CHRONIC OBSTRUCTIVE PULMONARY DISEASE is a common lung disease causing restricted airflow and breathing problems. It is sometimes called emphysema or chronic bronchitis. In people with COPD, the lungs can get damaged or clogged with phlegm. Signs and symptoms of COPD may include: Shortness of breath, especially during physical activities Wheezing Chest tightness A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish Frequent respiratory infections Lack of energy Causes The main cause of COPD in developed countries is tobacco smoking.

1. Casepresentation on:
CHRONIC
OBSTRUCTIVE
PULMONARY
DISEASE

2. Contoso
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Patient Demographics
andMedical search
Durga
Presentation(COPD)

3. Contoso
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PATIENT DEMOGRAPHICS:
A 51 years of male patient
was admitted in the general medicine on
15/10/2019. By his chief complaints like shortness of
breath, wheezing sounds, cough with sputum
(yellowish or greenish colour ) – since from 5days.
PAST MEDICAL HISTORY:
appendix operation- 16years ago
PAST MEDICAL HISTORY:
not know
PERSONAL HISTORY:
Smoking - since 7 years
Alcoholic – since 4years
Diet-mixed
Appetite- normal
Sleep - sleeplessness
FAMILY HISTORY :
Not know Durga
Presentation(COPD)

4. Vitals Day1 Day2 Day3
Temp(°f) 98.5 98.6 98.6
BP(mm/Hg) 110/80 110/70 100/70
PR(bpm) 110 100 96
On examination:
Durga
Presentation(COPD)
RS: Bilateral wheezing

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TEST Observed value Normal values
Haemoglobin
(gm/dl)
14.6 14-16
WBC(per cumm) 13,300 3,500-10,000
RBC(ml cumm) 5.05 3.8-5.8
MCV(fl) 86.7 80-96
MCH(PG) 28.9 27-33
PLT(lakh/cumm) 4,24,000 1-4
Neutrophils(%) 78 40-70
Lymphocytes(%) 15 15-30
Eosinophils(%) 04 1-6
LABORATORY
INVESTIGATION
Durga
Presentation(COPD)

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DIAGNOSIS:
Based on the subjective and objective evidence the patient was diagnosed as COPD
Durga
Presentation(COPD)
IMPRESSION
X-ray
The chest radiography
revealed evidence of
hyperinflation , an
increase in vascular
marking

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DISEASE
INFORMATION
Defination :
Chronic obstructive pulmonary
disease is a group of progressive lung disease . It
difficulty to empty air out of lungs and
emplyfying air out of lungs can lead to shortness
of breath (OR) feeling tired because of lung
working harder to breath.
Durga
Presentation(COPD)

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Causes
for
COPD
Durga
Presentation(COPD)

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S
Y
M
P
T
O
M
S
OF COPD
Durga
Presentation(COPD)

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Durga
Presentation(COPD)
TYPES
OF
COPD

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PA
TH
O
P
H
Y
S
I
O
L
O
G
Y

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Diagnosis
DIAGNOSIS:
Lung function tests – spirometry
Chest x-ray shows emphysema
CT of lungs detect emphysema
Arterial blood gas analysis – measures how well lungs are
bringing 02 into blood and removing co2
Sputum culture –to identify organism
Durga
Presentation(COPD)

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MANAGEMENT
SHORTACTING BETA2 AGONISTS
Albuterol
Levalbuterol
LONGACTING BETA2 AGONISTS
Formoterol
Salmeterol
SHORTACTING ANTI CHOLINERGICS
Ipratropium bromide
LONGACTING ANTI CHOLINERGICS
Tiotropium
Durga
Presentation(COPD)

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Soapnotes:
subjective
shortness of breath,
wheezing sounds, cough
with sputum (yellowish or
greenish colour ) – since
from 5days
Freedom to Invent
objective
WBC(per cumm ) 13,300 3,500-10,000
Neutrophils(%) 78 40-70
Few Competitors
AsSesment
COPD
Durga
Presentation(COPD)

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Plan
TREATment of disease………
S.No G.N DOS FREQ ROA DAY1 DAY2 DAY3
1 INJ.Pantaprazde 40mg OD IV   
2
INJ.hyoscine
butylbromide
20mg OD IV   
3 INJ.ceftriaxone 1gm OD IV   
4
Levosalbutamol &
Ipratropium bromide
&
budesonide
1.25mg,
500mcg
&
0.5mg/2
ml
OD NEB   
Durga
Presentation(COPD)

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PANTAPRAZOLE
MOA : Binds to H+/K+ pump to inhibit gastric acid and basal acid secretion
ADR’s: Headache, diarrhea , stomach pain
CEFTRIAXONE
MOA: It selectively and irreversibly inhibits bacterial cellwall synthesis by
binding to transpeptidases also called transmidases which are
pencillin-binding protins(PBPs) that catalyst the cross linking of the
peptidoglycan polymers forming the bacterial cellwall.
ADR’s : Diarrhea , nausea , stomach upset , headache
IPRATROPIUM BROMIDE
MOA : It is a beta2 adrenergic agonist which acts on airway smooth
muscle resulting in muscle relaxation.
ADR’s : Swelling of eyelids , lips , face , tongue , increased heartbeat ,
dizziness
BUDESONIDE
MOA : It have a potent anti-inflammatory actions that reduces
inflammation and hyper-reactivity of the airways.
ADR’s : Dry throat , voice changes
Durga
Presentation(COPD)

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CRITICAL EVALUATION
 Critical condition
 Drug of choice : ipratropium bromide or albuterol or
combination
 Dosage from all are appropriate
 Frequency all are appropriate
 Drug interactions : no intractions
 No contraindications
Durga
Presentation(COPD)

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Patient
councelling
Durga
Presentation(COPD)

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ThankYou
M DURGA ROHITHA
174T1T005
PHARM.D III year