chronic obstructive pulmonary disease

1. INTRODUCTION:
DEFINATION:Chronic obstructive pulmonary desease (COPD)
is a lung desease characterised by chronic obstruction of lung
airflow that interfere with normal breathing and is not fully
reversible
TYPE:1)Chronic Bronchitis,
2)Pulmonary emphysema
CASE PRESENTATION OF COPD
BY RAKIBUL HUSSAIN
PHARM D IV YEAR
1

2. 2
1)Tobacco smoke
2)Indoor air pollution
3)Occupational dust and chemical
4)Out door air pollution
5)Genetic factor
CLINICAL PRESENTATION:
1) Chronic cough
2) Sputum production
3) Wheezing
4) Chest tightness
5) Dyspnoea
6) Respiratory infection Weight loss
ETIOLOGY:

3. 3
PATHOPHYSIOLOGY:

4. DIAGNOSIS:
1)Blood test
2)Chest x Ray or CT scan
3)Sputum examination
4)ECG
5)Pulmonary function test
NON PHARMACOLOGICALTREATMENT:
1)Smoking cessation
2)Pulmonary rehabitation programme
3)Vaccination eg:pnemomococcal vaccine
4)Oxygen therapy
5)Surgery
4

5. Pharmacological treatment
1)Bronchodilator:
 MOA:Relax the muscle around airway
Eg:Albuterol,levobuterol,terbutaline ,etc
2)Corticosteroid:
 MOA:reduce airway inflammation
Eg:Hydrocortisone,prednisone
3)Phosphodiasterase 4 inhibitor:
MOA:dicrease airway inflammation and relaxes the
airway,eg:Theophylline,aminophylline
4)Antibiotic:
Eg:Azithromycin,Doxycycline 5

6. For Example:
 A 48 year old female patient was admitted in
the hospital with IP NO-769|18.
 Name:Vinoda
 Weight:60kg
 BMI:21.7
List of problem:
1)Fever
2)Cough with expectation
3)Right sided chest pain
6

7. SUBJECTIVE DATA:
 Chif complaint:
Fever-5days
Cough with expectation ,
Right sided chest pain
Past medical history:
History of Diabetes mellitus
History of Asthma
7

8. OBJECTIVE DATA
 Temp:Afebrile
 HR:118/min
 BP:90/60mmhg
 RR:18/min
 CVS:s1s2+
8

9. ASSESSMENT:
 Based on subjective and objective data
patient was finally diagnosied as COPD.
9

10. Day wise progress:
DAY1:
SPO2-95
CVS-S1S2+
BP-100/70
RS-Trachea control
PR-90/min
cough with sputum
Right sided chest pain
Rx
1)Strict bed rest
2)IVF-10NS,10RL
3)Inj.Augmentin 125gms/Ml
4)inj.Hydrocortisone 100mg
5)inj. Deriphylline 100mg
6)T.Tranexa 500mg
7)T.PCM 500mg
8)T.Diclofenac
9)T.Pantop 40mg
10)T.Azithromycin 100mg
11)Nabulisation with Salbar
10

11. DAY WISE PROGRESS:
DAY 2:
SPO2-95
CVS-S1S2+
BP-100/70mmhg
HR-93/min
Sputum C/S Cough with
sputum(yellowish white)
Rx
CST
1)Inj.Tramadol
11

12. DAY WISE PROGRESS:
DAY 3:
Patient conscious
CVS:S1S2
BP:110/80mmhg
Gc-Dull
Bowel and bladder :Normal
RS:Trachea control
Rx
CST
12

13. DRUG CHART
BRAND
NAME
GENERIC
NAME
DOSE ROA FREQUE
NCY
CATEGOR
Y
INDICATI
ON
MOA
1)Agumen
tin
amoxicilli
n
125mg IV BID Antibiotic Infection-
RTI,throat
Inhibit
bacter
ial cell
wall
2)Inj.Hydr
ocortisone
Hydrocort
isone
sodium
100mg IV TID corticoste
roid
Allergic
condition
Vasoc
onstri
ctive
agent
3)Inj.derip
hylline
etophyllin
e+theoph
ylline
100mg Iv TID methylxan
thine
COPD,
Asthma
Bronc
hodila
tion
4)T.Trenax
a
Tranxamic
acid
500mg oral BID antifibrino
lytic
Hemophili
a
Inhibit
plasm

14. DRUG CHART
5)T.PCM paraceta
mol
500mg oral TID Analgesic
and
antipyret
ic
Fever,pai
n
Inhibit
PG
synthesis
6)T.Diclof
enac
Diclofena
c sodium
75mg oral BID NSAID OA,pain Inhibit PG
synthesis
7)T.Azithr
omycin
azithrom
ycin
50mg oral BID Antibiotic COPD
,Conjuctiv
itis
Inhibit
protein
synthesis
8)inj.Tram
adol
Tramadol 50mg IV SOS Analgesic Dental
pain,pain
Inhibit
norepine
phrine,se
rotonin

15. PLAN
RECOMMENDATION:
1)Advise the patient to take small and frequent diet.
2)Teach food source rich in protein,iron,carbohydrate.
3)Surgical intervention .
PATIENT EDUCATION:
GOALS OFTHERAPY:
1)Relive symptoms.
2)Prevent disease progression.
3)Improve exercise tolerance.
4)Improve health status.
5)Reduce mortality.

16. MONITORING DRUG AND DISEASE:
DRUG:
1)Dosage of prescribed medication.
2)Adherence to regimen.
3)Side effect.
4)Effectiveness of current regimen.
DISEASE:
1)Monitor symptoms.
2)Exacerbation .

17. LIFE STYLE MODIFICATION
1)Smoking cessation.
2)Regular exercise.
3)Weight control.
4)Pulmonary rehabiltation programme.
PATIENTCOUNSELLING:
REGARDING DISEASE:
1)Avoid contact with allergens and polluted environment.
2)Avoid dairy product.
3)Avoid stress.
4)Increase intake of calories.
5)Avoid oily and fried food.
6)Chest massage with mustard oil.

18. 17
 REGARDING MEDICATION:
 1)All the medicine be taken on proper time which
are given in the prescription.
2)medicine should not be missed as it can
worsen the conditionand may lead to other
problem.
REFERENCE:
1)Micromedix.
2)myclinic.com.
3)pharmacotherapy-T.Dipiro
4)www.uptodate.com