Acute bronchitis S/S
- Spitting up sputum
- Going on for a while (10-11 days)
- Achy
- HA
- Fatigue
- Worse at night - hard time sleeping
- Relieved w/ taking a shower
Acute bronchitis VS?
- T: slightly elevated
- HR, RR, BP, SpO2 all NL
What would you find on PE for Respiratory?
- Scattered ronchi that change and sometimes clear when cough
- No wheezes
- Focal consolidation w/ crackles
- No use of accessory m.
- Coughing frequently
- Sometimes expectorates (clear, yellow/mucus)
What would you expect to see on labs?
CBC and CMP WNL
What are medications that help to thin/breaks up mucus?
Expectorants: Guaifenesin (Mucinex)
What medications help to suppress cough?
Cough syrup w/ codeine (controlled substance)
Dextromethorphan (Delsym, Robitussin)
What treatments would you recommend for alleviation of symptoms/supportive?
- Bed rest and fluids (tea, honey)
- Hot showers, humidifier
- Myalgias: NSAIDs
- Depending on lung sounds: Albuterol (SABA)
What would you caution regarding decongestants in patients taking BP medications?
Decongestants make BP and HR rise - may make BP drugs not work
What medication for bronchitis would be best for a HTN patient?
Coricidin
What medications should patients with CHF avoid?
- Meds with pseudoephedrine (Sudafed)
- Phenylephrine (nasal decongestant)
Coricidin, Robitussin DM, Mucinex are OK to use
Is sputum color a good indicator for viral vs bacterial infection?
NO!
yellow, green, tinge of blood (irritation) - all ok
Takeaways
- Bronchitis is most often viral
- Overprescribe ABX for viral cause
- Ask preferences of pt and their goals for tx
What medication works by reducing the reflex in the lungs that causes the urge to cough?
Benzonatate: Tessalon Pearls (non-sedating)
