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PHARMACOLOGY TERM 2 > Bacterial Pneumonia > Flashcards

Bacterial Pneumonia Flashcards

1
Q

What is meant by pneumonia

A

Acute infection of the lung parenchyma, usually caused by bacteria

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2
Q

Classifications of Pneumonia

A

Community acquired pneumonia
Hospital acquired pneumonia
Ventilator-associated pneumonia
Aspiration pneumonia

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3
Q

List the symptoms of pneumonia

A

Fever
cough
Shortness of breath
Malaise
Chest pain
Severe: shock and respiratory failure

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4
Q

Symptoms of pneumonia in frail eldery

A

Fever and cough are often absent, new of worsening confusion, detorioration of functional status or decompensating of underlying diseases

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5
Q

Signs of Pneumonia

A

Fever (>= 38)
Crackles ore crepitations
Tachypnoea
Bronchial breath sounds
Labs: Leukocytosis, procalcitonin

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6
Q

List pathogone for community acquired pneumonia

A

S. pneumonia
S. aureus
H. Influenzae

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7
Q

List pathogens for Hospital acquired pneumonia

A

Staphylococcus aureus
G-enterics (klebsiella pneumonia)
G-nonenterics (P. aeruginosa, H. Influenza, M. catarrhalis)

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8
Q

List pathogens for ventilator associated pneumonia

A

S. pneumonoa
S. aureus
H. Influenza

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9
Q

List pathogens for Aspiration Pneumonia

A

B. Melaninigenicus’Fusobacteria
Anaerobic streptococci
Polymicrobial infections with s. aureus, s. pneumonia gram negative bacilli

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10
Q

List pathogens for pneumocystis jiroveci pneumonia

A

P. jiroveci
Mycobacterium M. Tuberculosis

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11
Q

List the pathogens for community acquired pneumonia
In details

A

Gram Positive streptococci
* S. pneumoniae (pneumococcal pneumonia)
Gram Positive staphylococci
* S. aureus
Gram Negative found in GI tract (enterics)
* Legionella, Mycoplasma & Chlamydia (atypical pneumonia)
* H. influenzae (COPD)

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12
Q

Factors for determining the severity of community-acquired pneumonia

A

CURB-65
Confusion
Urea>7 mmol/L
Respiratory rate>30 breaths/min
Low blood pressure (SBP<90/DBP<60)
Age>65 yr
CRB-65
CRB-65 WITH NO UREA

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13
Q

CURB-65 SCORE LESS THAN OR EQUAL TO 1, TREATMENT SETTING?

A

Home

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14
Q

CURB-65 SCORE OF 2, TREATMENT SETTING?

A

HOSPITAL

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15
Q

CURB-65 SCORE GREATER OR EQUALS TO 3, TREATMENT SETTING?

A

Urgent admission to hospital ICU

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16
Q

List the CAP treatment considerations

A

Setting
* Age (65 years)
* Antibiotic use in past 90 days
* Drug intolerance/allergy
* Comorbidities
* Alcoholism / chronic liver disease
* Cardiovascular disease / cardiac failure
* Chronic kidney disease
* COPD
* Diabetes mellitus
* HIV

17
Q

CAP TREATMENT FOR OUTPATIENT LIST IT IN DETAILS

A

PO
<65 yrs or no antibioyics within 90 days
1. Amoxicillin
>65 yrs or antibiotics withini 90 days or comorbidity
1. Co-amoxiclav or 2nd gen cephalosporin
Alternatives: Moxifloxacin or levofloxacin

18
Q

CAP treatment for Inpatient (non-severe)
in details

A

PO/IV
<65 yrs or no antibiotics within 90 days
Ampicillin
>65 yrs or antibiotics within 90 days or comorbidity
Co-amoxiclav or 3rd gen cephalosporin
Alternatives: Moxifloxacin or levofloxacin

19
Q

Treatment for CAP for inpatient (Severe/ICU)
Indetails

A

Alternatives:
Moxifloxacin or
levofloxacin
PLUS cefuroxime
OR 3rd gen cephalosporin

Co-amoxiclav
OR cefuroxime
OR 3rd gen cephalosporin
PLUS macrolide/azalide
IV

20
Q

CAP adjuvant treatmnet:
Addition of which drug will better outcomes in severe CAP requiring ICU adminission

A

Addition pf macrolide (Azithromycin)

21
Q

Under CAP adjuvant treatment:
Systemic corticosteroids:

A
  1. Severe CAP requiring ICU admission
  2. Methylprednisone 0.5 mg/kh/12 h or equivalent
  3. Not of influenza or TB is likely pr history of GI bleeding in past 90 days
22
Q

How is the CAP treatment monitored?

A

Review culture results and sensitivity
Decrease
* Temperature ( over 8-24 hours)
* WBC
* s/sx of infection
Increased appetite- functional GI tract
Improved Chest X-ray

23
Q

which bacterial leads to CAP in children

A

Non-typical H. Influenza and S. aureus leading bacterial causes of severe pneumonia in children

24
Q

Which respirator viruses causes CAP in children

A

Leading cause of pneumonia in young children is Respiratpry syncytial virus (RSV) 18 to 31% pneumonia episodes

25
Q

Which opportunistic organisms causes CAP in children

A

PJP and cytomegalovirus (CMV)
Atypicals

26
Q

CAP in children- severity
Rapid breathing: list those values

A

Rapid Breathing
* Infant birth – 2 mo > 60 breaths/min
* Infant 2 mo – 1 yr > 50 breaths/min
* Children 1-5 yr > 40 breaths/min

27
Q

CAP in children- severity
Danger signs

A

Danger Signs
* O2 sat < 90% room air
* Cyanosis
* Inability to drink
* < 2 mo
* Impaired consciousness
* Grunting

28
Q

CAP in children general measurements

A

Ensure adequate hydration
Continue feeding

29
Q

Alternatives for CAP in children if they have penicillin allergy?

A

Azithromycin oral
Macrolides

30
Q

Explain the use of Ceftriaxone use in neonates for CAP

A
  • ONLY used in seriously ill neonates, even if jaundiced
  • DO NOT administer if Ca containing IV infusion being given (< 28 days
    of age)
  • After 28 days of age, may be given sequentially

PHARMACOLOGY TERM 2 (45 decks)

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