Acute bronchitis (±Þ¼º ±â°üÁö¿°)

The Root of Ambulatory Care
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KEYWORDS:
Acute infectious bronchitis
Caused by Virus : 90%
(rhinovirus, coronavirus, influenza virus, adenovirus, respiratory syncytial virus,
parainfluenza virus etc)
Caused by Bacteria : 10%
(mycoplasma pneumoniae, chlamydia pneumoniae, bordetella pertussis)
Exacerbation of chronic bronchitis
Exacerbated by Infectious organisms (viruses, haemophilus influenza, Streptococcus
pneumoniae etc)
Exacerbated by Non-infectious factors
(smoking, allergens, occupational irritants)
Acute infectious bronchitis
1. Cough (¡¾ sputum)
2. Chest discomfort
Exacerbation of chronic bronchitis
1. Worsening cough
2. Increased dyspnea
3. Sputum purulence
..±Þ¼º ±â°üÁö¿°ÀÇ ¾à ¹Ý¼ö¿¡¼ ±âħÀÌ 2ÁÖ°£ Áö¼ÓµÈ´Ù.
..Clues to the presence of pneumonia
- HR > 100 beats/min
- RR > 24 breaths/min
Acute
bronchitis
Key symptoms
- Oral temperature > 38¡É
- Focal findings on chest examination
1. Chest X ray if needed : dyspnea, rales, rigors, pleurisy, persistent fever/cough
..A sputum gram stain and culture are not usually obtained for patients treated in
the ambulatory setting.
- General considerations
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- Pharmacologic
1. ¥â2-agonist agents
..Ventolin.. evohaler 0.5mg/puff 1-2puff tid-qid (¼Ò¾Æ 1 puff tid-qid)
..Bambec.. 10mg 1T qd pohs (1-2ÁÖ ÈÄ Áõ»ó¿¡ µû¶ó 2T Áõ·®)
(2~12¼¼ : 10mg qd)
..Berotec.. 2.5mg 1T, 1T-2T tid
(5~10¼¼ : 2.5mg qd)
2. Anti-tussive
..Codein.. 1T tid qid
3. Mucolytics
..Mucopect.. 1T tid, qid
Exacerbation of chronic bronchitis
1. Antimicrobial agents
..Amocla.. 250mg/125mg 1C, 2C tid¡¿10days
..Avelox.. 400mg 1T, 1T qd¡¿5days
2. Stop smoking
3. Inhaled bronchodilators
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The Root of ambulatory care
Key tests
Key treatments
Key treatments
Acute
bronchitis
(ipratropium, ¥â2-agonist)
4. Systemic/inhaled corticosteroids
5. Oxygen supply
..Ventolin.. - Salbutamol
..Bambet.. - Bambuterol
..Berotec.. - Fenoterol
..Mucopect.. - Ambroxol
..Amocla.. - Amoxicillin/Clavulanate
..Avelox.. - Moxifloxacin
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- Incorrect diagnosis (perhaps pneumonia, neoplasm, or CHF)
- An issue of compliance
- Inappropriate antimicrobial selection
- Diminished antimicrobial bioavailability (the co-administration of iron,
antacids, dideoxyinosine, and multivitamins with zinc decreases the absorption
of tetracyclines and fluoroquinolones)
- Excessive bronchospasms and/or bronchial secretions
Âü°í ¹®Çå
Richard A. Gleckman: Bronchitis, in Saunders Manual of Medical Practice, 2nd ed, Robert E. Rakel(ed).
Philadelphia, Saunders, 2000, P 178-181
Nelson M. Gantz, M.D. : Acute Bronchitis, in Conn¡¯s Current Therapy 2004, Robert E. Rakel(ed), Edward
T. Bope(ed_). Philadelphia, Saunders, 2004, P 261-263
¿Àâ¼®(ed) : ±Þ¼º ±â°üÁö¿°, in Complete Guide To Practical Based Prescription Medicine. ¼¿ï, Çѿ츮,
2005, P 118-119
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The Root of ambulatory care