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Presented by-
Shahnawaz Ahmad Teli
M.Pharm 2nd Semester
(clinical pharmacy)
CASE PRESENTATION ON
emphysema
 Patient ID: 35726/16
 Patient name: XYZ
 Age: 5 years
 Gender: Male
 Date of admission: 17/10/16
 Date of discharge: 3/11/16
Patient details
Patient Complaints
 Fever and Chest pain since 30 days.
 Breathlessness
 Fever was gradual on onset , not associated with chills
Physical Examination-
General condition -- sick
CNS -- Conscious, well
oriented
CVS – S1 and S2 sounds
heard.
Abdomen -- Non-tender, Non-
distended (Normal).
Vital signs-
B.P- 118/80 mmHg
P.R- 80/Min
Resp.- 16/min
Temp.- 99.4 F
Spo2 --- 92%
PAST MEDICAL HISTORY :- ICD Insertion
Past Medication History :- Nil
Family History :- Nil
Past History
ICD insertion– An Implantable Cardiovascular
defibrillator (ICD) insertion of an electronic device just below
the collar bone is used to help regulate potentially life
threatening heart rhythms .
HAEMATOLOGI
CAL DATA
Investigations Value Normal range
Haemoglobin(Hb) 7.7 (L) 10-14g/dl
Monocytes 16% (H) 2-10%
ESR 120 (H) < 15mm/hr
MCH 23.1 (L) 24-30 pg
MCHC 30.3 (L) 31- 37 g/dl
RBC 2.24 (L) 3.1-5.3millions/cmm
TLC 27500 (H) 4000-11000/cmm
Scr. 0.3 (L) 0.8- 1.5 mg/dl
 USG :
 Organized debris in right pleural cavity & few thick septa, which
suggests of emphysema.
 Collapse /consolidation of right lung.
 Culture Report:
Technique- Zeil-Neelson Staining
Result- No acid fast bacilli seen.
Gram staining – No microorganism seen.
Other Investigations
 On the basis of Laboratory investigations and
Radio imaging, the patient was diagnosed as
Emphysema.
Final Diagnosis
Surgery
 Surgery was done to remove damaged
area of the lung and also Pleural fluid was
drained out.
MEDICATION CHART
Name, strength, route, frequency Date started Date stopped
Inj.Teicoplanin 140 mg ( iv) 17/10/16 20/10/16
Inj.Tazomac (Tazobactum+Piperacillin)
1.4gm(iv) TDS
20/10/16 Till discharge
Inj.Metrogyl (Metronidazole) 100mg (iv)
TDS
17/10/16 29/11/16
Syp. Zincovit( multivitamin and
minerals) BD
17/10/16 TILL discharge
Syp. Combiflame(
Ibuprofen+paracetamol)
325+400mg/5ml
SOS
20/10/16
Syp. Broncorex
(Bromohexine+terbutaline+Guaifenesin)
2 tsp. BD
29/10/16 TILL discharge
Susp. Lizomac Ds (Linezolid 30ml) TDS 2/11/16
DISCHARGE
SUMMARY
 Susp. Linezolid 7.5ml TDS X 10 DAYS
 Syp. Zincovit 5ml BD
 Steam inhalation 3-5 times/day
 Syp. Broncorex 2 tsf
 Review after 7 days
CLINICAL JUSTIFICATION
The treatment given was satisfactory almost as the condition of
the patient was improving, apart from this there were some
suggestions-
 First line treatment for emphysema are antibiotics ( Beta lactum
antibiotics, Aminoglycosides and Macrolides) .
 supplement (Syp. Zincovit) was given for low hemoglobin.
 Metrogyl and linzolid was given for surgical prophylaxis.
Patient Counselling
 Try to do some regular exercise or physical activity
that helps to improve breathing, ease symptoms and
have a better quality of life.
 Try to avoid triggering factors like extreme hot or cold
weather.
 Try to remain away from second hand smoking
exposure.
 Adhere to the medications.
 Maintain hygienic conditions.
