a case presentation on acute bronchopneumonia
TRANSCRIPT
A CASE
PRESENTATION ON
ACUTE BRONCHOPNUEMONIA
SUBMITTED BY,
ANVY THANKACHAN
PHARM -D 2nd YEAR
REGNO.:142820474
A 5 Years old female patient admitted in the
hospital with complaints of Fever, Vomiting,
Cough(with mucus), & Breathing difficulty for 3
days
SUBJECTIVE
Patient name : Ms. X
Age : 5 yrs
Sex : F
Weight: 20 kg
Dept. : PEADEATRIC
IP No: k-8845
DOA :30/01/16
DOD : 5/02/16
Past medical history: Not known
Past medication history: Not known
History Present illness : Fever , Vomiting ,
Cough & Breathing difficulty
OBJECTIVE
VITAL SIGNS
DATE 30/1/16 31/1/16 1/2/16 2/2/16 3/2/16 4/2/16
TEMP. 100.2 F 100.1 F 100F 99.5 F 99F 98.5 F
Investigation ChartDATE
Albumin Trace
Sugar Nil
Micro pus cells 2-3
Hb 12.1 gm%
TC 62500cell/mm
DC P-56%,L-64%,E-3%
ESR 35mm/ hr
CRP(+VE) 40.9mg/L
30/1/16
DIAGNOSIS
Chest X-Ray : patchy consolidation in the bases of lungs
Physical Examination : Crackling sound
Wheezing
CBC : ESR increased
Leukocyte count increased
CRP count increased
Sputum Culture : identified causative agent is
Streptococcus pneumoniae
ASSESSMENT
BRONCHOPNEUMONIA
Pneumonia is an inflamation
of the Lung Parenchyma .
Leading cause of death in children in the developing
world
Pneumonia is the highest in children under 5 years of
age
CLASSIFICATIONClassified based on 2 Types
1) TYPE : 1
a) LOBAR PNEUMONIA
b) BRONCHOPNEUMONIA
2) TYPE:2
a) COMMUNITY ACQUIRED PNEUMONIA
b) HOSPITAL ACQUIRED PNEUMONIA
BRONCHOPNEUMONIA
Infection of the terminal Bronchioles that
extends in to the surrounding alevoli resulting
in Patchy consolidation of the lung
AETIOLOGY
Bacteria
Viruses (less severe)
Signs & Symptoms
Tachypnea
Nasal Flaring : With inspiration,the side of the nostrils flares outwards
Head ache
Pathophysiology
Risk Factors
Risk Factors
Complications
Sepsis
Lung Abscess
Pleural thickening
Respiratory Distress Syndrome
Pneumothorax
PLAN
Therapeutic Goal
To Relieve Cough
To Reduce Body Temperature
To Keep the child breathe easier.
Keep the child’s air passages moist and better, able
to get rid of offending organism
Standard Medications
Antiviral Therapy: Zanamivir, Amatadine
Antipyretics : Paracetamol
Bronchodilator : Salbutamol
Oxygen Therapy
Intravenous fluids : to correct dehydration eg: Isolyte p
Expectorant/antitussives: Dextromethorphan
Antihistamines : Cetirizine
Decongestants : Phenylephrine
Treatment Planno TRADE NAME DOSE 30/1/16 31/1/ 1/2/16 2/2/16 3/2/ 4/2/
1 INJ.p.mol 2cc IV Stat & sos
+ + + + - -
2 INJ.PERISET2mg IV Stat& sos
+ + + - - -
3 IVF ISOLYTE P - + + + - - -
4 INJ.CLAVAM BD + + + + + +
5 ASTHALIN NEB. 2.5ml Q6H + + + + + +
6 SYP.ALTIME CF JR 5ml/60ml
BD + + + + + +
7 INJ.OFRAMAX IV BD + + + + + +
Q8H
GENERIC NAME USES
PARACETAMOL ANTIPYRECTIC
ONDANSETRON ANTI-EMETIC
SODIUM ACETATE+POTASSIUM CHLORIDE+MAGNESIUM CHLORIDE
BODY FLUID AND ELECTROLYTE BALANCE
AMOXICILLIN+CLAVULANIC ACID ANTIBIOTIC
SALBUTAMOL BRONCHODILATOR
AMBROXOL,DEXTROMETHORPHAN, CETIRIZINE
COUGH
CEFTRIAXONE ANTIBIOTIC
Progress Chart
DATE
ALBUMIN NIL
TC 13500cell/mm
DC P-47%,L-43%,E-1%
ESR 14mm/hr
CRP 9mg/L
3/2/15
Discharge Medications
NO TRADE NAME FREQUENCY PERIOD OF TREATMENT
1 TAB.MEDMOL 300mg SOS -
2 SYP.CEFOLAC 30ml/2.5ml
BD 5 DAYS
3 SYP.ALTIME CF JR60ml/5ml
BD 5 DAYS
Get vaccinated
Provide adequate rest
Drink plenty of fluids ,especially Water
Keep your child away from smoking
Frequently check Temperature
Using Humidifier
Get plenty sleep
Pharmacist Interventions
Control of indoor air pollution and promotion of
healthy environment
Adequate Nutrition
Zinc supplementation
Keep your child away from people with symptoms of a
respiratory infection
Practising Good Hygiene