1. pharmacotherapeutics III Case presentation on deep vein thrombosis

2. SCENARIO:
Here is a 20 year old male patient admitted to male surgery wards and diagnosed as deep vein thrombosis and hospitalized for 6 days
HISTORY OF PRESENT ILLNESS
The patient is apparently alright 2 years back developed swelling of both limbs with pain
H/O discoloration of both limbs since 2 months and itching
SOAP NOTE
SUBJECTIVE:
patient complains of swelling of legs since 2 years ,pain and itching
Decreased appetite
OBJECTIVE
ESR was elevated 20mm/hr
PT was prolonged 19.2 sec(10-14 sec)
CBC and urine analysis was normal.

3. DOPPLER
varicosity of bilateral saphaneous veins and left short saphaneous vein with partially occluding thrombus within
Multiple venous collaterals in thigh and pelvic region
Chronic echogenic noted causing partial or total occlusion of inferior venecava and bilateral common iliac , external iliac , femoral ,superficial and deep femoral and popliteal veins.

4. ASSESMENT
By the above subjective and objective physician diagnosed the condition as
DEEP VEIN THROMBOSIS
PROBLEM LIST:
SWELLING OF LEGS,PAIN AND ITCHING
DECREASED APETITE
VARICOSE VEINS
SWELLING OF LEGS ,PAIN AND ITCHING:
This is due to deep vein thrombosis due to venous obstruction and venous insufficiency and swollen varicose veins
DECREASED APETITE:
This may be due to stress induced.
DEEP VEIN THROMBOSIS:
An initial manifestation of the VTE disease process in which blood clots form deep in the venous system
Risk factors for VTE include cancer, surgery, immobilization, trauma, estrogen use, inherited or acquired thrombophilias , and central venous catheters .

5. VARICOSE VEINS: veins are swollen veins over-filled with blood
VARICOSE VEINS: veins are swollen veins over-filled with blood. The blood makes them look red, blue, or purple. These veins are usually in the legs. But you may have varicose veins in other parts of the body, such as around your anus PLANNING: GOALS OF THERAPY: To subside the symptoms To enhance venous blood flow by thrombolysis To prevent secondary complications like ruptured bakers cyst,cellulitis and post phlebitic syndrome PAIN IN LEG: ACECLOFENAC 100 MG 1-0-1: This is an NSAID .Cox I inhibitor to reduce pain in legs for 6 days HEPARIN BENZYL NICOTINATE TOPICAL ON BOTH LEGS For superficial thrombosis. For 5 days from day 2 LOSS OF APETITE self limiting

6. DEEP VEIN THROMBOSIS BEMIPARIN SODIUM 5000 IU: SC 1-0-1 for 6 days
Low molecular weight heparin which has anti-Factor Xa and anti-thrombin (anti- Factor IIa) activities FOR 6 DAYS
NICOUMALONE 2 MG 0-0-1:
anticoagulant that works by blocking the regeneration of vitamin K(1) epoxide, thus inhibiting synthesis of vitamin K-dependent clotting factors which include factors 2, 7, 9 and 10, and the anticoagulant proteins C and S. for 5 days
ASPIRIN 150 MG AND CLOPIDROGEL 75 MG
Thrombosis prophylaxis for 6 days.
VARICOSE VEINS:
B COMPLEX AND MULTI VITAMIN SUPPLIMENTS
CEFIXIME 200 MG AND DICLOXACILLIN 500 MG:
As prophylaxis for hospital acquired infection
RABEPRAZOLE 20 MG 1-0-0
AS PROPHYLAXIS FOR HYPERGASTRIC SECRETION INDUCED BY NSAID AND ANTIBIOTICS

7. Thank u DISCHARGE DRUGS: ZERODOL P SOS
CAP BENEFICIALE FOR 5 DAYS
THROMBOPHOB OINTMENT FOR 5 DAYS
Thank u