LRTI Flashcards

1
Q

What is the non-pharma treatment of cough?

A

throat lozenges
honey
smoking cessation

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2
Q

What is the pharma treatment of cough?

A

provide OTC meds such as:

  1. dextromethorphan
  2. guaifenesin
  3. Reserve albuterol for wheezing & pts w/underlying pulmonary disease
  4. AVOID opioid cough suppressants
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3
Q

How to treat cold syms of acute bronchitis?

A
  1. Analgesics (acetaminophen or NSAID)
  2. Antihistamine/decongestants
  3. Intranasal cromolyn sodium, intranasal ipratropium
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4
Q

If M.pneumoniae is suspected in acute bronchitis what do we use?

A

Antibiotic is usually discourged in acute bronchitis but it can be treated after culture serology / PCR with azithromycin OR FQ (levo / moxi )

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5
Q

If influenza A caused the acute bronchitis what can the patient use?

A
  1. Neuroamidase inhibitors:
    Zanamivir
    Oseltamivir
  2. Amantadine / rimantadine NO LONGER RECOMMENDED
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6
Q

What is the role of neuroamidase inhibitors in treating inf A acute bronchitis?

A

Reduce the severity & duration of the influenza episode

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7
Q

How to tret pertussis in acute bronchitis?

A

Macrolides

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8
Q

What are the drug classes used for chronic bronchitis

A
  1. Penicillin
  2. Macrolide
  3. 2nd/3rd/4th cephalo
  4. FQ
  5. TMP/SMX
  6. Doxycycline
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9
Q

Penicillin used for chronic bronchitis

A
  1. Amox+clav
  2. Amox
  3. Amp
  4. Pip-tazo if P.aeru is suspected
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10
Q

What are 2nd / 3rd cephalos used for chronic bronchitis w/ their DF

A

2nd:
ORAL cefuroxime

3rd:
ORAL : cefpodoxime, cefdinir
IV: Ceftriaxone, cefotaxime

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11
Q

What are the cephalos acting against p.aero & their DF in chronic bronchitis

A

Cefepime

ceftazidime

Both IV

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12
Q

How to treat infants with broncholitis?

A
1. Self-limiting disease so:
Provide reassurance 
Antipyretics
Adequate fluid intake 
Antibiotics not used routinely 
  1. In severly affected infants:
    If hypoxic O2 therapy
    If dehydrated IV fluids
  2. B adrenergic offers little benefit
  3. Don’t use corticosteroids
  4. Ribavirin not used except in immunocompromised w/ severe bronchiolitis due to RSV
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13
Q

Why do we use pencillins or macrolides or 2nd / 3rd / 4th cephalos for chronic bronchitis?

A

Bcz they act against

  1. S.pneumoniae
  2. H.influenza
  3. M.Catarrhalis

And 4th gen can act ag p.aeruginosa

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14
Q

What are the FQ used for chronic bronchitis

A
  1. Levofloxacin
  2. Moxifloxacin
  3. Ciprofloxacin

1+2 are resp FQ

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15
Q

What is the spectrum of FQ used in chronic bronchitis?

A
  1. S.pneumoniae
  2. M.catarrhalis
  3. P.aeruginosa only in case of cipro & levo ( alternative to cipro )
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16
Q

FQ DF

A

Oral / IV

17
Q

Macrolides used for chronic bronchitis

A

Azithromycin

Clarithromycin