2 dmtac clinic case

7/25/2019 2 DMTAC Clinic Case

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DM MTAC TRAINING CASE PRESENTATION

Nurul Farhana Binti IsmailPegawai Farmasi U4

!"s#ital Si$


2/13

DEMOGRAP!IC DATA

Name SHA

Age 34 years old

Gender Female

Race Malay

Weight 95 kg

Diagnosis DM%!TN%I!D%D&sli#i'emia


3/13

AS! M"D#$A% H#S!&R'Dia(etes Mellit)s !y*e +

Retino*athy ,se-ere NDR. eye clinic hos*k)lim/ rotein)ria +4 hr )rinary *rotein 401g2day

Hy*ertension

#HD ith dilated cardiomyo*athy Angiogram on 3225

Dysli*idemia


4/13

M"D#$A!#&N H#S!&R'

Medication Dose Fre6)ency

#ndication

S2$ Mi7tard +8 ) D DM

!0 Met:ormin 588 mg D DM

!0 iso*rolol +05 mg &D #HD2H!

!0 Fr)semide 48 mg &D #HD2H!

!0 Diltia;em 38 mg !DS #HD2H!

!0 Rami*ril +05 mg &D #HD2H!

!0 Ator-astatin 48 mg &N Dysli*idemia

!0 Ferro)s:)marate

488 mg &D Anemia

!0 co2Folate #2# &D 505 ,*oor adherence/

AS! M"D#$A% H#S!&R'


5/13

S&$#A% H#S!&R'

No dr)g a()se

No smoking

Non?Alcoholic

DR@G A%%"RG' NDA


6/13

H'S#$A% RAM"!"R2G%'$"M#$ $&N!R&%

Parameter N"rmal 4()(4 *+((,

,mmHg/ B38218 312C1 4211

FS ,mmol2%/ 404?08 0 05

+H ,mmol2%/ 404?108 ? ?

RS ,mmol2%/ B808 ? ?

H(Ac ,/ B05 ? 30

RS ,42925/ > 401 mmol2%


7/13

%##D R&F#%"

Parameter N"rmal *-(4(, ,(-(, *,()(,

!0 $hl,mmol2%/

305?50C C04 0 50

!G% ,mmol2%/ B 0C +0C +0+ +04

%D% ,mmol2%/ B +0 409 4 30

HD% ,mmol2%/ E 0 03 081 809


8/13

Signi./ant 0a1"rat"r& Fin'ingsRenal Pr".le

arameters Normal Range 5225 +52125

Na 3?45 mmol2% 35 3

305 405 mmol2% 505 40

S$r 5C 38 )mol2% 4 3C

$r$l 8 ?88 m%2min 9+ C


9/13

Signi./ant 0a1"rat"r& Fin'ings

arameters Normal Range 5225 +52125

Al()min 35 5+ g2% 34 +9

!0ilir)(in B38 )mol2% 40C 80C

!0rotein ?1C g2% C3 C8

A% 3?4 )2% 1 83

A%! B3+ )2% 4 4

0i2er Fun/ti"n Test

h i l $


10/13

harmace)tical $are#nter-ention

Issue Inter2enti"n Out/"meatient cannot stick torigid meal time0*atient )s)ally ski*meals

d)e to hectic li:e. th)s

notinecting ins)lin

S)ggest to change:rom

*remi7ed ins)lin to(asal

(ol)s ins)lin

$hange to S2c Actra*id8 @ !DS. S2c Gargine +4 @&N

I Glargine red)cesincidence o: hy*o

Nely startedActra*id

ins)lin and Glargine

ins)lin

$o)nselled on thedose and

:re6)ency o: ins)lin0

"nco)raged SMG

atient )nderstood

atient has less)nderstanding on

dia(eticdiet

$o)nselled ondia(etic diet.

em*hasi;e oncar(ohydrate

e7chage

atient )nderstood

atient has *oor $o)nselled on the atient )nderstood


11/13

NH


12/13


13/13

R"F"R"N$"S3 M"nami M et/3 0"ng a/ting insulin anal"gues 2s NP! insulin "r

te * 'ia1etes mellitus3 C"/hrane Data1ase S&st Re2iew3

*++)5)6)47)8*3 Peter Shar#lin et/3 im#r"2e' gl&/aemi/ /"ntr"l 1& swit/hing

r"m insulin NP! t" insulin Glargine6 a retr"s#e/ti2e stu'&3*++8

93 Stratt"n IM et/3 Ass"/iati"n " gl&/aemia with ma/r"2as/ularan' mi/r"2as/ular /"m#li/ati"ns " T*DM5 #r"s#e/ti2e"1ser2ati"nal stu'&3 BM: *+++3

43 MO! CPG Management " Te * Dia1etes Mellitus 4th

e'iti"n*++8

2 dmtac clinic case

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