CASE PRESENTATION ON COPD saru .pptx presentation

Case presentation

1. CASE PRESENTATION ON CHRONIC OBSTRUCTIVE PULMONARY DISEASE REGISTER NUMBER 380021503521

2. PATIENT DEMOGRAPHIC DETAILS Patient Name : XX Age : 45 years Gender : Male Date Of Admission : 18/03/2023 Date Of Discharge : 21/03/2023 Unit : Respiratory Medicine Ward IP No : 2202260005

3. COMPLAINTS ON ADMISSION C/O Wheezing C/O Fever for 2 days C/O Productive cough

4. Past medical history : NS Past medication history : NS Social history : Smoker ( past 15 years ) Family history : NS Allergies : NKA PATIENT MEDICAL HISTORY

5. P HYSICAL EXAMINATION CVS : S1 S2 (+) RS : B/L crepts + P/A : Soft CNS : NFND VITALS: Blood Pressure : 120/80mmHg Pulse Rate : 86beats/min RR : 20/min Temp : 102 °F Po 2 : 96%

6. LABORATORY INVESTIGATIONS PARAMETERS OBSERVED VALUE BIOLOGICAL REFERENCE Lymphocytes 50% ↑ 25-33% Eosinophil 12% ↑ 1-3%

7. OTHER INVESTIGATIONS Chest x rays : Flattening of the diaphragm Hyperinflated lungs

8. SOAP ANALYSIS SUBJECTIVE EVIDENCE Wheezing Fever for 2 days Productive cough OBJECTIVE EVIDENCE RS : B/L crepts Temperature : 102 °F Lymphocytes : 50%↑ Eosinophils : 12%↑ Chest x-ray : Flattening of the diaphragm , Hyperinflated

9. ASSESSMENT Based on the subjective and objective evidence the case is assessed as Chronic Obstructive Pulmonary Disease

10. GOALS OF THERAPY PATIENT SPECIFIC To relieve the wheezing , fever , cough. To improve the quality of life of the patient . DISEASE SPECIFIC To bring temperature , lymphocytes and Eosinophiles levels to normal. To prevent further complication.

11. PLANNING THERAPY S .No Generic name Brand name Dose FQ ROA Day 1 Day 2 Day 3 Day 4 1 Inj.Ranitidine rantac 50mg/2ml BID IV ✓ ✓ 2 Ipratropium bromide and levosalbutamol Neb duolin Ipratropium Br (20mcg) + salbutamol (100mcg) BID Nasal ✓ ✓ ✓ 3 Neb. Budesonide budez 0.5mg/2ml Q6hr nasal ✓ ✓ 4 T. paracetamol dolo 650 500 mg BID Oral ✓ ✓ 5 T cetirizine cetzin 10mg OD Oral ✓ ✓ 6 Inj.ceftriaxone cefivir 1g BD IV ✓ ✓ ✓ ✓

12. THERAPEUTIC PARAMETERS DRUG THERAPEUTIC PARAMETER Ranitidine Monitor AST,ALT ,serum creatinine Ipratropium bromide and levosalbutamol Monitor FEV 1 ,BP,HR Budesonide Monitor BP ,peak flow,FEV 1 Cetirizine Monitor relief of symptoms ,sedation and anticholinergic effects Ceftriaxone Monitor renal function

13. PROGRESSION CHART SI.NO DAY PROGRESS CHART 1 Day 1 BP: 120/80 mmHg Conscious , oriented PR: 86 bpm. RR: 20 / min Temp: 102°F 2 Day 2 Conscious , oriented BP:1 10/80 mm Hg PR:82 bpm RR:2 /min Temp: 100°F 3 Day 3 Conscious , oriented BP: 120/80 mmHg PR:7 8 bpm RR: 18 /min Temp:98°F 4 Day 4 Conscious, oriented BP:120/80 mm Hg PR:75 bpm RR:24/ min Temp:98°F

14. DISCHARGE MEDICATION S.No Generic name Brand name Dose ROA FQ 1. Ipratropium bromide and levosalbutamol Neb.duolin Ipratropium(20mcg) + salbutamol(100mcg) Nasal BID 2. Neb.budesonide Budez 0.5mg/2ml Nasal OD 3. T.Ranitidine Rantac 150mg oral BID All for 14 days and review after that .

15. TOXICITY PARAMETER DRUG TOXICITY PARAMETER Ipratropium bromide and levosalbutamol Hypersensitivity reaction,headache , palpitation,dry mouth. Neb.budesonide Nausea , abdominal pain , hypertension , hyperglycemia T.Ranitidine Abdominal pain , constipation ,nausea, vomiting, headache

16. RATIONALITY The given treatment for the patient is rational.

17. PATIENT COUNSELLING Disease Drugs Lifestyle modification

18. THANK YOU