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Ministerul Sănătății al Republicii Moldova

Universitatea de Stat de Medicină și Farmacie


”Nicolae Testemițanu”

Catedra de Farmacologie și farmacologie clinică

Șef catedră: Ghicavîi Victor –mc AȘM,profesor universitar


Conducătorul grupei: Chianu Marin,asistent universitar

Lucrare instructiv-didactică
(microcurația pacienților)

Student:Ciorici Victoria,gr.M1429
Facultatea: Medicină Nr.1

Chișinău 2019

Sex: female
Nationality: RM
Address: Mun. Chisinau, Sec: Botanica
Date of hospitalization: 23.11.16 at 19-00 o'clock
1. Hospitalization diagnosis: Acute Bronchitis
2a.Clinical diagnosis: Acute Bronchitis

2. Patient history: the patient came to the hospital after episodes of dyspnea also the
patient has a high fever father said, also that his daughter was compline before 2 years
for the same symptoms.

3. Treatment history: the patient family during these episodes of dyspnea gave her
dexamethasone as inhalation ”Aerosol Dexamethasone”.

4. Objective data and


PLAN OF LABORATORY INVESTIGATIONS:
CBC.
biochemical analysis of blood.
C-Xray

The result of laboratory investigations:


CBC:
Hb – 11.9
RBC – 5.15
WBC: 17.3 * 10`3 / UL H
Granulocytes: 15.2 H
Lymphocytes – 6.3% - 1.1 *10’3 / UL
Monocytes -5.6 %
MCHC 32.0
HCT 37.1
MCV 72.0
PLT 247
ESR 10
Neutrophils S: 26 H , UNSEGMENTED NORMAL 64
Conclusion: increased WBC, WHICH its an indicator for inflammation …

biochemical analysis of blood :

General Bilirubin – 8.5 micromol / l ( norm : 11 to 18 micromol / l) ;


bilirubin bound - --- “0” micromol / l ( norm : 0-1 micromol / l) ;
free bilirubin – 8.5 micromol / l ( norm :: 11 to 18 micromol / l) ;
ALAT -14.1 U / l;
ASAT -25.4 U / l ;
Glucose 5.5 / l ( standard 4 - 6.5 mmol / l ) ;

X-Ray: Showed Acute Bronchitis

5. TREATMENT ANALYSIS:

Dosage - 23.11 24.11 25.11 26.11 27.11 28.11 29.11


GR
Salbutamol Aerosol +++ +++ +++ +++ +++
O2 Inhalation + + +
Nitrous Inhalation ++ + ++ +
Chloride
Mg Sulphate Inhalation + +
Thiyophilline 0.15g ++ +
climasten 0.5g + + +
Fluticazone 0.12g ++
drotavirine 0.04g + +
clarithromycin 0.5g + + +

Salbutamol: it is short-acting β2 adrenergic receptor agonist, which works by causing airway


smooth muscles to relax, in our patient it was administrated for relief of bronchoconstriction
Side Effects: Common side effects include shakiness, headache, tachycardia, dizziness, and
feeling anxious. Serious side effects, irregular heartbeat, and low blood potassium levels. It can
be used during pregnancy and breastfeeding, but safety is not entirely clear.
Indications: It is used to treat asthma, exercise-induced bronchospasm, and
chronic obstructive pulmonary disease (COPD). It may also be used to treat high
blood potassium levels

Theophylline: it’s a phosphdisterase 3 inhibitor drug which is preventing and treating


symptoms of blockage of airway due to acute bronchitis.

O2 inhalation: Patient has low saturation because of this we gave her and it’s a good choice for
increasing the O2 saturation.
Clemastine: its first generation H1 receptor antagonist, that’s drug act by inhibiting
histamines and also can pass blood brain barrier and cause sedative effect they give the patient
to check if it’s the allergy the cause of bronchitis, but after the results of Cbc it was approved
that the patient have bacterial infection.

Drotaverine: is an antispasmodic drug, but an inhibition of the enzyme


phosphodiesterase causing elevation of cyclic AMP levels is significant in our
patient its not needed , only if she came with abdominal colic or pain otherwise it
is not appropriate to give her.

Flutcazone: its inhaled glucocorticoids which act by making a bronchodilator and


decreases inflammatory cells and mediators, its needed to administrate for the
patient, its good choice , but not for along period because may cause candidiasis
“oral” and dysphonia.

Clarithromycin: its Macrolide antibiotic which have a narrow spectrum of


action act on gram positive bacteria, its act by inhibiting protein synthesis in
bacteria, it’s a good choice as an antibiotic but we think that its better to give the
patient an broad spectrum antibiotics, Sputum Culture was not made but the
most common etiological factor is gram positive bacteria after viral , but the lab
studies shows that we have bacterial etiology “CBC”. Its Hepatic enzyme inhibitor
and should not be administered with other drug especially Theophylline.

6. Diaries (daily observation)


In 25.11.2016 the patient status was stable, and there’s a slight symptoms
which is cough. Heart rate was normal 89 beats/min and blood pressure
was also normal
Temperature the patient had 36.8 in the day. In general the status of the
patient was improved.
In 26.11.2016 : the patient Status Is better than how she came in first day
so the treatment is effective the heart rate was normal 92 Beats/Min and
temperature was 37.2..in general the status of the patient was very well
after these drug administration the patient discharged to home at
29.11.2016.
7. CONCLUSION: the treatment is appropriate and have shown that the
patient improved and her status start to be good, and we agree with the
treatment.
(Suggest your own treatment plan)

8. Personal Drug Selection (select the most efficient and harmless drugs)

Drugs Efficacy Inoffensivity Acceptability Price Total


(Side (Contraindications)
Effects)

Conclusion