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Therapeutics minor case presentation Acute exacerbation of COPD Q1326

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Presentation on theme: "Therapeutics minor case presentation Acute exacerbation of COPD Q1326"— Presentation transcript:

1 Therapeutics minor case presentation Acute exacerbation of COPD 12Q1326

2 SCENARIO: here is a male patient Shanmukappa Arakeri of 65yrs bearing I.P no:25369 is admitted to male medical ward has been hospitalized since 2 days. Chief complaints: c/o cough with expectoration since 1 month c/o breathlessness since 1 month HISTORY OF PRESENT ILLNESS: patient was apparently normal 1 month back since then he developed cough with expectoration which is whitish in colour about a cup per day, more in the evening and morning.

3 He also complaints of breathlessness which is insidious in onset presented both on exertion and on taking rest since 1 month. Social history: alcoholic & beedi smoker since 20 yrs. DIAGNOSIS: Acute exacerbation of COPD Laboratory investigation: CBC values WBC( cumm) 13,760 Increased Neutrophils(40-60) 83 Lymphocytes(20-60) 12 Decreased Monocytes(1-4) 05 ESR(<10mm/hr) 80

4 SOAP NOTE SUBJECTIVE: here is a 65y old male patient complaining of breathlessness and cough with expectoration since 1 month. OBJECTIVE: Increased WBC count indicates infection. Increased neutrophil & monocytes count indicates COPD. Decreased lymphocytes indicates severe illness. ESR increase in acute/ chronic infection.

5 ASSESSMENT: PROBLEM LIST- 1.Breathlessness 2.Cough with expectoration 3.COPD Breathlessness: due to hypertrophy of mucus gland and excessive mucus production leading to breathlessness. Cough with expectoration: it is a reflex mechanism to expel out sputum which triggers the chemo and mechano receptors COPD: it is a chronic obstructive pulmonary disease associated with air flow limitation due to abnormal inflammatory response of lungs to allergens.

6 GOALS OF THERAPY To subside signs and symptoms To improve the quality of life To prevent further complications and exacerbations To reduce morbidity and mortality.

7 Trade names Generic names indication dose Day 1 2 1 Inj. taxim
s.no Trade names Generic names indication dose Day 1 2 1 Inj. taxim cefotaxime Prophylaxis for hospital born infection 1gm 101 + Inj. Rablet rabeprazole Prophylaxis for Ab induced hyprgastric secrtn 20mg 100 3 Duolin neub Salbutamol+ ipratropium breathlessness 1111 4 Sy. Brozodex bromohexien Cough with expectoration 2tsp 111 5 Inj.deriphylline Theophylline+etiophylline bronchodialition 1amp 6 T. calpol paracetamol fever 500mg sos

8 Clinical Pharmacist Intervention:
Drug -drug Interaction:- 1.Theophylline + salbutamol : Moderate Interaction. Effect : Increases cardiovascular side effects such as Increased Heart rate, Increased PR & BP. Management: monitor serum K+ levels, BP & PR.

9 2. Theophylline+rabeprazole: Moderate interaction Effect:rabeprazole increases the effect of theophylline. Management: patients should be closely monitored for the development of toxicity, particularly serum theophylline levels.


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