a case presentation on acute bronchopneumonia

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