a case presentation on Acute bronchitis

a case presntation on acute bronchitis

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2. A CASE PRESENTATION ON ACUTE BRONCHITIS Submitted by, Anvy Thankachan Pharmd 2 nd year Roll no:6 2

3. A 5 Years old female patient admitted in the hospital with complaints of Breathing difficulty Cough , & Fever 3

4. SUBJECTIVE 4

5. Patient name : Ms . X Age : 5 yrs Sex : F Weight: 20 kg Dept. : PEADEATRIC IP NO:L-8955 DOA :24/01/15 DOD : 29/01/15 5

6. Past medical history: Not known Past medication history: Not known History Present illness: cough(with mucus and have croups)& Breathing difficulty & Fever 6

7. OBJECTIVE 7

8. VITAL SIGNS DATE 24/1/15 25/1/15 26/1/15 27/1/15 28/1/15 TEMP 100.1 F 99.5 F 99 F N N PULSE 72/mt 72/mt 72/mt 72/mt 72/mt BP - - - - - 8

9. Investigation Chart DATE Hb 13.4mg% TC 15800cells/mm DC P-80%,L-19%,E-1% ESR 11mm/hr PLATELET 2.8 lakhs CRP 21.57mg/L 24/11/15 9

10. DIAGNOSIS 10

11. Medical history Physical Examination - Presistent cough Fever Blood Test - C-reactive protein White blood cell count Sputum culture – Presence of Neutrophil granulocytes indicate streptococus pnuemonia Chest X –ray - If you have pneumonia and any other condition 11

12. ASSESSMENT 12

13. ACUTE BRONCHITIS 13

14.   Inflammation of the large breathing tubes (airways) called bronchi Increased production of mucus Type of Bronchitis : ACUTE BRONCHITIS CHRONIC BRONCHITIS 14

15. ACUTE BRONCHITIS Inflammation of the mucous membranes 15

16. AEITOLOGY Infection Polluted air Cigarette smoke Medical problems Premature birth 16

17. Signs & Symptoms Coughing Wheezing Shortness of breath Runny nose Malaise Chills Slight fever Back and muscle pain Sore throat 17

18. PATHOPHYSIOLOGY Hyperemia of the Mucous Membrane Desquamation,edema, leucocytic infiltration of the submucosa Production of sticky or mucopurulent exudate The protective fn. of bronchial cilia,phagocytes,and lymphocytes, are distributed 18

19. Bacteria invade the Bronchi Accumulation of cellular debris and mucopurulent exudate Cough,though distressing is essential to eliminate Bronchial seceration Edema of the bronchial walls Retained secerations Spasm of Bronchial muscles Air Way Obstruction 19

20. RISK FACTORS Second Hand Smoking  Asthma Airborne pollutants Winter months 20

21. Complications Chronic Bronchitis Pneumonia Bronchopneumonia Bronchiecstasis 21

22. PLAN 22

23. Therapeutic Goal To keep the child breathe easier. Keep the child’s air passages moist and better, able to get rid of germs. To relieve Cough 23

24. Standard Medications Bronchodilator : Theophylline Corticosteroides inhaled : Beclomethasone Corticosteroides systemic : Prednisolone  Antitussives/ Expectorant : Guaifenesin with Dextromethorphan Analgesic/Antipyretics : Ibuprofen, Acetaminophen Anti viral Agent : Rimantadine Anti microbial Agent : Erythromycin 24

25. Treatment Plan No TRADE NAME DOSE 24/1 25/1 26/1 27/1 28/1 1 EFCORLIN 1oml/2 drops BD + + + + + 2 INJ.TAXIM Q8 H + + + + + 3 SYP.TUSPEL PLUS 100ml/2.5ml BD + + + + + 4 Nebu.ASTHALIN 5mg/2.5ml stat& Q6H + + + + + 5 SYP.DEZACOR 6mg/ 5ml BD + + + + + 6 SYP.Dolo 250mg/ 5ml sos + + + - - OD 25

26. GENERIC NAMES USES Hydrocortisone+Naphazoline Unblock nose and reduce swelling in the nasal passage Cefotaxime Antibiotic Salbutamol Shortness of breath Deflazacort Immunosupressants Ammonium Chloride +Bromhexine+Menthol+Terbutaline Bringing mucosa out ofthe lungs thus relieving Cough 26

27. DATE TC 11600% CRP 3.11mg% DC P-50%,L-49%,E-1% 27/11/15 PROGRESS CHART 27

28. Discharge medication NO TRADE NAME FREQUENCY PERIOD OF TREATMENT 1 SYP.TUSPEL PLUS 100ml/2.5ml BD 5 DAYS 2 SYP. ZENTEL 5ml/10ml .h.s 2 DAYS 3 SYP.PHEXIN 250mg/5ml .h.s 3DAYS 4 Tab.MONTAIR LC KID 4mg/2.5mg .h.s 4DAYS 28

29. Pharmacist Intervention Limit exposure to cold, damp environments Good handwashing Steam humidifier can help the child feel more comfortable Keep your home and car smoke-free Keep away your child from second hand smoking Drink more water Use a mist humidifier Adequate nutrition 29

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