REFERNCE
 Micromedexsolutions.com
Case on emphysema....shahnawaz

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Case on emphysema....shahnawaz

  • 1. Presented by- Shahnawaz Ahmad Teli M.Pharm 2nd Semester (clinical pharmacy) CASE PRESENTATION ON emphysema
  • 2.  Patient ID: 35726/16  Patient name: XYZ  Age: 5 years  Gender: Male  Date of admission: 17/10/16  Date of discharge: 3/11/16 Patient details
  • 3. Patient Complaints  Fever and Chest pain since 30 days.  Breathlessness  Fever was gradual on onset , not associated with chills Physical Examination- General condition -- sick CNS -- Conscious, well oriented CVS – S1 and S2 sounds heard. Abdomen -- Non-tender, Non- distended (Normal). Vital signs- B.P- 118/80 mmHg P.R- 80/Min Resp.- 16/min Temp.- 99.4 F Spo2 --- 92%
  • 4. PAST MEDICAL HISTORY :- ICD Insertion Past Medication History :- Nil Family History :- Nil Past History ICD insertion– An Implantable Cardiovascular defibrillator (ICD) insertion of an electronic device just below the collar bone is used to help regulate potentially life threatening heart rhythms .
  • 5. HAEMATOLOGI CAL DATA Investigations Value Normal range Haemoglobin(Hb) 7.7 (L) 10-14g/dl Monocytes 16% (H) 2-10% ESR 120 (H) < 15mm/hr MCH 23.1 (L) 24-30 pg MCHC 30.3 (L) 31- 37 g/dl RBC 2.24 (L) 3.1-5.3millions/cmm TLC 27500 (H) 4000-11000/cmm Scr. 0.3 (L) 0.8- 1.5 mg/dl
  • 6.  USG :  Organized debris in right pleural cavity & few thick septa, which suggests of emphysema.  Collapse /consolidation of right lung.  Culture Report: Technique- Zeil-Neelson Staining Result- No acid fast bacilli seen. Gram staining – No microorganism seen. Other Investigations
  • 7.  On the basis of Laboratory investigations and Radio imaging, the patient was diagnosed as Emphysema. Final Diagnosis
  • 8. Surgery  Surgery was done to remove damaged area of the lung and also Pleural fluid was drained out.
  • 9. MEDICATION CHART Name, strength, route, frequency Date started Date stopped Inj.Teicoplanin 140 mg ( iv) 17/10/16 20/10/16 Inj.Tazomac (Tazobactum+Piperacillin) 1.4gm(iv) TDS 20/10/16 Till discharge Inj.Metrogyl (Metronidazole) 100mg (iv) TDS 17/10/16 29/11/16 Syp. Zincovit( multivitamin and minerals) BD 17/10/16 TILL discharge Syp. Combiflame( Ibuprofen+paracetamol) 325+400mg/5ml SOS 20/10/16 Syp. Broncorex (Bromohexine+terbutaline+Guaifenesin) 2 tsp. BD 29/10/16 TILL discharge Susp. Lizomac Ds (Linezolid 30ml) TDS 2/11/16
  • 10. DISCHARGE SUMMARY  Susp. Linezolid 7.5ml TDS X 10 DAYS  Syp. Zincovit 5ml BD  Steam inhalation 3-5 times/day  Syp. Broncorex 2 tsf  Review after 7 days
  • 11. CLINICAL JUSTIFICATION The treatment given was satisfactory almost as the condition of the patient was improving, apart from this there were some suggestions-  First line treatment for emphysema are antibiotics ( Beta lactum antibiotics, Aminoglycosides and Macrolides) .  supplement (Syp. Zincovit) was given for low hemoglobin.  Metrogyl and linzolid was given for surgical prophylaxis.
  • 12. Patient Counselling  Try to do some regular exercise or physical activity that helps to improve breathing, ease symptoms and have a better quality of life.  Try to avoid triggering factors like extreme hot or cold weather.  Try to remain away from second hand smoking exposure.  Adhere to the medications.  Maintain hygienic conditions.