LOWER RESPIRATORY TRACT CONDITIONS AND VIRAL INFECTION Flashcards
What is acute bronchitis
Common clinical condition characterised by an acute onset but persistent cough, with or without sputum production
what is chronic bronchitis?
Characteristics?
Causes?
Often co-exist with?
Chronic
* Chronic inflammatory
condition
* Characterised by thickened,
oedematous bronchial
mucosa with mucous gland
hypertrophy
* Caused by smoking
* Often co-exists with
emphysema – both =
airflow limitation and COPD
Exl]plain 6 point about acute bronchitis treatment approach
For most patients,
* Symptoms are self-limited, resolving in about one to three weeks.
* Reassurance and symptom control are the cornerstones of care.
* Antibiotics are not recommended for routine use.
* Nonpharmacologic options for cough relief such as throat lozenges,
hot tea, honey, steam inhalation, adequate hydration and/or smoking
cessation or avoidance of second-hand smoke is a reasonable first
step.
* Cough preparations
* Paracetamol for pain and fever
Antibiotics is NOT indicated in acute bronchitis in the absence of
underlying COPD.
True or False
True
Part of COPD also referred to as chronic obstructive airways disease COAD, and sometimes with emphysema are characterised by what?
chronic cough with/without sputum production on most days of ≥3
months for ≥2 consecutive years;
* dyspnoea or shortness of breath; and
* wheezing.
* If symptoms suggest TB (e.g. weight loss, night sweats, etc.),
investigate and manage accordingly.
Management of acute exacerbation
This is an emergency recognised by various combinations of:
* wheeze
* breathlessness
* tightness of the chest
* respiratory distress
* cough
* Bronchospasm is partially reversible with COPD
* Regular doses of short-acting bronchodilators (SABA, SAMA)
* Supplemental oxygen (24-28%)
* Oral corticosteroids: Prednisone, oral, 30mg daily for 5 days
what to note about oral corticosteroids in manangement of acute exacerbation
Oral corticosteroids may be required for acute exacerbations,
but these have severe long-term complications and should only be
used long-term if benefit has been proven by lung function testing.
Drug treatment of acute infective exacerbation of chronic bronchitis
Acute infective exacerbation of chronic bronchitis:
* Amoxicillin, oral, 8 hourly for 5 days.
Severe penicillin allergy:
* Doxycycline, oral, 12 hourly for 5 days.
Viral structures of pharmacological importance
Neuraminidase
Haemagluttin
Antiviral for influenza A and B?
Neuraminidase inhibitors:
Oseltamivir
Zanamivir
When to start using oseltamivir?
Initiate tx within 24-48 hours of symptoms reduce duration by less than 1 day
High risk influenza patients are?
Pregnant women and immunocompromised children <2 years
what should be given to patient within 48 hours of exposure
PEP only for high risk close contacts
Adverse effects of Oseltamivir?
N and V (report of fatal neuropsychiatric AEs)
Powder for inhalation
Zanamivir
