BRONCHITIS

DEFENITION
• Bronchitis is inflammation or swelling of the
bronchial tubes (bronchi), the air passages
between the nose and the lungs.
• More specifically, bronchitis is when the lining
of the bronchial tubes becomes inflamed or
infected.
• Bronchitis is caused by viruses, bacteria, and
other particles that irritate the bronchial
tubes.
 INCIDENCE
• The recent 'Indian Study of Asthma,
Respiratory Symptoms and Chronic Bronchitis'
study of 85,105 men and 84,470 women from
12 urban and 11 rural sites reported the
incidence of chronic bronchitis to be 3.49%
(4.29% in males and 2.7% in females) in adults
> 35 years.
 TYPES
1. Acute – it is a shorter illness that commonly
follow a cold or viral infection such as flu. It
consist of a cough with mucus, chest discomfort,
throat soreness, fever, shortness of breath. It is
usually a last a few days or weeks (1-3 week).

1. Chronic – it is a serious ongoing illness, it is a

persistent, mucus producing cough that last
longer then three month. The person is having
severe breathing difficulties & it may get
worsen. It occurs with emphysema and it may
become COPD.
 ETIOLOGY
• Etiologic agent – bacteria, virus
• Predisposing factor (contribute to the
problem)– smoking, long term illness, immune
deficiency and immobilization.
• Precipitating factor (trigger the problem)–
hospitalization, environment, smoking and
malnutrition.
 CLINICAL MANIFESTATION
Sign & symptoms for both acute and chronic
bronchitis :
• Persistent cough
• Production of mucus which can be clear, white,
yellowish gray or green in color, rarely it may be
streaked with blood.
• Crackles and Wheezing sound
• Low fever, chills, Headache
• Chest tightening
• Sore throat, dyspnoea
• Blocked nose & sinuses
 DIAGNOSTIC EVALUATION
• History
• Physical examination
• Chest x-ray
• Sputum
For gram stain, culture and sensitivity test
may be obtained to determine presence of bacterial
infection.
• Pulmonary function test by using spirometer
To determine peak expiratory flow (person's
maximum speed of expiration)
• ABG Level
 MANAGEMENT
People with bronchitis are instruct to
• Rest, drink fluid, breath warm & moist air, & take
OTC cough suppressant & pain relieve in order to
manage symptoms & ease breathing.
• Many case of acute condition may go away
without any specific treatment, but there is a no
cure for chronic condition.
• To keep bronchitis symptoms under control &
relieve symptoms, doctor may prescribe :
 Antibiotics – Azithromycin, for 7-10 days
 Antitussive – Codeine for suppressing the cough
• Bronchodilators –> To dilate the bronchi
Beta2-adrenergic agonist agents –> Salbutamol,
Terbutaline
Anticholinergic agents –> Ipratropium bromide
Methylxanthines –> Theophylline
• Mucolytics -> e.g. Acetylcysteine to thin the
secretions.
• Corticosteroids –> Dexamethasone,
Methylprednisolone to relieve the inflammation
• Antipyretics -> for fever
• Other -> Oxygen therapy, Pulmonary
rehabilitation program, chest physiotherapy,
nutritional therapy
 COMPLICATION
• Pneumonia
• Asthma
• COPD
 PROGNOSIS
Patients with acute bronchitis have a good
prognosis. Bronchitis is almost always self-
limited in individuals who are otherwise healthy,
although it may result in absenteeism from work
and school. Severe cases occasionally produce
deterioration in patients with significant
underlying cardiopulmonary disease or other
comorbidities.
 PATIENT EDUCATION
Patient education is essential in the prevention and
treatment of acute bronchitis. Unfortunately, health
care providers usually underemphasize education.
Patients should be counseled to take the following
measures:
• Avoid smoking and secondhand smoke
• Live in a clean environment
• Receive the influenza vaccine yearly between
October and December
• Receive the pneumonia vaccine every 5-10 years
if aged 65 years or older or with chronic disease