Coronary artery Disease(Single vessel Disease)

1. Case of Single Vessel Disease
• By
Vignesh.G
5th Pharm.D

3. Demographic details
• Name: XYZ
• Age:65yrs
• Sex:Female
• Weight:81Kg
• Admission Date:02/01/15
• Discharge Date:05/01/15
• Ward:Semi-Private(4th floor)

4. Subjective-Current Complaint And
History OF Illness
• C/o neck pain and headache since 2days with giddiness
• H/o Fever and Cough
• H/o Retrosternal chest pain radiating to right upper limb
since 4pm on admission day
K/C/o DM & HTN

5. Objective evidence
VITALS Day 1 Day 2 Day 3 Day 4
Temp(F) 98.6 99.2 98.7 98.6
RR(cpm) 15 18 18 20
Pulse(bpm) 85 82 84 80
BP(mmHg) 184/111 160/100 140/90 120/80

6. Radiographic Data
• ECG – RS, ST Elevation
• ECHO revealed RWMA with severe LV Dysfunction
• Angiogram revealed – single vessel disease

7. PTC Angioplasy

8. Treatment Details
Brand Name Dose Date Begin Date Ended Frequency
Inj.Dolbutamol 2.5mcq/Kg 03/01/15 04/01/15 1-0-1
T. ecosprin 150mg “ 05/01/15 1-0-1
T. Cardivas 3.125mg 04/01/15 “ 1/2-0-1/2
T.Pantodac 40mg 03/01/15 05/01/15 1-0-1
T.Atorva 40mg 03/01/15 05/01/15 0-0-1
T.Telma 40mg 03/01/15 05/01/15 1-0-0
T.clopilet 75mg 03/01/15 05/01/15 1-0-1

9. • Inj Dolbutamide: dolbutamine- It is a synthetic
catecholamine. It helps heart pump better by
strengthening the heart muscle.
ADRs-upset stomach, tingling sensations, leg cramp,
increasing fatigue.
• T.Ecosporin: Its an Antiplatelet. It inhibits
cyclooxygenase, which is responsible for the synthesis of
prostaglandin and thromboxane. It inhibits platelet
aggregation.

10. T.Cardivas: It is an alpha- and beta-blocker, prescribed
for heart failure and high blood pressure. It relaxes blood
vessels and slowing heart rate to improve blood flow and
decreases blood pressure.
ADRs-disorientation, sudden unusual weight gain,
Dizziness, fatigue, headache
• T.Pantop: PPI Class of drug acts by inhibiting the
proton pump found on cell that stomach uses to produce
acid.It prevents the excess flow back of acid into foodpipe
thus relieving the heart burn.
ADRs- overdosing may cause negative ionotropy effect by
inhibition of H+/K+ ATPase enzyme in myocardium.

11. Atorvastatin: Statins- these are HMG CoA
reductase inhibitors. They inhibit HMG CoA and
thus prevents the conversion of HMG to
mevalonate thus hindering the cholesterol
pathway,increasing the HDL level.
ADR-Myopathy,Rhabdomyolysis,diarrhea
,dyspepsia,nausea
Telma: sartans-these are AT2 receptors
antagonists-vasodilations. As well act in PPAR-y
regulating the insulin & glucose metabolism.
ADR- edema,irregular Heart beat.

12. • Clopidogrel: It is theonopyridine class of
antiplatelets. Inhibits the platlet activation by
acting in P2Y12 receptor of ADP in cell
membrane of platlets thus inhibition of fibrin and
so platelets.
• ADR- neutropenia, bleeding, thrombotic
thrombocytopenia purpura

13. Discharge Medications
Brand name Dose frequency ROA Duration
T.Ecosprin 150mg 1-0-1 P/O 7days
T.Clopilet 75mg 1-0-1 P/O 7days
T.Aztor 40mg 0-0-1 P/O 7days
T.cardivas 3.125mg 1-0-1 P/O 7days
T.Telma 40mg 1-0-0 P/O 7days
T.Pantodac 40mg 1-0-0 P/O 7days
T.Glycomet 500mg 1-0-0 P/O 7days

14. Patient counselling
• To have more plant proteins-soy chunks,nuts,grains as
they have low saturated fats.
• Increase intake of omega 3 fats- Fish,walnuts,greenleafy
• Olive, canola, peanut oil should be used for cooking.
• Avoid processed and baked food as they have high
triglycerides level.
• Decrease weight, do regular exercise,walking (30Min) .
• Eat more rice bran,fruits as they are more fibrous as
soluble fibers can bind to bile instead cholesterol.
• Balanced diet, reduce salt to 2g a day.

15. THANK YOU