4 COPD

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Case No.: Date: SUBJECTIVE OBJECTIVE ASSESSMENT PLAN PATIENT EDUCATION PROBLEM 1.VITAL SIGNS 2.LAB TESTS 3.MED.LIST ETIOLOGY OF PROBLEM 1.EVALUATE CURRENT THERAPY FOR PROBLEM 2.EVALUATE NEED FOR THERAPY GOALS FOR TREATMENT OF PROBLEM RECOMMEND 1. DRUG TREATMENT FOR PROBLEM 2. MONITORING PARAMETERS FOR EACH DRUG LISTED 3. FURTHER TESTS FOR PROBLEM IF NEEDED 4. DRUGS TO BE AVOIDED AND WHY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ACUTE EXACERBATIONS 78 y/o male, was admitted on 16/04/2014 with c/o Breathlessness. Difficulty in breathing – 6 months PMH: HTN,COPD,DIABETES >7 years Vitals: B.P : 150/90 mm of Hg PR : 80/min SPO 2 : 94% CVS : S1S2 ++ RS : B/L wheeze + B/L crepts + Labs: DAY 1 HB 12.2 gm% FBS 136mg/dl PBS 211mg/dl Current medication: Inj. Hydro Cortisone Na 100mg SOS Inj. Imipenem & Cilastatin 500mg BD Inj. Pralidoxime Iodide 40mg OD Inj. Etophylline +Theophylline 2ml OD T.Levo Salbutamol BD Budesonide Nebuliser BD Acetyl Cysteine Nebuliser BD A significant cause of breathlessnes s in COPD is hyperinflatio n of the lungs due to air trapping due to broncho constriction. most often caused by infections— such as acute bronchitis and pneumonia —and air pollution. Inj. Hydrocortisone Sodium , a corticosteroid is prescribed to prevent flare-up Imipenem& Cilastatin for bacterial exacerbations of COPD Inj.Pralidoxime Iodide for Respiratory Depression Inj Etophylline + Theophylline to prevent flare-up T. Levo Salbutamol (Bronchodilator) Budesonide Nebuliser control of asthma and COPD in persons requiring continuous, prolonged treatment. Acetyl Cysteine Nebuliser – Mucolytic Need for Therapy : Long-acting bronchodilators help prevent breathing problems. They Normalize breathing and to prevent further attack. 1. Continue the current medication 2. Nil 3. Nil 4. Avoid non selective β blockers for treating Hypertension in this patient because of their broncho constriction effect. Continue emphasizing medication adherence. Any regular exercise or physical activity is good. However, ideally the activity that you do should make you at least a little out of breath Avoid bad air (airway irritants like air pollutions, chemical fumes, and dust) Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, RVS Nagar, Chittoor-517127 (AP), INDIA

description

case study on copd

Transcript of 4 COPD

Case No.: Date:

SUBJECTIVEOBJECTIVEASSESSMENTPLANPATIENT EDUCATION

PROBLEM

1.VITAL SIGNS2.LAB TESTS3.MED.LIST

ETIOLOGY OF PROBLEM

1.EVALUATE CURRENT THERAPY FOR PROBLEM2.EVALUATE NEED FOR THERAPY

GOALS FOR TREATMENT OF PROBLEM

RECOMMEND1. DRUG TREATMENT FOR PROBLEM2. MONITORING PARAMETERS FOR EACH DRUG LISTED3. FURTHER TESTS FOR PROBLEM IF NEEDED4. DRUGS TO BE AVOIDED AND WHY

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)ACUTE EXACERBATIONS

78 y/o male, was admitted on 16/04/2014 with c/o Breathlessness. Difficulty in breathing 6 months

PMH: HTN,COPD,DIABETES >7 years

Vitals: B.P : 150/90 mm of HgPR : 80/minSPO2 : 94%CVS : S1S2 ++RS : B/L wheeze + B/L crepts +

Labs:DAY1

HB12.2 gm%

FBS136mg/dl

PBS211mg/dl

Current medication:Inj. Hydro Cortisone Na 100mg SOSInj. Imipenem & Cilastatin 500mg BDInj. Pralidoxime Iodide 40mg ODInj. Etophylline +Theophylline 2ml ODT.Levo Salbutamol BDBudesonide Nebuliser BDAcetyl Cysteine Nebuliser BD

Inj. Furosemide 10mg SOSInj. Paracetamol 250mg BDInj. Magnesium Sulphate 100ml ODT.Atenolol 25mg BDT.Lactic Acid Bacillus TID

A significant cause of breathlessness in COPD is hyperinflation of the lungs due to air trapping due to broncho constriction.

most often caused by infectionssuch as acute bronchitis and pneumoniaand air pollution. Inj. Hydrocortisone Sodium , a corticosteroid is prescribed to prevent flare-up

Imipenem& Cilastatin for bacterial exacerbations of COPD

Inj.Pralidoxime Iodide for Respiratory Depression

Inj Etophylline + Theophylline to prevent flare-up

T. Levo Salbutamol (Bronchodilator)

Budesonide Nebuliser control of asthma and COPD in persons requiring continuous, prolonged treatment.

Acetyl Cysteine Nebuliser Mucolytic

Need for Therapy :Long-acting bronchodilators help prevent breathing problems. They help people whose symptoms do not go away (persistent symptoms). They include: Anticholinergics (such as tiotropium). Beta2-agonists (such as arformoterol, formoterol, or salmeterol).

Phosphodiesterase-4 (PDE4) inhibitorsPhosphodiesterase-4 (PDE4) inhibitors are taken every day to help prevent COPD exacerbations. The only PDE4 inhibitor available is roflumilast.Normalize breathing and to prevent further attack.

1. Continue the current medication2. Nil3. Nil4. Avoid non selective blockers for treating Hypertension in this patient because of their broncho constriction effect.Continue emphasizing medication adherence.

Anyregular exercise or physical activityis good.

However, ideally the activity that you do should make you at least a little out of breath

Avoid bad air (airway irritants like air pollutions, chemical fumes, and dust)

Department of Pharmacy Practice, Sri Venkateswara College of Pharmacy, RVS Nagar, Chittoor-517127 (AP), INDIA


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