Mouth/ Throat Flashcards by Terrianna Emerson

bacterial pharyngitis bacteria that causes

Group A Beta hemolytic streptococcal infection

How well did you know this?

Not at all

Perfectly

bacterial pharyngitis patient presents with

Fever over 38 degrees C
Tender anterior cervical adenopathy
lack of a cough
Pharyngotonsillar exudate

How well did you know this?

Not at all

Perfectly

bacterial pharyngitis symptoms and likelihood

1 symptom unlikely it is bacterial pharyngitis

and 3 symptoms it is about 90% likely that it is bacterial pharyngitis

How well did you know this?

Not at all

Perfectly

bacterial pharyngitis treatment

Penicillins/Cephalosporins 1st gen

Erythromycins/Macrolides

How well did you know this?

Not at all

Perfectly

Is gray furry tongue likely seen in bacterial or viral pharyngitis?

bacterial

How well did you know this?

Not at all

Perfectly

Are red swollen tonsils seen in bacterial or viral pharyngitis?

both

How well did you know this?

Not at all

Perfectly

Penicillin adverse evetns / side effects

hypersensitivity

mild diarrhea, vomitingn nausea, oral candidiasis

How well did you know this?

Not at all

Perfectly

describe the hypersensitivity experienced by some patients taking penicillins

rash, hives, itching, swelling of lips, tongue, mouth, or throat

How well did you know this?

Not at all

Perfectly

describe the hypersensitivity experienced by some patients taking penicillins

rash, hives, itching, swelling of lips, tongue, mouth, or throat

How well did you know this?

Not at all

Perfectly

what should you monitor in patients taking penicillin for bacterial pharyngitis

monitor for signs of anaphylaxis during first dose

also monitor for opportunistic infections

How well did you know this?

Not at all

Perfectly

opportunistic infections associated with penicillin and bacterial pharyngitis

fever, chills, unhealed sores, white plaques in mouth or vagina, purulent vaginal discharge, fatigue

How well did you know this?

Not at all

Perfectly

Penicillin drug interactions Probenecid

Probenecid may increase the serum concentration of Penicillins

How well did you know this?

Not at all

Perfectly

Penicillin drug interactions Tetracycline Derivatives

Tetracycline Derivatives: May diminish the therapeutic effect of Penicillins
Bacteriostatic with bactericidal

How well did you know this?

Not at all

Perfectly

Penicillin drug interactions Warfarin

Penicillin may enhance the anticoagulant effect of Vitamin K Antagonist-warfarin

How well did you know this?

Not at all

Perfectly

Erythromycin, Macrolides mechanism

Inhibitor of translation and transcription

How well did you know this?

Not at all

Perfectly

what drug is given to patients with bacterial pharyngitis that have a penicillin allergy

Erythromycin, Macrolides

Erythromycin, Macrolides adverse events and side effects

hypersensitivity 
abdominal pain, anorexia, diarrhea (GI disturbances)
Qt prolongation
pruritus, rash 
ototoxicity, hearing loss 
cholestatic jaundice

What should you monitor in patients taking Erythromycin, Macrolides?

ask patients to report immediately any unusual malaise, nausea, vomiting, abdominal colic, or fever; skin rash or itching; easy bruising or bleeding

Erythromycin, Macrolides drug interactions

Effects on CYP450

Macrolides unlabeled use

serve as a gastrointestinal pro kinetic, which serve to increase the movement of ingested material through the GI tract

Acute Laryngitis cause

usually a viral cause

possible bacterial causes are M catarrhalis and H influenzae

Treatment for acute Layngitis

erythromycin (macrolide)
cefuroxime
amoxicillin-clavulanate (Augmentin)

RIH or RAS
few to several vesicles that are shallow with punctate ulcers, attached to the gingiva and hard palate, lasting 1 to 3 weeks, due to a virus

Recurrent Intraoral Herpes (RIH)

RIH or RAS
one to a few ulcers with erythematous halo on the burial mucosa, floor of the mouth, oropharynx, vitiable, tongue lasting one to two weeks

Recurrent Aphthous Stomatitis (RAS) (canker sores)

off label treatment for Viral-Herpes Simplex

Acyclovir, Valacyclovir, Famciclovir

Acyclovir

Viral-Herpes Simplex treatment needs to be used within 3 days of onset for 10 days

Valacyclovir

Viral-Herpes Simplex treatment prodrug of acyclovir

Famciclovir

used for Viral-Herpes Simplex treatment with no randomized control trials

Pain and fluid management for Viral-Herpes Simplex treatment

ice, popsicles, or rinse and expectorate every two hours with diphenhydramine mixed with magnesia-aluminum 1:1 Topical lidocaine Fluids as tolerated

Adverse events/Side Effects of antiherpetic

malaise, headache

Drug Interactions of antiherpetic

Acyclovir-Valacyclovir, Famciclovir may diminish the therapeutic effect of Zoster Vaccine discontinue antiviral agents with anti-zoster activity for at least 24 hours prior to and 14 days after receiving a live attenuated zoster vaccine

Fungal-Oral Candidiasis First line treatment

topical due to less adverse events and drug interactions ystatin Suspension 1:100,000 first choice

Fungal-Oral Candidiasis oral prototype

Fluconazole | Binds to sterols in fungal cell membrane, changing the cell wall permeability allowing for leakage of cellular contents

Fungal-Oral Candidiasis adverse effects

Increased Alkaline phosphatase, ALT, AST, hepatic failure (rare), hepatitis, jaundice Angioedema (rare)

What should you monitor in patents with Fungal-Oral Candidiasis treatment

Periodic liver function tests (AST, ALT, alkaline phosphatase) Renal function tests: baseline SrCr Potassium levels QT prolongation

Fungal-Oral Candidiasis treatment interactions

``` Inhibits CYP1A2 (weak), CYP2C19 (strong), CYP2C9 (strong), CYP3A4 (moderate) Increase the serum concentration of Atorvastatin, simvastatin Citalopram Phenytoin Proton Pump Inhibitors Sulfonylureas Vitamin K Antagonists ``` May decrease the metabolism of Benzodiazepines Carbamazepine Losartan May enhance the adverse/toxic effect of Calcium Channel Blockers

Fungal-Oral Candidiasis Treatment in pregnancy

Pregnancy category C (single dose for vaginal candidiasis)/D (all other indications)

Ketaconazole

used for Fungal-Oral Candidiasis needs to be taken with breakfast Treatment requires acidic gastric environment