Case Presentation On Asthma According to SOAP FORMATE for Pharm D.

1. 3/30/2022 Sree Siddaganga College of Pharmacy, Tumkur 1

2. INTRODUCTION ON DISEASE
• DEFINITION
It is a chronic inflammatory disease associated with airway
hyper-responsiveness that leads to recurrent attacks of
breathlessness, chest tightness,cough,wheezing which varies
in frequency from person to person
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3. EPIDEMIOLOGY
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According to WHO 300 million people
suffer from asthma and 2 Lac 55,000
people died of asthma in 2005
Asthma is most common chronic
disease in children
Asthma death will increase by 20% in
next 10 years

4. TYPES
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CHRONIC ASTHMA
SEVERE ACUTE ASTHMA
EXERCISE INDUCED ASTHMA
NOCTURNAL ASTHMA

5. ETIOLOGY/CAUSES
5
This Photo by Unknown Author is licensed under CC BY
Genetic factors account for 35 to 75% of suseptibility
Environmental risks factors that cause asthma-Traffic fumes,
Smoking or social economic status, exposure to tobacco
Bronchoconstriction-It is the narrowing of the airways to
react to stimuli or tigger to cause an asthma attack
Hyperresponsiveness
Childhood infections example:Respiratory Syncytial Virus
Allergen exposure example:Pollen,Animal dander
Indoor Pollution

6. RISK FACTORS
• Asthma attack
• Respiratory Failure
• In Childers- Growth Delay, High risk for learning disability
• In Adults- frequent Sick, Higher risk for depression
• Common to both- Permanent narrowing of bronchial tube, Higher risk
of obesity
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COMPLICATIONS
• Parent with Asthma
• Having a sever respiratory infection as a child
• Having an allergic conditions or being exposed to certain
chemical irritants or Industrial dusts in the workplace

7. SIGNS
• Wheezing
• Increased mucous secretion
• Narrow/Closed small airway
• Edema
• Contraction bronchiole smooth muscle
SYMPTOMS
• Breathlessness
• Cough- Chest tightness
• Dyspnea
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CLINICAL MANIFESTATION

8. DIAGNOSIS
•Lung function assessment by
using Spirometer
•It is reported as FEV1/FVC ratio.
•It is a reproducible measure of the
capabilities of the lungs
•Peak flow meter measures
PEFR(Peak Expiratory Flow
Rate)
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This Photo by Unknown Author is licensed under CC BY-SA

9. PATIENT DEMOGRAPHIC DETAILS
• PATIENT NAME: XYZ
• AGE: 00Years
• GENDER: Female
• IP NO:00000
• UNIT: Respiratory Care Unit
• WARD: Semiprivate Ward
• DOA: 00/00/000
• DOD: 00/00/0000
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10. SUBJECTIVE EVIDENCE
A 00yrs old Female patient was admitted to hospital with
c/o of Breathlessness,Fever,Cough and Chest pain while
coughing.
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11. PAST MEDICAL HISTORY: Nothing
Significant
PAST MEDICATION HISTORY: Nothing
significant
FAMILY HISTORY: Nothing significant
SOCIAL HISTORY: Nothing significant
ALLERGIES: Not known allergies
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PATIENT HISTORY
Sree Siddaganga College of Pharmacy, Tumakuru

12. 3/30/2022 12
PHYSICAL & SYSTEMIC
EXAMINATION
•CVS:S1S2 heard
•BP: 100/60mmhg
•RS: NVBS heard
•SPO2: 99%
•PR: 80b/min

13. OBJECTIVE EVIDENCE
TEST OBSERVED VALUES NORMAL VALUES
ESR 44mm/hr 0-30mm/hr
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 ESR- Erythrocyte Sedimentation Rate

14. ASTHMA
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PROVISIONAL DIAGNOSIS

15. LAB TEST
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TEST TEST VALUE NORMAL VALUE
Hb 13.4mg/dl 12-16mg/dl
ESR 44mm/hr 0-30mm/hr
PLATELETS 3.3 lakhs 2.4-3.5lakhs
RBS 128mg/dl 80-140mg/dl
RBC. 4.3million cells/mcL 4.2-5.2million cells/mcL
WBC 8100cells/cu mm 4,500-10,000cells/mcL
UREA 23mg/dl 15-45mg/dl
CREATININE 1.1mg/dl 0.5-1.5mg/dl

16. FINAL DIAGNOSIS
ASTHMA
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Sree Siddaganga College of Pharmacy, Tumakuru

