55 - Croup Flashcards
Which gender is affected more?
males
_____ are common cause
viruses
Describe the presentation
- seal-like barky cough
- worse at night
- fever may be present
- obstructive symptoms generally resolve within 48 hours
non-pharms
- keep calm
- oxygen for severe respiratory distress
What is mainstay of therapy for croup?
corticosteroids
Corticosteroids:
A single PO or parenteral dose of _____ is effective
dexamethasone
Corticosteroids:
_____ budesonide is effective and equivalent to oral dexamethasone
nebulized
Corticosteroids:
Severe patients may benefit form simultaneous administration of ?
- nebulized budesonide
- L-epinephrine
Corticosteroids:
Give ____ budesonide for those who vomit
inhaled
Corticosteroids:
Who should you avoid corticosteroids in?
- immunocompromsied
- recent exposure to varicella
Inhaled Adrenergic agonists:
-Give an example
L-epinephrine (usually nebulized)
Inhaled Adrenergic agonists:
Onset and duration of L-epinephrine
may reduce respiratory distress within 10 mins and last for more than 1 hour
Inhaled Adrenergic agonists:
When can a patient be safely discharged after receiving L-epinephrine?
if no symptoms for at least 2-3 hours after treatment
Inhaled Adrenergic agonists:
What dose is given to all kids for L-epinephrine?
5 mL
Inhaled Adrenergic agonists:
Only when should you administer repeated doses of epinephrine?
only if a child is near respiratory failure and close cardiac monitoring is possible
Inhaled beta agonists:
Should we recommend?
do not target upper airways, benefit is unlikely and not recommended for croup
Are analgesics recommended?
yes, can provide some comfort by reducing fever and pain
Are antitussives or decongestants recommended?
no studies, no rationale for their use in croup
Are antibiotics usually recommended?
no bc it is usually caused by a virus
if a culture is done and serious antibacterial infection is present then give IV antibiotics
Breathing in ____ air may help
cool
Oral dexamethasone is drug of choice. If can’t use this, then what do you choose?
parenteral dexamethasone or nebulized budesonide
Should we combine inhaled budesonide in addition to oral dexamethasone?
combo has no benefit so not recommended
