Puma, a 61-year old gentleman was admitted to the hospital having…

Question Answered step-by-step Puma, a 61-year old gentleman was admitted to the hospital having… Puma, a 61-year old gentleman was admitted to the hospital having been referred by his general practitioner with haematemesis and malaena. He had been feeling unwell over the last few day. Onthe morning of admission his wife said he had vomited about 500ml of fresh blood. He was known to have alcoholic liver disease and cirrhosis (Child-Pugh score B) and had been a heavy drinker for the past 15 years. His drug history on admission was spironolactone 100mgdaily, furosemide 20mg daily and chlorpheniramine 4mg three timesdaily. On examination, Puma was noted to be confused. He appeared jaundiced and was found to have severalclinical features of chronic liver disease, includingspider naevi on his face and abdomen, and pruritus. Pitting oedema was present in both ankles. His abdomen was grossly enlarged with shifting dullness and a fluid thrill due to the presence of ascites .Distended veins were visible on the abdominal wall. His blood pressure was 90/50mmHg and pulse rate 115 beats/min Puma was eventually discharged home on the following oral medication: furosemide 40mg dailyspironolactone 200mg daily propranolol 20mg twice daily thiamine daily 100mg daily lactulose 30 ml daily colestyramine 4g twice daily Discuss the indication for each of these drugs in Puma. Science Health Science BS IN PHAR CLINPHAR Share QuestionEmailCopy link Comments (0)