#Respiratory distress 2/2 Acute Exacerbation of Idiopathic Pulmonary Fibrosis.
-Steroids in the acute setting. MethylPrednisolone (Solu-Medrol) 40mg IV Push q6H. Be careful with long-term steroids. Some studies show that prior steroid administration may impact lung transplant. No steroids as routine maintenance as they can be harmful. But for exacerbation steroids are okay.
-Supportive care.
-Cont Supplemental oxygen.
-Cont Duonebs, Nebs, by RT q4h prn.
-CTA Chest with and without contrast to r/o PE.
-Pirfenidone or Nintedanib for Treatment. Approved by FDA in 2014. Defer to pulmonary.
-Pulmonary on board. Appreciate recommendations.
-PPI Therapy to prevent acid reflux.
-Pneumonia vaccinations if not already given.
-Flu shot yearly during flu season.
-Lung transplant referral- Consult case management to begin evaluation and application if qualified.
-Pulmonary rehabilitation in the outpatient setting.
-Education provided including anticipatory guidance, end-of-life issues, advance directives discussed.
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-VTE prophylaxis – Enoxaparin.