A CLINICAL PHARMACIST INTERVENTIONS ON MILIARY KOCH’S WITH ANTI-TUBERCULAR THERAPY INDUCED HEPATOTOXICITY AND PSYCHOSIS: CASE REPORT

Psychosis and hepatotoxicity are the dangerous side effects of the antitubercular drugs DOTS therapy. Haematological spreading of tubercular bacteria in the lungs is also known as miliary tuberculosis. In this case study, 45 years old man, weighing 55 kg was brought to the hospital with the chief complains of vomiting (multiple episodes), fever, pain in abdomen, difficulty in breathing, mucoid cough, disturbed sleep for past 1 week. He had a known case of smear positive pulmonary tuberculosis (in the last 1 months), but at that time patient was not taking regular ATT medications (DOTS therapy). After 3th week of irregular anti-tubercular drug treatment, patient developed with the problems like vomiting (multiple episodes), fever, pain in abdomen, difficulty in breathing, cough with expectorations, disturbed in sleep, delirium etc. Pulmonologists had found the provisional & final diagnosis on the bases of subjective and objective observations miliary KOCH’S with antitubercular drugs induced hepatotoxicity and psychosis. Patients recovered from psychosis and hepatotoxicity withdrawn the first line ATT medication and tablet pyridoxine, antipsychotic medicines and modified ATT was added in the therapy. Psychotic in a patient on ATT can be one of the complications of tablet INH. As a clinical pharmacologist we prevent and minimize drugs induced complication’s and ADRs. Proper patients counselling and patients’ educations is important for the better management of patients

EFFECTS OF PATIENT COUNSELING ON DRUG DOSE REGIME AND MEDICATION COMPLIANCE IN ASTHMA PATIENTS: A PROSPECTIVE STUDY

Objectives: The objective of study is to estimate the role of counseling on the diseased patients with asthma and its effects on the medication adherence in relation to their associated side effects on medicines on patients. Methods: The prospective case–control study was carried out at the outpatient department of respiratory department. 190 patients were enrolled for the study of 6 months. Patient counseling and follow-up were done on the basis of knowledge, attitude, and practice (KAP) questionnaire. In 190 subjects, 115 were female and 75 were male and were having the pathological history of cough cold, tuberculosis, hypertension, etc. Results: It was found that counseling causes increase in medication adherence of patients from 28.90% to 71.50% and inhaler adherence from 27.60% to 72.60%. Along with the medication adherence, fewer side effects due to various drugs were encountered such as sore throat, rhinitis, constipation, difficulty in glutition, hand tremor, and weight gain. Conclusion: The study concluded that, patient counseling plays an important role in diseases like asthma, which changes the attitude, increases the knowledge which turns out into the better medication results improving the asthmatic symptoms