COPD EXACBATION WITH CONSOLIDATION , WITH DIABETES

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Presented by: Mr. Jagtap Lalit R.
Department of Clinical Pharmacy

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3.  Chronic obstructive pulmonary disease (COPD), also known as chronic obstructive
lung disease (COLD), and chronic obstructive airway disease (COAD), among
others, is a type of obstructive lung disease characterized by chronically poor
airflow. It typically worsens over time. The main symptoms include shortness of
breath, cough, and sputum production. Most people with chronic bronchitis have
COPD.
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 In absence of concomitant presence of emphysema, the underlying condition may be
classified as chronic bronchitis alone, and the exacerbations are then termed "acute
exacerbations of chronic bronchitis" (AECB), and shares many characteristics with that of
acute exacerbation of COPD.As COPD progresses, exacerbations tend to become more
frequent, the average being about three episodes per year.

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Name : Mrs. A.B.C.
Address : THALNER , DIST.- DHULE.
Age : 68 year
Sex : Female
Weight : “73” kg
Inpatient no : 1755
Hospital name : Indira Gandhi Memorial Hospital,
Shirpur
D.O.A : 19/01/2014
D.O.D : 26/01/2014
Consultant name : Dr. Pitambar Dighore

5.  FAMILY HISTORY: Nil
 SOCIAL HISTORY: Non alcoholic,
Non Smoker,
Non Vegetarian .
 OCCUPATION: Farmer
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 COPD with exacerbation.

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 ASSOCIATED DISEASE:- None
 PAST MEDICATION HISTORY:- Nil
 PAST MEDICAL HISTORY:- Nil

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
 Cough from last one week
 Chest tightness from last one night
 Wheezing from last one day
 Breathlessness from last one day
 Burning sensation from last one day for 2 hours
 Dysponea
 Restlessness from last one day

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DATE 20/09 21/09 22/09 23/09
G.C Fair Fair Fair Fair
PULSE per
min.
83 91 85 80
P/A Soft Soft Soft Soft
B.P. (mmHg) 110/65 130/80 115/72 120/75

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Hemogram :-
Normal value
Hemoglobin 9.25gm % 14-16 gm %
Leukocyte count >250 cell/mm3 250 cell/mm3

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LUNGS VOLUMES
AND FLOW RATE
MEASUREMENT:
Forced expiratory volume
(FEV1) was decrease
Forced vital capacity (FVC)
was decrease
FEV1/FVC ratio was also
decrease

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 ECG REPORT:
The report was found to be normal range.

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Chronic Obstructive Pulmonary Disease:-
 Physical examination
 Chest X-ray.

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Sr
no Medication
Dose
mg
Std
Dose
mg
Frequency Route Date
1. Nebulizer with
Duolin
(Ipratropium
bromide)
0.20 - 1 1-5 6 hrly inh 20-23
2. Nebulizer with
Budecort
(Budesonide)
0.10 -
0.20
0.20 -
0.40
8 hrly inh. 20-23
3. Inj Oframax forte
(Ceftriaxone sod.)
1500 4000 12 hrly iv 20-23

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Sr
no
Medication Dose
mg
Std
Dose
mg
Frequency Route Dat
e
4. Inj Efcorlin
(Hydrocortisone)
100 400 8 hrly iv 20-
21
5. Tab Omnacortil
(Prednisolone)
20-20-
10
05- 60 8 hrly oral 21-
22
6. Syp Grillinctus
BM
(Bromhexine +
Terbutaline)
10 ml 30 ml 12 hrly oral 20-
23

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 Tab Omnacortil 20-20-10 mg thrice in a day for three days
 Nebulizer with Duolin 4 times in a day for 5 days
 Nebulizer with Budecort thrice in a day for 5 days
 Inj Oframax fort 1.5 g daily for 7days
 Syp Grillinctus BM 2 t.s.f. for a week

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Ceftriaxone with corticosteroids:-
 Effect:– Antibiotics increased pharmacological action of
corticosteroids such as carbohydrate, fat, protein, calcium
metabolism, water excretion, inflammatory, immunologic and
allergic responses.

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Prescription outcome:-
 The diagnosis data analysis shows that haemoglobin was found to
be decreased level.
 The physician should be prescribed some blood forming agent
such as haematinics to the patient only orally/ as possible as blood
transfusion.
Ex – Iron and its preparations:-
1) Tb Fersolate 200 mg oral
2) Syp Imferon 10 ml oral

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 Smoking should be stopped (or go for nicotine replacement
therapy)
 Eat the iron rich food and blood forming foods.
 Available oxygen therapy for emergency acute exacerbation.
 Tell the patient not to use inhaler more than six times per day.
 Instruct the patient how to use the nasal sprays.

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 Instruct patient the
technique for use of
Nebulizer.

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 Instruct patient
the technique for
use of Peak flow
meter.

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 Some drugs may cause dizziness so use with caution while
driving or performing other task requiring mental alertness
 Patient should notify physician if conditions like dizziness,
palpitation, nausea, cough, weight loss, swelling in feet and
ankles, and sign of infection
 Maintain hygienic condition
 If any type of side effect occur by drug therapy consult
physician immediately

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