1

2

A CASE PRESENTATION ON

ACUTE BRONCHITIS

Submitted by, Anvy Thankachan Pharmd 2nd year Roll no:6

3

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

4

SUBJECTIVE

5

Patient name : Ms. XAge : 5 yrsSex : FWeight: 20 kgDept. : PEADEATRIC

IP NO:L-8955DOA :24/01/15DOD : 29/01/15

6

Past medical history: Not known

Past medication history: Not known

History Present illness: cough(with mucus and have croups)& Breathing difficulty & Fever

7

OBJECTIVE

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 - - - - -

9

Investigation Chart DATE

Hb 13.4mg%TC 15800cells/mm

DC P-80%,L-19%,E-1%

ESR 11mm/hrPLATELET 2.8 lakhsCRP 21.57mg/L

24/11/15

10

DIAGNOSIS

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

12

ASSESSMENT

13

ACUTE BRONCHITIS

14

 Inflammation of the large breathing tubes (airways) called bronchi

Increased production of mucus Type of Bronchitis :

ACUTE BRONCHITIS

CHRONIC BRONCHITIS

15

ACUTE BRONCHITIS

Inflammation of the mucous membranes

16

AEITOLOGY Infection

Polluted air

Cigarette smoke

Medical problems

Premature birth

17

Signs & SymptomsCoughingWheezingShortness of breathRunny noseMalaiseChillsSlight feverBack and muscle painSore throat

18

PATHOPHYSIOLOGYHyperemia 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

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 Obstructio

n

20

RISK FACTORS

Second Hand

Smoking

 Asthma

Airborne pollutants

Winter months

21

Complications

Chronic Bronchitis

Pneumonia

Bronchopneumonia

Bronchiecstasis

22

PLAN

23

Therapeutic GoalTo keep the child breathe easier.Keep the child’s air passages moist and

better, able to get rid of germs.To relieve Cough

24

Standard MedicationsBronchodilator : Theophylline

Corticosteroides inhaled : Beclomethasone

Corticosteroides systemic : Prednisolone 

Antitussives/ Expectorant : Guaifenesin with

Dextromethorphan

Analgesic/Antipyretics : Ibuprofen, Acetaminophen

Anti viral Agent : Rimantadine

Anti microbial Agent : Erythromycin

25

Treatment PlanNo

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.TUSPELPLUS 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

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

27

DATE

TC 11600%

CRP 3.11mg%

DC P-50%,L-49%,E-1%

27/11/15

PROGRESS CHART

28

Discharge medicationNO 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

29

Pharmacist InterventionLimit exposure to cold, damp environmentsGood handwashingSteam humidifier can help the child feel more

comfortable Keep your home and car smoke-freeKeep away your child from second hand smokingDrink more waterUse a mist humidifier Adequate nutrition

30

31