17. SUBJECTIVE EVIDENCE
• Fever
• Breathlessness
• Cough Since 2days
OBJECTIVE EVIDENCE
•Increased ESR
•ESR-44mm/hr (1-30mm/hr)
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18. ASSESSMENT
From the subjective and objective evidence it has
been diagnosed as ASTHMA
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19. GOALS OF THERAPY
Prevent disease progression.
Relieve symptoms.
Improve exercise tolerance.
Improve health status
Patient Specific
oTo relieve cough & fever
oTo cure breathlessness & chest pain
Disease Specific
oTo reduce ESR level
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20. TRATMENT CHART
DRUGS
BRAND GENERIC
ROUTE DOSE FREQUENCY DAYS
01 02
Inj. DERIPHYLLIN
ETOFYLLINE+
THEOPHYLLINE
IV 2ml 1-0-1  .  .
T. PANTOP PANTOPRAZOLE P/O 40mg 1-1-1  .
Inj. DEXONA DEXAMETHASON
E
IV 2ml 1-0-1  .  .
Inj. METROGYL METRONIDAZOL
E
IV 2ml 1-0-0  .
NEUROBION FORTE THIAMINE/VITAM
IN B
P/O 10mg 1-1-1  .  .
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21. PROGRESS REPORT
•DAY 01
O/E
BP : 110/80mm Hg
Pulse Rate : 88bpm
Respiratory Rate: 24bpm
Rx
• Inj. Deriphylline
• T. Pantop
• Neurobion forte
• Inj. Dexona
Soft and nutritional diet is advised
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•DAY 02
O/E
• BP 120/80mmHg
• Pulse rate 82bpm
• Respiratory rate 25bpm
Rx
Inj. Deryphylline
Inj. Dexona
Neurobion forte
Inj. metrogyl
Patient is conscious and no fresh complaints.

22. 3/30/2022 22
DAY 03
O/E
BP 110/80mmHg
PR 92bpm
RR 22bpm
• No fresh complaints.
• Patient is well.
• Patient is ready for
discharged.

23. DISCHARGE MEDICATION
DRUGS
BRAND GENERIC ROUTE DOSE FREQUENCY
T. DOXOVET DEXOFYLLINE P/O 400MG 1-0-0
T. PANTOP PANTOPRAZOLE P/O 40MG 1-0-1
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24. MONITORING PARAMETERS
 Spirometry should be done at the time of diagnosis
Heart rate.
Respiratory rate
Monitor vital signs and watch for signs and symptoms
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25. PROBLEMS IDENTIFIED
 PANTOPRAZOLE + THEOPHYLLINE
Pantoprazole increase toxicity of theophyllin
i.e Prolonged use of proton pump inhibitors can cause hypochlorhydria which
in turn causes paristalsis in small intestine
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26. PATIENT COUNSELLING
ABOUT DISEASE :
• It is mainly a respiratory track infection
• It is a chronic inflammatory disease associated with airway hyper-
responsiveness that leads to recurrent attacks of breathlessness,
chest tightness,cough,wheezing which varies in frequency from
person to person
• Educate the patient about aim of the treatment and the possible
side effects
• Educate the patient about the cause risk factor and other’s
• Prevent further complications
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27. ABOUT MEDICATION :
Take medication as prescribed by the doctors
Do not miss or double the dose
Advise the patient about drug reaction drug dosage
Name and strength of the medication
Reason why it has been prescribed
How to take the medication
Advice on correct storage
Drug :Inj. DERIPHYLLIN
• Pharmacological class: Bronchodialator
• USE:Dilates and relaxes the airway muscles
• ADR: Nausea,Diarrhea,Abdominal Pain
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28. Drug :Pantop
• Pharmacological class: Proton Pump Inhibitor
• USE:Decreases the acidity of stomach
• ADR:Headache,Constipation,Sever stomach pain
Drug :Inj Dexona
• Pharmacological class: Carticosteriods
• USE:To treat inflammatory conditions and for relieving pain
• ADR:Indigestion,Weight gain
Drug :Inj Metrogyl
• Pharmacological class: Antibiotics
• USE:Used to treat variety of infections
• ADR:Stomach pain,Vomitting
Drug :Neurobion Forte
• Pharmacological class: B-Complex Vitamins
• USE:Used to treat Vit-B Deficiencies
• ADR: Anemia, Fatigue
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29. LIFE STYLE MODIFICATION:
What to do?
• Regular Check up
• Maintain ideal Body weight
• Follow a proper healthy diet that is:
• Drink boiled water in plenty
• Light food should be taken at night and all sour substances should be almost
restricted
• Clove-Clove has expectorant properties hence it is effective in the treatment
of asthma also Garlic regular use of garlic can reduce the severity of
asthmatic attacks as follows Ginger-Ginger is used in treatment of asthma
due to its expectorant properties
• 2-3 dry figs each morning clears the respiratory track
• Exercise like swimming,walking&yoga
• Plenty of sleep (8 hours)
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This Photo by Unknown Author is licensed under CC BY-NC-ND

30. LIFE STYLE MODIFICATION:
What not to do?
• Smoking
• Exposure to allergens,dust and pollution
• Excessive physical exercise (Long distance running)
• Food such as curd, buttermilk and heavy milk products like cheese,paneer
etc.. which has natural tendency to accumulate the mucus
• Overeating. Take light dinner one hour before going to bed
• Dietary habits that leads to overweight which increase the risk of asthma
(High sodium intake, Fast foods)
• Use of sulfites (Pickles, Grape juice ,wine)
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31. THANK
YOU