a case presentation on Acute bronchopneumonia
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Transcript of a case presentation on Acute bronchopneumonia
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A CASE
PRESENTATION ON
ACUTE BRONCHOPNUEMONIA
SUBMITTED BY,
ANVY THANKACHAN
PHARM -D 2nd YEAR
REGNO.:142820474
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A 5 Years old female patient admitted in the
hospital with complaints of Fever, Vomiting,
Cough(with mucus), & Breathing difficulty for 3
days
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SUBJECTIVE
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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
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Past medical history: Not known
Past medication history: Not known
History Present illness : Fever , Vomiting ,
Cough & Breathing difficulty
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OBJECTIVE
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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
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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
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DIAGNOSIS
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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
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ASSESSMENT
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BRONCHOPNEUMONIA
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Pneumonia is an inflamation
of the Lung Parenchyma .
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Leading cause of death in children in the developing
world
Pneumonia is the highest in children under 5 years of
age
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CLASSIFICATIONClassified based on 2 Types
1) TYPE : 1
a) LOBAR PNEUMONIA
b) BRONCHOPNEUMONIA
2) TYPE:2
a) COMMUNITY ACQUIRED PNEUMONIA
b) HOSPITAL ACQUIRED PNEUMONIA
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BRONCHOPNEUMONIA
Infection of the terminal Bronchioles that
extends in to the surrounding alevoli resulting
in Patchy consolidation of the lung
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AETIOLOGY
Bacteria
Viruses (less severe)
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Signs & Symptoms
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Tachypnea
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Nasal Flaring : With inspiration,the side of the nostrils flares outwards
Head ache
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Pathophysiology
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Risk Factors
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Risk Factors
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Complications
Sepsis
Lung Abscess
Pleural thickening
Respiratory Distress Syndrome
Pneumothorax
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PLAN
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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
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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
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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
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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
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Progress Chart
DATE
ALBUMIN NIL
TC 13500cell/mm
DC P-47%,L-43%,E-1%
ESR 14mm/hr
CRP 9mg/L
3/2/15
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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
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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
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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
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