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PRESENTED BY:
Makbul Hussain chowdhury
Pharm. D 5th year
Anurag Pharmacy College
INTRODUCTION
Pneumonia is an inflammatory condition of the lung
affecting primarily the microscopic air sacs known as
alveoli.
Pneumonia is the most common infectious cause of death
in the United States.
 It occurs in persons of all ages, although the clinical
manifestations are most severe in the very young, the
elderly, and the chronically ill.
Pneumonia is usually caused by infection with viruses or
bacteria and less commonly by other microorganisms,
certain medications and conditions such as autoimmune
Diseases
Pneumonia affects approximately 450 million people globally
(7% of the population) and results in about 4 million deaths per year.
ETIOLOGY
 Bacteria : Streptococcus pneumoniae, Legionella pneumophila,
Chlamydophila pneumoniae, Staphylococcus aureus, Moraxella catarrhalis,
Streptococcus pyogenes, Neisseria meningitidis, Klebsiella pneumoniae,
and Haemophilus influenzae , Pneumocystis jiroveci.
 Viruses : Influenza virus, Adenoviruses, Rhinovirus
 Mycoplasmas : They are not classified as to whether they are bacteria or
viruses, but they have traits of both.
 Other infectious agents, such as fungi : Pneumocystis carini
 Various Chemicals
CLINICAL PRESENTATION OF PNEUMONIA
Signs and symptoms
 Abrupt onset of fever, chills, dyspnea, and productive cough
 Rust-colored sputum or hemoptysis
 Pleuritic chest pain
Physical examination
 Tachypnea and tachycardia
 Dullness to percussion
 Increased tactile fremitus, whispered pectoriloquy, and egophony
 Chest wall retractions and grunting respirations
 Diminished breath sounds over the affected area
 Inspiratory crackles during lung expansion
Chest radiograph
 Dense lobar or segmental infiltrate
Laboratory examination
 Leukocytosis with a predominance of polymorph nuclear cells
 Low oxygen saturation on arterial blood gas or pulse oximetry
SUBJECTIVE DATA:
 Patient Name: Xxx
 Age: 45yrs
 Gender : Male
 Department: General Medicine( MMW)
 DOA:12-10-2018
 Chief Complaints:
 cough * 4 days
cough with expectoration
Pain in abdomen *2 days
PAST HISTORY & FOOD HABITS
History of pneumonia* 1year back with same complain.
No history of DM or TB or HTN.
Family history: not significant.
Social history : no history of addiction.
Non-vegetarian.
Alcohol-occasional
OBJECTIVE DATA
 GENERAL EXAMINATION:
PR:81b/min
BP:120/80mm Hg
Height:154 cm
BMI:23.61
Wt. 56kg
CVS: S1 &S2 normal
S.NO LAB TESTS LAB VALUE NORMAL VALUE
1 HEAMGLOBIN 8.4g/dl 13-14g/dl
2 T. WBC 12,600C/cu mm 4000-11000c/cu mm
3 NEUTROPHILS 8% 54-62%
4 LYMPHOCYTES 1.6% 25-33%
5 EOSINOPHILS 0.1% 7-10%
6 MONOCYTES 0.2% 1-3%
7 Platelet count 220,000C/cu mm 150,000-450,000c/cu
mm
6 RBC 133000c/cu mm 45OOO-5.9OOOc/cu
mm
9 Blood urea 32 O8-23 mg/dL
10 Cretenine 1.3 0.6-1.2 mg/dL
11 Sodium 138 136-142 mmol/L
12 Potassium 3-9 3.8-5.0 mmol/L
ASSESSMENT
On the basis of subjective and objective
information patient was diagnosed Right lower zone
Pneumonia.
