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Treatment of acute attacks, you must not make such a mistake!

Bronchian dilatation is a common chronic respiratory disease. It has a long course of disease and irreversible diseases. The main clinical characteristics are sustainable or repeated cough, cough, phlegm, or pus, and can varying hemoptysis [1]. The extension of the bronchial tube can be limited, involving local airways, or diffuseness, involving a wider range of airway [2]. The acute phase manifested as symptoms such as cough, asthma, breath, breath, sputum increase, or changes in nature, hemoptysis and fever. The use of multiple antibiotics repeatedly, resulting in an increase in drug -resistant strains, and the curative effect is not good. Choosing an effective treatment plan is essential for rapid control of infection and improving clinical symptoms. Xiao Bian organized five prescriptions for the duration of asthma [3], let’s see what problems are.

Case 1:

Male, 30 years old. Repeated cough and cough and yellow pus for more than 10 years. It was obvious in the morning, and the right lower lung support was found in the chest. Three days ago, the patient cough and sputum after coldness, and the sputum was yellow -green. Come to the clinic today. Examination: You can smell and wet lung.

Diagnosis: acute seizures of bronchial dilation.

prescription:

1. Mosha star tablets 0.4 g × 6 tablets: 1 tablet each time, once a day, orally.

2. 0.25 × 24 capsules for cefraine capsules: 2 capsules each time, 3 times a day, orally.

3. 30 mg × 20 tablets for ampacarium cables: 1 tablet each time, 3 times a day, orally.

4. Complex licorice convergence 180 ml × 1 bottle usage: 10 ml each time, 3 times a day, orally.

Analysis: The patient belongs to the mild attack of bronchial dilatation and should be given anti -infection treatment, but Mossian husaccharine and head holding are unreasonable combined medication. Cela as the first generation of cephalosporins is a strong effect on G+bacteria and weak effects on G-bacteria. With the antibacterial spectrum of the head hug, the two have the advantages of not taking long supplements, and the occurrence of adverse reactions and the economic burden of patients.

Suggestion: Celarazine should be stopped, and Mossian Stepons are used alone.

Case 2:

Male, 68 years old. Repeated cough and cough for more than 20 years, and have made a chest HRCT display two lower lung dilation changes. In the past few weeks, patients have cough and sputum, and they have been accompanied by qi. Today, I came to the emergency treatment, and the body was checked: the two lung respiratory sounds were thick, the lungs were heard and wet. Decarn the history of diseases such as liver and kidney dysfunction.

Diagnosis: acute seizures of bronchial dilation.

prescription:

1. Amikar 0.4 G+physiological saline 250 ml usage: once a day, intravenous dripping.

2. 30 mg × 20 tablets for ampacarium cables: 1 tablet each time, 3 times a day, orally.

Analysis: Amyka Star Aminoceides antibiotic, which has a strong antibacterial effect on Enterobacter bacteria and copper -green monolithic tools, has a good effect on Staphylococcus genus, so it has a certain effect on bronchial expansion and infection in infection Essence However, the elderly of the patient should be cautiously used with amino glycoside antibiotics, and antibiotics such as cephalosporins, ninone, β lactam/β lactamase inhibitors that are treated with infection are available. star.

Suggestion: Disable Amcar Star, and use Mossian Steel injection 0.4 G usage: once a day, intravenous injection.

Case 3:

Male, 25 years old. There are more than 8 years of bronchial dilatation history. In the past a week, patients have cough and sputum, and the amount of sputum is about 100 ml per day. It is accompanied by fever, hemoptysis, chest pain, etc., and then came to the emergency treatment. Physical examination: T38 ° C, shortness of breath, double lungs and wet snoring sounds. Check blood white blood cells 12.4 × 109/L, 80%neutral granulocytes, and 20%of lymphocytes. Deepen the history of penicillin allergies.

Diagnosis: acute seizures of bronchial dilation.

prescription:

Phlegm bacterial culture+medicinal sensitivity; strengthening position drainage.

1. 12 12 1 1 12 G+physiological saline 500 ml usage: once a day, intravenous dripping. (Dibromycopicin test negative)

2. 30 mg × 20 tablets for ampacarium cables: 1 tablet each time, 3 times a day, orally.

Analysis: 西 Lesin is a semi -synthetic penicillin antibiotic. Peloxycin antibiotics belong to time dependent antibiotics, and no antibacterial effect (PAE). The dose of 1 day should be divided into 2-4 times on average, that is, once 6-12 hours of administration, you can maintain blood medicine for a long time. The concentration exceeds the minimum bacterial concentration (MIC). Moreover, if the single dose is too high, the instant blood concentration is too high, prone to adverse reactions, and cannot effectively kill bacteria and cause bacterial resistance.

Suggestion: Change the usage of 哌 Lesin to: 哌 Lasin 4 G+physiological saline 250 ml usage: once every 8 hours, intravenous injection.

Case 4:

Female, 54 years old. Repeated cough and cough for more than 20 years, which has been obvious in the morning. Cough and cough for nearly 3 days: T38 ° C, shortness of breath, double lungs and wet snoring sounds. Check blood white blood cells 15.4 × 109/L, 85%of neutral granulocytes and 15%of lymphocytes. HRCT examination on the chest shows that the cystic bronchial expansion is seen after the two lower lungs and the bottom section of the outer base. There is a history of allergic shock.

Diagnosis: acute seizures of bronchial dilation.

prescription:

1. Cobe ketone/sodium Schubatan sodium 0.3 g+physiological saline 250 ml usage: 2 times a day, intravenous dripping.

2. Aurbidate hydrochloride solution 30 ml+physiological saline 2 ml usage: 3 times a day, atomization inhalation. Phlegm bacterial culture+medicine sensitivity, position drainage.

Analysis: Ceiftero/sodium sodium soda sodium is a compound preparation of β lactam as a lactaminase inhibitor. Ceifterin antibiotic and penicillin have cross -allergic reactions, while Schubatan sodium is also prohibited from penicillin allergies. The patient has a history of allergic shock, so the prescription is improper.

Suggestion: Stop cephalosporin sodium soda sodium sodium, and use Mossian Stepacon injection 0.4 G usage: once a day, intravenous dripping.

Case 5:

Male, 35 years old. There are more than 10 years of bronchial dilatation history. In the past few weeks, patients have cough and cough fatigue. The amount of sputum is about 100 ml per day. It is accompanied by fever, hemoptysis, chest pain, etc., and then came to the emergency room for treatment. Physical examination: T39 ° C, shortness of breath, double lungs and wetness. Check blood white blood cells 12.8 × 109/L, 80%neutral granulocytes, and 20%of lymphocytes. Deepen the history of penicillin allergies. See the dioprocata of the pulmonary cystic bronchial dilatation.

Diagnosis: acute seizures of bronchial dilation.

prescription:

Phlegm bacterial culture+medicinal sensitivity.

1. 0.5 g × 4 tablets of Left Motoly: 1 piece each time, once a day, orally.

2. Complex licorice convergence 180 ml × 1 bottle usage: 10 ml each time, 3 times a day, orally.

3. 30 mg × 20 tablets for ampacarium cables: 1 tablet each time, 3 times a day, orally.

Analysis: The patient is an acute attack of bronchial dilatation, fever 39 ° C, rapid breathing, and a medium and severe infection. Only oral antibiotic treatment can obviously cannot achieve the role of controlling infection. Intraraculi administration should be used.

Suggestion: Put the oral levofol peroxide for intravenous medication. Levofloxacin injection 0.5 G Usage: Once once a day, intravenous dripping.

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