1. A Case Study On
Hyperthyroidism, Anemia,
Polyhydramnios,Hypotension
and Post partum
haemorrhage.
09408103
Pharm-D ( V year )
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2. PATIENT PROFORMA
NAME: Mrs X SEX: FEMALE
AGE: 35 HEIGHT : 150cm
WEIGHT: 60kg BMI: 27
IP NO: 201221612 DEPT: OBG
DOA: 10-12-13 DOD: 15-12-13
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3. PROBLEMS
 1.Hyperthyroidism
 2.B/L Pedal oedema
 3.Anaemia
 4.Polyhydramnios
 5. Hypotension
 6.Post partum haemorrhage
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4. SOAP NOTES
SUBJECTIVE : A 35 years old female patient was
admitted in hospital with C/O: Draining PV, pain in
lower abdomen, pain while micturating and
oedema on both legs.She didn’t had a significant
past medical & medication history. She was a
married lady.
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5. OBJECTIVE
INVESTIGATIONS DONE: PICCL(+)E(+).
 HAEMATOLOGY: Blood urea: 55(elevated)
o Creatinine:1.77mg/dl(elevated)
o Serum ferritin: 229.72(elevated)
o Haemoglobin: 11.1(decreased)
o AFI: 31.4cm(elevated)
o FHR: 123 BPM
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DATE 10th
DEC
11th
DEC
12th
DEC
13th
DEC
14th
DEC
15th
DEC
TEMP N N N N N N
BP 120/70 110/70 120/70 110/80 120/70 110/70
PULSE 72 73 72 73 72 72

6. ASSESMENT
 Based on the clinical evidences, the patient was
diagnozed with Hyperthyroidism, B/L pedal
oedema, Anemia, Polyhydramnios,Hypotension
and Post partum haemorrhage.
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7. PLAN OF TREATMENT
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S.No DRUGS DOSE DAYS
T.NAME G.NAME D1 D2 D3 D4 D5 D6
1 INJ. IVF Normal saline 100ml √ √ x x x x
2 T.Orofer XT Iron, Folic acid,
calcium
100mg
1.1mg
√ √ √ √ √ √
3 T.Neomercazol
e
Carbimazole 5mg OD √ √ √ √ √ √
4 INJ.Metrogyl Metronidazole 500mg
OD
x x √ √ √ √

8. 5 INJ.cal.gluco
nate
Calcium
gluconate
10ml
IV
x x x √ √ √
6 Packed cell 1 unit x x x √ √ √
7 Syp.Piriton cs Chlorpheniramin
e maleate
2tsp
tds
x x x x √ √
8 INJ.Lasix Furosemide 1amp
IV
x x x √ √ √
9 T.Dytor Torsemide 20mg
OD
x x x √ √ √
10 T.Misoprost Misoprostol 50mg
OD
√ √ √ √ x x
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9. DRUG INTERACTIONS-
 No significant drug interactions were found
ADR-
 No significant ADR were found
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10. PLAN OF TREATMENT
 DISCHARGE MEDICATION -
1. T.Torsemide,
2. Syp.piriton cs and
3. T.Neomercazole
 PATIENT COUNSELLING -
 Take Antacids to relieve Heart burn & Nausea which may be
caused due to Polyhydramnios.
 Furosemide-Furosemide will make you urinate more often, so
don’t panic.you may get dehydrated easily so avoid exposure
to sunlight .
 Metronidazole-Skipping doses may also increase your risk of
further infection & development of resistance to antibiotics.
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11.  Chlorpheniramine maleate- Advise patient medication may
cause drowsiness or dizziness and not to drive or perform
other activities requiring mental alertness until tolerance is
determined.
• Advise patient to take each dose without regard to meals, but
to take with food if stomach upset occurs.
 MONITORING PARAMETERS-
• Monitor the T3 & T4 levels for the control over the Thyroid
functioning
• Monitor the Hb & serum ferritin levels for the control over
Anaemia
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12. LIFE STYLE MODIFICATIONS-
 Anti-oxidants like vitamin C (lemon, orange, amla, sweet lime
etc.), vitamin E (meat, liver, fish etc.) must be suggested as
these reduce the iron from ferric state to its ferrous state
(since iron can be absorbed only in its reduced form).
 Avoid sea foods as they contain high iodine content.
 Broccoli, soya products, cabbage, cauliflower, strawberries
comprises a good diet for Hyperthyroidism
FOLLOW UP-
Review after 10 days
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13. Thank you
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