TREATMENT CHART
S.N
O
BRAND
NAME
GENERIC NAME DOSE ROA FREQUENCY DURATION
1 Ceftrimax Ceftriaxone
Sodium,
Sulbactam
15mg IV bd 4 days
2 Azee Azithromycin 500mg Oral od 4days
3 Pan-40 Pantoprazole 40mg IV BD 4days
4 sucrapil Sucralfate 10 ml Oral TID 3days
5 Calpol Paracetamol 500mg oral SOS
6 Ns NORMAL
SELINE
150ML IV Hourly 2 DAYS
PROGRESS
DAY 1:
 patient was admitted due asymptomatic *4days
and developing fever and chills, body pain, cough with
expectoration sputum ,defused chest pain, abdomen pain
and shortness of breathing
 Patien conscious: oriented
 Temp:99 F
 PR: 81%b/min
 BP: 120/80 mm Hg
 CNS: NORMAL
 Medication: INJ.CEFTRIMAX, TAB.AZEE, INJ.PAN-40 and N.S fluid.
DAY 2:
Patient conscious, oriented
Temp: afebrile
PR: 84/min
BP: 120/80 mm Hg
Medication: Syp. Sucrapil was added
DAY 3:
Patient conscious, oriented
Temp: afebrile
PR: 88b/min
BP: 110/80 mm Hg
Medication: CST and stop N.S
DAY 4:
No fresh complaints
BP: 110/70 mm Hg
PR: 82b/min
Medication :CST
THERAPEUTIC GOALS
 SHORT TERM GOAL-
 To provide symptomatic relief from fever, cough and Pain in abdomen.
 To provide symptomatic relief from pneumonia.
 LONG TERM GOAL-
 Eradication of the offending organism and complete clinical cure are the
primary objectives. Associated morbidity should be minimized.
 To decrease the mortality.
 To improve quality of life.
PATIENT COUNSELLING
REGARDING DRUGS:
 Ceftrimax: It is the combination of ceftriaxone sodium,
sulbactam . it is an antibiotic useful for thetreatment of a number
of bacterial infection .
 Azee: It is an antibiotic use for the treatment of bacterial
infection, if any side effect occur like heart problem then repot to
the physician.
LIFE STYLE MODIFICATIONS:
 Don't smoke.
 Practice good hygiene.
 Stay rested and fit.
 Wearing surgical masks by the sick
may also prevent illness.
 Appropriately treating underlying
illnesses (such as HIV/AIDS, diabetes mellitus, and
malnutrition) can decrease the risk of pneumonia.
 Get a Pneumonia Vaccination.
pnemonia-210126105302 (1).pptx

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pnemonia-210126105302 (1).pptx

  • 1. PRESENTED BY: Makbul Hussain chowdhury Pharm. D 5th year Anurag Pharmacy College
  • 2. INTRODUCTION Pneumonia is an inflammatory condition of the lung affecting primarily the microscopic air sacs known as alveoli. Pneumonia is the most common infectious cause of death in the United States.  It occurs in persons of all ages, although the clinical manifestations are most severe in the very young, the elderly, and the chronically ill. Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune Diseases Pneumonia affects approximately 450 million people globally (7% of the population) and results in about 4 million deaths per year.
  • 3. ETIOLOGY  Bacteria : Streptococcus pneumoniae, Legionella pneumophila, Chlamydophila pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, Streptococcus pyogenes, Neisseria meningitidis, Klebsiella pneumoniae, and Haemophilus influenzae , Pneumocystis jiroveci.  Viruses : Influenza virus, Adenoviruses, Rhinovirus  Mycoplasmas : They are not classified as to whether they are bacteria or viruses, but they have traits of both.  Other infectious agents, such as fungi : Pneumocystis carini  Various Chemicals
  • 4.
