Respiratory Tract Infections

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Pharmacology of respiratory tract infectious
Sonja Hutchens
Flashcards by Sonja Hutchens, updated more than 1 year ago
Sonja Hutchens
Created by Sonja Hutchens almost 6 years ago
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Question Answer
How should common colds be treated? -Analgesics -Nasal decongestants, sprays, oral -Cough Suppressants
How old do you have to be before treating cold symptoms? kids should be older than 2
How long do flu symptoms last Symptoms usually last 3-7 days, cough may last over 2 weeks.
Which strain of the flu is responsible for epidemics? influenza A
How is the flu transmitted? respiratory secretions -viral shedding before onset of illness and then for 24-48 hours after
What is the clinical presentation fo the flu? 1) Fever, chills, headache, myalgias 2) cough, nasal congestion
What antivirals are recommended if suspected or confirmed influenza? Zanamivir, oseltamivir, premivir
What patients should not be given Zanamivir? patients with COPD or asthma should not be given as it can cause bronchospasm
How old should the patient be before prescribing zanamivir? >5yrs for prophylaxis >7 years for treatment
When should a patient not be give oseltamivir? if they have renal failure -the dose should be decreased to 75mg QD if CrCl,< 30
When should you consider giving paramavir? if the patient is unable to take oral medications -is very expensive -only give if the patient has had symptoms less than 2 days
What criteria must be me in order for patients with egg allergies to be given the flu vaccine? if they have only had hives to past vaccinations (have to wait 30 mins after administration)
What symptoms indicate that phyngitis is viral? no severe pain, normal appearance, cough, no fever and no N/V
How should strep throat be treated in children? Amoxicillin 50 mg/day once daily(max 1,000 mg)
How should strep throat be treated if a child is allergic to penicillin? Clina(7mg/kg TID max 300mg/dose) OR Azithromycin(12mg/kg once daily, max 500mg for one day then 6mg/kg once daily, max 250mg for four days)
How should a child be treated if they are a carrier of strep? Clinda 20-30 mg/kg/day orally in three divided doses (max 300 mg/dose)
How should otitis media be treated in children? amoxicillin 80-90mg/kg/day divided twice daily treatment 5-7day(10 days)
If a child initially fails treatment for otitis media how what is your next step? if they fail within 72H then amoxicillin-clavulanate 90 mg/kg/day(amox) divided twice daily
What meds are specifically not first lne for otitis media due to resistance? Cephalosporins Macrolides TMP/SMX – not recommended due to resistance Quinolones are not approved in children
What symptoms are specific to abute bronchitis? Hoarseness Substernal pain No evidence of consolidation
When is bronchtis considered chronic? Coughing up sputum on most days during 3 consecutive months for more than 2 consecutive years
How should an exacerbation of chronic bronchitis be treated? Antibiotic therapy for 7-10 days for acute infectious exacerbations TMP/SMX 1 DS BID Doxycycline 100 mg BID Amoxicillin Clavulanate 875/125 BID Clarithromycin 500 mg BID Azithromycin 500 mg x 1; 250 QD x 4 Levofloxacin 500 mg QD Systemic steroids
What organisms that cause pneumonia are not visible on gram stain? M. pneumonia Legionella pneumophila Viruses
Are community acquired or hospital acquired pneumonia more likely to be gram (-)? hospital acquired
How should community acquired outpatient treatment for pneumonia? macrolide(azithromycin) or doxycycline
What are some risk factors for bbeata-lactam resistant s. pneumonia? Age <2 yrs or > 65 years B-lactam therapy within the previous 3 months Alcoholism, immunosuppressive illness or therapies Exposure to a child in a day care center
How should PRSP pneumonia be treated? B-lactam PLUS macrolide Amoxicillin or Amoxicillin/Clavulanate or cephalosporin Azithromycin or Clarithromycin (Doxycycline may be used for macrolide but not preferred)
How should inpatient community acquired pneumonia be treated? Cefotaxime or Ceftriaxone with or without a macrolide or doxycycline Or Fluoroquinolone alone (NO cipro)
How should community acquired inpatient treatment be approached for patients in the ICU? Macrolide or fluoroquinolone Plus Cefotaxime or Ceftriaxone Or B-lactam/b-lactamase inhibitor combination
HAP/VAP Late Onset, MDR risk pneumonia be treated? Combination Therapy Antipseudomonal cephalosporin OR Antipseudomonal carbapenem OR Blactam/blactamase inhibitor PLUS Antipseudomonal fluoroquinolone OR Aminoglycoside PLUS Vancomycin or linezolid
What is empyema? Collection of pus in a cavity, hollow organ or space
What is a lung abscess? Pulmonary infection involving the destruction of the lung parenchyma to produce cavities with an air-fluid level.
How should a lung abscess be treated? Penicillin plus Clindamycin or Metronidazole 3rd gen. Cephalosporin plus Clindamycin or Metronidazole Carbapenem B-lactam-bDuration: 2-4 months
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