This document presents a case of a 55-year-old male patient admitted with complaints of retrosternal and epigastric pain. He has a history of hypertension for 23 years and is overweight. Diagnostic tests confirmed acute pancreatitis, hypothyroidism, hypertension, and type 2 diabetes. The patient was treated with medications like amlodipine, glimepiride, levothyroxine, pantoprazole, and analgesics. His treatment goals were to relieve symptoms, avoid complications, maintain a healthy weight and lifestyle modifications. He required monitoring of electrolytes, renal function, thyroid levels and glucose levels.

1. CASE PRESENTION ON
HYEPRTENSION ,TYPE 2DIABETES
MELLITUS, HYPOTHYROIDISM AND
ACUTE PANCREATITIS
CHANDANA C
2nd PHARM D
SSCP

2. PATIENT DEMOGRAPHIC DETAILS
Name:-Amarnath
Age:-55years
Gender:-Male
BMI:-overweight
DOA:-27-11-2018
DOD:-3-12-2018

3. CHIEF COMPLAINTS ON
ADMISSION:-
C/O Retrosternal pain
Epigastric pain

4. PATIENT HISTORY:-
 Past medical history:-k/c/o HTN since
23 years
 Past medication history:-Taking
Tab.Amlodipine 5mg
 Social history:-NS
 Family history:-NS
 Allergies:-NKA
 Diet:- Vegetarian

5. PROVISIONAL DIAGNOSIS:-
Hypertension with type 2 diabetes
mellitus

6. PHARMACEUTICAL CARE PLAN:-
SUBJECTIVE EVIDENCE OBJECTIVE EVIDENCE
c/o retrosternal pain Amylase-2500u/l
c/o epigastric pain Lipase-2300u/l
k/c/o hypertension troponin-0.013ng/ml
Gama GT-61u/l
WBC-13660cells/cumm
Hb-12.9g/dl
Sodium:-134mg/dl
T4-4.97ug/dl
T3-0.78ng/ml
TSH-22ul u/l
RBS-410mg/dl
BP-160/80mmHg

7. FINAL DIAGNOSIS:-
Hypertension,Type 2 diabetes
mellitus,Hypothyroidism and acute
pancreatitis

8. TREATMENT GOALS:-
 To releive signs and symptoms
 To avoid further complication
 To maintain healthy weight and BMI
 To reduce the co morbidity of the
disease
 To decrease the morbidity and
mortality of the disease

9. TREATMENT OPTION:-
 Calcium channel blocker:-amlodipine, nifedipine
 Beta blockers:-
propranolol,metaprolol,esmolol,temolol
 Sulfonylurea:-glimepiride
 Biguanide:-metformin
 Antidiabetic fast acting insulin:-human (mixtard,
acropid) insulin
 Antihypothyroidism drug:-levothyroxine
 Antibiotic:-
pipercillin,refaximin,ceftriaxone,cefixime
 Proton pump inhibitor:-pantoprazole, rabeprazole
 Analgesic:-paracetamol,aceclofenac,aminophellin

10. PROBLEMS IDENTIFIED:-
DRUG INTERACTION:-
Pantoprazole inj. Increase levels of
refaximin oral by affecting low drug is
eliminated from body

11. MONITORING PARAMETER:-
 Electrolytes
 Renal function test
 Hepatalogy
 Thyroid function test
 Glucose test
 Hematology
 Ultrasound abdomen and pelvis

12. PATIENT COUNSELLING:-
ABOUT DISEASE:-
 About comorbities of disease
 About complication of disease
 About morbidity and mortaliy of
disease

13. ABOUT MEDICATION:-
 Donot miss or double the dose
 Take medication as per
prescription
ABOUT LIFESTYLE MODIFICATION:-
 Regular exercise
 Regular check up
 Eat healthy food
 Eat fresh vegetables and fruits

14. THANK YOU