A 40-year-old male presented with fever, cough, dark urine, and yellow eyes for 5-10 days. Examination found elevated blood pressure and temperature. Tests showed anemia, elevated ESR, liver enzymes, and acid fast bacilli in sputum. Chest x-ray found left lung opacities. The patient was diagnosed with tuberculosis and prescribed a multi-drug regimen including isoniazid, rifampin, pyrazinamide, and ethambutol for two months, followed by isoniazid and rifampin for four months to reduce symptoms, prevent complications like liver disease, and decrease disease progression while being monitored for response.

1. Pharmacotherapeutics-ii
By
616178102020
3rd year pharm D
CASE PRESENTATION ON TUBERCULOSIS

2. Demographic details
 Name: T.V.N Subrahmanyam
 Age: 40years
 Residence: peravali
 DOA: 28/12/17 at 1:40pm
 Marital status: married.
 No habbits of alcohol &smoking
 No past medical & medication history

3. SOAP NOTE ANALYSIS
 Subjective information:
A male patient of age 40 years , was admitted in the hospital with
the following chief complaints:
 Fever.
 Dry cough since 5 days.
 Dark coloration of urine since 10 days.
 Yellow discoloration of eyes.

4. Objective Information:
No history of diabetes, HTN, asthma.
Physical examination:
PARA
METE
RS
NORMA
L VALUE
S
D1 D2 D3 D4
Bp(mmh
g)
180/90 110/70 120/70 120/80 120/80
PR (bpm) 72 70 71 72 72
RR(cpm) 22 20 23 23 24
Temp 98.6 100 98.6 98.6 98.6

5. Laboratory Investigations:
Parameters Normal values Observed values
Hb 14-18gm/dl 15gm/dl
WBC 4000-11000cells/cumm 3700cells/cumm
RBC 4.5-5.5m/cumm 5.4m/cumm
ESR 20mm at 1st hr 40mm at 1st hr
PCV 36-47% 43.8%

6. Biochemical Parameters:
Parameters Normal values Observed
values
Blood urea 15-45mg/dl 26mg/dl
SGOT 5-45IU/l 76Iu/l
SGPT 5-40IU/l 56Iu/l
T.bilirubin 0.2-1.0mg/dl 0.97mg/dl
Sr.creatinine 0.5-1.2mg/dl 0.9mg/dl

7. Diagnosis:
 Chest x ray-identified opacities on left side.
 Sputum test -acid fast bacilli.
Final diagnosis:
Based on subjective, objective data evidence the final
diagnosis was made to be ...

9. Assessment:

11. Transmission:

13. Pathophysiology:

15. Drug
Name
Generic
name
Dose Route Frequency D1-D4 For2
months
For 4
months
IV
fluids(NS,
RL)
500ml
500ml
IV
IV
✓
Inj.zofer Ondonset
ron
8mg Iv SOS ✓
Inj.pantozi
l
Pantopraz
ole
40mg IV OD ✓
Inj.ceftria
xone
Ceftriaxon
e
1g IV BID ✓
Inj.parace
tmol
Paracetam
ol
650mg Oral OD ✓
AKT4 Isoniazid
Rifampin
Pyrazinam
ide
Ethambut
ol
300mg
600mg
800mg
1100mg
Oral
Oral
Oral
Oral
OD
OD
OD
OD
✓
✓
✓
✓
AKT2 Isoniazid
Rifampin
300mg
600mg
Oral
Oral
OD
OD
✓
✓

16. Planning:
 To reduce symptoms like fever, cough etc.
To prevent from further complications like liver diseases.
To increase patient quality of life.
To decrease progression of disease.
Check parameters like..
① Complete blood count.
② Renal function tests.
③ Liver function tests.

17. Counselling points:
 Take the medications regularly.
 Don't discontinue the course.
 Limit the intake of alcohol.
 Cover your nose while coughing, sneezing to prevent the
spread of infection.
 Take healthy diet like milk ,meat, boiled water, fruits, egg etc.

18. Drug interactions:
 No drug interactions were found.

19. Prevention