Pharmacotherapy of Pneumonia

Question 1

What are the main treatment goals?

Answer 1

Treat the infection and treat the symptoms

Question 2

How would you treat the infection as part of the immediate management?

Answer 2

Give empirical therapy, until causative bacteria is confirmed with lab tests

Question 3

How to treat the symptoms in immediate management?

Answer 3

Oxygen
IV fluids
Analgesia

Question 4

What kind of treatments fall under analgesia?

Answer 4

Paracetamol
NSAIDs
Opioids

Question 5

For CAP Outpatient with NO comorbidities or resistant bacteria what kind of treatment would you give?

Answer 5

Aminopenicillin –> Amoxicillin
Macrolides or Doxycycline –> Azithromycin or Clarithromycin

Question 6

FOR CAP outpatients WITH comorbidities or resistant bacteria what kind of treatment would you offer?

Answer 6

Combination therapy or mono therapy

Question 7

What are the options for combination therapy for CAP outpatients with comorbidities?

Answer 7

Beta - lactam + Macrolide
Beta - lactam + Doxycycline

Question 8

What are the different options of beta lactams for CAP outpatients (combination therapy)?

Answer 8

Amoxicillin/ Clavulanate, Cefuroxime

Question 9

What are the different options of macrolides for CAP outpatients (combination therapy)?

Answer 9

Azithromycin, Clarithromycin

Question 10

What are the available mono therapies available for CAP outpatients with comorbidities?

Answer 10

Respiratory Fluoroquionoles

Question 11

What are the examples of respiratory fluoroquionoles?

Answer 11

Levofloxacin
Moxifloxacin

Question 12

What is the best option of treatment for any kind of organism that has caused pneumonia?

Answer 12

Quinilone

Question 13

If the pneumonia is caused by Strep. Pneumoniae what are the treatment options? (CAP Outpatient)

Answer 13

Macrolides or High dose beta lactams

Question 14

When do we give macrolides? (organisms) (CAP Outpatient)

Answer 14

Strep. Pneumoniae
Haemophilus Influenzae
Legionella
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Staphylococcus aureus

Question 15

What is the standard treatment for non-severe CAP? (Inpatient)

Answer 15

Beta lactam + macrolide
Respiratory Fluoroquionoles

Question 16

What are the beta lactams that can be used for non-severe CAP? (Inpatient)

Answer 16

Ampicillin/ Sulbactam, Cefotaxime, Ceftriaxone

Question 17

What are the macrolides that can be used fro non-severe CAP? (Inpatient)

Answer 17

Azithromycin, clarithromycin

Question 18

What are the respiratory fluroquinoles that can be used for non-severe CAP? (Inpatient)

Answer 18

Levofloxacin

Question 19

What is the standard treatment for severe CAP? (Inpatient)

Answer 19

Beta - lactams + macrolides
Beta lactams + respiratory fluoroquinoles

Question 20

If MRSA coverage is required then which drug/ drugs are added?

Answer 20

Vancomycin or linezolid

Question 21

If Pseudomonas aeruginosa coverage is required what do you change to the treatment?

Answer 21

Switch beta lactam to an antipseudomonal beta lactam
OR
Add aminoglycoside

Question 22

What are the examples of antipseudomonal beta lactams? (CAP) (Inpatient)

Answer 22

Piperacillin-tazobactam
Cefepime
Imipenem
Meropenem
Aztreonam

Question 23

What are the examples of aminoglycosides? (CAP) (Inpatient)

Answer 23

Tobramycin

Question 24

In case of a penicillin allergy, what are the alternatives? (CAP) (Inpatient)

Answer 24

Doxycycline
Clarithromycin
Erythromycin

Question 25

In case of pregnancy, what drugs can be taken ? (CAP) (Inpatient)

Answer 25

Amoxicillin Azithromycin

Question 26

Which kind of treatment should be avoided during pregnancy? (CAP) (Inpatient) Why?

Answer 26

Doxycycline Inhibit bone growth

Question 27

For early set HAP what is the treatment?

Answer 27

Ceftriaxone Quinolone Ampicillin/ Sulbactam Ertapenem

Question 28

For late onset HAP, caused by pseudomonas aeruginosa or enterobacteriaceae what is the treatment?

Answer 28

Antipsudomonal cephalosporin, piperacillin, tazobactam or quinolone Aminoglycoside Carbapenem

Question 29

For late onset HAP, caused by pseudomonas aeruginosa or enterobacteriaceae or acinetobacter spp. what is the treatment?

Answer 29

Aminoglycosides Carbapenem

Question 30

What are the adverse effects of beta lactams?

Answer 30

GI Disturbances

Question 31

What are the adverse effects of doxycycline?

Answer 31

Photosensitivity Inhibit bone growth Liver failure

Question 32

What are the adverse effects of macrolides?

Answer 32

Prolonged QT interval Hepatic dysfunction

Question 33

What are the adverse of fluroquionolones?

Answer 33

Tendon rupture

Question 34

Who should get vaccinated against pneumonia bacteria?

Answer 34

Babies People > 65 Individuals of high risk