Hemiplegia is paralysis of one side of the body caused by damage to spinal chord or to the brain, mostly seen in cva patients

1. CASE PRESENTATION ON
HEMIPLEGIA
PRESENTED BY:
P. Vigneswari
Y17PHD0821.
IV/VI PHARMD
NIRMALA COLLEGE OF PHARMACY
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2. • Hemiplegia is a condition caused by brain damage or spinal
cord injury that leads to paralysis on one side of the body.
HEMIPLEGIA
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3. SUBJECTIVE DATA
• A 52 yrs old female patient was admitted in hospital
with chief C/o left sided weakness and drowsiness.
She had past history of HTN+DM on medication.
She had undergone CABG 3 grafts a month ago.
• Her bowel and bladder habits are normal with normal
appetite.
• She had no social and familial histories.
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4. . Physical examination-. Systemic-
Conscious. CVS - S1S2 +
Temperature- 98 c RS - B/L VBS +
BP - 140/90 mm of hg. P/A - Soft
PR - 86 beats/min
SPO2- 100%
• Provisional diagnosis-
Left hemiplegia
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5. OBJECTIVE DATA
Lab investigations-
S.NO PARAMETER OBSERVED VALUE NORMAL RANGE
1. Serum sodium 120 mEq/L 135-145 mEq/L
2. Serum potassium 4.2 mEq/L 3.6-5.2 mEq/L
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6. Radiographical investigations
CT brain-
Left infracts in right fronto, parietal and occipital bone.
Chronic infarcts in left thalamo capsulo ganglionic
regions and corona radiata. Large chronic infarct in left
cerebellum
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7. ASSESSMENT
• Based on the subjective and objective data, the final
diagnosis was found to be HEMIPLEGIA.
• Definition: It is the severe/ complete loss of motor
function on one side of the body.
ETIOLOGY :
• CVA
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9. PATHOPHYSIOLOGY
Brain is deprived of O2
Results in death of neurons
Corticospinal tract is damaged and thus injury
develops on the other side of the body
(Depending on the site of lesion , severity of the
condition varies)
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10. CLINICAL PRESENTATIONS
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11. STANDARD TREATMENT
• Physiotherapy
• Occupational therapy
• Psychotherapy
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12. PLAN
GOALS-
• To get symptomatic relief
• To avoid further complications
• To suppress the disease progression
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13. DRUG CHART
S.NO BRAND GENERIC DOSE ROA FRE CATEGORY INDICATION
1. T.ARKAMIN Clonidine 0.1 mg p/o TID Alpha agonist To treat HTN
2. T.PANTOCID Pantoprazole 40 mg p/o OD PPI To treat GERD
3. T.TOLVAPTAN Tolvaptan 15 mg p/o OD V2
antagonist
To treat
hyponatremia
4. T.Met-XL Metaprolol 50 mg p/o BD B-blocker To treat HTN
5. T.ECOSPRIN
GOLD
Aspirin
Clopidogrel
Atorvastatin
75 mg
75 mg
20 mg
p/o OD Anti-platelet
Statin
Prophylactic
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14. PHARMACIST INTERVENTIONS
DRUG INTERACTIONS :
MAJOR-
• Clonidine x Metaprolol - Lowers BP & leads to slower HR
Management: Monitor BP
MINOR-
• Aspirin x Pantoprazole - Co-administration
decreases the bioavailability of aspirin
Management: Avoid combination
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15. PATIENT COUNSELLING
About disease-
• Plegia- weakness, hemi- one side
• Complete paralysis of one half of the body, including
one arm and leg
• It is caused due to stroke, embolus, hemorrhage, head
injury, infections, migraine syndrome
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16. About drugs:
• Pantop- Administer 15-20 min before breakfast
• Tolvaptan- Avoid co-administration with grape juice
• Metaprolol- Avoid food ingestion 30 min before/ after
administration
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17. LIFESTYLE MODIFICATIONS
• Start an exercise plan
• Follow regular medications and checkups
• Reduce saturated fat and cholesterol
• Maintain sugar & BP levels
• Avoid stress
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