DRUGDEPENDANCE AND

POLY SUBSTANCEABUSE

BYK.S.MAHA LAKHSMI

IV/VI PHARM D611171602016

PATIENT PROFILE FORM Name: P.Harish DOA : 23-1-14 Unit : Psychiatry Age : 22 years Weight : 50 kgs Gender : male Occupation: coolie

Reasons for admission: Talking irrelevantly and misbehaviour since 1

week, sleep disturbances and taking drugs.

Past medical history: Taking drugs regularly , no roaming

outside/convulsions.

Past Medication history: Not significant

Family History: Nil with particular

DIAGNOSIS:

DRUG DEPENDANCE AND POLY SUBSTANCE ABUSE

Pharmaceutical care plan1.Subjective evidence: Talking irrelevantly and misbehavior since 1 week,

sleep disturbances and taking drugs.

2.Objective evidence: There are no any specific lab investigations for poly

drug abuse. The characteristic symptoms like sleep disturbances, misbehavior are included in the drug dependance and poly substance abuse.

3.Assessment: Based on subjective and objective evidence the

diagnosis was made as DRUG DEPENDANCE AND POLY SUBSTANCE ABUSE.

Goals to be achieved To reduce the signs and symptoms of patient.

To save patient life.

To avoid or reduce the use of drugs.

To reduce further symptoms of disease.

To improve patient quality of life.

TREATMENT OPTIONSBenzodiazepines: Diazepam, Oxazepam,

Lorazepam Iminostillbens:

Carbamazepine,Oxcarbazine Antipsychotics: First generation: Haloperidol,

Chlorpromazine, Flupentixol Others: Arkamine

Day 1: B.P : 130/80 mm Hg

Heart rate: 76/min

Anti psychotics are given.

Allow IV fluids

DRUG CHART :DRUG DOSE ROA FRQ D 1 D2 D3 D4 D 5 D6 D 7

Tab.Haloperipol 5mg oral ½ HS

Tab.Arkamine 1mg oral 1-1-0 -----

Tab.Carbamazepine 200mg oral 1HS

Tab. Diazepam 5mg oral 1-1-1

Inj.Haloperpol +

1amp(100mg/ml)+1amp(25mg/ml)

IV 1HS ---- ---- ---- -----

Inj.Phenergan 1amp(50mg/ml)

IV 1amp ---- ---- ---- ---- ---- -----

Day 2: Slept well Patient is feeling better. Relevant talk

Day 3:

Patient is feeling better. Relevant talk. Electro convulsive therapy (ECT) is given.

Day 4: Patient is feeling better. Relevant talk. Inj.Haloperidol + Inj.Phenergan(IM) is

included.

Day 5: Patient is responding better Relevant talk.

Day 6: Patient drew blood by himself. Relevant talk.

Day 7: Patient is irritable. Wants to go to home.

GOALS ACHIEVED:Reduction of sleep disturbances and patient

is sleeping well after taking the medication.Patient is feeling better from 4rd day.Relevant talk by 5th day.

MONITORING PARAMETERS Side effects are more with typical

antipsychotics than with atypical antipsychotics.

Side effects like misbehavior, taking drugs should be monitored.

PROBLEMS IDENTIFIEDPatient drew blood by himself is

identified.

PATIENT COUNSELLING:ABOUT DISEASE: Patient should be offered a Psychological

treatment called Cognitive Behavioral Therapy.

Patient’s family members should be advised not to leave her alone and not discuss about the illness in front of her.

Also the patient should be provided with social support which have proven to be the most effective

ABOUT DRUGS: Tab.Haloperidol: The patient was advised to

take 1HSmg of Haloperidol which is a ‘typical antipsychotic’ twice a day.

Tab.Carbamazepine : The patient was advised to take 200 mg at bed time which was adminstered orally.

Tab.Diazepam: It belong to the class of benzodiazepines, which is used to treat anxiety . It is given 5mg twice a day at bed time.

Inj.Phenergan:(50mg/ml)given IV-It is a neuroleptic, patient was advised to take 1 amp in i.v. route.