Ch13 Aerosolized Antiinfective Agent

Question 1

What are some Antiinfective agents approved

Answer 1

Pentamidine isethionante ( nebupent) : prevent/treat pneumocystis pneumonia ( PCP)

RIBAVIRIN ( virazole): treat respiratory syncytial virus (RSV)

Tobramycin (TOBI): Manage P. Aeruginosa in CF

Aztreonam (Cayston): Improve pulmonary symptoms in CF patients with P aeruginosa

Zanamirvir ( relenza) : treat uncomplicated acute influenza virus

Question 2

What type of agent is pentamidine isethionate

Answer 2

Antiprotozoal agent

Question 3

What is a dosage of pentamidine

Answer 3

300 mg, given by inhalation once every 4 weeks

Question 4

What is the mode of action for pentamidine

Answer 4

Mode of action is unknown

Theory to interfere with nuclear metabolism and inhibiting DNA RNA phospholipids and protein synthesis

Question 5

What is the main side affect of pentamidine

Answer 5

Prevents airway effects- pretreat with B-adrenergic bronchodilator

Question 6

What are 3 environmental precautions for pentamidine

Answer 6

• patients using pentamidine should not mix with other medication until coughing subsides
• Healthcare workers should periodically screen themselves for TB
• Pregnant women and nursing mothers should avoid exposure and all practitioners should limit exposure
• use barrier protection
• use nebulizer system with one way valves and expiratory filter

Question 7

Aerosol therapy for prophylaxis of pneumocystis carinii pneumonia

Answer 7

2009 CDC recommendations- oral trimethoprim sulfamethoxazole(TMP-SMX) is preferred for prophylaxis

Aerosolized pentamidine is only recommended if the oral TMP-SMC is unsuccessful

Question 8

What is the dosage of ribavirin

Answer 8

20-mg solution administered on SPAG2 for 12-18 hours a day

Question 9

How is RIBAVIRIN administered

Answer 9

SPAG: Large volume pneumatically powered nebulizer

Question 10

What is the mechanism of action for ribavirin

Answer 10

MOA is virostatic, as a nucleoside analog, it interferes with viral transcription and replication

Question 11

What is the clinical indication for Tobramycin(TOBI)

Answer 11

Management of chronic pseudomonas aeruginosa infection in cystic fibrosis

Question 12

Tobramycin is a member of what group

Answer 12

Aminoglycoside group

Question 13

What is the clinical indication for zanamivir

Answer 13

Uncomplicated influenza in adults and children 5 years and over who have been symptomatic for no more than 2 days