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Case Presentation

Case Presentation. M5/G3 PK Course IM8 Allergy 2007313075 Son Eui Young. Contents. Case Summary Tx . of Asthma : OPD Level of Asthma Control Case Relevance. Case Summary. 이 0 수 , 75/M. ID: 00129692 C.C: Dyspnea 93. Bronchial Asthma Dx . 96. DCMP Dx . Repeated AE of asthma.

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Case Presentation

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  1. Case Presentation M5/G3 PK Course IM8 Allergy 2007313075 Son Eui Young

  2. Contents • Case Summary • Tx. of Asthma : OPD • Level of Asthma Control • Case Relevance

  3. Case Summary 이0수, 75/M ID: 00129692 C.C: Dyspnea 93. Bronchial Asthma Dx. 96. DCMP Dx. • RepeatedAE of asthma

  4. Case Summary 이0수, 75/M • Past Medical History • HTN(+) DM(+) Hepatitis(-) Tb(-) • Allergy(-) • EchoCG • Dilated LV cavity size & moderate to severe LV systolic dysfunction (LVEF = 34%) • Tethering motion of MV with mild to moderate MR • Trivial TR

  5. Case Summary

  6. Case Summary NT-proBNP > 2,000pg/mL Chronic HF Likely

  7. Tx. of Asthma : OPD 4 Components of Asthma Care • Develop patient/doctor partnership • Identify and reduce exposure to risk factors • Assess, treat, and monitor asthma • Manage asthma exacerbation

  8. Tx. of Asthma : OPD 천식의 악화 예방하기 • AVOID!! : 원인 항원, 담배연기, 심한 대기오염, 베타 차단제, 아황산염 함유음식 • Aspirin이나 NSAIDs 사용 시 주의 • 중증 지속성 천식환자 • Nasal Polyp이 있는 환자 • Aspirin이나 NSAIDs에 과민한 환자 • 치료가 필요한 동반질환 : 비염 및 부비동염, GERD • 인플루엔자 백신 : 특히 노인 및 지속성 천식환자

  9. Tx. of Asthma : OPD 약물 요법 • Symptom Reliever • β2 agonist (Short-acting) • Anti-cholinergic • Short acting Theophylline • Controller • ICS • β2 agonist (Long-acting) • Anti-leukotrienes

  10. Level of Asthma Control

  11. START ‘GINA 2010 POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION’

  12. Case Relevance Poor compliance Poor control

  13. Case Relevance Prescription • 2008. 04. 21. • SER2-K (Fluticasone Propionate + Salmeterol) • Theophylline 100mg 1C 2회/일 • Rhinathiol 500mg 1C 2회/일 • Ipratropium 6mg/15mL 1EA 3회/일

  14. Case Relevance Prescription • 2009. 09. 21. • Theophylline 100mg 1C 2회/일 • Rhinathiol 500mg 1C 2회/일 • Prednisolone 5mg 7.5mg 2회/일

  15. References • GINA 2010 POCKET GUIDE FOR ASTHMA MANAGEMENT AND PREVENTION • Handbook of Internal Medicine in SMC 5th Ed. 군자출판사, 2011

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