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Acute Exacerbation of COPD: Case Presentation and Therapeutics

This case presentation involves a 65-year-old male patient with acute exacerbation of COPD, presenting with cough and breathlessness. The goal of therapy is to alleviate symptoms, improve quality of life, and prevent complications. The clinical pharmacist intervention includes monitoring drug-drug interactions and managing potential risks.

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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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