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Prabhu, an Indian man in his late 50s, presents to your office with an acute cough. He has been feeling sick for the past three weeks. He occasionally produces green sputum and sometimes experiences shortness of breath with exertion. He asks for an antibiotic because his neighbor was diagnosed with bacterial pneumonia a few weeks ago and got better with an antibiotic.

On examination, Prabhu’s body temperature is 37.2°C, his heart rate is 88 beats per minute, and his respiratory rate is 22 breaths per minute. Auscultation of the lungs reveals some wheezing in the upper lung fields, but he is otherwise clear to auscultation and percussion. He states that he is allergic to penicillin and had a rash when he took it.

How would you treat Prabhu? Include both pharmacologic and non-pharmacologic therapy. Provide at least two current and scholarly references that support your choice of treatment.

completely Rewrite with a different reference:

Management of Acute Cough and Wheezing for Mr. Prabhu

Mr. Prabhu has most likely acute bronchitis. He is afebrile, his lung fields are clear to percussion, and the wheezing is mild to hear on auscultation (Shalabi et al., 2022). The etiologies of viruses explain the dominance of acute bronchitis, and active antibiotic treatment is often not used in situations where it can be conclusively proved that bacteria are involved. In this regard, Mr. Prabhu will be treated using both non-pharmacological and pharmacological health care interventions. The first non-pharmacological intervention in managing his condition is through educating him about the self-limiting character of acute bronchitis, its major causes (virus), and how it can resolve within a few weeks on its own. He will also be educated on the potential risks of unnecessary antimicrobial use, including antimicrobial resistance and adverse drug reactions.

Consequently, Mr. Prabhu will be required to rest, as such will enable his body to recover. The patient will be encouraged to consume more fluids, such as warm water, to help thin mucus and soothe his throat (Shalabi et al., 2022). In addition, the patient is to avoid respiratory irritants such as tobacco smoke. Consequently, the patient needs adequate hydration and humidification to help moisten the airways and loosen congestion. Proper handwashing and coughing etiquette should be taught to patients to prevent the spread of viral pathogens. Mr. Prabhu will need to be advised to reconsider if the symptoms do not improve within two weeks or become more pronounced, which will help prompt intervention in case of a secondary bacterial infection. This intermediate, evidence-based strategy reduces the risk of unwarranted antibiotic exposure and provides sufficient symptomatic relief.

Pharmacologic therapy for acute bronchitis will help Prabhu obtain relief from his symptoms. A short course of an inhaled bronchodilator, such as albuterol, will help alleviate intermittent wheezing and exertional dyspnoea (Shalabi et al., 2022). General discomfort will be treated with over-the-counter painkillers, such as acetaminophen or ibuprofen. His coughing can be managed using mucolytic such as guaifenesin or cough suppressants like dextromethorphan (Shalabi et al., 2022). Moreover, Mr. Prabhu is recommended to use natural honey, as it is a sufficient cough suppressant. He can opt to consume it alone or mix it with warm water. If Mr. Prabhu experiences persistent symptoms, dyspnoea develops, or chest pain appears, further tests to exclude pneumonia or other complications would be justified. 

Reference

Shalabi, M., Gazzaz, A., Alkhazal, A., Sanad, K., Albahrani, M., Alghamdi, A., Almuslim, S., Alsaad, A., Alotaibi, J., Alogla, S., & Hassan, M. (2022). Management of acute bronchitis in adults: Recent trends and practices. Journal 20f Healthcare Sciences, 2(06), 94-99. https://doi.org/10.52533/johs.2022.2602

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