CASE PRESENTATION ON BRONCHIOLITIS

1. CASE PRESENTATION ON
ACUTE BRONCHIOLITIS
SUBMITTED BY
METI.BHARATH KUMAR
16DK1T0014
Pharm.D INTERNSHIP

2. DEMOGRAPHIC DETAILS
• NAME: Abhayaram
• AGE: 7 months
• GENDER: male
• WEIGHT: 6 kgs
• DEPARTMENT: paediatrics
• UNIT: children unit- ll
• IP NO: 48725
• DOA: 14/9/21
• DOD: 18/9/21
• CONSULTANT PHYSICIAN:Dr.likitha P.G

3. SUBJECTIVE EVIDENCE
• A 7 months male child was admitted in the pediatrics department
unit-ll with the chief compliants of,
cough,cold, fast breathing since 3 days.
cough: insidous onset,gradually progressive ,no diurnal
variation,
fever : since 3 days intermittent
PAST HISTORY: no similar complaints in the past.

4. OBJECTIVE EVIDENCE
COMPLETE BLOOD PICTURE:
HGB: 9.0
WBC: 9.8
RBC: 3.4
PLT: 330
CX-RAY : bronchiolitis conformed

5. ASSESSMENT
• Based on the subjective and objective evidence the case is confirmed
as “ Acute bronchiolitis”.

6. PLAN OF TREATMENT
MONITOR VITALS DAY 1
• O/E pt is c/c
• Fever,cough,cold since 3 days
• Accepting expressed BF-well
• PV: N
• RR:51/min
• HR: 136 bpm
• CVS: s1s2+ve
• CNS: AF flat open
• Crt: < 3 sec
• P/A: soft
Rx
• 1.guarded oral feeds
• Inj.amoxiclav 240 mg IV BD
• Neb with 3 % NS Q6H
• O2 inhalation via nasal prongs
@21/min
• Kufril drops 1ml-1ml
• Syrup.pct 3 ml PO TID
• w/f increase RD
• Syrup zinc 2.5 ml-2.5 ml

7. PLAN OF TREATMENT
MONITOR VITALS DAY 2
• Accepting expressed BF-well
• PV: N
• RR:52/min
• HR: 136 bpm
• CVS: s1s2+ve
• CNS: AF flat open
• Crt: < 3 sec
• P/A: soft
Rx
• 1.guarded oral feeds
• Inj.amoxiclav 240 mg IV BD
• Neb with 3 % NS Q6H
• O2 inhalation via nasal prongs
@21/min
• Kufril drops 1ml-1ml
• Syrup.pct 3 ml PO TID
• w/f increase RD
• Syrup zinc 2.5 ml-2.5 ml

8. PLAN OF TREATMENT
MONITOR VITALS DAY 3
• No fresh complaints
• Accepting expressed BF-well
• PV: N
• RR:52/min
• HR: 136 bpm
• CVS: s1s2+ve
• CNS: AF flat open
• Crt: < 3 sec
• P/A: soft
Rx
• 1.guarded oral feeds
• Inj.amoxiclav 240 mg IV BD
• Neb with 3 % NS Q6H
• O2 inhalation via nasal prongs
@21/min
• Kufril drops 1ml-1ml
• Syrup.pct 3 ml PO TID
• w/f increase RD
• Syrup zinc 2.5 ml-2.5 ml

9. DISCHARGE MEDICATION
• Syrup.ambroxyl.HCL 2.5 ml - 2.5 ml BD
• Syrup.pct 3 ml sos
• Syrup. Zinc 2.5 ml -2.5 ml BD

10. DRUG CHART
S.NO GENERIC NAME BRAND NAME INDICATION DOSE ROA FREQUENCY
1 Ambroxyl
levosalbutamol
Kufril LS Reduce cough 1 ml PO BD
2 Amoxicillin+potas
sium
amoxyclav Reduce
infection
240 mg IV BD
3 acetaminophen paracetamol Reduce fever 3 ml PO SOS
4 Syrup zinc zinkos To increase
haemoglobin
2.5 ml PO BD

11. PHARMACEUTICAL CARE ISSUES
• No pharmaceutical care issues found the prescription was rational.

12. DISCUSSION
• Bronchiolitis is a viral lung infection that causes inflammation in the
smallest air passages in your lungs called bronchioles. Although it’s
generally a childhood condition, bronchiolitis can also affect adults.
• Inflammation of your bronchioles can cause a blockage of oxygen in
your airways that leads to symptoms such as coughing or trouble
breathing. Bronchiolitis generally causes mild illness, but serious cases
can progress to lung failure.
• Bronchiolitis and bronchitis are both viral infections of your lungs, but
they affect different structures.
• Bronchitis is an infection of your bronchi.bronchiolitis is an infection
of the smaller bronchioles.

13. CLINICAL MANIFESTATIONS
• runny nose
• fever
• stuffy nose
• loss of appetite
• cough
Over the next several days, symptoms often get worse before gradually getting better. They might
include:
• shortness of breath
• wheezing
• worsening cough that may be raspy
• brief pauses in breathing
• irritability
• vomiting after eating
• having fewer wet diapers than usual
• fatigue

14. CAUSES
• Respiratory syncytial virus
(RSV)
• Adenoviruses
• Influenza viruses
RISK FACTORS
• not being breastfed
• being born prematurely or born
with a heart or lung condition
• having a suppressed immune
system
• being exposed to cigarette smoke
• being in crowded places where
the virus is present, like daycare
centers

16. DIAGNOSIS
• physical exam and medical history
evaluation, including potential
environmental exposures.
• imaging testing, including chest X-
rays or a CT scan.
• spirometry, which measures how
much and how quickly you take in
air with each breath.
• arterial blood gas tests measure
how much oxygen and carbon
dioxide are in your blood.
TREATMENT
• Many cases of viral bronchiolitis
are mild and clear up without
treatment.
• For more severe cases in infants,
hospitalization may be necessary.
• A hospital can provide oxygen and
intravenous fluid treatments.

17. PREVENTION AND PATIENT
COUNSELLING
• Keep them away from people who are sick with infectious diseases,
especially when your child is younger than 2 months.
• Regularly disinfect surfaces and toys your child often comes into
contact with.
• Fully wash and dry your child’s utensils.
• Wash your child’s hands frequently, especially before and after feeding
and after they touch their nose or mouth.
• Keep your child away from secondhand smoke.