Management of Chronic Bronchitis

General:

• Education to patients and their families
• Stop smoking and avoid air pollution
• Prevent infection
• Clean environment
• Hydration moderation: drink enough water (8-10 glasses a day)
• Proper nutrition: protein rich diet and avoid heavy meals before bedtime, milk can cause increased bronchial secretions, should be prevented.

Provision of drugs:
1. Bronchodilators:

• Aminophylline inj. 5.6 mg / kg i.v. or oral loading dose of 3 x 100-200 mg.
• Terbutaline 3 x 2.5 mg oral or injection 0.25 mg s.c. every 4-6 hours (1 mg / ml; = 2 ml ampoule).
• 3 x 2 mg salbutamol orally.

2. Expectorant:

• Water is a good expectorant
• Glyceryl guaiacolate 4 x 100-200 mg.

3. Mucolytic :

• Bromhexine HCL: 3 x 1 tablet by mouth.
• N-acetyl cysteine: 3 x 200 mg orally.

4. Respiratory therapy:

• Aerosols: Ipratropium Bromide 3 x 2 puffs
• Oxygen: 1-2 liters / minute via nasal cannula if PaO2 <55 mm Hg.

5. Rehabilitation:

• Physiotherapy
• Relaxation exercises
• Breathing exercises
• Chest percussion and postural drainage
• Exercise physical abilities
• Psychosocial Rehabilitation
• Vocational Rehabilitation.

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