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Acute Exacerbation of COPD: Case Presentation and Therapeutics

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  1. Therapeutics minor case presentation Acute exacerbation of COPD 12Q1326

  2. SCENARIO: here is a male patient Shanmukappa Arakeri of 65yrs bearing I.P no:25369 is admitted to male medical ward has been hospitalized since 2 days. Chief complaints: c/o cough with expectoration since 1 month c/o breathlessness since 1 month HISTORY OF PRESENT ILLNESS: patient was apparently normal 1 month back since then he developed cough with expectoration which is whitish in colour about a cup per day, more in the evening and morning.

  3. He also complaints of breathlessness which is insidious in onset presented both on exertion and on taking rest since 1 month. Social history: alcoholic & beedi smoker since 20 yrs. DIAGNOSIS: Acute exacerbation of COPD Laboratory investigation:

  4. SOAP NOTE SUBJECTIVE: here is a 65y old male patient complaining of breathlessness and cough with expectoration since 1 month. OBJECTIVE: • Increased WBC count indicates infection. • Increased neutrophil & monocytes count indicates COPD. • Decreased lymphocytes indicates severe illness. • ESR increase in acute/ chronic infection.

  5. ASSESSMENT: • PROBLEM LIST- 1.Breathlessness 2.Cough with expectoration 3.COPD Breathlessness: due to hypertrophy of mucus gland and excessive mucus production leading to breathlessness. Cough with expectoration: it is a reflex mechanism to expel out sputum which triggers the chemo and mechano receptors COPD: it is a chronic obstructive pulmonary disease associated with air flow limitation due to abnormal inflammatory response of lungs to allergens.

  6. GOALS OF THERAPY • To subside signs and symptoms • To improve the quality of life • To prevent further complications and exacerbations • To reduce morbidity and mortality.

  7. Clinical Pharmacist Intervention: • Drug -drug Interaction:- • 1.Theophylline + salbutamol : Moderate Interaction. Effect : Increases cardiovascular side effects such as Increased Heart rate, Increased PR & BP. Management: monitor serum K+ levels, BP & PR.

  8. 2. Theophylline+rabeprazole: Moderate interaction Effect:rabeprazole increases the effect of theophylline. Management: patients should be closely monitored for the development of toxicity, particularly serum theophylline levels.

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