Pathophysiology and Pharmacology

Running head: PATHOPHYSIOLOGY AND PHARMACOLOGY
Pathophysiology and pharmacology
Name of the student:
Name of the University:
Author’s note

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Pathophysiology and pharmacology related to the case patient:
The clinical scenario is based on Mr. Roger Wilson, a 32 year old man admitted to the
emergency department (ED) with symptom of breathlessness, chest pain and cough. He has been
diagnosed with respiratory tract infection (RTI) and chest x-ray shows bilateral pneumonia. It is
a type of acute lower respiratory tract infection affecting both the lungs and leading to symptom
of headache, sneezing, breathlessness, tight feeling in the chest and productive cough (Fabbri et
al., 2017). The review of the case study shows that Roger also has similar symptoms. The
anatomical structure that is mostly affected for Roger includes the lungs and the alveoli. Because
of this, the patient is suffering from slight chest pain, productive cough and breathlessness. This
is in relevance with the anatomy and physiology of the disease because during bilateral
pneumonia, inflammation of the alveoli takes place and it becomes filled with pus leading to
symptom of breathlessness (McCauley & Dean, 2015).The change in physiology of the lungs
due to bacterial or viral infection leads to breathing difficulty and wheezing (Craft & Gordon,
2019). Structural changes in the lung is seen due to direct invasion of bacteria in the pleural
space and initiation of cascade of inflammatory events (Quinton, Walkey & Mizgerd, 2018).
The anatomy of bilateral pneumonia and physiology is linked to the pathophysiology
behind the disease of the patient in the case study too. Understanding pathophysiology behind
the disease is also critical to understand the rationale behind a pharmacological regimen for Mr.
Roger. Direct bacterial invasion, inflammation in the lungs and pleural space, cascade of
inflammatory events and bacteriologic virulence features are some of the pathophysiology
behind the disease (Quinton, Walkey & Mizgerd, 2018). Mr. Roger has experienced episodes of
shortness of breath and productive cough. This has occurred because of the pathophysiological
process associated with bilateral pneumonia. Pneumonia is mainly caused by viral or bacterial

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infection. The process of inflammation of the air sacs in the lung occurs due to initiation of an
immune response in the lung following invasion by bacteria or virus. Acceleration of the
immune response contributes to fluid loculation. This occurs by migration of the neutrophil and
activation of the coagulation cascade leading to fluid within the alveoli. As the protein rich fluid
accumulates in the alveoli, the mucus plugs reduces the efficiency of gas exchange in the lungs.
The alveoli are further filled with fluid resulted in impaired gas exchange and risk of continued
infection (McCauley & Dean, 2015). These pathophysiological changes might be the reason for
clinical manifestation of pneumonia for Mr. Roger and it is linked to anatomical structures
associated with pneumonia too as changes in the lung structures initiates cascade of
inflammatory events and causes accumulation of fluids (Gon & Hashimoto 2018).
Management of bilateral pneumonia is mainly dependent on pharmacological treatment.
Treatment is also dependent of type of infection and the main goal is to reduce the symptoms
associated with impaired gas exchanged and breathing difficulty for patient. The pharmacology
of the prescribed pharmacology for Mr. Roger can help to understand how the drug is going to
act in the body of patient. Antibiotic is the main frontline therapy for management of pneumonia.
IV Benzylpencillin is a narrow spectrum antibiotic that has been provided to Roger and it is
prescribed mainly to treat bacterial infection in patients with pneumonia. It is administered
intravenously due to poor oral absorption and the drug works by binding to penicillin binding
proteins within the bacterial cell wall. In this way, it inhibits the last stage of bacterial cell wall
synthesis leading to cell lysis (Drug Bank, 2018). Evidence suggests that benzyl penicillin is an
appropriate pharmacological option for treatment of patient with pneumonia. Early use of this
medication provides many benefits such as reduced demand for nursing care, elimination of
injectable medications and low cost of treatment (Agweyu et al., 2014). Hence, use of

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Benzylpenicillin can hasten recovery by reducing progression of infection and preventing
complications for Mr. Roger.
Another medication prescribed to Roger for first day includes Doxycyline. The main
rationale behind giving this medication is that it also works to prevent growth of bacteria and
thus treat infection. It belongs to the drug class tetracycline antibiotics and it is used to treat
different types of bacterial infection. It also has similar course of action like that of
benzylpencillin and it inhibits protein synthesis by binding to the 30S ribosomal unit. This
results in inhibition of bactetial growth and consequently improvement in symptoms of patient
(Nightingale & Bishai, 2016). In response to history of mild asthma, Mr. Roger takes Salbutamol
via metered dose inhaler (MDI). Salbutamol is a short acting beta2adgrenergic receptor agonist
used in the treatment of asthma. Evidence suggests that β2‐Adrenoceptor agonists and
glucocorticoids are the most effective pharmacological options for the treatment of airway
inflammation. It is part of first line therapy for asthma. β2‐Adrenoceptor agonists are most vital
drug class for the treatment of asthma. Short acting preparations like salbutamol is provided on
need basis and long-acting preparation in combination with glucocorticoid is used for long-term
treatment (Amrani & Bradding 2017). This pharmacological treatment is linked to treatment of
bronchocontriction for Mr. Roger because this class of drug has bronchodilator effect and they
play a role in relieving breathlessness.
Explanation of the three symptoms in the cases study:
The three dominant symptoms of bilateral pneumonia that has been found in Mr. Roger
includes breathlessness, productive cough and chest pain. These three symptoms are some of the
clinical manifestation of pneumonia too. These three symptoms are connected with the