Diabetic foot ulcer case analysis by a clinical pharmacist

• Autores: Arumugam Porselvi, Shankar Marakanam Srinivasan Uma, Lakshmi Karunanidhi Santhana
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 20, Nº. 5, 2018, págs. 270-273
• Idioma: inglés
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• Resumen

  • Diabetic foot ulcers (DFU) are common among diabetes patients that have a long term impact on the morbidity, mortality and quality of patients lives. The patient was a 63 year old retired teacher with a long term history of Type 2 Diabetes Mellitus (DM) and hypertension. He was admitted with the complaints of burning sensation and unbearable pricking pain on both the feet after a pilgrimage trip by walking. On examination, the patient was found febrile at 39.10°C, anxious and restless. His pulse rate was 110/minute and Blood Pressure (BP) was 190/100 mm Hg and his sugar levels were found high, Fasting Blood Sugar (FBS) level 170 mg/dl, Post Prandial Blood Sugar (PPBS) level 320 mg/dl and Glycosylated Hemoglobin (HbAlc) level 9.5%. He had elevated lipid profile of Cholesterol 260 mg/dl, Triglyceride (TGL) 180 mg/dl, Low-Density Lipoprotein (LDL) 190 mg/dl, and High-Density Lipoprotein (HDL) 25 mg/dl. Local examination of his right foot revealed gangrene of the sole as well as 2nd, 3rd and 4th toes later developed flap necrosis and progressive gangrene spread over the sole of the right foot. Patient was diagnosed with diabetic foot ulcer involving right foot and a course of broad spectrum antibiotics were started. The patient was advised to do aerobic exercises for his upper limbs, to consume diabetic diet and to take oral hypoglycemic agents regularly. Clinical pharmacist can perform a vital role in diabetic patients with foot ulcers by revising the antibiotics in accordance with guidelines, monitoring side effects and proving counseling on prevention and management. In this case apart from usual roles, the clinical pharmacist performed risk assessment, provided detailed patient counseling and monitored patient for about six months to record the short-term positive health outcomes. The aim of this case presentation is to serve as a model in bringing up awareness on effective role of clinical pharmacist in DFU management and prevention