Case No.: Date:

SUBJECTIVEOBJECTIVEASSESSMENTPLANPATIENT EDUCATION

PROBLEM

1.VITAL SIGNS2.LAB TESTS3.MED.LIST

ETIOLOGY OF PROBLEM

1.EVALUATE CURRENT THERAPY FOR PROBLEM2.EVALUATE NEED FOR THERAPY

GOALS FOR TREATMENT OF PROBLEM

RECOMMEND1. DRUG TREATMENT FOR PROBLEM2. MONITORING PARAMETERS FOR EACH DRUG LISTED3. FURTHER TESTS FOR PROBLEM IF NEEDED4. DRUGS TO BE AVOIDED AND WHY

Cerebral Vascular Accident (CVA) - HEMIPARESIS

30 y/o Male, was admitted on 02/04/2014 with c/o Pain on both left upper limb and left lower limb at 2 O clockPMH: Deviation of mouth to left side

VITALS:PR: 92/minB.P: 130/90 mm of HgSPO2 : 98%CVS : s1 s2 + +RS: ClearABD: SoftCNS: Sensory - NormalRADIOLOGY: CT BRAIN: Cranial nerve examination : Normal Pupil : NormalCurrent medication:Inj. Ondansetron 4mg SOSInj. Citicoline 500mg B.DInj. Piracetam 7.2gm B.DInj. Pantoprazole 40mg O.DT. Atorvastatin 40mg H.ST. Aspirin 75mg H.ST. Clopidogrel 75mg H.SHemiparesis is weakness of the entire left or right side of the body. Hemiplegia is its most severe form, complete paralysis of half of the body. Hemiparesis and hemiplegia can be caused by different medical conditions, including congenital causes, trauma, tumors, or stroke

1. To decrease the pain on left upper and lower limbs and prevent the further attacks

Need for Therapy: No change in therapy is required. Continue current therapy to prevent further TIA and CVA.1. Increase the blood flow to brain.2. Prevent the platelet aggregation. 3. Increase the muscle rigidity1. Inj. Citicoline 500mg B.DInj. Piracetam 7.2gm B.DInj. Pantoprazole 40mg O.DT. Atorvastatin 40mg H.ST. Aspirin 75mg H.S T. Clopidogrel 75mg H.S Inj. Ondansetron 4mg SOS

2. In case of ondansetron administration we have to monitor cardiac function and continuous blood pressure check up should be needed.

3. MRI should be done if needed.4. Piracetam itself may induce Hemiparesis

1. Continue emphasizing medication adherence. Strengthening the leg and hand muscles and balance through regular walking and exercises.2. Attend atleast 5 months programme of physiotherapy.3. Patient should wear flat and wide toed shoes.4. Dont drive or handle the machines while using the medications because some drugs cause drowsiness.5. Pay close attention while walking.6. Take calcium rich foods and also take calcium supplements.

Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, RVS Nagar, Chittoor-517127 (AP), INDIA