BRONCHIAL ASTHMA

with
URINARY TRACT INFECTION

Presented by :
Jyothsna kumari.K
177N1T0013
4th PharmD
SUBJECTIVE DATA

 Demographic details

 Name of the patient : Anitha. G

 Age : 27years.
 Gender : Female.
 Department : Pulmonology.
 IP No : 1583.
 Reasons for admission :

 Informer : Husband

 Chief complaints : Patient  came with complaints of SOB since yesterday  morning,
chest pain and burning micturition since yesterday.

 History of present illness: Patient was apparently asymptomatic till yesterday

morning and suddenly developed SOB Grade-3 ( in on walking and  taking rest).

C/O chest pain since morning, non radiating.

H/o fever yesterday morning subsided on taking medications.

H/O burning micturition since 10days.

 C/O hematuria 

H/O cough since yesterday with dry cough, intermittent .

Cause of tingling sensation of both upper limb and lower limb.

 History of past illness : H/O similar complaints 20 days back.
 Past History : No history of HTN/DM/Epilepsy/tuberculosis.

No history of any surgeries.

 Personal History :

 Diet : Takes vegetarian diet.

 Sleep and appetite : Normal.

 Bowel and bladder movements : Normal and regular.

 No h/o addictions.

 No allergies.

 Family History : No f/h/o similar complaints.

OBJECTIVE DATA

 General consideration on examination :

 Patient is conscious, coherent, well built, nourished, and well oriented

 Pallor/icterus/cyanosis/clubbing/lymphadenopathy/edema : absent.

 Vitals :

 Blood pressure : 140/80mmHg.

 Pulse rate : 74beats/min

 Respiratory rate : 22 breaths/min

 Spo2 : @88%
 Systemic Examination :

 CVS : S1S2 heard, no murmurs.

 RS : B/L NVBS +
 CNS : conscious and oriented
 P/A : Soft, non-tender, no organomegaly.
LABORATORY INVESTIGATIONS

PARAMTERS   DAY 1 DAY 2 DAY 3 NORMAL 

TOTAL WBC 10,200/CUMM 15,800CUMM 8,100CUMM 4000-

11000CUMM
NEUROPHILS  83% 79% 54% 40-80%

LYMPHOCYTES 15% 14% 41% 20-40%

MONOCYTES 1% 3% 2% 2-10%

EOSNOPHILS 1% 4% 3% 1-6%

Hb% 12.0gm% 10.9gm% 11.7gm% 12-16gm%

RBC 4.56mil/cumm 4.01mill/cmm 4.89mill/cmm 4.3mil/cmm

PT COUNT 3.31 La/cumm 3.15 La/cumm 3.30 La/cumm 1.5-4La/cumm

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PARAMETERS DAY 1 DAY 2 DAY 3 NORMAL

RBS 152mg/dl 152mg/dl - 80-130mg/DL

urea 27mg/dl 27mg/dl 29mg/dl 15-40mg/dl

creatinine 0.7mg/dl 0.7mg/dl 0 .9mg/dl 0 .5-1.2mg/dl

Na 139mmol/L 139mmol/L 141mmol/L 135-155mmol/L

K 3.6mmol/L 3.6mmol/L 3.0mmol/L 3.5-5.5mmol/L

Ca 9.0mg/dl 9.0mg/dl - 8.5-10.3mg/dl

T.Bilirubin  1.0mg/dl 1.0mg/dl - 0.1-1.0mg/dl

Direct bilirun 0.2mg/dl 0.2mg/dl - <0.25mg/dl

Epethelial cells  4-5HPF 4-5HPF 3HPF  

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DIAGNOSTIC TESTS

 Chest X-Ray :  pulmonary hyperinflation, bronchial wall thickening.

 USG TEST
 Kidney: C/O multiple calculi largest meaning 6mm in Rt kidney and
5.5mm calculi noted in Lt kidney.

 UTERUS: Post-hestorectomy status.

 Impression : renal calculi.

 UROLOGY : C/O Burning micturition due to renal calculi and bacterial infection.

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ASSESSMENT

By observing the subjective and Objective evidences the patient was diagnosed to be ..,

BRONCHIAL ASTHMA with URINARY TRACT INFECTION.

PLANNING
MEDICATION DOSE FREQUENCY ROA
Tab. DOXOFYLLINE 400mg BD PO
Inj. HYDROCORTISONE 100mg SOS IV
Tab. NITROFURANTOIN 100mg BD PO
Tab. ACETAMINOPHEN 50mg BD PO
Syp. DISODIUM HYDROGEN 10ml TID PO
CITRATE
Neb with BUDESONIDE BD Nasal
Tab. CALCIUM+ VIT D3 500mg OD PO
Tab. FOLIC ACID OD PO
Inj. CEFTRIAXONE 1g BD IV

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 MEDICATIONS DOSE FREQUENCY ROA
Tab. TRYPSIN+ BROMELAIN 100mg OD PO
Inj. SALBACTAM + 1.5g OD IV
CEFOPEROZONE
Tab. LINEZOLID 600mg OD PO

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 PATIENT
COUNSELLING
ABOUT DISEASE

 Bronchial Asthma is a medical condition in which the  airways become

inflamed ,narrow and swell and produce extra mucus. This mucus makes  hard to
breathe which results in coughing, shortness of breath and wheezing.
 A Urinary tract infection, or UTI, is an infection in any part of your urinary
system, which includes your kidneys, bladder, ureters, and urethra.

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Pathogenesis of Asthma

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Pathophysiology of Urinary Tract Infection

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PHARMACIST INTERVENTION

• Drug interaction

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LIFE STYLE MODIFICATIONS
Managing Asthma attacks

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Take home messages for Urinary Tract infection

 Drinking plenty of water—Aim to drink eight 8-ounce glasses of water a day. This
will help flush the bacteria and antibiotics out of the urinary tract.
 Going to the bathroom when you need to—If you feel the urge to pass urine, do so
as soon as you can. Holding back may cause bacteria to grow.
 Passing urine and drinking a full glass of water after having sex.
 Washing your genitals daily.
 Wiping from front to back after a bowel movement (women).
 Not using douches and feminine sprays (women).
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