikacin
Applies to: ceftriaxone, Amikin (amikacin)
PHARMACIST INTERVENTION

14. SUBJECTIVE
A 56 years old male patient was admitted in the
hospital with c/o cough with expectoration
which is whitish in color since2 months
H/O fatigue, lethargy, weight loss of
about 6 kg and fever.
Personal history: He is a smoker and alcoholic.
OBJECTIVE
Systemic and physical examination was found to be
normal SGPT and GOT were found to be Decreased.
Chest X ray: Significant cavities found
Sputum AFB: A+ B+
ASSESSMENT PULMONARY TUBERCULOSIS
PLAN OF TREATMENT
Patient was given treatment with T.Para
Inj.Ceftrioxone, T.AKT 4,Inj. Amikacin.
SOAP NOTES

15.  T.Para (Paracetamol):
It is an analgesic and antipyretic drug used to relieve from fever
andpain. Take one tablet whenever required
 Inj.Ceftrioxone:
It is an antibiotic used to treat any infections. It is given twice daily.
 T.AKT 4:(Isoniazid + Rifampicin + Pyrazenamide):
These drugs are given to treat active tuberculosis infection. Take
2tablet of each thrice weekly
 Inj. Amikacin:
It is an antibiotic. This injection is given twice in a week

16. PATIENT COUNSELLING
• REGARDING DISEASE CONDITION:
 Cover your mouth and nose with a tissue.
 Put your used tissue in a closed bag and throw it away.
 If you don't have a tissue, cough or sneeze into your upper
sleeve or elbow, not your hands.
 Wash your hands often with soap and warm water for 20
seconds.

17. • REGARDING DRUGS:
Avoid Dairy Products Such As Milk,cheese,ice Cream
While Taking INJ.AMIKACIN
TO FACILITATE DRUG ABSORPTION IN THE EMPTY
STOMACH, YOU ARE ADVISED NOT TO TAKE FOOD FOR 2
HOURS BEFORE AND AFTER TAKING DRUGS.
Quit Alcohol When Taking Medications

18. • REGARDING THERAPEUTIC LIFESTYLE MODIFICATIONS:
As a TB patient, you must avoid caffeine, refined sugar
and flour, sodium, and bottled sauces.
 Foods containing saturated and trans fats worsen the TB
symptoms of diarrhoea and abdominal cramping and fatigue.
 Additionally, alcohol and tobacco are a definite no-no
during the disease treatment and cure phase

19. THANK YOU