BY

GEORGIN GEORSON
PHARM D
A 19 year old girl, was admitted
in the hospital on 27 June and
was discharged on 29th June
2012 with c/o fever with
recurrent chills and rigor
associated with intermittent
episodes of sweating following
which fever reduces. It is
associated with headache and
loss of appetite. H/O Malaria in
PRESENTING COMPLAINTS:
* Fever with chills and rigor
* Episodes of sweating
* Headache
* Loss of appetite
PAST MEDICAL HISTORY :
* NIL
*DIETIC HISTORY- Normal appetite

*SOCIO ECONOMIC HISTORY : Middle Class

 On examination , patient was conscious
PULSE 108beats/min
RR 22/min
BP 130/100mmHg
Hb 12.5g%
PCV 36.8%
T.WBC 10,500cu.mm
DC.POLYMORPHS 77%
DC.LYMPHOCYTES 19%
DC.EOISINOPHIL 4%
ESR 33mm/hr
PLATELETS 1 lakhs/cu.mm
RBS 106 mg/dL

UREA 25 mg/dL

CREATININE 5.4mg/dL

Serum Sodium 137 mmol/L

Serum Potassium 4.1 mmol/L

DATE 27/06/2012 28/06/2012 29/06/2012

TEMP. 104◦F 103◦F 98.6◦F

 RBC : Normocytic and Normochromic, some
RBC show ring, amoeboid and shizonts of P.
vivax

 WBC : Count towards upper limit of normal

with more NEUTROPHIL

 PLATELET : Seen singly , moderate

decrease in number
»SYSTEMIC EXAMINATION:

RS: B/L air entry equal, NVBS, No added sound.

.
CVS: S₁S₂ heard, Tachycardia

CNS: No FND. HMF normal

»Problem 1 :
MPlasmodium vivaxALARI
DRUGS GENERIC CLASS ADR INTERCTIONS
NAME

T.Dolo Paracetamol NSAID Nausea,vomit

ting,hepatoto
xicity
T,Rabewun Rabeprazole Proton Pump Vomitting,Dia
Inhibitor rrhoea
T.Emeset Omdansetron Anti emetic Pruritis,Rash,
Diarrhoea
T.Chloroquine Chloroquine Anti Malarial Nausea,vomit
ting
,anorexia,itch
ing
T.Primaquine Primaquine Anti Malarial GI Hemolysis in
upset,abdomi G6PD
nal pain deficient
patients
 DATES

BRAND NAME GENERIC DOSE FREQUE ROUT 27/0 28/0 29/0

NAME NCY E 6 6 6
TAB. DOLO PARACETAMOL 650mg SOS ORAL √ √

TAB. RABEWUN RABEPRAZOLE 20mg 1-0-0 ORAL √ √

TAB.EMESET ONDANSETRON 4mg sos ORAL √

TAB. CHLOROQUIN CHLOROQUINE 250mg 4-4-2 ORAL √

INJ. EMESET ONDANSETRON STAT IV √

TAB. PRIMAQUINE PRIMAQUINE 15mg OD ORAL √ √

 TAB. 15mg OD X 14
PRIMAQUINE DAYS (7.5mg Tab X
2)
TAB. DOLO 650mg SOS

TAB. RABEWUN 20mg 1-0-0 X 1

week
TAB.EMESET 4 mg SOS

REVIEW AFTER 2 WEEKS

• Proper medication adherence
• Application of malaria prevention methods such
as sleep under Insecticide Treated Nets (ITNs).
• Avoid stagnation of water and avoid usage of
contaminated water
• Drink plenty of fluids to avoid dehydration
COUNSELLING :

* Malaria is treatable and curable by effective

antimalarials.
*Malaria can also be transmitted through blood
transfusion if the blood contains malaria parasites
Usage of primaquine can cause dark coloration of
urine which can alarm patients
Malaria in pregnant women can cause weakening and
anaemia
Usage of primaquine in G6PD deficient patients can
cause haemolysis
 CIMS
 DIPIRO
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