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Phar 506 > Community-Acquired Pneumonia > Flashcards

Community-Acquired Pneumonia Flashcards

1
Q

How do mucous and pH make the nose and throat inhospitable for some organsims

A

Germs are caught and cannot move while the pH is to low for some germs

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2
Q

T/F: Cilia constantly move mucus up and out

A

True

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3
Q

T/F: Cough and Gag reflex helps to aid in destroying organisms by either spitting out or sending them to the stomach

A

True

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4
Q

How do microorganisms gain access to the body

A

Aerosolized particles, hematogenous, Aspiration

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5
Q

What diseases can impair lung defenses

A

Guillian Barre, Multiple Sclerosis, Seizures, Cystic Fibrosis, Myocardial Infaction, Stroke, HIV

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6
Q

What factors can impair lung defenses

A

using narcotics, alcohol, smoking, colonization

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7
Q

What lung sounds can be heard in a patient

A

Rales and rhonchi, dullness to percussion

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8
Q

What is a key way to know if pneumonia is present

A

Infiltrates on chest x-rays

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9
Q

What is the definition of community acquired-pneumonia

A

an acute infection of the pulmonary parenchyma in a patient that has not been recently hospitalized, exposed to antibiotics , or residing in a nursing home

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10
Q

Along with the definition of community acquired-pneumonia what else is need to diagnose community-acquired pneumonia

A

Clinical symptoms or presence of an infiltrate or ausculatory findings

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11
Q

T/F: Diagnosing the cause of pneumonia is done 70% of the time

A

False: 40-60% of cases of CAP fail to identify a causative organism

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12
Q

What are the typical organisms that cause pneumonia

A

Streptococcus pneumonia, moraxella catarrhalis, hemophilus influenzae

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13
Q

What are the atypical organisms that cause pneumonia

A

Chlamydophilia, mycoplasma

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14
Q

What are the opportunistic organisms that pneumonia (Immunocompromisde/elderly)

A

legionella, influenza

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15
Q

What risk factors for acquiring pneumonia

A

Age, immunocompromised (HIV/ Hematologic malignancy), COPD. smoking, alcoholism, chronic cardiovascular disease, diabetes

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16
Q

What constitutes a good sputum culture

A

Greater than 25 WBCs and less than 10 epithelial cells

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17
Q

T/F: A negative chest X-ray proves there is no pneumonia

A

False: Negative chest X-rays could be because the patient is dehydrated

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18
Q

What is the CURB-65, what does each letter stand for

A

Clinical predication tool for the severity of the pneumonia/ C= confusion, U=uremia, R= respiratory rate, B= blood pressure

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19
Q

What are the ranges for each section of the CURB-65

A

Uremia- BUN greater than 20mg/dl, Respiratory rate- greater than or equal to 30, Blood Pressure less than 90/60 mmHg, Age greater than 65

20
Q

What score on the CURB-65 leads to outpatient, inpatient, ICU

A

0-1, 2, greater than 3

21
Q

What are the the two antibiotics that can be given for a patient with no risk factors and has not be on any antibiotics

A

Macrolides OR doxycycline

22
Q

What is the drugs names dose, frequency for macrolides used to treat a patient with pneumonia with no risk factors and not recent antibiotic therapy

A

Azithromycin extended release suspension 2 grams once or 500 mg tablet for 1 day then 250 mg tablet for 4 days, clarithromycin 250-500 mg every 12 hours or extended release 1 gram for 1 day

23
Q

What is dose and frequency for doxycycline used to treat a patient with pneumonia with no risk factors and no recent antibiotic therapy

A

100 mg every 12 hours for 7 to 14 days

24
Q

T/F: Clarithromycin must be renally adjusted and is a strong inhibitor of 3A4 therefore it is not used as often as azithromycin

A

True

25
Q

What are drug interactions for doxycycline

A

Antacids, magnesium, iron, calcium

26
Q

What are the antibiotics would be given if a patient has pneumonia as well as co-morbid diseases as well but no risk factors

A

Respiratory fluoroquinolone OR macrolide or doxycline plus a beta-lactam

27
Q

What is the drug, dosing, and frequency for respiratory fluroquinolones used to treat pneumonia in a patient with co-morbid conditions

