Bronchopneumonia is a type of pneumonia that is characterized by an inflammation of the lung generally associated with, and following a bout with

bronchitis. This is really a specific type of pneumonia that is localized in the bronchioles and surrounding alveoli. This article provides a general overview of this condition, including symptoms and treatment options for those who have been diagnosed with bronchopneumonia. The most common pneumonia-causing bacterium in adults is Streptococcus pneumoniae (pneumococcus) PATHOPHYSIOLOGY Etiologic Agent: • Bacteria • Virus Predisposing Factors: * Elderly * Hospitalization * Immobilization * Immune Deficiency * Long Term Illness * Smoking Microorganism enter alveolar Spaces by droplet inhalation ↓ Inflammation occurs ↓ Alveolar fluid increase ↓ Ventilation decreases as secretion thicken ↓ Bronchopneumonia

Empyema (collection of pus & liquid From infected tissue)

Pleurisy (Inflammation of membrane)

Lung Abscess (collection of pus, inflammation & destruction of tissue) ↓ Cancer of the lung ↓ Death

Pathophysiology: Inoculation of the respiratory tract by infectious organisms leads to an acute inflammatory response in the host that is typically 1-2 weeks in duration. This inflammatory response differs according to the type of infectious agent present.

Viral Infection

These are characterized by the accumulation of mononuclear cells in the submucosa and perivascular space, resulting in partial obstruction of the airway. They clinically manifest as wheezing and crackles. Disease progresses when the alveolar type II cells lose their structural integrity and surfactant production is diminished, a hyaline membrane forms, and pulmonary edema develops. Bacterial Infection The alveoli fill with proteinaceous fluid, which triggers a brisk influx of red blood cells and polymorphonuclear cells (red hepatization) followed by the deposition of fibrin and the degradation of inflammatory cells (gray hepatization). During resolution, intra - alveolar debris is ingested and removed by the alveolar macrophages. This consolidation leads to decreased air entry and dullness to percussion. Inflammation in the small airways leads to crackles. Wheezing is less common than in viral infections. Inflammation and pulmonary edema resulting from these infections causes the lungs to become stiff and less distensible, thereby decreasing tidal volume. The patient must increase his respiratory rate to maintain adequate ventilation. DRUG STUDY

DRUG Generic Name: Salbutamol Brand name: Ventolin proventil Classification: Sympathomimetic Dosage: ½ tsp – tid

USES Prophylaxis and treatment of bronchospasm d/t reversible obstructive airway disease. Inhalation solution for acute bronchospasm attacks. Stimulates beta-II receptor of bronchi leading to broncho dilation

SIDE EFFECTS Headache, N&V, palpitations, Tachycardia, tremor, bronchospasm

CONSIDERATIONS • When given by nebulization, use face mask or mouthpiece • Monitor pulmonary status

DRUG Generic Name: Hydrocortisone sodium succinate Brand name; A-hydrocort solucortef Dosage: 15 mg – IV q6 Classification: Corticosteroids

USES Prophylaxis and treatment of chronic bronchial asthma, perennial rhinitis, symptomatic sarcoidosis

SIDE EFFECTS Anorexia N&V Lethargy Headache Fever Joint pain Desquamation Myalgia Weight loss Hypotension

CONSIDERATION • Assess for any allergic reaction • Monitor v/s, I&O, and weight • Avoid alcohol and caffeine

DRUG NAME Generic Name: Paracetamol Brand Name: Tylenol, Biogesic Tempra Route: Oral, Rectal Dosage: Q4h/Q6h Available forms: Tablet and suppository

USES Analgesics and antipyretic commonly used for relief of fever, head aches and other minor pains and aches.

SIDE EFFECTS Rare side effects: Hives; rash; Shortness of breath. Prolonged & habitual use may lead to liver damage or failure.

CONSIDERATION Check the time and dosage before administering. Assess for possible drug reactions.

DRUG NAME Generic Name: Cefuroxime Brand Name: Zinacef, Ceftin Route: IV Dosage: 125 mg/q6 Classification: Cephalosporin, Second Generation

USES For lower respiratory tract infection due to S. pneumoniae, UTI’s due to e. coli & skin and skin structure due to s. aureus

SIDE EFFECTS Most common: Diarrhea/loose stools, abdominal pain & N/V

CONSIDERATION Asses for possible S&S of drug reaction. Asses for anemia & renal dysfunction.

DRUG NAME Generic Name: Ceftriaxone Brand Name: Rocephin Route: IV Dosage: 250 mg Classification:

USES For lower respiratory tract infection due to S. pneumoniae, UTI’s due to e. coli & skin and skin structure due to s. aureus

SIDE EFFECTS Most common: Diarrhea, rash, nausea, pain, induration tenderness at injection site

CONSIDERATION Asses for possible S&S of drug reaction. Asses for GI disease. Monitor renal dysfunction.

Cephalosporin, Third Generation

DRUG NAME Generic Name: Ambroxol HCL Brand Name: Bromussyl, Ambolyt Route: IV Dosage & Strenth Syrup 30mg/5 ml

USES A mucolytic agent used in the treatment of respiratory disorders associated with viscid or excessive mucus. It is the active ingredient of link Mucosolvan or link Mucoangin.

SIDE EFFECTS GI side effects like epigastric pain, gastric fullness may also occur. Rare allergic responses such as eruption, urticaria & angioneurotic edema may also occur.

CONSIDERATION Asses for possible S&S of drug reaction. Asses for GI disease. Monitor renal dysfunction.