ACUTE BRONCHITIS

A SEMINAR ON LOWER RESPIRATORY TRACT INFECTIONS

Submitted to:B.P. Satish Kumar Assistant.Professor Submitted by: P.Deepak Pharm D (P.B) 1st Yr

ACUTE BRONCHITIS DEFINITION : Acute bronchitis or chest cold, is a condition that occurs when the bronchial tubes in the lungs become inflamed. The bronchial tubes swell and produce mucus, which causes a person to cough. This often occurs after an upper respiratory infection like a cold. Most symptoms of acute bronchitis (chest pain, shortness of breath, etc.) last for up to 2 weeks, but the cough can last for up to 8 weeks in some people.

PATHOGENESISAcute bronchitis is a self limiting illness.Infection of trachea and bronchi produce hyperemic and edematous mucous membranes with an increase in bronchial secretions which can become thick and tenacious impairing mucociliary activity.Recurrent respiratory infections may be associated with increase airway hyperreactivity and leads to pathogenesis of asthma and COPD.Causes of Bronchitis

Several types of viruses, most often:Respiratory syncytial (sin-SIH-shull) virus (RSV)AdenovirusInfluenzaParainfluenzaBacteria, in rare casesPollutants (airborne chemicals or irritants)

CLINICAL PRESENTATIONSigns and Symptoms :Cough persisting > 5 days to weeksCoryza,sore throat,malaise,headacheFever rarely > 39cPhysical examination :Rhonchi or coarsePurulent sputum in 50% of patientsPHARMACOLOGICAL THERAPYMild analgesic or antipyretics therapy is helpful in removal of malaise , lethargy and fever.Aspirin 650 mg in adults or 10-15 mg/kg in childrenIbuprofen 200-800 mg in adults or 10 mg/kg in children.Chronic Bronchitis

Definition: Chronic bronchitis is defined as chronic cough and expectoration. Excessive tracheo bronchial mucus production sufficient to cause cough with expectoration for most days of at least 3 months of the year for 2 consecutive years.

Etiology:The most important etiologic factor in the development of chronic bronchitis is cigarette smoking.

CHRONIC BRONCHITISClassification:Simple chronic bronchitisChronic mucopurulent bronchitisChronic bronchitis with obstructionChronic bronchitis with obstruction and airway hyperreactivity.CHRONIC BRONCHITIS

PATHOPHYSIOLOGY :Chronic inflammation Hypertrophy & hyperplasia of bronchial glands that secrete mucusIncrease number of goblet cellsCilia are destroyed

Chronic Bronchitis PathophysiologyNarrowing of airway Starting w/ bronchi smaller airwaysairflow resistancework of breathingHypoventilation & CO2 retention hypoxemia & hypercapnea

Chronic Bronchitis PathophysiologyBronchospasm often occursEnd resultHypoxemiaHypercapneaPolycythemia (increase RBCs)CyanosisCor pulmonale (enlargement of right side of heart)

Chronic Bronchitis: Clinical ManifestationsIn early stagesClients may not recognize early symptomsSymptoms progress slowlyMay not be diagnosed until severe episode with a cold or flu Productive coughEspecially in the morningTypically referred to as cigarette coughBronchospasmFrequent respiratory infections

Chronic Bronchitis: Clinical ManifestationsAdvanced stagesDyspnea on exertion Dyspnea at restHypoxemia & hypercapneaPolycythemiaCyanosisBluish-red skin colorPulmonary hypertension Cor pulmonale

Goals of Treatment:Chronic BronchitisImproved ventilationRemove secretionsPrevent complicationsSlow progression of signs & symptomsPromote patient comfort and participation in treatment Its an acute viral infection of lower respiratory tract infection affecting nearly 50% of children during 1st year of life and 100% by age of 3 years.Respiratory syncytial virus is the most common cause of bronchiolitis accounting for 70 % of cases. BRONCHIOLITIS

INFLUENZAInfluenza is an acute, viral respiratory infection.Fever, chills, headache, aches and pains throughout the body, sore throat which may lead to bronchitis or pneumonia.

SYMPTOMSFEVERHEADACHEMYALGIACOUGHRHINITISOCULAR SYMPTOMS17

17NON-PULMONARY COMPLICATIONSmyositis (rare, > in children, > with type B)cardiac complicationsrecent studies report encephalopathystudies of patients