A

Levofloxacin 750 mg daily for 5 days or 500 mg daily for 7 days, moxifloxacin 400 mg daily, gemifloxacin 320 mg daily

28
Q

T/F: All of the respiratory fluroquinolones need renal adjustment except moxifloxacin

A

True

29
Q

What is drug, dosing, and frequency for beta lactams used with macrolide OR doxycycline to treat pneumonia in a patient with co-morbid conditions

A

Amoxicillin-clavulanate 500 mg every 8 hours or 875 mg every 12 hours, Amoxicillin 1 gram every 8 hours, cefuroxime 500 mg every 12 hours, cefpodoxime 200mg every 12 hours

30
Q

T/F: Beta-Lactams do not need to adjusted for renal disfunction

A

False: Beta-lactams do need to be renally adjusted

31
Q

What are the antibiotics name, dose, frequency that would be given if a patient has aspiration pneumonia

A

Clindamycin 300 mg every 6 hours or 450 mg every 8 hours, Amoxicillin-clavulanate 500 mg every 8 hours or 875 mg every 12 hours

32
Q

What is the usual length of therapy for pneumonia, what is the pneumonia is caused by legionella, what antibiotics are the exceptions

A

7-14 days, 10 days, azithromycin and levofloxacin 750 mg

33
Q

What are the antibiotics that would be given to a patient that is inpatient

A

Respiratory fluoroquinolone OR macrolide or doxycline plus a beta-lactam

34
Q

What are the beta-lactams name, dose, frequency and route given if a patient is inpatient with pneumonia

A

Ceftriaxone 1 gram IVPB every day, Cefuroxime 0.75-1.5 grams IVPB every 8 hours, ampicillin/sulbactam 3 grams IVPB every 6 hours or ertapenem 1 gram IVPB daily

35
Q

T/F: For the beta-lactams that are given inpatient they all need to be renally adjusted except ceftriaxone

A

True

36
Q

What is the macrolide and doxycline dose, route and frequency that will be given along with the beta-lactam for inpatient

A

Azithromycin 500 mg IVPB daily, Doxycycline 100 mg IVPB every 12 hours

37
Q

What are the fluoroquinolones name, route, dose and frequency given for inpatient pneumononia

A

levofloxacin 500-750 mg IVPB daily, moxifloxacin 400 mg IVPB daily

38
Q

T/F: Macrolide, doxycycline and fluroquinolone can give the same oral doses as alternates in inpatient

A

False: Macrolides and fluroquinolones can be given as alternative oral doses in inpatient

39
Q

What are the antibiotics that would be given if the patient is in the ICU from pneumonia

A

Beta-lactam PLUS macrolide or respiratory fluroquinolone

40
Q

What are the beta lactams that name, dose, frequency and route given if a patient is ICU with pneumonia

A

Ceftriaxone 1 gram IVPB every 12 hours, Cefuroxime 0.75-1.5 grams IVPB every 8 hours, ampicillin/sulbactam 3 grams IVPB every 6 hours or ertapenem 1 gram IVPB daily

41
Q

What are the macrolide and respiratory fluroquinolones name, dose, frequency, and route given if a patient is in ICU with pneumonia

A

Azithromycin 500 mg IVPB daily, levofloxacin 500-750 mg IVPB daily, moxifloxacin 400 mg IVPB daily

42
Q

What is given if a patient has pneumonia in the ICU but also has a penicillin alergy

A

Respiratory fluroquinolone AND aztreonam 1-2 grams IVPB every 8 hours

43
Q

T/F: Psedumonal infection caused pneumonia get treated as hospital acquired pneumonia patiens

A

True

44
Q

What are special populations when treating pneumonia

A

Cystic fibrosis, bronchiectasis, HIV

45
Q

How long should therapy be if the patient is inpatient or ICU

A

7-14 days total

46
Q

When should a patient be switched from IV to Oral

A

Afebrile 24-48 hours and the GI tract is intact

47
Q

What are the best ways to prevent pneumonia

A

Vaccination, hand hygiene

Phar 506 (37 decks)

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