Case No.:

Date:

SUBJECTIVE

OBJECTIVE

ASSESSMENT

PLAN

PATIENT EDUCATION

PROBLEM

1.VITAL SIGNS

2.LAB TESTS

3.MED.LIST

ETIOLOGY OF PROBLEM

1.EVALUATE CURRENT THERAPY FOR PROBLEM

2.EVALUATE NEED FOR THERAPY

GOALS FOR TREATMENT OF PROBLEM

RECOMMEND

1. DRUG TREATMENT FOR PROBLEM

2. MONITORING PARAMETERS FOR EACH DRUG LISTED

3. FURTHER TESTS FOR PROBLEM IF NEEDED

4. DRUGS TO BE AVOIDED AND WHY

ENTERIC FEVER

14 y/o male was admitted on 28/03/2014 with c/o on and off fever since 4 days and chills, cough, headache, anorexia.

PMH: Non- remarkable prior to admission.

Vitals:

B.P: 110/70 mm of Hg

PR:64/min

Temp:99F

CVS:S1S2 ++

RS :18/min

PALLOR: NO

ANEAMIA: NO

CYANOSIS:NO

JAUNDICE: NO

OEDEMA: NO

Labs:

DATE

1

Hb

10.4gm%

Current medication:

T.Cefixime 200mg BD

T.Paracetmol 650mg BD

Syp.Multi Vitamins+Micro Nutrients-1tsp

Enteric Fever / Typhoid fever also known simply as typhoid is a common worldwide bacterial disease transmitted by the ingestion of food or water contaminated with the feces of an infected person, which contain the bacterium Salmonella enterica subsp. enterica, serovar Typhi

1. The treatment of choice is a fluoroquinolone such as ciprofloxacin. Otherwise, a third-generation cephalosporin such as ceftriaxone or cefotaxime is the first choice. Cefixime is a suitable oral alternative.

Need for Therapy:

Oral Rehydration Therapy

1. Complete bacterial suppression

2. Reduce fever, chills, cough and head ache

1. T.Cefixime 200mg BD

T.Paracetmol 650mg BD

Syp. Multi Vitamins+Micro Nutrients-1tsp

2. Monitor the temperature frequently

3. Sensitivity culture test & other non specific laboratory test includes - ESR, PT, aPTT, Na and K levels.

A serum alanine amino transferase (ALT)tolactate dehydrogenase (LDH) ratio of more than 9:1 appears to be helpful in distinguishing typhoid from viral hepatitis. A ratio of greater than 9:1 supports a diagnosis of acute viral hepatitis, while ratio of less than 9:1 supports typhoid hepatitis

4. Typhoid vaccine should not be used in a person who is a typhoid carrier.

1. Continue emphasizing medication adherence.

2. Eat foods that have been thoroughly cooked and that are still hot and steaming.

3. Keep taking the prescribed antibiotics for as long as the doctor has asked you to take them.

4.Wash your hands carefully with soap and water after using the bathroom, and do not prepare or serve food for other people. This will lower the chance that you will pass the infection on to someone else.

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