  • 5. CLINICAL PRESENTATION OF PNEUMONIA Signs and symptoms  Abrupt onset of fever, chills, dyspnea, and productive cough  Rust-colored sputum or hemoptysis  Pleuritic chest pain Physical examination  Tachypnea and tachycardia  Dullness to percussion  Increased tactile fremitus, whispered pectoriloquy, and egophony  Chest wall retractions and grunting respirations  Diminished breath sounds over the affected area  Inspiratory crackles during lung expansion Chest radiograph  Dense lobar or segmental infiltrate Laboratory examination  Leukocytosis with a predominance of polymorph nuclear cells  Low oxygen saturation on arterial blood gas or pulse oximetry
  • 6. SUBJECTIVE DATA:  Patient Name: Xxx  Age: 45yrs  Gender : Male  Department: General Medicine( MMW)  DOA:12-10-2018  Chief Complaints:  cough * 4 days cough with expectoration Pain in abdomen *2 days
  • 7. PAST HISTORY & FOOD HABITS History of pneumonia* 1year back with same complain. No history of DM or TB or HTN. Family history: not significant. Social history : no history of addiction. Non-vegetarian. Alcohol-occasional
  • 8. OBJECTIVE DATA  GENERAL EXAMINATION: PR:81b/min BP:120/80mm Hg Height:154 cm BMI:23.61 Wt. 56kg CVS: S1 &S2 normal
  • 9. S.NO LAB TESTS LAB VALUE NORMAL VALUE 1 HEAMGLOBIN 8.4g/dl 13-14g/dl 2 T. WBC 12,600C/cu mm 4000-11000c/cu mm 3 NEUTROPHILS 8% 54-62% 4 LYMPHOCYTES 1.6% 25-33% 5 EOSINOPHILS 0.1% 7-10% 6 MONOCYTES 0.2% 1-3% 7 Platelet count 220,000C/cu mm 150,000-450,000c/cu mm 6 RBC 133000c/cu mm 45OOO-5.9OOOc/cu mm 9 Blood urea 32 O8-23 mg/dL 10 Cretenine 1.3 0.6-1.2 mg/dL 11 Sodium 138 136-142 mmol/L 12 Potassium 3-9 3.8-5.0 mmol/L
  • 10. ASSESSMENT On the basis of subjective and objective information patient was diagnosed Right lower zone Pneumonia.
  • 11. TREATMENT CHART S.N O BRAND NAME GENERIC NAME DOSE ROA FREQUENCY DURATION 1 Ceftrimax Ceftriaxone Sodium, Sulbactam 15mg IV bd 4 days 2 Azee Azithromycin 500mg Oral od 4days 3 Pan-40 Pantoprazole 40mg IV BD 4days 4 sucrapil Sucralfate 10 ml Oral TID 3days 5 Calpol Paracetamol 500mg oral SOS 6 Ns NORMAL SELINE 150ML IV Hourly 2 DAYS
  • 12. PROGRESS DAY 1:  patient was admitted due asymptomatic *4days and developing fever and chills, body pain, cough with expectoration sputum ,defused chest pain, abdomen pain and shortness of breathing  Patien conscious: oriented  Temp:99 F  PR: 81%b/min  BP: 120/80 mm Hg  CNS: NORMAL  Medication: INJ.CEFTRIMAX, TAB.AZEE, INJ.PAN-40 and N.S fluid.
  • 13. DAY 2: Patient conscious, oriented Temp: afebrile PR: 84/min BP: 120/80 mm Hg Medication: Syp. Sucrapil was added DAY 3: Patient conscious, oriented Temp: afebrile PR: 88b/min BP: 110/80 mm Hg Medication: CST and stop N.S
  • 14. DAY 4: No fresh complaints BP: 110/70 mm Hg PR: 82b/min Medication :CST
  • 15. THERAPEUTIC GOALS  SHORT TERM GOAL-  To provide symptomatic relief from fever, cough and Pain in abdomen.  To provide symptomatic relief from pneumonia.  LONG TERM GOAL-  Eradication of the offending organism and complete clinical cure are the primary objectives. Associated morbidity should be minimized.  To decrease the mortality.  To improve quality of life.
  • 16. PATIENT COUNSELLING REGARDING DRUGS:  Ceftrimax: It is the combination of ceftriaxone sodium, sulbactam . it is an antibiotic useful for thetreatment of a number of bacterial infection .  Azee: It is an antibiotic use for the treatment of bacterial infection, if any side effect occur like heart problem then repot to the physician.
  • 17. LIFE STYLE MODIFICATIONS:  Don't smoke.  Practice good hygiene.  Stay rested and fit.  Wearing surgical masks by the sick may also prevent illness.  Appropriately treating underlying illnesses (such as HIV/AIDS, diabetes mellitus, and malnutrition) can decrease the risk of pneumonia.  Get a Pneumonia Vaccination.