EENT- Nasal infections Flashcards
What is the most common cause of sinusitis?
Viral!
–Inflammation of > 1 of the paired paranasal sinuses—maxillary most common
Sinusitis
–Pathogen
- S pneumoniae > H influenzae > M catarrhalis
Most common pathogens responsible for bacterial sinusitis
–Treatment for sxs:
- fluids
- humidity
- nasal saline/irrigation
Treatment for Bacterial sinusitis
(give meds for allergic rhinitis)
When do you give abx for a patient that has bacterial sinusitis?
only if sx worsen after 5-7 days or sx persist > 10-14 days
Mechanism: folate-antagonist anti-infectives.
Mechanism for TMP- SMX (bactrim)
Used to treat Bacterial sinusitis
What are 2 treatment options for Bacterial sinusitis?
- Amoxicillin, Amoxicillin-clavulanate (do not give if PCN allergic)
- TMP-SMX
Which medication used to treat bacterial sinusitis has the following ADEs?
- Nausea, vomiting, anorexia
- Rash, urticaria
- Stevens-Johnson syndrome
- Rash, sore throat, fever, arthralgia, pallor, purpura, or jaundice may be early indications of serious reactions.
TMP-SMX (trimethoprim-sulfamethoxazole)
Which medication that is used to tx bacterial sinusitis has the following Efficacy and monitoring recommendations
- Use with caution in patients with severe allergy or bronchial asthma
- Hemolysis may occur in individuals with G6PD deficiency; this effect may be dose-related.
- Use with caution in patients with impaired hepatic function
- Adjust dose in renal impairment
TMP-SMZ
Which medication that is used to tx bacterial sinusitis has the following drug interactions?
–Possible inhibition of warfarin clearance and prolonged PT/INR
–Inhibit metabolism and increase half-life of phenytoin
–Possible potentiation of hypoglycemic effects
–Possible increased digoxin concentrations, especially in geriatric patients
–Possible decreased efficacy of the tricyclic antidepressant
TMP-SMX
What is the MOA of Doxycycline, a medication that can be used to treat bacterial sinusitis
–Inhibits protein synthesis
Which medication has the following adverse Events/Side Effects:
–Photosensitivity, rash, skin hyperpigmentation, Stevens-Johnson syndrome, urticaria
–Anorexia, diarrhea, vomiting
–Tooth discoloration (children)
–Hepatotoxicity (rare)
–BUN increased (dose related)
Doxycycline
which med has the following Adverse event/side effect?
–Tooth discoloration (children)
- Cross the placenta and accumulate in developing teeth and long tubular bones
- Do not use during pregnancy and to age 8 unless benefit exceeds risk
Doxycycline
Which med?
•Efficacy/Monitoring
–Medication may be taken with food if gastric irritation occurs.
–May be sensitive to sunlight.
Doxycycline (can be used to tx sinusitis)
Which med?
•Drug Interactions:
- Antacids/vitamins may decrease the absorption of Tetracycline (any di- or trivalent medications)
- Carbamazepine: May decrease the serum concentration of Doxycycline.
Doxycycline
