This is a case on Diastolic heart failure with Type 2 Diabetes mellitus. Here we have discussed the pharmaceutical care plan (SOAP) about the treatment and non pharmacological approaches to treat the specified conditions
5. • Age: 55 years
• Sex: Female
• Weight: 67 Kg
• Unit: Med 4
• IP No: 283747
6. • Reasons for admission:
C/O breathlessness and wheezing since 2 days
H/O excessive breathlessness more during
activity since 2 days and is progressive in
nature from grade 2 to grade 4.
H/O cough since 1 week.
• PMHx:
k/c/o HTN and T2DM since 20 years and on
regular treatment Enalapril 2.5 mg 1-0-0
and insulin
34. Final Diagnosis
Based on subjective and objective evidence the
patient was diagnosed with T2- DIABETES
MELLITUS with HYPERTENSION with HEART
FAILURE (Hypertrophic Cardiomyopathy –
Preserved Ejection Fraction) with CHRONIC
KIDNEY DISEASE
35. Goals of Treatment
For Heart Failure:
• Relieve symptoms of central and
peripheral circulatory congestion
• Improve quality of life
• Reduce neurohormonal activation
• Minimize or prevent acute CHF
exacerbations
• Slow progression of CHF
• Increase survival
• Maintain appropriate blood pressure
and lipid values.
• Reduce mortality
For Diabetes mellitus:
• focus on controlling blood sugar
levels in the normal or near-normal
range
• Prevent symptoms of hyperglycemia
• Promote SMBG
• Administer medical and nutritional
therapy that balances food intake
with physical activity and
pharmacologic therapies
• Prevent long-term complications
(micro vascular and macro vascular
disease)
• Maintain appropriate blood pressure
and lipid values.
• Treat other physiologic derangements
when present.
• Maintain a flexible and normal
lifestyle
44. About Medication
– Name and purpose
– Dose and frequency
– Medication adherence
– Possible adverse effects
– Missed dose
45. DASH Diet
• Cut the Salt
• Get Your Grains
• Load Your Plate With
Vegetables
• Don't Forget Fruit
• Have Some Yogurt
• Go for Lean Meats and Fish
• Add Nuts and Legumes
• Cut Back on Fats and Oils
• Watch the Sweets
• Get Enough Potassium
46. • Healthy life style with daily
exercise
(the ADA recommends 150
min/week (distributed over at
least 3 days) of aerobic
physical activity)
• Self-Monitoring of Blood
Glucose
• Nutritional recommendations
Food/amount Serving/exchange The size of
1 cup cooked rice or pasta 2 starch tennis ball
1 slice bread 1 starch compact disc case
1 cup raw vegetables or fruit 1 fruit or vegetable baseball
1/2 cup cooked vegetables or fruit 1 fruit or vegetable cupcake wrapper full or size of ice cream
scoop
1 ounce cheese 1 high-fat protein pair of dice
1 teaspoon olive oil 1 fat** half dollar
3 ounces cooked meat 1 protein deck of cards
3 ounces tofu 1 protein deck of cards
** Remember to count fat servings that may be added to food while cooking (oil for sautéing, butter, or shortening for baking)